Healthcare system, Various Indian Healthcare system, Health policies, Health Programme, Five year Plan, Health Manpower.
A healthcare system can be defined as the method by which healthcare is financed, organized, and delivered to a population. It includes issues of access (for whom and to which services), expenditures, and resources (healthcare workers and facilities).
India has a mixed healthcare system, inclusive of public and private healthcare service providers.
Private HCPs are concentrated in urban India providing secondary and tertiary care healthcare services.
Public healthcare infrastructure in rural areas has been developed as a three tier system based on population norms.
Launched on 12th April, 2005.
Decentralization of village and district level health planning and management.
Appointing ASHA (Accredited Social Health Activist) for facilitating the access to healthcare services.
Strengthening public healthcare delivery services at primary and secondary level.
Mainstreaming AYUSH.
Improve management capacity to organize health systems and services.
Improve intersectoral coordination.
Healthcare system, Various Indian Healthcare system, Health policies, Health Programme, Five year Plan, Health Manpower.
A healthcare system can be defined as the method by which healthcare is financed, organized, and delivered to a population. It includes issues of access (for whom and to which services), expenditures, and resources (healthcare workers and facilities).
India has a mixed healthcare system, inclusive of public and private healthcare service providers.
Private HCPs are concentrated in urban India providing secondary and tertiary care healthcare services.
Public healthcare infrastructure in rural areas has been developed as a three tier system based on population norms.
Launched on 12th April, 2005.
Decentralization of village and district level health planning and management.
Appointing ASHA (Accredited Social Health Activist) for facilitating the access to healthcare services.
Strengthening public healthcare delivery services at primary and secondary level.
Mainstreaming AYUSH.
Improve management capacity to organize health systems and services.
Improve intersectoral coordination.
Waste management in the center and clinicsKrupa Mathew
community health nursing - Role of community health nurse in waste management in the center and clinics --- for bsc nursing students --- hospital waste management ---biomedical waste management
solid waste is defined as “non liquid, non-soluble materials ranging from municipal garbage to industrial wastes that contain complex & sometimes hazardous substances”
Basic information on waste management system and the various type of waste and the disposal methods. few requirement to start the waste management company is discussed. also practical challenges were explain with points in the slide
Although 76-90% of the BMW is non-hazardous and harmless as any of the other municipal waste, the remaining 10-26% is hazardous to humans or animals and deleterious to environment. Inappropriate handling of the BMW may have serious public health consequences and the significant impact on the environment. Major hospitals contribute substantially to the quantum of generation of the BMW. Smaller hospitals, the nursing homes, clinics, the pathological laboratories and blood banks also have major contribution to BMW. The common methods adopted for the BMW disposal are incineration and land filling. However, these methods are mainly considered more expensive and less ecofriendly due to their main negative impact on the environment
Waste management in the center and clinicsKrupa Mathew
community health nursing - Role of community health nurse in waste management in the center and clinics --- for bsc nursing students --- hospital waste management ---biomedical waste management
solid waste is defined as “non liquid, non-soluble materials ranging from municipal garbage to industrial wastes that contain complex & sometimes hazardous substances”
Basic information on waste management system and the various type of waste and the disposal methods. few requirement to start the waste management company is discussed. also practical challenges were explain with points in the slide
Although 76-90% of the BMW is non-hazardous and harmless as any of the other municipal waste, the remaining 10-26% is hazardous to humans or animals and deleterious to environment. Inappropriate handling of the BMW may have serious public health consequences and the significant impact on the environment. Major hospitals contribute substantially to the quantum of generation of the BMW. Smaller hospitals, the nursing homes, clinics, the pathological laboratories and blood banks also have major contribution to BMW. The common methods adopted for the BMW disposal are incineration and land filling. However, these methods are mainly considered more expensive and less ecofriendly due to their main negative impact on the environment
1.Introduction
2.Definition
3.Classification
a) based on source or origin
b) based on nature of waste
#Non hazardous or solid waste
#Hazardous waste
4. Health hazards of accumulated solid waste
- Definitions
- Public health importance
- Environmental and Health Impact of Solid Waste
- Functional elements of solid waste
- Integrated waste management and waste management hierarchy
Biomedical waste management and biohazards by Dr. Sonam AggarwalDr. Sonam Aggarwal
According to biomedical waste (management and Handling rules 1998 of India) –
"bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camps.
https://www.slideshare.net/SonamAggarwal7/biomedical-waste-management-and-biohazards-by-dr-sonam-aggarwal
A thorough presentation on Solid Waste Management. Divided in three parts: Overview - covers basic terms and definitions, Managing Solid Waste - discusses some of the treatment methods and finally SWM in India - presents some data and current scenario.
Severe Acute Malnutrition (SAM) and Nutrition Rehabilitation Centre (NRC)- Dr...Yogesh Arora
A presentation on severe acute malnutrition and nutritional rehabilitation center. Various preventive, promotive, and curative aspects of SAM are discussed in this presentation.
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Health and wellness center is one of the two component of Ayushmann Bharat. HWC ensures comprehensive, quality, and affordable care to be achieved by all.
Breast Cancer, Cervical cancer, and Oral Cancer Screening according to Nation...Yogesh Arora
A brief description on screening of breast, cervical, and oral cancer and their various components including who to screen, when to screen, where to screen, who will screen, and what will be the consequences if comes screen positive
A short take on different generations and their link with public health development through the ages.
Mindset of different age groups and their qualities are mentioned in relation to public health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Community and hospital waste management- Dr. Atul MD PGIMER
1. Presented By : Dr. Atul Gupta
Moderated By :Dr. Ravindra Khaiwal
Additional Professor (Environmental Health)
Community and Hospital Waste
Management
2. Outline of presentation
• Waste definition
• Classification and Sources
• Community Waste Management
• Hazards of waste
• Biomedical Waste
• Hazards of BMW
• BMW management
• E-waste
• Status of waste management in Chandigarh
3. Waste
• Waste (rubbish, trash, refuse, garbage, junk, litter) is
unwanted or useless materials.
OR
• Waste includes all items that people no longer have any
use for, which they either intend to get rid of or have
already discarded.
OR
• Any material which is not needed by the owner, producer
or processor
4. Types of waste on the basis of their
physical state
• Solid waste
• Liquid waste
• Gaseous waste
5. On the basis of Properties
• Biodegradable wastes - can be degraded (paper,
wood, fruits and others)
• Non–Biodegradable wastes - cannot be degraded
(plastics, bottles, old machines, cans, containers
and others)
6. On basis on effects on human health
• Hazardous waste - Substances unsafe to use
commercially, industrially, agriculturally, or
economically and have any of the following
properties- ignitability, corrosivity, reactivity &
toxicity.
• Non – hazardous waste - Substances safe to use
commercially, industrially, agriculturally, or
economically and do not have any of those
properties mentioned above.
8. • Residential Area
• Commercial Area
• Hospitals
• Industrial Area
• Streets
• Institutions
• IT Parks etc.
Sources of Solid Waste
9. Municipal Solid Waste (MSW)
Municipal solid waste (MSW) is
the waste material that is
collected from residential,
commercial, institutional etc.
areas which is either in solid or
semi-solid form and generally
exclude industrial hazardous
waste.
10. Categories of MSW
• Food and kitchen waste, green
waste, paper
Biodegradable
waste
•Paper, glass, bottles, cans,
metals, certain plastics, etc.
Recyclable
material
• Construction and demolition
waste, dirt, rocks, debris.
Inert waste
11. Changing Composition of MSW In India
Items
Composition in %
1995 1999 2005 2015*
Compostable Matter 43.1 41.8 47.44 52.2
Paper 4.04 5.7 8.14 5.9
Plastic, Leather, Rubber 0.60 3.9 9.27 9.1
Glass 0.60 2.1 1.00 1.4
Metal 0.52 1.9 0.496 -
Inert + others 51.14 44.6 33.65 27.7
* Mor, S., Kaur, K., Ravindra, K., (2016). SWOT analysis of waste management practices in Chandigarh, India and
prospects for sustainable cities. J. Env. Bio., 36, pp-pp
12. Solid Waste Management
Storage –
– Galvanized steel dust bin with close fitting cover
– Public Bin
Collection
– House to house collection
– Dumping the refuse into the nearest public bins
– Thrown in the street
Transport -
– Dustless refuse collector (Vehicle)
14. Methods of disposal
Depends upon cost and availability of land and labour
Principle methods:
– Dumping
– Sanitary landfill or controlled tipping
– Incineration
– Composting
– Manure pits
– Burial
15. Dumping
• Refuses are dumped in low lying areas
• Mechanism of action- As a result of bacterial action, refuse
decreases considerably in volume and is converted into
humus.
Disadvantages
• Refuse is exposed to flies and rodents
• Nuisance from smell and unsightly appearance.
• Dispersed by wind
• Drainage from dumps- contribute to pollution of surface
and ground water.
17. Controlled tipping (Sanitary land fill)
• Most satisfactory method if suitable land is available.
• The refuse is placed in a trench or a prepared area,
adequately compacted and covered with earth at the
end of the working day.
• Three types
Trench method- level ground is available
Ramp method- well suited for sloping land
Area method- land depression, disused quarries and
clay pits
19. Incineration
• Refuse can be disposed off hygienically by burning or
incineration
• Method of choice where suitable land is not available
• Hospital refuse which is hazardous is best disposed off
by this method.
Disadvantages:
Costlier method
Refuse in India is not properly segregated, contains
fair amount of ash and sand.
20. Composting
• Method of combined disposal of refuse and night soil.
• Two main methods
Bangalore method (Anaerobic method)- Hot
fermentation method:
Mechanical composting (Aerobic method)
• Vermicomposting (For garbage only)
21. Major Deficiencies in Management System
• Littering of garbage due to unorganized primary collection
• Irregular Street Sweeping
• Unhygienic Transportation in open vehicles
• Lack of Community Involvement
• Provision and operation of interim storage facilities is
unsatisfactory
22. Major Deficiencies in Management
System
• Garbage is lifted irregularly.
• Transportation system is not synchronized with storage
facilities
• Processing/ treatment of MSW not effective.
• The common practice of disposing the waste through
dumping and burning garbage is still prevalent.
• Lack of Priority & Financial Allocation to SWM
23. Hazards of Waste if not Managed Wisely
• Poor waste handling and disposal ----- environmental
pollution ---- breeding of disease vector insects, animal,
scavengers and rodents --- diseases
• Public or community nuisance due to foul odour and poor
sight.
• Obstruction of drainage systems
• Fire hazards.
• Improper handling of the solid wastes ,a health hazard for
the workers who come in direct contact with the waste.
24. Hazards of Waste if not Managed Wisely
Landfill Gas Emissions Causing
Air Pollution
Leachate Generation Contaminate Soil
And Water Resources
Effect on Public Health
25. Bio-Medical Waste
Bio-medical Waste (BMW):
Any waste, which is generated during the diagnosis,
treatment or immunisation of human beings or animals
or research activities pertaining thereto or in the
production or testing of biological or in health camps,
including the categories mentioned in Schedule I of the
Biomedical Waste Management Rules, 2016
26. Bio-Medical waste
BMW Composition
• 80% non infectious: Kitchen
waste, paper etc.
• 15% is infectious: Dressings,
anatomical wastes etc.
• 5% is non infectious but
hazardous: Chemicals, drugs
and mercury etc.
• When 20% of the hospital infectious material is mixed
with 80%. Then all the 100% waste becomes hazardous
and infectious
28. Hazards of BMW
The disposal of untreated BMW poses both environmental
and public health risks due to -
• Presence of toxic chemicals, radioactive and heavy metals
• It spreads infection / communicable disease
– AIDS, Hepatitis B&C
– Gastro enteric Infection (cholera)
– Respiratory infection (tuberculosis)
– Blood stream infections
– Skin Infection
– Intoxication
– Effects of radio-active substances
29. Hazards of BMW
Hazards from Radioactive Waste:
Type of disease caused by radioactive waste determined by
type and extent of exposure
• Range from headache, dizziness and vomiting
• It can affect genetic material
• It can cause Hematologic Disorders
• Cause Carcinogenicity
30. Hazards of BMW
Occupational Hazard
• BMW also acts as an occupational health hazard to the
health care personnel who handles such waste at the
point of –
– generation
– segregation
– storage
– transport
– treatment & disposal
• Pathogens can enter through puncture, abrasion or cut in
skin, mucous membrane, inhalation and by ingestion
• Needle stick injuries
31. Hazards of BMW
Occupational Hazard
Needle Stick Injuries in Health Care Workers
Source: WHO
52%
29%
9%
6% 4% Nursing Staff
Medical Staff
Health Attendants
Hospital Cleaners
Lab Technicians
32. Hazards of BMW
Occupational Hazard
• Exposure to BMW can result in disease or injury due to one
or more of the following characteristics:
– It contains infectious agents
– It contains toxic or hazardous chemicals or
pharmaceuticals
– It contains sharps
– It is genotoxic
– It might contain radioactive substances
• Who is at Risk?
– Doctors, nurses and Hospital support staff
– Waste collection and disposal staff
– Patients and general public
33. Hazards of BMW
Environmental Hazard
• Inappropriate treatment and disposal contributes to
environmental pollution
– Uncontrolled incineration causes air pollution
– Dumping in drains (nallas), tanks and along the river
bed
causes water pollution
– Unscientific land filing causes Soil pollution.
34. Bio-Medical Waste Rules
• Background of BMW Rules
• BMW (Management & Handling) Rules, 1998 – in July
1998.
• Amended twice – June, 2000 & September 2003
• BMW Management Rules, 2016 notified by MOEF&CC –
28/03/2016
Need for amendment:
• To implement the rules more effectively
• To improve the collection, segregation, processing
treatment and disposal
35. Bio-Medical Waste Rules
Occupier
person having administrative control over the institution
generating BMW, which includes a hospital, nursing home
clinic, veterinary institution, pathological laboratory, blood
bank, health care facility and clinical establishment,
irrespective of their system of medicine.
Operator
• means a person who owns or controls a (CBMWTF) for the
collection, reception, storage, transport, treatment,
disposal or any other form of handling of bio-medical
waste.
36. Bio-Medical Waste Rules
1998 2016
Occupier with more than 1000
beds required to obtain
authorization.
Every occupier generating BMW,
including health camp and AYUSH
require to obtain authorization
Operator duties absent Duties of the operator listed
Bio-medical waste divided in 10
category.
Bio-medical waste divided in 4
category
Chemical pretreatment with 1%
sodium hypochlorite
Chemical pretreatment with 10%
sodium hypochlorite
No format for Annual reports Format appended with rules
Focus on discarding the waste Focus on recycling the waste
37. Bio-Medical Waste Rule
Salient Features of BMW Rules 2016 – 12 Chapters, 4 Schedules & 5
Forms
Schedule Contents
Schedule I BMW categories and their segregation, collection,
treatment, processing and disposal options
Schedule II Standards for Treatment and Disposal of
Bio-medical wastes
Schedule III List of Prescribed Authorities and the Corresponding
Duties
Schedule IV Label for Bio-medical waste containers or bags
Label for Transporting Bio-medical Waste Bags or
Containers
38. Bio-Medical Waste Rule
Forms
Form I – Accident Reporting
Form II – Application for authorization or Renewal of
authorization
Form III – Authorization
Form IV – Annual Report
Form V – Application for filling appeal against order
passed by the prescribing authority
39. BMW Categorization
Category 1: Yellow
• Human Anatomical Waste
• Animal Anatomical Waste
• Soiled Waste
• Expired or Discarded Medicines
• Chemical Waste
• Chemical Liquid Waste
• Discarded linen, mattresses, beddings contaminated with
blood or body fluid
• Microbiology, Biotechnology and other clinical laboratory
waste
40. Chemical liquid waste:
• Liquid generated from X-ray films developing,
• Formalin(neutralised)
• Infected secretions,
• Aspirated body fluids,
• Liquid from laboratory instruments
• Floor washing etc should be pre-treated onsite using
Sodium Hypochlorite
BMW Categorization
41. BMW Categorization
Category 2: Red
• Contaminated Waste (Recyclable):
Wastes generated from disposable items such as
tubing, bottles, intravenous tubes and sets, catheters,
urine bags, syringes (without needles and fixed needle
syringes) and vaccutainers with their needles cut) and
gloves.
42. BMW Categorization
Category 3: White (Translucent)
• Waste sharps including Metals, Needles, syringes with fixed
needles, needles from needle tip cutter or burner, blades, or
any other contaminated sharp object that may cause puncture
and cuts. This includes both used, discarded and contaminated
metal sharps .
43. BMW Categorization
Category 4: Blue
• Glass ware: Broken or discarded and contaminated
glass including medicine vials and ampoules except
those contaminated with cytotoxic wastes.
• Metallic Body Implants
45. Segregation
• Segregation refers to the basic separation of different
categories of waste generated at source and thereby
reducing the risks as well as cost of handling and disposal.
• Segregation is the most crucial step in bio-medical waste
management. Effective segregation alone can ensure
effective bio-medical waste management.
• The BMWs must be segregated in accordance to guidelines
laid down under schedule 1 of BMW Rules, 2016.
46. Collection & Storage
• The collection of biomedical
waste involves use of different
types of container .
• The containers/ bins should
be placed in such a way that
100 % collection is achieved.
• Sharps must always be kept in
puncture-proof containers to
avoid injuries and infection to the
workers handling them.
48. Collection & Storage
• Once collection occurs then BMW is stored in a proper
place.
• Segregated wastes of different categories need to be
collected in identifiable containers. The duration of
storage should not exceed for 8-10 hrs in big hospitals
(more than 250 bedded) and 24 hrs in nursing homes. Each
container may be clearly labeled to show the ward or
room.
49. Transportation
Avoid passage of waste through patient care areas as far as
possible. Separate time schedules for transportation of bio-
medical waste & general waste
Dedicated wheeled containers, trolleys or carts with proper
label.
50. Transportation
Outside the hospital - Through vehicles specially
constructed for the purpose, having fully enclosed body,
lined internally with stainless steel or aluminium.
Separate driver compartment from the load compartment.
The load compartment provided with roof vents for
ventilation.
52. Treatment and Disposal of BMW
Incineration.-
• All incinerators shall meet the following operating and
emission standards-
• A. Operating Standards
1). Combustion efficiency (CE) shall be at least 99.00%.
2). The Combustion efficiency is computed as follows:
%C02
C.E. = ------------------------------X 100
%C02 + % CO
3). The temperature of the primary chamber shall be a
minimum of 800 0C and the secondary chamber shall be
minimum of 1050 degree C + or – 50 degree C.
53. Emission Standards
S.No Parameter Standards
Limiting concentration
in
mg Nm3 unless stated
Sampling Duration in minutes,
unless stated
1 Particulate
matter
50 30 or 1NM3 of sample volume,
whichever is more
2 Nitrogen Oxides
NO and NO2
expressed
asNO2
400 30 for online sampling or grab
sample
3 HCl 50 30 or 1NM3 of sample volume,
whichever is more
4 Total Dioxins
and Furans
0.1ngTEQ/Nm3 (at 11%
O2)
8 hours or 5NM3 of sample
volume,
whichever is more
5 Hg and its
compounds
0.05 2 hours or 1NM3 of sample
volume, whichever is more
54. Treatment and Disposal of BMW
Stack Height:
Minimum stack height shall be 30 meters above the ground
and shall be attached with the necessary monitoring facilities
as per requirement of monitoring of ‘general parameters’ as
notified under the Environment (Protection) Act, 1986 and in
accordance with the Central Pollution Control Board
Guidelines of Emission Regulation Part-III.
55. Treatment and Disposal of BMW
Autoclaving
1) Low heat thermal process
2) Designed to bring steam
into direct contact with the
waste in a controlled
manner & for sufficient
duration to disinfect the
waste.
Validation test by Spore
testing
(biological indicators using
Bacillus stearothermophilus
spore strips), Color change
(using chemical indicator
strip)
56. Treatment and Disposal of BMW
Microwaving
• Volumetric heating (heats the material inside out)
Radiofrequency spectral region – 300 to 300000 MHz
(thermal effects of radiation)
• Not for cytotoxic, hazardous or radioactive wastes
metal items.
• Kill bacteria and other pathogenic organisms
57. Treatment and Disposal of BMW
Deep Burial
• Separate pits for solid and sharp waste.
• A pit or trench about 2 meters deep and one meter
diameter. Half filled with waste, then covered with lime
within 50 cm of the surface then cover with soil.
• On each occasion, when wastes are added to the pit, a
layer of 10cm of soil
added to cover the
wastes.
• Burial must be
performed under close
and dedicated supervision.
58. Treatment and Disposal of BMW
• The deep burial site should be relatively impermeable
and no shallow well should be close to the site.
• The pits should be distant from habitation, and sited so
as to ensure that no contamination occurs of any
surface water or ground water.
59. Treatment and Disposal of BMW
Effluent Treatment plant
(ETP)
• Treat the liquid from all
sources like
• Waste water from autoclave
sterilization
• Liquid waste from shredders
• Waste water from scrubber
installed in the incinerator
• Floor washings etc.
60. Rates for BMW disposal waste by CBWTF
S.No No. of Beds/ Patients Revised rates in
Rupees
1 OPD/ Clinics / Labs/ Nursing
homes/ HCFs less than 10 beds
Rs. 1000/ per
month
2 HCFs from 11-20 beds Rs. 4.20 - per bed/
day
3 HCFs from 21 beds and above Rs. 5.40 per bed/
day
61. E-waste
*‘E-waste’ waste electrical and electronic equipment
(WEEE), whole or in part or rejects from their
manufacturing and repair process, which are intended
to be discarded”.
*e-waste (Management and Handling) Rules, 2016
62. E-Waste – A Growing Concern
• Most e-waste in the world in 2014 was generated in Asia
at 16 Mt or 3.7 kg per inhabitant
• The top three Asian nations with the highest e-waste
generation in absolute quantities are China (6.0 Mt),
Japan (2.2 Mt) and India (1.7 Mt)
63. E-Waste – A Growing Concern
Indian Context
• India is the 5th biggest producer of e-waste in the world
after U.S., China, Japan and Germany
• Discarded 1.7 million tonnes (Mt) of electronic and
electrical equipment in 2014
• UN report has warned that the volume of global e-waste
is likely to rise by 21 per cent in next three years. (United
Nations University (UNU) Report)
64. E-Waste - A Growing Concern
• 300 million computers and 1 billion cell phones are put
into production each year. This global mountain of waste
is expected to continue growing 8% per year
• 15-20% of e-waste is recycled, the rest of these
electronics go directly into landfills and incinerators (EPA
Report)
• 0 to 85% of electronic products were discarded in landfills
or incinerators, which can release certain toxics into the
air.
65. E-Waste – A Growing Concern
• Proper disposal or recycling in the present set up is
expensive and technical
• Managed through various low-end management
alternatives such as product reuse, conventional disposal
in landfills, open burning, and back yard recycling
• Children and women are routinely involved in the
operations
• Creates serious worker, community and environmental
problems, not only in production but also at the waste
end
• Much of the heavy metals (including mercury and
cadmium) found in landfills are emanated from electronic
discards.
66. Toxicity involved with E-Waste
• Contains some very toxic substances, such as mercury,
lead, cadmium, arsenic, beryllium and brominated flame
retardants.
• Create additional toxins, such as halogenated dioxins and
furans, when latter burnt at low temperatures
• Toxic materials in electronics can cause
• Cancer
• Reproductive disorders
• Endocrine disruption
• and many other health problems if not handled
properly
67. Management practices and Health
Impacts
Incineration or open burning
Motherboards are put for open pit
burning to extract the thin layer of
copper foils laminated in the circuit
board.
After charring it is distilled through
simple froth floating process.
The ash is washed out and the
copper, with some carbon impurity,
goes to another recycling unit.
68. Management practices and Health
Impacts
Recycling
• E-waste recycling is presently
concentrated in the informal
(unorganized) sector
• Operations are mostly illegal
• The human health hazards associated
with the process of recycling or
reclamation of materials from
components of computers are high
• Extremely high environment and
health cost attached to the process
• Process of resource recovery is highly
polluting
69. Management practices and Health
Impacts
• Recycling operations engage in:
• Dismantling
• Sale of dismantled parts
• Valuable resource recovery
• Export of processed waste for
precious metal recovery
• Recycling is helpful only in the recovery of
a few metals and non-metals, including
copper, gold, silver, aluminum, iron, tin,
lead and plastics
70. Concern: Informal Recycling
• High-risk backyard operation
• Non- efficient and Non-
environmentally sound
technologies
• Occupational and environmental
hazards
• Loss of resources due to
inefficient processes
• Impacts vulnerable social groups-
Women, children and migrant
laborers.
71. MSW Waste Processing
• Approximately 450 tones of municipal solid waste is
generated daily in the Chandigarh city.
• Around 50-60 tones of waste is directly dumped into the
dumping site or some fraction is picked up by the informal
activities.
• The remaining fraction is sent to the processing plant and
processed for producing RDF (Refuse Derived Fuel)
• Around 30-70 tones of waste is generated after processing
of the waste and that is also dumped in the dumping site as
inerts/rejects.
Status of SWM In Chandigarh
72. In Chandigarh city the corporation has introduced
“door to door collection system” which is run by
“Resident Welfare Associations”
Presently about 930 number of collection of bins are
placed at several collection points and Sehaj Safai
Kendra’s.
Containers having the capacity of 4.5 m3 are maximum
in number.
Waste Collection
73. • In Chandigarh waste is collected and stored at the transfer stations
commonly known as the Sehaj Safai Kendras.
• Presently in the city 31 “SEHAJ
SAFAI KENDRAS” has been developed.
• Degradable and non degradable waste
is stored in different bins.
• From SSK MSW is transported to
Refuse Derived Fuel (RDF) plant.
RDF plant utilizes the combustible
fraction of MSW but discard organic
fraction, which is dumped at an open disposal site.
Collection Points/ Sehaj Safai
Kendras
74. • In Chandigarh around 350
vehicles are used for the
collection and transportation of
solid waste.
• Different type of vehicles are
used for the waste
transportation like trolleys are
used to transfer horticulture
waste, compactors are used to
transfer mainly organic fraction
of waste similarly dumper
placers are used for the
transportation of the waste.
Transportation of Waste
75. • A processing plant has been set up
to produce RDF (Refuse Derived
Fuel) from the municipal solid
waste. About 350 tonne of waste is
processed daily.
• RDF is composed of the
combustible fractions from the
solid waste.
• Presently the remaining inert and
organic fraction is dumped into the
Dadumajra dumping site.
Waste Disposal and Treatment
76. • Dumping ground in
Chandigarh is in west of 38
sector near Dadumajra
colony.
• Its area is 42 acres out of
which 8 acres is converted to
sanitary landfill.
• The dumping site does not
have any provision for the
collection of leachate and
landfill gases.
Contd….
Contd…
78. Parameter MSW RDF
Calorific Value 800 to 1000Kcal/Kg 3100Kcal/Kg
Moisture Content 50% <15%
Inerts 37 % <2%
Municipal Solid
Waste
Refuse Derived Fuel
(Fluff Form)
Characteristics of RDF Obtained
After Processing
79. • Reduces volume
• Such projects help municipal corporations in India in
implementing MSW Rules 2016 as such project activities
face a number of barriers to their implementation.
• Encourage more industries to adopt the effective
technologies not only in the region but also on the
national level.
• By avoiding open dumping, the aesthetics of the area can
be enhanced and overall hygiene in and around the
dumping sites would be improved appreciably.
Benefits of Waste Treatment
Processing
80. • Treatment of waste would result into reduction in emission of
green house gases that are otherwise released due to
anaerobic decomposition of MSW in open and uncontrolled
dumping sites.
• Production of fuel out of the waste will help in conservation of
fossil fuels.
• Ground water contamination due to leakage of leachate is
avoided by such project activity.
• Producing compost from the waste helps in encouraging
organic farming.
• Production of biogas from the organic fraction of waste is
another good source of generating energy.
Benefits of Waste Treatment
Processing
81. Hazardous waste is the waste
that is toxic and is unsafe to use
commercially, industrially,
agriculturally, or economically
and is hazardous to
environment if not disposed
safely.
Small fraction of toxic waste is
generated from the household
activities and is often found
mixed with the municipal solid
waste.
Hazardous Waste Management in
Chandigarh
82. High quantity of waste is
generated from the industrial
units located in the industrial
area of the city and have the
separate provision for the
treatment and disposal of this
type of waste.
The toxic waste generated by
these units is send to the secured
landfill that is located in Nimbua.
Contd..
Contd…
83. Biomedical waste is the waste generated from health facilities
like hospitals, dispensaries, clinics etc. during activities like
diagnosis, immunization and other activities.
In Chandigarh about 1690 kg of biomedical waste is generated
per day.
There are 1913 health facilities out which 77 units are
authorized by Chandigarh Pollution Control Committee.
Out of the total BMW generated 940kg is incinerable and 749 kg
is non- incinerable.
BMW generated is commonly treated at CBWTF (Central
Biomedical Waste Treatment Facility) located in Mohali that
has facility for the disinfection, autoclaving and destruction of
solid waste.
Biomedical Waste in Chandigarh
84. • Yellow colored bags that are
non-chlorinated are used for
destroying the highly
infectious waste at very high
temperature in the
incinerators.
• Collection efficiency of
biomedical waste is not good
as a lot of biomedical waste
is found mixed with the
municipal solid waste and in
the disposal site.
Contd..
85. • Electronic waste consists of any broken or unwanted
electrical or electronic appliance. It includes all types of
electronic equipments/products which have become
obsolete.
• A Mega E-Waste Collection Drive was launched on
November 30, 2011 during which 8 especially designed
E-Waste Collection Bins have been placed at strategic
locations.
Electronic Waste in Chandigarh
86. • Slaughterhouse waste
constitutes waste from
slaughterhouses and meat
markets.
• In Chandigarh city a Bio-
methanation plant has been
proposed that will manage the
slaughter house waste and will
have the capacity to dispose
more that 3 tones of waste
daily.
Slaughter House Waste in Chandigarh
87. BMW management in PGIMER
• Total Quantity of BMW generated (in kgs/day) : Approx
1400
• Quantity of incinerable waste generated (in kgs/day) :
Approx 850
• Quantity of non incinerable waste generated (in kgs/day) :
Approx 550
• Waste generated in wards, OPD emergency, labs and
other parts is transported to a collection point through
covered trolleys/containers.
• The bio-medical waste collected in coloured containers is
transported to the BMWTF in a fully covered vehicle
88.
89. BMW management in PGIMER
• Yellow bags are incinerated
• From the incinerator process the ash generated
is stored in black bags and disposed off to secured
landfill of M/S Nimbua Greenfield Punjab Ltd.
90. What Steps to be taken for the Effective
Waste Management System?
Community Participation
Common people to be made aware
of health hazards of mismanaged
Solid Waste
91. • More efficient collection
• Waste reduction
• More environmentally
sound disposal
Composting
• Practicing in-house
composting
Contd…
93. References
• Mor S, Kaur K, Khaiwal R.( 2016) SWOT analysis of waste management
practices in Chandigarh, India and prospects for sustainable cities.
Journal of Environmental Biology. 2016 May 1;37(3):327.
• Ravindra K, Kaur K, Mor S. Occupational exposure to the municipal solid
waste workers in Chandigarh, India. Waste Management & Research.
2016 Nov;34(11):1192-5.
• BMW Management Rules 2016, By MOEF&CC
• Solid Waste Management Rules 2016, by MOEF&CC
• E Waste Management Rules 2016, by MOEF&CC
• Nandan A, Yadav BP, Baksi S, Bose D. Recent Scenario of Solid Waste
Management in India. World Scientific News. 2017(66):56-74.
• Ravindra K, Kaur K, Mor S. System analysis of municipal solid waste
management in Chandigarh and minimization practices for cleaner
emissions. Journal of Cleaner production. 2015 Feb 15;89:251-6.
97. BMW segregation, collection, treatment, processing and
disposal options
Category Type of Waste Type of Bag or
Container to be used
Treatment and Disposal
options
Yellow Human Anatomical
waste
Animal Anatomical
waste
Soiled waste
Yellow coloured
non- chlorinated
plastic bags
Incineration or Plasma
Pyrolysis or deep burial
Expired or
discarded
medicines
Yellow coloured
non- chlorinated
plastic bags or
containers
Expired cytotoxic drugs and
items contaminated with
cytotoxic drugs to be
returned back to the
manufacturer or supplier for
incineration at temperature
>1200 degree C
Chemical waste Yellow coloured
non- chlorinated
plastic bags or
containers
Disposed of by incineration or
Plasma Pyrolysis or
Encapsulation in hazardous
waste treatment, storage and
disposal facility.
98. BMW segregation, collection, treatment, processing
and disposal options
Category Type of Waste Type of Bag or
Container to be used
Treatment and Disposal
options
Yellow Chemical liquid
waste
Separate collection system
leading to effluent
treatment system
After resource recovery, the
chemical liquid waste shall be
pre-treated before mixing with
other wastewater.
Discarded linen,
mattresses,
beddings
contaminated with
blood or body fluid.
Non-chlorinated yellow
plastic bags or suitable
packing material
Non- chlorinated chemical
disinfection followed by
incineration or Plazma
Pyrolysis or for energy
recovery.
Microbiology,
Biotechnology and
other clinical
laboratory waste
Autoclave safe plastic bags
or containers
Pre-treat to sterilize with non-
chlorinated chemicals on-site
as per National AIDS Control
Organisation or WHO
guidelines thereafter for
Incineration.
99. BMW segregation, collection, treatment, processing
and disposal options
Category Type of Waste Type of Bag or
Container to be used
Treatment and Disposal
options
Red Contaminated
Waste
(Recyclable)
Red coloured non-
chlorinated plastic bags
or containers
Autoclaving or micro-
waving/ hydroclaving
followed by shredding or
mutilation or combination
of sterilization and
shredding.
Treated waste to be sent to
registered or authorized
recyclers or for energy
recovery or plastics to
diesel or fuel oil or for road
making, whichever is
possible.
Plastic waste should not be
sent to landfill
sites.
100. BMW segregation, collection, treatment, processing
and disposal options
Category Type of Waste Type of Bag or
Container to be used
Treatment and Disposal
options
White
(Translucen
t)
Waste sharps
including Metals
Puncture proof, Leak
proof, tamper proof
containers
Autoclaving or Dry Heat
Sterilization followed by
shredding or mutilation or
encapsulation in metal
container or cement
concrete; combination of
shredding cum autoclaving;
and sent for final disposal
to iron foundries (having
consent to operate from
the State Pollution Control
Boards or Pollution Control
Committees) or sanitary
landfill or designated
concrete waste sharp pit.
Editor's Notes
Make useful again; transform from a useless or uncultivated state
A surface excavation for extracting stone or slate