This document discusses healthcare waste management. It defines healthcare waste as all waste from medical facilities, including sharps, infectious materials, chemicals and pharmaceuticals. Most healthcare waste (75-90%) is non-hazardous, similar to domestic waste, while a smaller portion (10-25%) requires special treatment as infectious waste. Exposure to infectious waste can cause disease through infectious agents, sharps, hazardous materials or radiation. Proper segregation and treatment of healthcare waste is necessary to protect medical staff, patients and the public from health risks.

1. Healthcare
(Biomedical)
Waste
Management
Professor Syed Amin Tabish
FRCP (London), FRCP (Edin.), FAMS, MD
Postdoc Fellowship, Bristol University (England)
Doctorate in Educational Leadership (USA)

2. Definition
Health-care waste includes all the
wastes generated by medical
activities of diagnosis as well as
preventive, curative and
palliative treatments
Includes all the wastes produced
by a medical institution (public or
private), a laboratory.

3. Healthcare Wastes
HCW includes:
 Sharps
 Non-sharps
 Blood
 body parts
 Chemicals
 Pharmaceuticals
 Medical devices
 Radioactive materials.

4. Proportion & Hazards
Most of it (75-90%) is similar
to domestic waste: paper,
plastic packaging, glass, etc…
that haven't been in contact
with patients
A smaller proportion (10-
25%) is infectious waste
that requires special
treatment.

5. Proportion & Hazards
If these two basic
categories of waste
aren't segregated
(separated) properly,
the entire volume of
HCW must be considered
as being infectious

6. Proportion & Hazards
Exposure to infectious waste can result
in disease or injury because of the
following characteristics:
it contains infectious agents
it contains sharps
it contains hazardous chemicals
or pharmaceuticals
it is genotoxic
it is radioactive.

7. Hospital Waste
Hospitals generate
enormous amounts of waste:
0.5-2 Kgs/Bed/Day
85% of waste is Non-
hazardous
10% is infectious
5% Non-infectious but
hazardous

8. Segregation
Segregation of waste at source
and safe storage is the key to
whole waste management
process
At this stage wastes are
segregated into different schemes
All high risk waste should be
clearly labeled

9. Risks associated with HCW
 All individuals exposed to waste are
potentially at risk of being injured or
infected. They include:
 Medical staff: doctors, nurses, sanitary
staff and hospital maintenance
personnel
 Patients receiving treatment in
healthcare facilities as well as their
visitors
 The general public and more
specifically the children playing with
the items

10. Occupational & H Risks
Many injuries occur
because syringe needles
or other sharps have not
been collected in safety
boxes or because these
have been overfilled

11. Occupational & PH Risks
Dumping wastes in open areas is
a practice that can have major
adverse effects on the population
The “recycling” practices that
have been reported, particularly, the
reuse of syringes is certainly
the most serious problem in a
number of countries

12. Occupational & Health Risks
The WHO estimates that over
23 million infections of
hepatitis B, C and HIV occur
yearly due to unsafe injection
practices (reuse of syringes
and needles in the absence
of sterilization).

13. Risk associated with hospital
waste
Hepatitis B Virus
HIV/AIDS Infection
Lack of awareness
Bottlenecks
Insufficient Resource
Allocation
Lack of adequate Equipment

15. Types of Waste
Clinical waste
Laboratory Waste (high risk
category)
Non-clinical waste
Kitchen waste
Radioactive waste

16. CATAGORIES OF WASTE
 Infectious waste
 Pathological & Anatomical waste
 Hazardous pharmaceutical waste
 Hazardous Chemical waste
 Waste with a high content of heavy metals
 Pressurized Containers
 Sharps
 Highly infectious waste
 Genotoxic/Cytotoxic waste
 Radioactive waste

17. Non-Risk wastes
Non-risk HCW includes all the
waste that has not been
infected like general office
waste, packaging or left over
food
They represent between 75%
and 90% of the total amount
of Waste generated by medical
institutions

18. Waste requiring special attention
Human anatomical waste
This category of waste
comprises non-infectious
human body parts and blood
bags.
Examples of such wastes:
tissue waste, removed organs,
amputated body parts,
placentas, etc…

19. Special Attention: Waste sharps
Sharps pose a potential risk of
injury and infection due to
their puncture or cut property
Examples of such wastes:
all types of needles, broken
glassware, ampoules,
scalpel blades, lancets,
vials without content

20. It includes wastes that are not
categorized as infectious waste but
are contaminated with human
blood, secretions and excretions
Examples of such wastes:
Dressing material, swabs, syringes
without needle, infusion equipment
without spike, bandages
Special Att: Blood and body fluids waste

21. Special Attention
Infectious wastes
 All waste known to have the
potential of transmitting infectious
agents to humans
 Examples: isolation wards; dialysis
wards or centres caring for patients
infected with hepatitis viruses; pathology
departments; operating theatres;

22. Special Attention
Highly infectious wastes
All microbiological cultures in which a
multiplication of pathogens of any kind
has occurred.
Laboratory waste

23. Radioactive wastes
Radioactive waste includes
liquids, gases and solids
contaminated with radionuclides
whose ionizing radiations have
genotoxic effects
It concerns mainly therapeutic and
imaging investigation activities
where Cobalt (60Co), Technetium
(99mTc), iodine (131I) and iridium
(192Ir) are most commonly used.

24. Clinical waste
Generated during routine patient
care, surgery and in high-risk units
Presents a high risk of infection
Examples: soiled dressings, body
fluids, IV needles & syringes,
drainage bags, pathology waste,
blood products, amputated limbs
It should be clearly labeled “High
Risk”

25. Laboratory waste
High Risk category
Should be autoclaved before
leaving the department
Should be clearly labeled as
‘Biohazard’

26. Non-clinical waste
Includes
Wrapping paper
Office paper
Plastic that has not been in contact
with patient body fluids
No potential harm
Bulky

27. Kitchen waste
Includes
Leftover food
Dirty water
Potential source of pests &
vermin (cockroaches, mice,
rats)
Indirect potential hazard

28. Radioactive wastes
These wastes are
disposed as per
guidelines of
International Atomic
Energy Regulatory Board

29. Pathological/Anatomical Waste
Pathological waste
consists of organs,
tissues, body parts or
fluids such as blood.
Anatomical waste
consists of human body
parts

30. Safe Waste Management
A person who experiences
one needle-stick injury
from a needle used on an
infected source patient has
risks of infection:
 30% with HBV
 1.8% with HCV
 0.3% with HIV

31. Colour Coding (contd.)
Type of waste Colour
Clinical Yellow
Non-clinical Black
Soiled/infected linen Red
Dirty/used linen White
Theatre Green/Blue
Kitchen Different coloured
gloves used for cooking

32. Disposal
After compaction, non-clinical waste
can be disposed of at a land-fill site
Clinical waste requires incineration
Disinfectants: Sod. Hypochlorite
(0.5%). Bleach (10 gms in 1 litre of
water), savlon 1%, Glutaraldehyde 2%)
All sharps must be ‘single-use’
only

33. Disposal of waste
All sharp-containers
must be leak-proof
and puncture-proof
and carry a ‘biological
hazard’ sign

34. Disposal of waste
 Incineration: burning at 1500 C to
2500 C or higher
 Pyrolysis: improved method of incineration, in
which extremely high temp. burning process
under low oxygen conditions is employed. It
reduces emission limits of gases which pollute the
environment
 Where incineration facilities are not available,
clinical waste can be treated with lime and
buried in the hosp. ground (cheapest method)

35. THANK YOU
VERY MUCH

36. Liquid waste
 After water has been used it
becomes sewage
 Liquid wastes generated by
hospital is either infectious or
chemical in nature
 The liquid pathological waste
should be treated with a
chemical disinfectant
 Sophisticated Sewage
Treatment facilities