Biomedical Waste Managment

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engineering aspects to biomedical waste managment

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Biomedical Waste Managment

  1. 1. 10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL WASTE MANAGMENT Medical Waste Usually called Hospital ,Health Care Waste Is defined as any waste generated at any medical facility. It may consist of pathological waste, infectious waste, hazardous waste and general wastes. Medical Waste is a sub set of Hospital Waste Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Hospital waste management rules not implemented correctly Lack of control over the Environmental protection Wastes not segregated in many hospitals Disposed off together with municipal solid waste Openly burnt in some hospital Medical waste segregation, recycling and reused by rag pickers No specific legislation directly to medical waste Poorly managed incinerators No regulated disposal sites Sharps collected/reused without cleaning or sterilization. No clear classification of HCW & BMW No color coding and types of containers for different categories and their corresponding treatment & disposal option with standards No polices &legislation dealing with hazardous waste Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dressings and swabs Laboratory wastes Instruments used in patient care Potentially infectious materials : tissues, tumors ,organs removed during surgery. Potentially infected animals used in diagnostic or research studies pathological waste - human tissues, organs, body parts removed during surgery or autopsy or medical procedures and specimens of body fluids. Potentially toxic waste A. Radioactive – can be solid , liquids and gases used for analytical procedures, body organ imaging and tumor localization and treatment. Kitchen waste, office waste, wrapping papers and bouquets, etc. Kitchen waste - left B. Chemical waste - they may be hazardous toxic , corrosive, inflammable over food , swill , peels and dirty water. ,reactive or genotoxic .they require safe disposal which will ensure that human or environmental problems do not arise during storage, transport, Bio-degradable waste – peels of fruits and vegetable skin and left over food and other and final disposal. natural kitchen wastes. C. Pharmaceutical waste: surplus stock , spillage , or contamination is Non Bio-degradable waste - wrappings foils plastic bags etc. detected or expiry date is over Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dr.Eng Walid Salameh Tarawneh lectures - BMW
  2. 2. 10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL WASTE MANAGMENT Others from In relation to production area medical Biomedical Waste hospital dept; Is defined as the waste generated during the diagnosis, 17% treatment or immunization of human beings or animals or maternity; 8% in research activities pertaining there to or in the production of testing Biologicals. Orthopedic; 7% Kitchen; 50% Biomedical waste is generated in different departments of the hospital. Surgical Dept; 4% In health care settings, Offices; 2% about 85% of the waste generated is non hazardous Others non about 10% is infectious ( OR, ISO- ROOMS , ER …etc) medical hospital dept; 5% non infectious but hazardous waste ( CHEM ,LAB , NM…etc) 12% (Source : WHO Report- 2003) Source : hospital waste , machado Jr., sobral G.M - DETESB Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Category Waste 1 Human Anatomical (human tissues, organs, body parts) 2 Animal (experimental animals used in research) Microbiology & Biotechnology (laboratory cultures, stocks or micro-organisms 3 , infectious agents ….. etc ) Radiological 4 Sharps (needles, syringes, scalpels, blade, glass) Waste Radio - 5 Discarded Medicines & Cytotoxic Drugs pharmaceutic als , Nuclear Soiled (Contaminated with Blood & Body Fluids -cotton, dressings, soiled radio therapy 6 plaster casts, lines, bedding) and x-ray chemical 7 Solid (Disposable Items other than sharps- tubings, catheters, intravenous sets) Liquid (from laboratory and washing, cleaning, housekeeping and disinfecting 8 activities) 9 Incineration (Ash from incineration of any bio-medical waste) 10 Chemical (Chemicals used in production of biologicals, chemicals solutions ) Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 BMW lab & blood bank ICU, CCU 10% 8% out patient Waste Minimization OTHERS 6% 4% Segregation ER 11% Collection Storage Transportation Treatment Disposal wards 48% Infectious waste can cause diseases like Hepatitis, AIDS, etc. When waste containing plastics are burnt, Dioxin is OR +RECOVERY 13% produced, which can cause Cancer, birth defects, hearing defects. Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dr.Eng Walid Salameh Tarawneh lectures - BMW
  3. 3. 10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL WASTE MANAGMENT The objective of BMW management always shall be to Bio-medical waste shall not be mixed with other wastes. Bio- reduce the risk and liabilities Bio-medical waste shall be segregated(Segregation at source – both at ward Bio- The main concepts should include the following and unit level) into containers/bags at the point of generation prior to its : 1. BMW should be managed through a pathway that includes : Generation , Storage Segregation , Collection , Storage , Processing transport, Treatment and Transportation Disposal Treatment 2. Where possible hazardous waste should be treated prior to disposal to Disposal reduce and eliminate its hazard • The containers shall be labeled 3. BMW minimization and education should be the most desirable goal of • Transport waste safely to pick up site waste management. This means : Material substitution, Waste segregation • Identify destination for each type of , Recycling, Reuse, Procedural changes, Acquisition constrains and waste and ensure safe disposal Treatment • Keep track of usage 4. The BMW management must includes Processes that Reduce a waste • Untreated BMW shall be transported only in vehicles authorized for the amount or hazards purpose by the competent authority as specified by the government. Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 • Untreated BMW shall not be kept/stored beyond a period of 48 BMW shall be segregated into containers/bags at the point of hours. generation, prior to its storage, transportation, treatment and disposal. • High considerations should be paid to the : These containers should be labeled and Colour Coded Interest from senior management Colour Coding Type of Container Waste Category Treatment options Ownership of the process Yellow Plastic Bag Categories 1, 2, 3 & 6. Incineration/ deep burial Awareness of problems Red Disinfected container/Plastic bag Categories 3, 6, 7 Autoclaving/Micro- waving/Chemical Treatment Need for constant monitoring Blue/White Plastic Bag /punctproof containers Cat. 4, Autoclaving/Micro-waving/ Translucent Cat. 7 Chemical Treatment & Segregation of waste to be taken seriously at user level Destruction / shredding Cost of color coding, staff, transport and disposal Black Plastic Bag Categories 5, 9, 10 Disposal in secured landfill. Quantification of waste generated to be accurately done Notes Protection of healthcare Patients , Healthcare workers , 1. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics. workers ,public and Community 2. Categories 8 and 10 (liquid) do not require containers/bags. 3. Category 3, if disinfected locally need not be put in containers/bags. • Compliance with statutory requirements Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Incineration I. Double- Double-chamber pyrolytic incinerators II. Single-chamber furnaces Single- III. Rotary kilns To Min 800 C over an 12-h incinerating cycle. Disinfection Chemical disinfection used for treating liquid waste Thermal disinfection generally used for treating solid waste Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dr.Eng Walid Salameh Tarawneh lectures - BMW
  4. 4. 10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL WASTE MANAGMENT Sterilization Steam sterilization I. Capacity & Cost. autoclave used to disinfect waste. II. Types of waste treated. Microwave irradiation uses III. Space requirements. radiant energy to heat moisture within the Waste IV. Reduction of waste volume and mass. Plasma arc technology V. Noise and odor. Operates on principles of an electrical VI. Community and staff acceptance. arc struck between two electrodes. There is no burning and no formation of ash. Landfill The cost of construction, operation and maintenance of system for managing Open dumps : not recommended biomedical waste represents a significant part of overall budget of a hospital. Sanitary landfills Two types of costs are required to be incurred by hospitals for BMW mgt Disposing of certain types of BMW (infectious waste and small quantities of is the cost for segregation, mutilation, disinfection, internal storage and pharmaceutical waste) in sanitary landfills is transportation including hidden cost of protective equipment acceptable involves off site transport of waste, treatment and final disposal Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Mostly chemical - collection-syringe needles, cotton swabs, blood, blood bags, slides, gauze pieces, plastic tubes Atmosphere Weighing Marketing Recycling Storage Open Gases Special Special Container collection Removal Cementery Unlabeled container Plastic bags or Internal Reception Identification Municipal Segregation Galvanized collection and cart Final storage Collection improper pins Ward wash Waste No secondary Correct Ward containment Generation storage Incineration Dilution Transport manual External collection storage Sewerage Drainage Channel Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Radiological waste ≠ Radioactive waste NEWER TECHNOLOGIES ADOPTED FOR BMW Radiological waste : x-ray film ,film fixers, NON INCINERATION TECHNOLOGY developers…etc AUTOCLAVING Radioactive waste is material contaminated with radioactive substances HYDROCLAVING Radioactive waste must be stored in lead containers for a MICROWAVING period of 10 half life of the waste before disposing USE OF REUSABLES WHERE POSSIBLE INSTEAD Radioactive waste is produced, during nuclear medicine, radio immunoassay and bacteriological procedures OF DISPOSABLES Radioactive waste, once lead shielded and allowed to SAFE SUBSTITUTES FOR MERCURY decay to a safe level, is no longer deemed to be MODERNIZATION OF THE OPERATING PLANTS radioactive waste. IMPLEMENTING NEW ENGINEERING SOLUTION IN In Isolation ward nuclear medicine dept. All patient radioactive wastes are placed in a plastic bag and the bag is properly HOSPITAL DESIGNING & PLANNING tagged. Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dr.Eng Walid Salameh Tarawneh lectures - BMW
  5. 5. 10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL WASTE MANAGMENT A) Clean Materials B) Soiled Materials The management of BMW should be start at the design - planning phase of hospital planning and construction : Determination of BMW types and sources within the new planned hospital Determination of equipment and tools needed to collect , segregate , storage, analyze, transport, treatment and disposal of BMW in each area in the planned hospital Estimating quantities and weights of BMW Determination of Employer’s, management and Waste Management Committee responsibilities Establishing a clear BMW- mgt. working, monitoring and quality control procedures Establishment of the educational and training strategies From the The clean core on a dedicated OR semi- To the (SPD) cart lift or Surgical restricted "soiled" Building the risk management policies "clean" side of Supply dedicated clean elevator procedure corridor side of SPD Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 1. building-up of a comprehensive system, address responsibilities, resource allocation, handling and disposal 2. gradual improvements of the system and processes within it 3. Specific personnel need to be assigned to monitor the bio- medical waste management in the hospital. 4. Man power needs and other resources for the BMWM of hospital to be addressed. 5. Quality assessment of bio-medical waste management should be done from time to time 6. Segregated collection and transportation - The use of color coding and labeling of hazardous waste 7. Clear directives in the form of a posters and notice to be displayed in all concerned areas 8. Taking care about Safety of handlers Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 8. Raising Awareness about risks related to health-care waste; training staff and HCW on safe practices. 9. Selection of safe and environmentally friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste. 10. Issue of all protective clothes such as, gloves, aprons, masks etc. to all HCW. 11. Regular medical check-up (half-yearly) of staff associated with BMWM. 12. Maintenance of Record registers for this purpose. 13. Containers should be robust and leak proof 14. Tracking of Bio Medical Waste up to point of Disposal. 15. Proper treatment and final disposal. Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Dr.Eng Walid Salameh Tarawneh lectures - BMW

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