a detailed presentation on bio medical waste management

1. BIO-MEDICAL WASTE
MANAGEMENT
By: Dr. Anup Kumar Yadav
Hospital Administration
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2. DEFINITION
“Any Waste generated during the diagnosis, treatment or
immunization of human beings or animals or in research
activities pertaining or in the production / testing of biological
substances or in health camps ”.

3. OBJECTIVES
To understand:
 Hazards of BMW
Categories of BMW
Best practices for disposal of BMW
Individual responsibilities
Right waste in Right bag at the point of generation

4. BMW (MANAGEMENT & HANDLING
RULES) NOTIFICATIONS ANDAMENDMENTS
Ministry of Environment and Forests (MoEF), Govt. of India:
 Bio- medical Waste (Management and Handling) Rules -20th July,
1998 .
 1st amendment - 2000
 2nd amendment- 2003
 3rd amendment- 2011
 New BMW (M) Rules- 28th March, 2016.
 BMW (amendment) Rules, 2018.

5. Organization chart
MEDICAL SUPERINTENDENT
DMS
ANS
INCINERATOR SUPERVISOR

6. 6
TYPES OF HOSPITAL WASTE
1. GENERAL WASTE:
• Paper, card board, tissue, packing material.
• Aluminum foils.
• Tea bags, disposable plates, glass, bottles.
• Used polythene bags.
• Vegetables, fruit peels and left over food.
• Non infected plastic covers and papers.
• Any other non infectious waste.

7. 7
2. BIOMEDICAL WASTE:
• Soiled cotton, swabs, dressings, bandages, plaster casts.
• Amputated body parts, pathological specimens.
• Microbiology, laboratory waste.
• Plastics, disposable syringes.
• Tubing, catheters and bags.
• Sharps, blood bags.
• Human parts, placenta etc.

8. 8
• 80% General Waste.
• 15% Infectious & Anatomical Waste.
• 3% Chemical And Pharmaceutical.
• 1% Radioactive waste with Heavy metal.
• 1% Sharps.
BREAK-UP OF WASTE GENERATED

11. BIOMEDICAL WASTE HANDLING &
MANAGEMENT RULES 2016

12. Biomedical waste classified into four categories based on
treatment options
Category Type of bag /
container
used
Type of waste Treatment/
disposal options
Non-
chlorinated
plastic bags
Separate
collection
system leading
to
effluent
treatment
system
a) Human Anatomical
Waste
b) Animal Anatomical
Waste
c) Soiled Waste
d) Expired or Discarded
Medicines & Cytotoxic
drugs along with glass or
plastic ampoules, vials etc.
e) Chemical Waste
f) Micro, Bio-t and other
clinical lab waste
g) Chemical Liquid Waste
h) Discarded linen,
mattresses, beddings
contaminated with blood
or body fluids. Also
routine mask & gown as
per BMW rules, 2018.
Incineration or
Plasma
pyrolysis or deep
burial*

13. Non-
chlorinated
plastic
bags or
containers
Contaminated Waste
(Recyclable)
Vacutainers, tubing,
bottles, intravenous
tubes
and sets, catheters,
urine bags, syringes
(without needles)
and gloves
Autoclaving/mi
crowaving/hydr
oclaving and
then sent for
recycling, not
sent to landfill
(Translucent)
Puncture,
Leak, tamper
proof
Containers
Waste sharps
including Metal
sharps-Needles,
Syringes with fixed
needles, Needles from
needle tip
cutter/burner,
Scalpels, Blades
Auto or Dry
Heat
Sterilization
followed by
shredding or
mutilation or
encapsulation

14. Cardboard
boxes with
blue colored
Marking.
Puncture
proof and
leak proof
boxes or
containers
with blue
colored
marking, as
per BMW
rules, 2018
Broken/
discarded glass-
Medicine vials &
ampoules except
those
contaminated with
cytotoxic wastes.
Metallic Body
Implants
Disinfection
or
autoclaving,
microwaving,
hydroclaving
and then sent
for recycling

17. STEPS IN BMW MANAGEMENT AS PER BMW
RULES 2016
 Generation
 Segregation
 Collection
 Transport
 Storage
 Treatment
 Disposal

18. 18
GENERATION of BMW
• Doctors, Nurses, Technicians, Pharmacists, Receptionists,
Secretaries, Cooks, Store keepers, Housekeeping staff,
Maintenance staff, Administrators, Officers, Gardeners, Security
staff, Food outlets etc.
• Around 3 million tons of Medical waste is generated in India
every year, and this amount is expected to grow at 8% annually.
The generation rate is approximately 0.5 and 1.0 Kg per bed per
day.

19. GMCH 32 BMW Generation
Total BMW waste generation :-
• per day :- approx.. 600 kg per day (.59kg /bed )
• Per month :- approx. 18000 kg
Total general waste :- 23200
• Daily
o RED bag :-
o Blue bag :-
o White bag :-
o Yellow bag :-
o General waste :-

20. 20
SEGREGATION
• Segregation is considered the most important aspect.
• It refers to the basic separation of different categories of waste done at
source of generation of bio-medical waste
• Effective segregation alone can ensure effective bio-medical waste
management.
• Proper segregation is achieved through training, clear standards, and
tough enforcement.

21. DISINFECTION
Using 1% bleaching powder (Calcium hypochlorite) solution-
Three to four tablespoons of bleaching powder in one liter of water
is needed to prepare 1% bleaching powder solution.
oContainer -air tight.
oContact time-Half hour for any infected material.
oStability - 3 hrs.
Sodium hypochlorite solution can also be used but it is costlier
and decreases the life of the linen.
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22. • Dumping- the tissues should not be disinfected, as it delays the
decomposition.
• Treatment of spillage: layer of 1% bleaching powder solution for
½ hr. and then soaked with cotton which should then be put in the
yellow bin.
• Disinfection of the sputum cups: The sputum cup is filled with
5% phenol for 18 hrs. Its cover is tightly closed and then it is put in
the container having 1% bleaching powder solution. Cups are then
shredded.
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TRANSPORTATION
• Waste routes are designated to avoid the passage of waste
through patient care areas.
• Dedicated wheeled plastic drums are used to transport the waste
bins to the main storage areas. They are thoroughly cleaned and
disinfected in the event of any spillage.
• The bags/container containing BMWs are labeled before
transporting and it is accompanied with a register/record of what
waste is being transported mentioning date, shift, quantity and
destination.

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STORAGE
Biomedical waste storage areas should be separate from general
waste storage areas.
Clear signs indicating “For Biomedical Waste Only”. should be
indicated with a caution sign..
• The areas should be locked and a care taker should be able to operate
the storage area around the clock if necessary.
• The storage area is away from public access and routes and is easily
accessible to internal and off site transport.
• Well lit and ventilated

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TREATMENT & DISPOSAL
WHY TREAT??
• To disinfect the waste so that it is no longer the source of
infection
• To reduce the volume of the waste
• Make waste unrecognizable for aesthetic reasons
• Make recycled items unusable.

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METHODS OF DISPOSAL
Secured Landfill: Incinerator ash, discarded medicines, Cytotoxic
substances and solid chemical waste.
Deep burial: Pathological waste, anatomical body parts, sharps.
In deep burial there are 2 types of pits: well covered:
For sharps: A “pucca” pit of size 2×2 meters with concrete roof and
an outlet of 4 inches diameter in the form of one foot size PVC pipe.
For Decomposable material: A “kuchcha” pit of the same size
should be constructed covered with steel structure.

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HAZARDS OF HOSPITAL WASTE
Air pollution Water pollution Land pollution
Transmission of infections

28. SUMMARY
• The proper handling of the biomedical waste is a
responsibility of the In-charge of the Institution.
• It is responsibility of the In-charge to get the
authorization/renewal of authorization from the
prescribed authority.
• The segregation of the waste is the responsibility of
the generator and should be done at the point of
generation.
• Team work and team spirit are required to implement
it effectively.
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29. THANK YOU