UNIT-2.pdf

ENVIRONMENTAL MANAGEMENT &
AUDIT
UNIT
-II
BIOMEDICAL WASTE MANAGEMENT

BIOMEDICAL WASTE
➢ Bio-medical waste means “any solid and/or liquid waste produced during diagnosis,
treatment or vaccination of human beings or animals.
or
➢ “Biomedical waste is any waste which is generated during the Diagnosis, treatment or
immunization, of human beings or animals in hospitals, clinics or in research activities
pertaining to production or testing of biomedicals”
➢ The need of proper hospital Waste management system is of prime importance and is
an essential component to prevent spread and transmission of infections in Hospital.
➢ Biomedical waste creates hazard due to two principal reasons:
infectivity and toxicity

SOURCES OF BIOMEDICAL WASTE
➢ The source of biomedical waste is the place or the location at which
biomedical waste has been generated.
➢ The source of biomedical waste is classified into two types based on
the quantity of waste generated.
➢ They include major and minor source.
➢ Major source generates more amount of biomedical waste compared
to minor source and also there is regular generation of biomedical
waste in the major source which includes government hospitals,
private hospitals, nursing home and dispensaries.
➢ Minor source includes physicians and dental clinics.

CLASSIFICATION
➢The classification of the biomedical waste is carried out based
on its characteristics, source of generation and the level of hazard
to the environment.
➢The biomedical waste is classified into two types:
1. Non hazardous waste
2. Hazardous waste

Non-hazardous waste:
➢About 75% to 90 % of biomedical waste characteristics were
similar to that of domestic waste and are non risky in nature.
➢This waste is generated mainly from the organization and
maintenance of hospital and health care centers.
Hazardous waste:
➢The remaining 10 – 25% of biomedical waste falls under the
hazardous waste categories.
➢The hazardous waste contains infectious characteristics of about
15% - 18 % and toxicity characteristics of about 5% - 7%.

The various hazardous wastes includes,
Infectious waste:
➢Waste containing pathogens; e.g. excreta; laboratory cultures;
isolation wards waste; swabs, materials, or equipment that have
been in contact with infected patients.
Pathological waste:
➢Human tissues or fluids e.g. body parts; blood and other body
fluids; fetuses.

Pharmaceutical waste:
➢Waste containing pharmaceuticals; e.g. pharmaceuticals that are
expired or no longer needed; contaminated pharmaceuticals (bottles,
boxes).
Genotoxic waste:
➢Waste containing cytostatic drugs (often used in cancer therapy)/
genotoxic chemicals.
Chemical waste:
➢Waste containing chemical substances e.g. laboratory reagents; film
developer; disinfectants and solvents that are expired or no longer
needed.

Wastes with high content of heavy metals:
➢Batteries, Broken thermometers, blood pressure gauges,
Pressurized containers, gas cylinders, gas cartridges, aerosol cans.
Radioactive waste from radiotherapy:
➢Waste containing radioactive substances e.g. unused liquids from
laboratory research; contaminated glassware, packages or absorbent
paper; urine and excreta from patients treated or tested with
uncapped radionuclide

OBJECTIVES
➢To prevent the harm resulting from waste.
➢To protect the risk of spreading diseases.
➢To protect the health and well-being of health care workers
and the community.
➢To protect against injury and potentially fatal infection.
➢To provide environment-friendly waste management
solutions.
➢To promote the quality and sustainability of the environment.
➢To Ensure safe economical disposal.

BIOMEDICAL WASTE MANAGEMENT
➢Proper management of biomedical waste is highly essential since it induces
various risk to the human health and to the surrounding ecosystem that leads
to the ecological hazard, professional hazard and public hazard.

STEPS OF BIOMEDICAL WASTEMANAGEMENT
Steps of
BMW
Segregation
of generated
waste
Collection
Storage
Transportati
on
Treatment
Disposal

SEGREGATION
➢ To avoid mixing of the biomedical waste with other, a container
should be set to the side with colour coding bags at the point of
generation.
➢ The sorting or separation of waste into different categories is
referred as segregation.
➢ Segregation will decrease or minimize the risks in addition to rate of
managing and disposal.
➢ Segregation is the most important and critical step in bio-medical
waste management.
➢ Only, effective segregation can confirm the effective bio-medical
waste management.

➢ 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.

LABELLING COLLECTION
Colour coding biomedical waste
➢ Pathological waste
➢ Soiled (infectious) waste
➢ Medical chemical waste
➢ Clinical lab waste
➢ Pharmaceutical waste (discarded/expired medicines and drugs)
1.YELLOW
➢ Contaminated waste (recyclable)
2. RED
3. WHITE (or
translucent) ➢ Sharps waste
4. BLUE ➢ Medical glassware waste
➢ The bins and bags should carry the biohazard symbol indicating the nature of waste to the
patients and public.

➢Segregation reduces the amount of waste needs special handling
and treatment
➢Effective segregation process prevents the mixture of medical
waste like sharps with the general municipal waste.
➢Prevents illegally reuse of certain components of medical waste
like used syringes, needles and other plastics.
➢Provides an opportunity for recycling certain components of
medical waste like plastics after proper and thorough disinfection.
SEGREGATION

STORAGE
➢Once collection occurs then biomedical waste is stored in a proper place.
➢Segregation 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 and
24 hrs in nursing homes.
➢Each container may be clearly labelled to show the ward or room where it is
kept.
➢The reason for this labelling is that it may be necessary to trace the waste
back to its source.
➢Besides this, storage area should be marked with a caution sign.

➢ Healthcare facilities must make available a storage area for medical
waste until it is collected for treatment and clearance.
➢ Storage area should be designated carefully which is remote to the
general public and must display cautionary symbols & signs.
➢ It should be deposited in a dry and secured area before being
transported.
➢ The area must be sheltered from water, wind, rodents, insects and
animals.
➢ Harmful biomedical waste should not be stored for more than 3
months.
:
STORAGE OF BIOMEDICAL WASTE

COLLECTION
➢ 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.
➢ Each container may be clearly labelled to show the ward or room
where it is kept.
➢ The reason for this labelling is that it may be necessary to trace the
waste back to its source.
➢ Besides this, storage area should be marked with a caution sign.

TRANSPORTATION
➢The collected wastes are transported in trolleys or in enclosed wheelbarrow for
treatment.
➢Manual loading should be avoided as far as for as possible.
➢The bags / Container containing biomedical wastes must be tied/ lidded before
hauling for treatment.
➢Before transporting the bag containing BMWs, it should be accompanied with a
signed document by Nurse/ Doctor mentioning date, shift, quantity and destination.
➢Vehicles used for transporting should be special to avoid contact to, and direct
contact with the operator, scavengers and the public.
➢the driver must be trained in the procedures he must follow in case of an accidental
spillage.
➢It should also be possible to wash the interior of the containers thoroughly.

TRANSPORT OF CLINICAL WASTE TO
TREATMENT/DISPOSAL UNIT OUTSIDE THE
HOSPITAL
➢If the hospital waste is to be transported outside the hospital for final treatment and
disposal in a shared facility, guidelines as per the rules should be followed
➢Large hospitals having their own treatment facility in their campus may not need to
transport their waste over long distances. Smaller establishment may need to transport
waste over some distance, hence road transport must be provided.
➢ Hazardous biomedical waste needing transport to a long distance should be kept in
container and should have labels prescribed in schedule of biomedical waste management
and handling rules 1998.
➢The transport is to be done through dedicated vehicle specially constructed for the
purpose having fully enclosed body, lined internally with stainless steel or aluminium to
provide smooth and impervious surface, which can be cleaned.
➢The drivers compartment should be separated from the loas compartment with a bulkhead.
The load compartment should be provided with roof vents for ventilation

Handling devices
Trolleys
➢The use of trolleys will make the elimination of infectious waste
possible at the source itself, instead of accumulation a new category
of waste.
Wheelbarrows
➢Wheel barrows are used to transfer the waste from the point
source to the collection centers

.
Chutes:
➢Chutes are vertical conduits provided for easy transportation of refuse
vertically in case of institutions with more than two floors.
➢Chutes are necessary to avoid horizontal transport of waste thereby
minimizing the routing of the waste within the premises and hence
reducing the risk of secondary contamination
➢Alternately, elevators with mechanical winches or electrical winches can
be provided to bring down waste containers from each floor.

DISPOSAL METHODS (OR) TREATMENT OF
BIOMEDICAL WASTE
➢ It is a process where we are going to treat waste (free of micro-
organism) before its disposal.
➢ Use of suitable treatment technique and proper protective devices
allocation is vital.
➢ Finally biomedical waste is disposed in accordance with requirements
applicable.

DISPOSAL METHODS OF BIO-MEDICAL WASTES
➢Incineration
➢Chemical disinfection
➢Inertisation
➢Autoclave
➢Encapsulation
➢ Microwave
➢ Shredder
➢Plasma pyrolysis
➢ Deep burial

TREATMENT AND DISPOSAL
➢Before its final disposal of biomedical waste, it must be disinfected.
➢Anatomical waste can be disposed by deep burial.
➢Syringes to be cut (with hub cutters) and chemically disinfected
with 1% bleaching powder solution at source of generation before
final disposal into sharps pit.
➢Infected plastics to be chemically disinfected or autoclaved,
shredded and recycled and sent for final disposal into municipal
dumps.

INCINERATION
➢ Most of the hazardous biomedical wastes was treated by the method of
incineration to reduce organic and combustible waste to inorganic incombustible
matter.
➢ Incineration is a high temperature, dry oxidation process that results in significant
reduction of waste volume and weight.
➢ Wastes that cannot be reused, recycled or pose problem in disposing in landfills are
treated by incineration.
➢It is a treatment process used to transform pathological and pharmaceutical waste
into ash, flue gases and heat.
➢Functioning temperature for incineration should be in the range of 800- 1400
degree Celsius.
➢It reduces the bulk of waste by 90-95% and thus decreases harmful effects on the
surroundings

➢Examples of wastes that cannot be incinerated are chemical wastes,
wastes containing high mercury or cadmium ( broken thermometers,
second-hand batteries, and lead lined wooden panels, sealed ampules
or ampules containing heavy metals), silver salts, pressurized gas
containers, photographic or radiographic wastes, halogenated plastics
such as PVC.
➢The advantages of incinerator include high reduction of waste
volume in addition to good disinfection competence.
➢ It helps to save the space in the landfill. The ash generated can be
disposed of safely in the landfills.

CHEMICAL TREATMENT
➢This treatment is frequently used to decontaminate liquid waste, so
that it can be disposed-off nearby.
➢It makes use of a number of techniques such as oxidation, reduction,
precipitation and pH neutralization to transform waste into less
dangerous substances.
➢Chlorine, sodium hydroxide or calcium oxide can be used agreeing
to the nature of waste.
➢Pathological waste after being treated with chemical disinfectants
are flushed into the sewage system.

➢Mostly they are neutralized and dumped in sewer network.
➢Highly skilled operators are required for this technique as it involves
handling of hazardous substances.
➢The biomedical waste effluent generated from the various source
should conform to the following limits.
➢Environment (Protection) Act, 1986 prescribes the discharge limits
of these waste into public sewers.

AUTOCLAVING
➢It is a method of steam sterilization and is the most common substitute to
incineration.
➢Autoclaving necessitates a temperature of 121 degree Celsius and pressure of
about 15 pounds per square inch (psi) for 20-30 minutes.
➢This action is applied to inactivate the contagious agents and to sterilize the
apparatus used in clinical services.
➢It is less expensive and carries no recognized health impacts.

MICROWAVE TREATMENT
➢During this process, waste is shredded, mixed with water, and then internally
heated to kill microorganisms and other harmful elements.
➢One of the main benefits of this process is the shredding aspect; it lowers the
volume of biomedical waste, and it is reportedly more energy efficient to use
this method than to incinerate.
➢While it can’t be used for all biomedical wastes, it can be utilized for a good
90% of it, just like autoclaving.
➢Microwave treatment uses a frequency and wavelength of 2450 MHz for the
destruction of microorganisms.
➢The infectious contaminants in water with biomedical waste are destroyed by
heat conduction when it is rapidly heated by the microwaves.

➢This method shows good disinfection competence with good waste
shrinking capacity.
➢Similar to incineration this method also involves high operating
costs.
➢It is an eco-friendly process with potential operation and
maintenance problems.
➢The biomedical waste is evenly heated to a temperature of 97-
100°C by means of microwaves in treatment chamber.
➢Treatment of biomedical waste by microwaving can be carried out in
the source itself.

IRRADIATION
➢These methods are at present being used in waste treatment procedures
which include gamma, electron-beam, ultraviolet and X-rays.
➢Irradiation sterilizes waste in a sealed off chamber by uncovering it to a
radioactive cobalt-60 which gives out gamma rays that are lethal to micro-
organisms.
➢It is very costly as associated to other methods and protections must be
taken to guard workers from detrimental effects of radiations such as
cancer, radiation sickness or even death

DISPOSAL OF BIOMEDICAL WASTE
➢Land disposal is usually employed for remediation of waste which is
decontaminated by appropriate treatment approaches.
➢This technique is generally used in developing countries which includes
the throwing away of waste into a landfill.
➢Land-filling should be conducted at places where groundwater level is
low and which are far from flooding sources.
➢Radioactive wastes are commonly dumped in the oceans far away from
human inhabitations.
➢Every state and local government has its own rules and regulations for
dumping of sanitized waste

EFFECTS OF IMPROPER HOSPITAL WASTE
MANAGEMENT
➢Collection, reuse or recycle of the single-use products without adequate
treatment results in spread of infections to waste handlers.
➢Improper burning or sub standard incineration of these plastics release
dioxins and furans which are carcinogenic in nature.
➢Improper landfilling or dumping them results in leaching & contamination
of soil & surrounding water bodies.

STAFF SAFETY
1. Proper training
2. Personal protective clothing and equipment
3. Immunization
4. Post-exposure prophylaxis
5. Medical surveillance
6. Personal hygiene

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