BIOMEDICAL WASTE

MANAGEMENT

Facilitator:
Dr. NAVPREET
Assistant Professor, Department of Community Medicine
Govt. Medical College & Hospital, Chandigarh.
 Specific Learning Objectives
• At the end of session, the learner shall be able to
know about:
 INTRODUCTION
• Since beginning, the hospitals are known for
the treatment of sick persons but we are
unaware about the adverse effects of the
garbage and filth generated by them on
human body and environment. Now it is a
well established fact that hospital waste is a
potential health hazard to the health care
workers, public and flora and fauna of the
area.
The act was passed by the Ministry of
Environment and Forests in 1986 & notified the
Bio Medical Waste (Management and
Handling) Rules in July 1998. In accordance
with these rules, it is the duty of every
“occupier” i.e. a person who has the control
over the institution or its premises, to take all
steps to ensure that waste generated is handled
without any adverse effect to human health and
environment.
 DEFINITIONS
• Hospital waste refers to all waste, biological or non‐
biological that is discarded and not intended for further
use.
• Bio‐medical waste means any waste, which is generated
during the diagnosis, treatment or immunization of
human beings or animals or in research activities
pertaining thereto or in the production or testing of
biologicals, and including categories mentioned in
Schedule I.
• Infectious waste: The wastes which contain pathogens in
sufficient concentration or quantity that could cause
diseases. It is hazardous e.g. culture and stocks of
infectious agents from laboratories, waste from surgery,
waste originating from infectious patients.
Classification of Bio‐Medical Waste
SOURCES OF BIO MEDICAL WASTE
• Hospitals
• Nursing homes
• Clinics
• Medical laboratories
• Blood banks
• Mortuaries
• Medical research & training centers
• Biotechnology institution/production units
• Animal houses etc.
• Such a waste can also be generated at home if health care
is being provided there to a patient (e.g. injection, dressing
material etc.)
 CATEGORIES OF BIO‐MEDICAL WASTE
Option Waste Category Treatment & Disposal

Category No. I Human Anatomical Waste (human tissues, organs, incineration/deep

body parts) burial
Category No. 2 Animal Waste (animal tissues, organs, body parts incineration/deep
carcasses, bleeding parts, fluid, blood and burial
experimental animals used in research, waste
generated by veterinary hospitals colleges, discharge
from hospitals, animal houses)
Category No 3 Microbiology & Biotechnology Waste (wastes from local
laboratory cultures, stocks or specimens of micro‐ autoclaving/micro‐
organisms live or attenuated vaccines, human and waving/incineration
animal cell culture used in research and infectious
agents from research and industrial laboratories,
wastes from production of biologicals, toxins, dishes
and devices used for transfer of cultures)
Category No 4 Waste sharps (needles, syringes, scalpels, blades, disinfection (chemical
glass, etc. that may cause puncture and cuts. This treatment/autoclavin
includes both used and unused sharps) g/microwaving and
mutilation/shredding
Category No 5 Discarded Medicines and Cytotoxic drugs incineration@/destruction
(wastes comprising of outdated, and drugs disposal in secured
contaminated and discarded medicines) landfills

Category No 6 Soiled Waste (Items contaminated with Incineration/

blood, and body fluids including cotton, autoclaving/microwaving
dressings, soiled plaster casts, lines,
beddings, other material contaminated with
blood)
Category No. 7 Solid Waste (wastes generated from disinfection by chemical
disposable items other than the waste treatment/autoclaving/
sharps such as tubings, catheters, microwaving and mutilation/
intravenous sets etc). shredding
Category No. 8 Liquid Waste (waste generated from disinfection by chemical
laboratory and washing, cleaning, house‐ treatment and discharge into
keeping and disinfecting activities). drains

Category No. 9 Incineration Ash (ash from incineration of disposal in municipal landfill
any bio‐medical waste)
Category No. 10 Chemical Waste (chemicals used in Chemical discharge into drains
production of biologicals, chemicals used in for liquids and secured landfill
disinfection, as insecticides, etc.) for solids
 Rule 1998 schedule II
Color coding Type of Waste categories
container
Yellow Plastic bags Cat 1 human anatomical waste
Cat 2 Animal Waste
Cal 3 Microbiological Waste
Cat 6 Solid Waste

Red Disinfected container Cat 3 Microbiological

plastic bags Cat. 6 Soiled Dressing

Blue/white Plastic bags, puncture Cat. 4 Waste sharp

proof containers Cat.7 Plastic disposable

Black Do Cat. 5 Discarded medicine

Cat. 9 Incineration ash
Cat 10 Chemical Waste
 TRANSPORTATION AND STORAGE
• The waste may be temporarily stored at the central storage area of the
hospital and from there it may be sent in bulk to the site of final disposal
once or twice a day depending upon the quantum of waste. During
transportation following points should be taken care of:
• Ensure that waste bags/containers are properly sealed and labeled.
• Bags should not be filled completely, so that bags can be picked up by the
neck again for further handling. Hand should not be put under the bag. At
a time only one bag should be lifted.
• Manual handling of waste bags should be minimized to reduce the risk of
needle prick injury and infection.
• BMW should be kept only in a specified storage area.
• After removal of the bag, clean the container including the lid with an
appropriate disinfectant.
• Waste bags and containers should be removed daily from wards / OPDs or
even more frequently if needed (as in Operation Theatres, ICUs, labour
rooms). Waste bags should be transported in a covered wheeled
containers or large bins in covered trolleys.
• No untreated bio‐medical waste shall be kept
stored beyond a period of 48 hours
 TRANSPORT TO FINAL DISPOSAL SITE
• Transportation from health care establishment to the site of final disposal
in a closed motor vehicle (truck, tractor‐trolley etc.) is desirable as it
prevents spillage of waste on the way.
• Vehicles used for transport of BMW must have the “Bio‐Hazard”
symbol and these vehicles should not be used for any other purpose.
• CYTOTOXIC HAZARD SYMBOL

HANDLE WITH CARE

Note: Label shall be non‐washable & prominently

visible.
DISPOSAL OF BIOMEDICAL WASTE
• Deep burial:
– Category 1 and 2 only
– In cities having less than 5 lakh population & rural area.

• Autoclave and microwave treatment

– Standards for the autoclaving and microwaving are also
mentioned in the Biomedical waste (Management and
Handling) Rules 1998.
– All equipment installed/shared should meet these
specifications.
– Category 3, 4, 6 and 7 can be treated by these techniques.
• Shredding:
– The plastic (I.V. bottles, I.V. sets, syringes, catheters etc.),
sharps (needles, blades, glass etc) should be shredded but
only after chemical treatment/microwaving/autoclaving.
– Needle destroyers can be used for disposal of needles directly
without chemical treatment.

• Land disposal:
– Open dumps
– Secured/Sanitary landfill: advantages.

– The incinerator ash, discarded medicines, cytotoxic substances

and solid chemical waste should be treated by this option.
 Incinerator

Autoclaves
 Incineration
• A high temperature dry oxidation process, which reduces
organic and combustible waste to inorganic
incombustible matter.
• Usually used for the waste that can not be reused,
recycled or disposed of in landfill site.
• The incinerator should be installed and made operational
as per specification under the BMW rules 1998
• Certificate may be taken from CPCB/State Pollution
Control Board
• Category 1, 2, 3, 5, and 6 can be incinerated.
• Characteristics of waste suitable for incineration are:

 Low heating volume

 above 2000 Kcal/Kg for single chamber incinerators and
 above 3500 Kcal/Kg for pyrolytic double chamber incinerators.
 Content of combustible matter above 60%.
 Content of non combustible matter below 50%.
 Content of non combustible fines below 20%.
 Moisture content below 30%.
• Waste types not to be incinerated are:
 Pressurized gas containers.
 Large amount of reactive chemical wastes.
 Silver salts and photographic or radiographic wastes.
 Halogenated plastics such as PVC.
 Waste with high mercury or cadmium content such
as broken thermometers, used batteries.
 Sealed ampoules or ampoules containing heavy
metals.
1. Double chamber pyrolytic incinerators
2. Single‐chamber furnaces
3. Rotary kilns
 Safety measures
• All the generators of biomedical waste should adopt universal
precautions and appropriate safety measures while handling
the bio‐medical waste.
• It should be ensured that:
 drivers, collectors and other handlers are aware of the nature
and risk of the waste.
 written instructions provided regarding the procedures to be
adopted in the event of spillage/ accidents.
 protective gears provided and instructions regarding their
uses are given.
 workers are protected by vaccination against tetanus and
hepatitis B.
 Training
• Every hospital must have well planned awareness
and training programme for all category of
personnel.
• Training should be conducted in appropriate
language/medium and in an acceptable manner.
• All the medical professionals must be made aware of
Bio‐medical Waste (Management and Handling)
Rules 1998.
 Management and Administration
• Each hospital should constitute a hospital waste
management committee
– chaired by the head of the Institute and having wide
representation from all major departments.
• This committee should be responsible for making
Hospital specific action plan
– for hospital waste management and its supervision,
monitoring and implementation.
• The annual reports, accident reports, as required
under BMW rules should be submitted to the
concerned authorities as per BMW rules format.
Measures for waste minimization
• As far as possible, purchase of reusable items made
of glass and metal should be encouraged.
• Select non PVC plastic items.
• Adopt procedures and policies for proper
management of waste generated, the mainstay of
which is segregation to reduce the quantity of waste
to be treated.
• Establish effective and sound recycling policy for
plastic recycling and get in touch with authorized
manufactures.
 Coordination between hospital and
outside agencies

• Municipal authority :
• As quite a large percentage of waste (in India up to
85%), generated in Indian hospitals, belong to
general category (non‐toxic and non‐hazardous),
hospital should have constant interaction with
municipal authorities so that this category of waste
is regularly taken out of the hospital premises for
land fill or other treatment.
• Co‐ordination with Pollution Control Boards:
– To search for better methods technology, provision of
facilities for testing, approval of certain models for hospital
use in conformity with standards 'aid down.
– To search for cost effective and environmental friendly
technology for treatment of bio‐medical and hazardous waste.
– To search for suitable materials to be used as containers for
bio‐medical waste requiring incineration/autoclaving/
microwaving.
V‐BMW