Biomedical Waste

GOVERNMENT HOSPITAL, BHAVANI Management/SOP

Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

OVERVIEW OF SOP

S.NO. SUBJECT SOP

1. Introduction SOP 001

2. Hospital Waste Management SOP 002

3. Waste Disposal SOP 003

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

Document No. /Biomedical Waste Management

SOP 001: Introduction:

Biomedical waste or hospital waste is any kind of waste containing infectious (or potentially
infectious) materials.[1] It may also include waste associated with the generation of biomedical waste
that visually appears to be of medical or laboratory origin (e.g. packaging, unused bandages, infusion
kits etc.), as well research laboratory waste containing biomolecules or organisms that are mainly
restricted from environmental release. As detailed below, discarded sharps are considered biomedical
waste whether they are contaminated or not, due to the possibility of being contaminated with blood
and their propensity to cause injury when not properly contained and disposed. Biomedical waste is a
type of bio-waste.

Biomedical waste may be solid or liquid. Examples of infectious waste include discarded blood,
sharps, unwanted microbiological cultures and stocks, identifiable body parts (including those as a
result of amputation), other human or animal tissue, used bandages and dressings, discarded gloves,
other medical supplies that may have been in contact with blood and body fluids, and laboratory
waste that exhibits the characteristics described above. Waste sharps include potentially
contaminated used (and unused discarded) needles, scalpels, lancets and other devices capable of
penetrating skin.

Biomedical waste is generated from biological and medical sources and activities, such as the
diagnosis, prevention, or treatment of diseases. Common generators (or producers) of biomedical
waste include hospitals, health clinics, nursing homes, emergency medical services, medical
research laboratories, offices of physicians, dentists, veterinarians, home health
care and morgues or funeral homes. In healthcare facilities (i.e. hospitals, clinics, doctor's offices,
veterinary hospitals and clinical laboratories), waste with these characteristics may alternatively be
called medical or clinical waste.

Biomedical waste is distinct from normal trash or general waste, and differs from other types
of hazardous waste, such as chemical, radioactive, universal or industrial waste. Medical facilities
generate waste hazardous chemicals and radioactive materials. While such wastes are normally not

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

infectious, they require proper disposal. Some wastes are considered multihazardous, such as tissue
samples preserved in formalin.

Types of Biomedical Wastes:

 Solid Biomedical Waste (i.e. plastic ware, tubing, pipette tips, gloves).

 Sharps Waste (i.e. needles, glass, scalpels, razor blades).

 Liquid Biomedical Waste (i.e. cultures, stocks, vaccines).

 Pathological Waste (i.e. human tissues, blood and other body fluids).

 Animal Waste (i.e. carcasses, tissues, bedding).

 Chemotherapy Agent Wastes (i.e. any disposable material that has come into contact with
cytotoxic/antineoplastic agents including gloves, vials, IV tubing).

 Discarded Contaminated Equipment (i.e. centrifuges, shakers, biosafety).

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

Document No/Biomedical Waste Management

SOP 002: Hospital Waste Management
 Objectives:
a. To prevent infection by maintaining good hygiene and sanitation.
b. To protect the patient, patient attendants and all health care personnel from avoidable
exposure to infection.
c. To prevent environmental pollution.
d. To manage waste in a clean, healthy, economical and safe manner.
e. To minimize waste

It is important aspect of overall Infection control programme as most hospital waste is potentially
hazardous, when not segregated and disposed correctly.

By definition, any waste generated in the diagnosis, treatment or immunization of human beings or
animals, in research pertaining there to or in the biological tests. In practical sense, it would
encompass all activities related to patient-care, which generated any waste is “Medical waste”.

Correct handling of segregation, collection, transport and ultimate disposal of medical waste is
essential for the health and well-being of patients, hospital staff, community and environment.

Classification of waste: To streamline overall handling of hospital waste, it has been classified into
several categories.

Each department and work areas like laboratories, operation theatres etc. should have a working
estimate of non-hazardous and hazardous waste produced there on day-to-day basis.

The waste segregation with an ultimate aim of safe handling and disposal has been classified into
various categories. They have been given colour coding for collection i.e. in a specified coloured
container only a specified type of waste should be collected.

Segregation at the point of generation of waste must be in accordance with this colour coding.
Categorized waste segregation and collection for us in India is a mandatory legal requirement. The

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

following table comes as product of schedule I of Rule 5 of Bio-medical waste (Management and
handling) Rules 1998 (ref: Gazette Notification of 20th July, 1998, MOEF).

Yellow Coloured Non-chlorinated Plastic bag Incineration or Deep Burial

A. Human Anatomical Waste
Human tissues, organs, body parts and fetus below the viability period (as per the Medical
Termination of Pregnancy Act 1971, amended from time to time).
B. Soiled Waste
Items contaminated with blood, body fluids like dressings, plaster casts, cotton swabs and
bags containing residual or discarded blood and blood components.
In absence of above facilities, autoclaving or micro-waving/hydroclaving followed by shredding
or mutilation or combination of sterilization and shredding can be done. Treated waste to be
sent for energy recovery.
C. Chemical Waste: Chemicals used in production of biological and used or discarded
disinfectants is collected in yellow coloured non-chlorinated plastic bag disposed by
incineration or Plasma Pyrolysis or Encapsulation in hazardous waste treatment, storage and
disposal facility.
D. Chemical Liquid Waste: Liquid waste generated due to use of chemicals in production of
biological and used or discarded disinfectants, silver X-ray film developing liquid, discarded
Formalin, infected secretions, aspirated body fluids, liquid from laboratories and floor
washings, cleaning, housekeeping and disinfecting activities, etc. Separate collection system
leading to effluent treatment system after resource recovery, the chemical liquid waste shall
be pre-treated before mixing with other wastewater. The combined discharge shall conform
to the discharge norms given in Schedule-III.
E. Discarded linen, mattresses, beddings contaminated with blood or body fluid, routine mask
and gown (2018Amendment) is collected in yellow coloured non-chlorinated bags or suitable
packing material followed by incineration or Plasma Pyrolysis for energy recovery.
F. Microbiology, Biotechnology and other clinical laboratory waste: Blood bags, laboratory
cultures, stocks or specimens of microorganisms, live or attenuated vaccines, human and

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

animal cell cultures used in research, industrial laboratories, production of biological, residual
toxins, dishes and devices used for cultures collected in Autoclave/Microwave/Hydroclave
safe plastic bags or containers and Pre-treat to sterilize with non-chlorinated chemicals on-
site as per World Health Organization guidelines on Safe management of wastes from health
care activities and WHO Bluebook, 2014 and thereafter sent for incineration
(2018Amendment).
Red contaminated waste (recyclable)
Wastes generated from disposable items such as tubing, bottles, intravenous tubes and sets,
catheters, urine bags, syringes (without needles and fixed needle syringes), vacutainers, and gloves
has to be collected in RED coloured non-chlorinated plastic bags or containers.
Autoclaving or microwaving/hydroclaving followed by shredding or mutilation or combination of
sterilization and shredding. Treated waste to be sent to registered or authorized recyclers or for
energy recovery or plastics to diesel or fuel oil or for road making, whichever is possible. Plastic
waste should not be sent to landfill sites.
White (translucent) waste
a. Sharp including metals: Needles, syringes with fixed needles, needles from needle tip cutter
or burner, scalpel, blades or any other contaminated sharp object that may cause puncture and
cuts. This includes both used, discarded and contaminated metal sharp has to be collected in
puncture-proof, tamper-proof and leak-proof containers. Autoclaving or dry heat sterilization
followed by shredding or mutilation or encapsulation in metal container or cement concrete;
combination of shredding cum autoclaving; and sent for final disposal to iron foundries (having
consent to operate from the SPCBs or Pollution Control Committees) or sanitary landfill or
designated concrete waste sharp pit.
b. Glassware: Broken or discarded and contaminated glass including medicine vials and
ampoules except those contaminated with cytotoxic wastes has to be collected in puncture proof
and leak proof boxes or containers with blue coloured marking (2018 Amendment).
Disinfection (by soaking the washed glass waste after cleaning with detergent and Sodium
Hypochlorite treatment) or through autoclaving or microwaving or hydroclaving and then sent
for recycling.
Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L., Dr. Mir
Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L., Dr. B. K
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED Dr. T. A
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

c. Metallic Body Implants are collected in puncture proof and leak proof boxes or containers
with blue coloured marking.
 All plastic bags shall be as per BIS standards as and when published, till then the prevailing
Plastic Waste Management Rules shall be applicable.
 Chemical treatment using at least 1% to 2% (2018 Amendment) Sodium Hypochlorite having
30% residual chlorine for 20 minutes or any other equivalent chemical reagent that should
demonstrate reduction efficiency for micro-organisms.
 Mutilation or shredding should be to an extent to prevent unauthorized reuse.
 There will be no chemical pre-treatment before incineration, except for microbiological, lab and
highly infectious waste.
 Dead fetus below the viability period (as per the Medical Termination of Pregnancy Act 1971,
amended from time to time) can be considered as human anatomical waste. Such waste should
be handed over to the operator of common BMW treatment and disposal facility in yellow bag
with a copy of the official Medical Termination of Pregnancy certificate from the Obstetrician
or the Chief Medical Officer of the hospital.
 Cytotoxic drug vials shall not be handed over to unauthorized person under any circumstances.
These shall be sent back to the manufacturer for necessary disposal at a single point. As a
second option, these may be sent for incineration at common BMW treatment and disposal
facility or TSDFs r Plasma Pyrolysis at temperature >1200°C.
 Residual or discarded chemical wastes, used or discarded disinfectants and chemical sludge can
be disposed at hazardous waste treatment, storage and disposal facility. In such case, the waste
should be sent to hazardous waste treatment, storage and disposal facility through operator of
common BMW treatment and disposal facility only.
 On-site pre-treatment of laboratory waste, microbiological waste, blood samples, blood bags
through disinfection or sterilization onsite in the manner as prescribed by the WHO on safe
management of wastes from healthcare activities and WHO Blue book, 2014 and then given to
the common BMW treatment and disposal facility for safe disposal.

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

 Installation of in-house incinerator is not allowed. However in case there is no common bio-
medical facility nearby, the same may be installed by the occupier after taking authorization
from the SPCB.
 Syringes should be either mutilated or needles should be cut and/or stored in tamper-proof, leak
proof and puncture-proof containers for sharps storage. Wherever the occupier is not linked to a
disposal facility it shall be the responsibility of the occupier to sterilize and dispose in the
manner prescribed.
 BMW generated in households during healthcare activities shall be segregated as per the rules
laid on by the BMW.

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

Document No. /Biomedical Waste Management

SOP 003: Waste Disposal

Scope:
To establish proper waste disposal.

Responsibility:
Incharge Medical Officer, Staff Nurse, Blood bank Staff nurse, Lab technician
Procedure: Waste disposal:
Proper waste disposal and management of biomedical wastes is essential to limit the risk of
infections to the health care workers. Hospital wastes include infectious and non-infectious items that
have to be disposed using the following steps:

1. Segregation
2. Transport
3. Temporary storage
4. Final disposal
While the laboratory may not be directly involved with steps 3 and 4, segregation of wastes at source
and proper/timely transport of the wastes to the terminal area will remain a responsibility of the
laboratory.

1. Segregation:

Segregation of wastes generated in the laboratory is the responsibility of every laboratory

worker. The sanitary staff are responsible for ensuring that every section of the laboratory has
disposal containers with all the bags as mentioned below. The following colour code has to
be strictly followed while the wastes are segregated.
Yellow bags: Human tissues, Organs, Body parts-HPE.
 Item contaminated with blood and body fluids, dressings, plaster casts, cotton swabs.
 Residual discarded blood & blood components bags used discarded disinfectants.
 Discarded linen mattress.
 Bedding contaminated with Blood and body fluids.
Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,
Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

 Separate collection system leading to effluent treatment system.

 Discarded formalin o Infected secretion.
 Aspirated body fluids,
 Liquid from laboratories.
 Cleaning and Housekeeping disinfectant.
 Microbiology, biotechnology other laboratory waste.
 Blood bags, lab cultures, live attenuated vaccines, human / Anatomical cell cultures.

Red bags: Contaminated waste (Recyclable)

 Disposable item
 Vacutainer with their needle cut
 IV tube / sets
 Gloves
 Catheters
 Test tubes
 Urine bags
 Urine containers
 Syringes without needles

White container (Translucent):

 Waste sharps including metals

 Blades
 Lancets
 Scalpels
 Needles from needle tip cutter / Burner
 Used/Discarded and contaminated metal sharps.

Blue bag:
 Broken/discarded and contaminated glass (Vaginal smear slides).
 Medicines vials / Ampoules.

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED
 Biomedical Waste
GOVERNMENT HOSPITAL, BHAVANI Management/SOP
Issue No: 01
BIOMEDICAL WASTE MANAGEMENT
Issue Date:
August 12,2020

 Metallic body implants.

 All bags that are being transported to the central waste receiving terminal will
have to be tied at the mouth to avoid spillage during transport.
 Bags should be picked up by the neck and then transported.
 Avoid the transport of too many bags at one time and contact of the bag with the
body.
 Avoid mixing of segregated wastes.

2. Transport:

 All bags that are being transported to the central waste receiving terminal will have to be
tied at the mouth to avoid spillage during transport.
 Bags should be picked up by the neck and then transported.
 Avoid the transport of too many bags at one time and contact of the bag with the body.
 Avoid mixing of segregated wastes.

Prepared by: Dr.N.POORNACHANDRIKA, M.B.B.S.,D.DV.L.,

Approved by: Dr.M.VASANTHAMANJU, M.B.B.S.,D.DV.L.,
Authorized by: Dr. M.GOPALAKRISHNAN, M.B.B.S., M.D, PAED