Swasthvritta Vigyan

(As per latest CCIM syllabus)

Author: Nidhi Gupta and Dr. Manish Agarwal

Salient Features :
1. Strictly as per the latest CCIM syllabus issued by CCIM, New Delhi.
2. Contains tables and pictures for easy explanation.
3. Color pictures for clear understanding of the procedure.
4. Covers the ayurveda and modern portion.

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ISBN: 978-93-86735-16-4, PRICE: 395.00
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Bramhpuri Jaipur-302002
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 THE
Brajratnadas Prachyavidya Granthmala
54
µµµ

mJemLeJe= òe efJe%eeve
(Text Book of Swasthvritta)
(YeejleerÙe efÛeefkeâlmee kesâefvõÙe heefj<eod veF& efouueer Éeje mJeerke= âle veJeerve hee"Ÿe›eâceeveg meej)

By
Dr. Nidhi Agarwal
NDDY, M.D. (Swasthvritta)
RGPG: Paprola (H.P)
Associate Professor
Deptt. of Swasthavritta

&

Dr. Manish Agarwal

M.D; Ph.D (RS&BK)
NIA: Jaipur (Raj.)
Associate Professor
Deptt. of (RS&BK)

CHAUKHAMBHA PRAKASHAK
Post Box No. 1150
K. 37 / 116, Gopal Mandir Lane
Varanasi
mJemLeJe=òe efJe%eeve
Text Book of Swasthvritta

Edition : First, 2019

© Copyright Reserved

Publisher :
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(xiii)
 8
Disposal of solid waste
(viÊO; fuZewyu)

(i) Types of solid waste

(ii) Storage of refuse
(iii) Collection of refuse
(iv) Methods of disposal of solid waste
(v) Bio- Medical waste
(vi) Objective of BMW management
(vi) Categories of BMW
(viii) Hospital waste disposal
(ix) Bio-Medical Waste Management in India

Health professionals need to have a basic
knowledge of subject since improper disposal of
wastes constitutes a health hazards. The health
professional may be called upon to give advice in
some special situations, such as camp sanitation
or coping with waste disposal problems when there
is a disruption or breakdown of community health
services in natural disasters.
The waste products of the community living
are refuse, human excreta and sewage.
Refuse
Refuse is a solid waste, material that cannot
Storage of refuse
be reused. It is also called as trash or garbage. It is
unwanted and no longer reusable unless it can be
converted to another form through recycling. For
example metals and glass can be recycled.
Type of solid waste
1. Street refuse: e.g. leaves, straw, papers,
animal dung etc.
2. Market refuse: e.g. putrid vegetable and
animal matters etc.
3. Domestic refuse : e.g. ash, rubbish (pieces
of papers, clothes, wood, metal, glass and
dust), garbage (waste arising from the
kitchen,)
4. Industrial refuse: e.g. toxic chemical
compounds
5. Stable (A building in which domestic
animals are sheltered and fed): e.g. animal
dung and left over animal feeds from
animal stables.
1. The galvanized steel dust bin with close
fitting cover is a suitable receptacle
(Container) for storing refuse. The
capacity of a bin will depend upon the
number of user and frequency of
collection.
2. Refuse is stored in the paper sack, and the
272
sack itself is removed with the contents for
disposal and a new sack is substituted.
3. Public bins: for large number of people.
They are usually without cover in India,
and kept on concrete platform, 2-3 inches
above ground level.
Collection of refuse
The method of collection depends upon the
funds available. House to house collection is the
best method of collecting refuse, but in India in
majority of places there is no house to house
collecting system. The collection methods normally
practised in this country need drastic revision and
improvement in the interest of better hygiene.
The collected refuse transported in refuse
collection vehicles to the place of disposal.
Methods of disposal of solid waste (Rural &
Urban)
The choice of a particular method is governed
by local factors such as cost and availability of land
and labour. The methods are
1. Dumping
Refuse is dumped in low lying areas partly as
a method of reclamation of land.
Drawbacks of dumping
(i) The refuse is exposed to flies and rodents
(ii) It is a source of bed smell and unsightly
appearance
(iii) Refuse is dispersed by the action of wind
(iv) It contributes to the pollution of surface
and ground water.
2. Sanitary land fill
It is most satisfactory method of refuse disposal
where suitable land is available. It is differs from
LoLFko`Ÿk foKku
ordinary dumping in that the material is placed in
a trench or other prepared area , adequately
compacted, and covered with the earth at the end
of the working day.
It is of three types
(i) Trench method
(ii) Ramp method
(iii) Area method
Chemical, bacteriological and physical changes
occur in buried refuse. Normally it takes 4 to 6
months for complete decomposition of organic
matter into an innocuous (Harmless) mass.
Residental
Area Landfill
Fig. 61 : Sanitary land fill
3. Incineration
Waste destruction in a furnace by controlled
burning at high temperature is called incineration.
It removes water from hazardous waste, reduce its
volume and convert it in to ash. It is the method
of choice where suitable land is not available. But
it has limited application in India.
4. Composting
Composting is a method of combined disposal
of refuse and night soil or sludge. It is a process of
recycling decomposed organic material into a rich
soil known as compost.
Disposal of solid waste
Microorganism
Water Air
Organic waste
e.g. Newspaper,
leaves, grass, fruits, vegetables,
kitchen waste etc.
carbon dioxide Heat
Compost
Methods
(i) Bangalore method (Anaerobic method)
Indian Council of Agricultural Research at the
Indian Institute of Science, Bangalore, a method
(hot fermentation process) has been developed.
Procedure
The trenches are dug. First a layer of refuse about
15cm. thick is spread at the bottom, over this night
soil is added corresponding to a thickness of 5 cm.
Then alternate layers of refuse and night soil are added
in the proportion of 15 and 5 cm respectively. The
top layer should be of refuse, at least 25 cm. Then
the heap is covered with excavated earth.
Within about a week intense heat is generated
to about 60 0C, persisting for about 2 to 3 weeks
killing all the pathogens and the parasites. The lignins
and cellulose are broken down. The end products
acted upon fungi and anaerobic bacteriae, resulting
in harmless, odourless, innocuous humus mass, called
“Compost”, which has high manorial value.
Earth
Top layer of Refuse (25 cm.)
Trench for
Composting
Night soil layer (5 cm)
Refuse layer (15 cm)
Bangalore Method of composting
273
(ii) Mechanical composting (Aerobic method)
The refuse is first cleared of salvageable
materials such as rags, bones, pieces of metals,
woods, glasses etc. and then powdered in a
pulveriser. It is then mixed with human night soil
in a rotating machine and incubated for 4-6 weeks,
at the end of which the entire process of
composting is complete by the action of
temperature, moisture, pH and aerobic bacteria.
The mixture gets changed to compost.
5. Manure pits
The individual householder should have a
“manure pit” where in the daily domestic refuse is
dumped and covered with earth after each day’s
dumping. When one is filled other pit should be
used. After about 4-6 months, the refuse is
converted into compost, which can be used to the
field as manure (Compost or fertilizer). This
method is preferred in rural areas, where collection
and removal system of refuse is absent.
6. Burial
This is suitable for small camps. This is also
the same as trench method, but in trenches, only
the refuse is dumped and not the human excreta.
At the end of each day the refuse is covered with
earth. When the trench is filled, new trench is dug
out. After 4- months the compost is removed and
used as manure.
Fig. 62 : Burial pit
274
Bio- Medical Waste
Biomedical waste (BMW) is defined as a waste
generated during diagnosis, treatment,
immunization of human beings or animals or in
research activities pertaining thereto or in the
production or testing of biological. Thus BMW
encompasses a wider category of waste and includes
waste from veterinary institutions and slaughter
houses also.
Objective of BMW management
1. To reduce the infectious, hazardous
nature of waste.
2. Reduce the volume of BMW.
3. Prevent misuse and abuse of BMW.
4. To recycle the waste.
Categories of BMW
There are 10 categories of BMW as follows—
Categories Waste
Cat- 1 Human anatomical waste (e.g. tissues,
organs, ampulated parts, body parts,
placenta etc.)
Cat-2 Animal waste (e.g. tissues, organs, waste
generated in veterinary hospitals and
animal houses etc.)
Cat-3 Microbiology and biotechnology waste
(e.g. laboratory cultures, specimens, vaccines,
human and animal cell culture, toxins etc.)
Cat-4 Waste sharps ( both used and unused e.g.
needles, syringes, scalpels, blades, glass)
Cat-5 Discarded medicines and cyto toxic drugs
Cat-6 Solid waste (waste contaminated with blood
and body fluids such as cotton swabs,
bedding, dressings, plaster casts etc.)
Cat-7 Solid waste ( e.g. Catheters, IV sets,
tubings, blood bags etc.)
Cat-8 Liquid waste ( e.g. waste generated from
laboratories, washing, cleaning, house-
keeping etc.)
LoLFko`Ÿk foKku
Cat-9 Incineration ash ( e.g. ash generated from
incineration of biomedical waste)
Cat-10 Chemical waste (waste of disinfectants,
insecticides etc.)
Hospital waste disposal
The basic principle is that the wastes are
disposed in most hygienic and cost-effective
manner, by methods which at all stages, minimise
risk to healthy environment. Government of India
has prescribed certain procedures and guidelines
as follows:
1. Collection of wastes
The waste should be collected and stored in a
thick, non-corrosive, disposable plastic bags of
adequate size, which may kept in a hard plastic
container of suitable size covered with a lid. A list
of common wastes to be deposited in the container
pasted on the container. The container need to be
cleaned with hot water frequently.
2. Source segregation
Segregation simply means separation of the
waste into different categories. The hospital wastes
of different categories are best segregated at source
by personnel who generate the waste and collected
into appropriate plastic bags kept in colour coded
containers.
3. Transportation
Within the hospital, the plastic bags
containing the waste may be tied well and
transported by handcart to a storage point.
Recyclable waste may be transported to
suitable areas for temporary storage from where
they can be sold periodically.
Designated vehicles used for external transport
of wastes should be road worthy and carry the waste
in covered container.
Disposal of solid waste 275

4. Storage Categories Treatment

Daily hospital waste from different sections Cat-1 Incineration/ Deep burial
of the hospital awaiting final disposal are stored in Cat-2 Incineration/ Deep burial
a storeroom. The storeroom should be away from Cat-3 Local autoclaving/ microwaving/
the service area and should be dry & well secured. incineration
Cat-4 Disinfection/chemical treatment/
5. Treatment autoclaving/microwaving/ mutilation
Treatment modifies the wastes before final and shredding
disposal. It is a technique which decontaminates Cat-5 Incineration/destruction and disposal
in secured landfills
the wastes to destroy spores of bacillus, resulting Cat-6 Incineration/ autoclaving/ microwaving
in reduction of volume and making the waste Cat-7 Disinfection by chemical treatment/
unrecognizable with minimum handling and autoclaving/microwaving/ mutilation/
transportation. shredding
Cat-8 Disinfection by chemical treatment and
discharge in to drains
Waste Generator
Cat-9 Disposal in municipal landfill
↓฀ Cat-10 Chemical treatment and discharge into
(Hospital) drains for liquids and secured landfill
↓฀ for solid.
Collection of Wastes Bio-Medical Waste Management in India
↓฀
Segregation in colour
Bio-medical Waste (Management and
Handling) Rule 1998, prescribed by the ministry
coded poly bags
of Environment and Forests, Government of India,
↓฀ came into force on 28th July 1998. This rule applies
Transportation by Hand cart to to those who generate, collect, receive, store,
a storage place dispose, treat or handle bio-medical waste in any
↓฀ manner. The BMW should be segregated in to
Store room at hospital It should be away containers/bags at the point of generation of waste.
from service area The categories of BMW, treatment & disposal
option, colour coding & type of container are
↓฀
Transportation by approved special vehicle to the described in table given below:
treatment paint.

↓฀
Unloading and Treatment Disposal
temporary storage at Incineration, Recycling &
CBWTF Autoclaving and landfill
Common Biomedial
shredding
waste treatment and
disposal facility
276 LoLFko`Ÿk foKku

Colour coding Type of container Waste category Treatment

Yellow Plastic bag Cat 1, 2,3, 6 Incineration/

deep burial
Red Disinfected container/ Cat 3, 6,7 Autoclaving/
plastic bag microwaving/
chemical treatment
Blue/white translucent Plastic bag/ Cat 4, 7 Autoclaving/
puncture proof microwaving/
container chemical treatment
and destruction /
shredding
Black Plastic bag Cat 5, 9, 10 Disposal in secured
landfill

Yellow Red White Black

Fig. 63 : BMW disposal
Biomedical wastes containing container label with Bio hazard symbol & Cyto toxic symbol.