 Health Care Facilities (HCFs) are primarily responsible for

management of the healthcare waste generated within the facilities

 Waste generated from the healthcare facility is classified as:

1. BIO MEDICAL WASTE 15%
2. GENERAL WASTE 85% (General consists OF waste which has not been in contact
with any hazardous or infectious, chemical or biological secretions and does not
includes any waste sharps. WHICH IS mainly: News paper, paper and card boxes (dry
waste Plastic water bottles)
3. OTHER WASTES (Other wastes consist of used electronic wastes, used batteries have to
be disposed under E-Waste (Management) Rules, 2016)

if both of these waste mix up the situation could be hazardous

 thus, for proper management of the waste in healthcare facilities

they have to be in accordance with the BMWM Rules, 2016.

 health care facilities, while generating the waste are responsible for
segregation, collection, in-house transportation, pre-treatment of
waste and storage of waste, before such waste is collected by
Common Bio-medical Waste Treatment Facility (CBWTF) Operator.

 BY DEFINITION: Bio-medical waste means any waste, which is

generated during the diagnosis, treatment or immunization of
human beings or animals or research activities pertaining thereto or
in the production or testing of biological or in health camps.

 Bio-Medical waste includes all the waste any THAT HAS AN adverse
effect to the health of a person or to the environment in general if
not disposed properly. AND IS is considered as infectious and such
waste has to be managed as per BMWM Rules, 2016.

 materials which have been in contact with the patient’s blood, secretions, infected parts,
biological liquids such as chemicals, medical supplies, medicines, lab discharge, sharps metallic
and glassware, plastics etc

SLIDE 2
FURTHER CLASSIFICATION OF HOSPITAL WASTE:
 Bio-Medical Waste Management Rules, 2016 categorises the
bio-medical waste generated from the health care facility into
 four categories based on the segregation pathway and colour
code.
 Yellow Category 2. Red Category 3. White Category 4. Blue
Category

IN THE YELLOW CATEGORY GOES ALL THE Human Anatomical Waste

Human tissues, organs, body parts

Soiled Waste Items contaminated with blood, body fluids like dressings,
plaster casts, cotton swabs

cytotoxic drugs along with glass or plastic ampoules, vials etc.

Discarded linen, mattresses, beddings contaminated with blood or

body fluid, routine mask & gown

IN THE RED CATEGORY GOES: Wastes generated from disposable items

such as tubing, bottles, intravenous tubes and sets, catheters, urine
bags, syringes without needles, fixed needle syringes with their needles
cut, vaccutainers and gloves

IN THE WHITE, Waste Sharps including metals Needles, syringes with

fixed needles, needles from needle tip cutter or burner, scalpels, or any
other contaminated sharp object that may cause puncture and cuts. This
includes both used, discarded and contaminated metal sharps
IN THE BLUE, Broken or discarded and contaminated glass including
medicine vials and ampoules except those contaminated with cytotoxic
wastes. B

General Waste
General waste consists of all the waste other than bio-medical waste
and which has not been in contact with any hazardous or infectious,
chemical or biological secretions and does not includes any waste
sharps.

These general wastes are further classified as dry wastes and wet wastes
and should be collected separately

This quantity of such waste is around 85 % to 90 % of total waste generated from the
facility. Such waste is required to be handled as per Solid Waste
Management Rules, 2016
News paper, paper and card boxes (dry waste) (ii) Plastic water bottles
(dry waste) (iii) Aluminium cans of soft drinks (dry waste) (iv) Packaging
materials (dry waste) (v) Food Containers after emptying residual food
(dry waste) (vi) Organic / Bio-degradable waste - mostly food waste (wet
waste)

Other Wastes
Other wastes consist of used electronic wastes, used batteries, and
radio-active wastes which are not covered under biomedical wastes but
have to be disposed as and when such wastes are generated as per the
provisions laid down under E-Waste (Management) Rules, 2016,
Batteries (Management & Handling) Rules, 2001, and Rules/guidelines
under Atomic Energy Act, 1962 respectively

SLIDE 3
The management of bio-medical waste can overall be summarized in the
following steps; -
 WASTE SEGREGATION IN COLOR CODED BAGS and barcode
labeled bags/ containers at source of generation –
 Pre-treat Laboratory and Highly infectious waste –
 Intra-mural transportation of segregated waste to central storage
area –
 Temporary storage of biomedical waste in central storage area –
 Treatment and Disposal of biomedical waste through CBWTF or
Captive facility

SO FOR THE segregation OF WASTE at the point of generation IN A

HOSPITAL FACILITY, IT SHOULD BE PLANNED IN A WAY THAT THERE
SHOULD BE
 Posters for bio-medical waste segregation provided in all the
wards and waste storage areas, SO IT CAN BE EASY FOR THE
STAFF, EVEN FOR NEW STAFF, TRAINEES TO DISPOSE THE WASTE
IN THE CORRECT BINS.
 The Adequate number of colour-coded bins/containers and bags
should be available at the point of generation of bio-medical
waste THAT IS NEAR THE PATIENT BED.
 Provide Personnel Protective Equipment to the bio-medical waste
handling staff. THAT IS PROPER GLOVES FOR THE STAFF
HANDLING THE WASTE.
SLIDE 4
Bio Medical Waste Collection
NOW THAT THE WASTE IS SEGREGATED, IT IS TO BE COLLECTED AND
TAKEN TO THE Central Waste Collection AREA
 Bio-medical waste should be collected on daily basis from each ward
of the hospital at a fixed interval of time. SO AS HOUSEKEEPING
STAFF IS GENERALLY RESPONSIBLE FOR HANDLING THE HOSPITAL
WASTE, THEY HAVE FIXED TIMING AND SHIFTS IN WHICH THEY
COME AND COLLECT THE WASTE FROM THE WARDS TIMELY SO AS
TO AVOID AND PREVENT OVERFLOWING OF THE WASTE FROM THE
BINS.
General waste should not be collected at the same time or in the same trolley in
which bio-medical waste is collected.
IT SHOULD BE PLANNED IN A WAY THAT IT match the pattern of waste
generation during the day. For example, in an IPD ward where the
morning routine begins with the changing of dressings, infectious
waste could be collected midmorning to prevent soiled bandages
remaining in the area for longer than necessary.
 General waste collection, must be done immediately after the visiting hours of
the HCFs, as visitors coming to facility generate a lot of general waste and in
order to avoid accumulation of such general waste in the HCF.

Packaging Bio-medical waste bags and sharps containers should be filled to no more
than three quarters full. Once this level is reached, they should be sealed ready for
collection.
Replacement bags or containers should be available at each waste-collection
location so that full ones can immediately be replaced.
Labeling
All the bags/ containers/ bins used for collection and storage of bio-medical waste,
must be labelled with the Symbol of Bio Hazard or Cytotoxic Hazard as the case may
be as per the type of waste in accordance with the BMWM Rules, 2016. Bio-medical
waste bags / containers are required to be provided with bar code labels in
accordance with CPCB guidelines for “Guidelines for barcode System for Effective
Management of Biomedical Waste”.

Interim Storage
Interim storage means a site used to temporarily store WASTE AND IS
USUALLY discouraged in the wards / different departments of HCF.

BUT If waste is needed to be stored on interim basis in the departments

it must be stored in the dirty utility/sections.
  No waste should be stored in patient care area and procedures
areas such as Operation Theatre. All infectious waste should be
immediately removed from such areas. BECAUSE OF THE HIGH
CHANCES OF INFECTION.
 In absence of dirty utilities/ sections such BMW must be stored in
designated place away from patient and visitor traffic or low
traffic area. SO THAT IT IS OUT OF REACH OF THE PATIENT AND
VISITORS.

SLIDE 5
In-House Transportation of Bio Medical Waste 2.4.1 Transportation Trolleys In house
transportation of Bio Medical Waste from site of waste generation/ interim storage
to central waste collection centre, within the premises of the hospital must be done
in closed trolleys / containers preferably fitted with wheels for easy manoeuvrability.
Such trolleys or carts are designated for the purpose of Bio Medical Waste Collection
only. Patient trolleys must not be used for BMW transportation. Size of such waste
transport trolleys should be as per the volume of waste generated from the HCFs.

Route of intramural transportation of bio-medical waste

Bio-Medical Waste Generated from different wards or laboratories in
the HOSPITAL must be transported in the covered trolleys/carts through
a route which has low traffic flow of patients and visitors. Route of
transportation preferably be planned in such a way that:
 Transportation does not occur through high risk areas.
 Supplies and waste are transported through separate routes. SO
THERE COULD BE NO CONFUSION OR MIX, FOR EXAMPLE, CLEAN
LINEN AND DIRTY LINEN ARE GOING IN THE SAME ROUTE AND ARE
CREATING CONFUSION.
 Waste is not transported through areas having high traffic of patients
and visitors THAT IS THE OPDS OR THE WAITING AREAS AS IT COULD
POSE AS A HAZARD TO THE PUBLIC.
 Central Waste collection area can be easy accessed through this
route. SO THE ULTIMATE PLACE WHERE ALL THE WASTE GOES TO IN
A HOSPITAL IS A Central Waste collection area. SO THE ROUTE FOR
THE intramural transportation of bio-medical waste SHOULD
DIRECTLY LEAD TO MAIN CENTRAL WASTE AREA WITHOUT ANY
HINDRANCE OR MUCH CHANGE OF ROUTES.
SO THAT THERE IS
 Safe transportation of waste is undertaken to avoid spillage and
scattering of waste
SLIDE 6
Central Waste Collection Room for Bio-medical Waste
Each Healthcare facility should ensure that there is a designated central
waste collection room situated within its premises for storage of bio-
medical waste, till the waste is picked and transported for treatment
and disposal at CBWTF.
Such room should be under the responsibility of a designated person
and should be under lock & key. The following points may be considered
for construction of central waste collection room:
 The location of central waste collection room must be away from the
public/ visitors access. BECAUSE OF HIGH CHANCES OF INFECTION.

 The space allocation for this room must be as per the quantity of
waste generated from the hospital. ACCORDING TO THE SIZE OF
HOSPITAL CONSIDERING HOW MANY BEDDED IT IS THE COMMON
WASTE AREA SOULD BE DESIGNED, SUFFICIENT TO STORING ALL THE
HOSPITAL WASTE OF AT LEAST 2 DAYS.
 Central waste collection room must be roofed and manned and
should be under lock and key under the responsibility of designated
person. SO THAT NO PERSON OR EVEN ANIMAL CAN GET INSIDE.
 The entrance of this centre must be accessible through a concrete
ramp for easy transportation of waste collection trolleys. FOR THE
EASE AND BETTER MOVEMENT OF WASTE TROLLEYS.
 Flooring should be of tiles or any other glazed material with slope so
as to ease the cleaning of the area.
 Exhaust fans should be provided in the waste collection room for
ventilation.
 It is to be ensured by the health care facility that such central storage
room is safety inspected for potential fire hazard and based on such
inspection preventive measure has to be taken by the health care
facility like installation of fire extinguisher, smoke detector etc
 There should also be provision for water supply adjacent to central
waste storage area for cleaning and washing of this station and the
containers. The drainage from the storage and washing area should
be routed to the Effluent Treatment Plant. 
 Sign boards indicating relevant details such as contact person and
the telephone number should be provided. 
 The entrance of this station must be labelled with “Entry for
Authorized Personal Only” and Logo of Bio Medical Waste Hazard. 
SLIDE 7
DESCRIPTION OF A WASTE MANAGEMENT UNIT
The Waste Management Unit should have the following features:
 Easily accessible from all functional areas. It should be easy to
reach the
 Accessible from within the unit and externally EASILY ACCESSIBLE
FROM ALL FUNCTIONAL AREAS. IT SHOULD BE EASY TO REACH
THE UNIT BE IT FOR THE STAFF WHO ARE TRANSPORTING THE
WASTE IN THE TROLLEYS OR BE IT FOR THE COMMON WASTE
TREATMENT WHEN THEY ARE COMING TO COLLECT THE HOSPITAL
WASTE.
 Fitted with security fittings such as door locks, keypad/card access,
CCTV and motion sensor depending on operational policy.
UNACCESSIBLE TO THE PEOPLE OTHER THAN WHO ARE ACTUALLY
HANDLING THE WASTE, AS IT IS A HIGHLY CONTAGIOUS PLACE.
 Located away from food and clean storage areas. CLEARLY THE
PLACE OF THE WASTE MANAGEMENT UNIT IN THE HOSPITAL
SHOULD BE AWAY FROM THE CLEAN AREAS LIKE, FOOD AND
CLEAN STORAGE AREAS
 Not accessible to the public. IT SHOULD BE AT PLACE LIKE AT THE
BACK SIDE OF THE HOSPITAL, WHERE THERE IS NO GENERAL
PUBLIC.

GENERALLY Speaking, Building Services are the electrical, plumbing, and

mechanical systems in a building. But when we talk about Building
service requirements for the Waste Management Unit, there are certain
points that should be there when planning and designing a Waste
Management Unit.
 The temperature with the waste handling area should be
maintained at a temperature that helps control odours.so there
should be temperature control and also an alarm control, incase
of an emergency.

 For the cleaning the area in case of spillage or just general routine
cleaning there should be, A high pressure wash down unit should
be provided for the adequate cleaning.
  Also about the drainage, drainage would include disinfectants;
therefore liquid wastes may require special treatment prior to
discharge.

 Walls should be sealed and floors should be made with a slope

slightly downhill to allow run off.

 All power points should be waterproof to allow for thorough

cleaning of floors and walls.
 Lighting should be adequate to allow staff to see clearly especially
in waste storage areas and corridors.

There are several government environmental pollution control laws that

a hospital has to abide when designing, construction, renovating a
hospital.
The main environmental laws under which hospitals and medical
facilities may be regulated include, most notably, the following;
• Biomedical medical waste management handling rules 2006
(Amended in 2018)- These rules apply to all persons who
generate, collect, receive, store, transport, treat, dispose, or
handle bio medical waste in any form.
• Water ( prevention and control of pollution ) Act 1974 Water Act
is enacted with the aim of prevention and control of Water
Pollution in India.
• The Noise Pollution (Regulation and Control) (Amendment)
Rules, 2010. The increasing ambient noise levels in public places
from various sources, industrial activity, construction activity have
• deleterious effects on human health, it is considered necessary to
regulate and control noise producing and generating sources with
the objective of maintaining the ambient air quality standards in
respect of noise
• The Air (Prevention and Control of Pollution) Rules, 1987 An Act
to provide for the prevention, control and abatement of air
pollution, for the establishment
• Environment Protection Act, Amendment 2022 An act to provide
for the protection and improvement of environment and for
matters connected with it.
RESEARCH SHOWS THAT A WELL DESIGNED HOSPITAL BUIDING CAN
ACTUALLY ACCELERATE THE CURING PROCESS. DESIGNERS ARE
FOCUSSING ON THE GREEN STRATEGIES TO ENHANCE THE POSITIVE
IMPACTS ON PATIENTS AND STAFF IN HOSPITALS.

BY THE DEFINITION A GREEN BUILDING CAN BE DEFINED AS ONE WHICH

ENHANCES PATIENT WELL BEING, UTILIZING NATURAL RESOURCES IN AN
EFFICIENT AND ENVIRONMENT FRIENDLY MANNER.

FOCUS AREAS IN THE DESIGN OF HEALTHCARE STRUCTURES

LIGHTING

 A good design of a healthcare facility should maximize day light

and optimize the artificial lighting requirement, THAT IS natural
light from the sky, into a building, so as to reduce the use of
electrical energy for lighting

 Corridors and waiting areas, have sconces and other decorative

lamps integrated in the walls. The soft glow of the wall sconces
and / or indirect lighting is more relaxing and helps the patient
recover better because the sharp light from light bulbs and
fluorescent tubes is avoided.

 Use of light-emitting diode (LED) lighting is another green option

that offers services for pretty long time. ALSO THEY emit if any,
very low amounts of heat

 Light from the sun is the cheapest and plays a vital role in the
healing process and has been documented to provide both
psychological and physiological benefits
• Large windows should be a part of the total hospital experience,
from patient rooms, to public spaces, to staff quarters, to surgical
rooms
• They however come with a disadvantage, they can increase heat
loads. Installation of controlled shades on these large windows
help regulate the amount of direct sunlight while still providing a
wide view of the outside

Indoor Air Quality

IAQ is defined as the process of providing air which is comfortable in
every way and does not cause negative health effects and is devoid of
dust, smells, draughts and noise as much as possible
1. During the design stage it’s necessary to use special care for space
design for infection control. Segregation of sterile areas, separate
path for dirty materials movement, provision of staff change /
wash areas, sealed rooms are few important factors to be
considered during the space design as a strategy for infection
control

2. Proper space planning, routine monitoring of various parameters

of HVAC systems, proper maintenance of all parts of the system
and regular inspection and cleaning of a.c ducts are some of the
airborne infection control techniques.

CLEAN AND GREEN INTERIOR BUILDING MATERIALS

1. Interior surfaces of Healthcare Buildings should be from materials
that are capable of repelling, resisting or even discouraging
growth of pathogenic germs and bacteria on them. The
construction market now prides itself with the availability of
patented interior surfaces like countertops, tiles, vinyl flooring
etc., that are resistant to bacterial and fungal growth.
2. copper offers great appearance and offers a good surface that can
be touched without worrying concerns, copper based interior
materials ARE IN the use AS WELL.

Gardens and Landscaping

Gardens and landscape are an aesthetic delight and promotes wellness
of patients in hospitals.
Outdoor as well as the indoor spaces of healthcare structures are
understood as crucial to patients’ physical, psychological and social
recuperation and wellness.
appropriately designed active and passive hospital landscapes enhance
patients’ interaction with nature and so reduce stress, facilitating
interaction with others in ways compatible with and complementary to
those found in the urban environment.

CONCLUSION
• AS WE ALL KNOW THAT A HOSPITAL IS A SYSTEM OF DIFFERENT
SUB SYSTEMS/UNITS THAT WORK INTERDEPENDENTLY. Non-
 functionality of even one service can hamper the working of
several other services and ultimately may damage the patient
satisfaction. AND Patient satisfaction COMES NOT ONLY FROM
THE clinical BUT asLO FROM non-clinical services.

AND WHILE WE PLAN AND DESIGN HOSPITALS FOR BETTER SERVICES

FOR THE THE PATIENTS AND PEOPLE COMING TO HOSPITAL, WE MIGHT
AS WELL DESOGN AND PLAN IT IN A WAY THAT IT IS ENVIRONMENT
FRIENDLY AND STILL EFFICIENT. SO THAT WE WHEN WE TAKE FROM
ENVIRONMENT “THE NATURE” , RESOURCES LIKE LAND AND WATER AIR,
WE CAN ATLEAST IF NOT GIVE BACK BUT MAKE IT A BETTER PLACE, OR
ATLEAST NOT DO MORE HARM.
BECAUSE NOW MORE THAN EVER, THE CLIMATE CHANGE AND GLOBAL
WARMING IS ONE OF THE MAJOR ISSUE OF THE WORLD AND WE
HEALTHCARE CAN BE ATLEAST A LITTLE LESS CONTRIBUTOR TO IT.
BECAUSE THE HEALTHCARE INDUSTRY IS BOTH A CONTRIBUTOR AND A
VICTIM.

THANK YOU.