BIOMEDICAL WASTE MANAGEMENT

PERITONEAL DIALYSIS
HEMODIALYSIS
 BIOMEDICAL WASTE MANAGEMENT

Definition
Waste generated during the diagnosis, testing, treatment, research or production of
biological products for humans or animals (WHO)
Procedure of Biomedical Waste Management
The crucial steps for scientific and proper management of biomedical wastes are:
 Handling
 Segregation
 Accumulation and storage
 Treatment
 Transportation
 Disposal of waste
I have mentioned these steps in detail below :
OBSERVATION OF BIOMEDICAL WASTE
Waste should be observed carefully, from the point of generation to type of
waste. Level of generation and disinfection determines the process of treatment
of waste.
SEGREGATION OF WASTE
Separation of different types of waste is essential. It reduces the risk of
infection among workers and the public. In addition, it avoids physical injury. Color
coding is not only for us. It represents the basic principle that all the waste is not the
same so they will not end up in the same place. Different kinds of waste means their
treatment process is also not the same. For the intention of segregation colour coded
bins are used. Every bin has a distinct waste base on their treatment process and
their quality.
Segregation of biomedical waste in different colour bins.
Red bins:-
It is used to store contaminated wastes that can be recycled. These bags or bins
should be non-chlorinated since chlorinated bags can react with the waste. These are
used for collection of following:
Research lab waste
 Catheters
 Tubes
 Cannula
 Syringes
 Plastic IV bottles and sets
 Rubber gloves
 Specimen containers
 Infected plastics
 Lab wastes
 Microbiology culture
 Used discarded blood bags/ blood products
 Vaccines, etc.
Yellow bins:-
The yellow coloured bins are used to store many type of wastes like:
Biomedical waste container labeling
1. Pathological waste
2. Solid (infectious) waste
3. Medical Chemical waste
4. Clinical Lab wastes
5. Pharmaceutical waste
 These waste are stored in differently marked bins. Biohazard, radioactive, and
cytotoxic marks are some examples of different marks. Some examples that comes
under this category are mentioned below:
Antibiotic wastes
 Human anatomical wastes
 Expired medicine waste like cytotoxic drugs along with vials
 Antibiotics
 Liquid wastes
 Disinfectant wastes
 Silver X- ray liquid
 Formalin solutions
 Infected secretions
 Aspirated body fluids
 Floor washing liquids
 Liquids from laboratories
 Soiled cotton swabs, bandages, dressing pads, contaminated gauze piece
 Discarded linen beddings and mattress
 Biotechnological or microbiological lab wastes, etc.
White Bins :-
These are white or translucent puncture proof bags. These bags are used to
store sharps like :
 Needles
 Syringes with fixed needles
 Needle from needle cutter or burner
 Scalpels
 Blades
 Razors
 Nails
 Contaminated sharp metal objects, etc.
Blue bin:-
Blue bins are used to store glassware whether medicinal or general. Some examples
are like:
Broken and infected glassware
 Infected broken glass/ bottle
 Broken or unbroken glass
 Vials
 Ampules
 Glass IV bottles
 Glass injections
 Metallic body implants
 Slides
 Glassware used in wards
 Glass injections or syringes, etc.
ACCUMULATION AND STORAGE
Waste bag
Storing waste is for collection purposes. Accumulation stands for holding of waste for a
short time near the point of waste generation. Storage stands for long term storing of
wastes near the waste treatment or disposal site.
TRANSPORTATION OF WASTE
Transporting of waste in closed vehicle
Wastes are mobilized from the generation point to the treatment disposal site via
a designated vehicle. To avoid public exposure, smell, and microbes, containers must
always be covered. All the vehicles used by CBWTF operators should not be sub-
letters. Operators cannot use a contract vehicle. CBWTF operator’s vehicles should
only be used for waste collection purposes. CBWTF operator’s vehicles should be
registered under Motor Vehicle Act with the R.T.O/ Transport Department. Such vehicle
numbers should be registered with respective SPCB/PCC. Closed vehicles should be
used.
TREATMENT OF WASTE
Treatment signifies the modification of waste before sending it to its final resting
place. Treatment should be at the source of generation. Treatment is making waste safe
through some process to make it no longer a source of the pathogen. Some of the
processes are bleaching, shredding, and chemical disinfecting. Indian govt. Has issued
a set of guidelines for waste treatment. After treatment, the residual can be transported
to their disposal site. Some common treatments of waste are:
 Needles and syringes nozzles should shred into a needle destroyer or syringe
cutter.
 Glassware should be clean, disinfected and sterilized.
 Scalpel, razor, blades, broken glass should be stored in a puncture proof container
with bleach. Then transferred into labeled plastic or cardboard box . These boxes
should be sealed to prevent spillage, and further send it to incubators.
 Culture plates are disposed of into appropriate bags. And plates should be
autoclave and then sterilized. Sterilized plates can be reused.
 Gloves must be shredded, mutilated, cut and destroyed; before disposal.
DISPOSAL OF BIOMEDICAL WASTES
Dumping of waste into landfill
Disposal methods differ in availability, efficiency, cost effectiveness and
impacts on the environment. Biomedical waste should be pathogen free before
disposal. This should ensure utmost public health and hygiene.
Less developed countries are advised to use solar heating systems for
disinfecting infectious wastes. This method results in considerable reduction in the
number of viable bacteria but not completely. That still poses a threat. Disposal without
treatment is non- advisable for anatomical, sharps and waste from labs. Various
disposal methods are:
1). Incinerators:
This is a process of burning waste at a high temperature. The temperature in
incinerators ranges from 1,800 degrees F to 2,000 degrees F (982 degrees C to 1093
degrees C). Incinerators have the advantage of quick, easy disposal methods.
But their major concern is due to emissions. Many states and localities have
postponed the use of incinerators for the time being until further information on safety
an option is available.
2). Autoclaving:
 Autoclaving is comparable to steam sterilization. It is the most commonly used
alternative to incineration. It is cost-effective as well as has no reported health impacts.
Waste is sterilized or disinfected before being dumped in landfills. Waste bags are
placed in chambers. Then steam is started for a specific time at a definite temperature
and pressure.
This method has assurity in the destruction of microorganisms. Approx 90% of
biomedical wastes are suitable for autoclaving, particularly microbiological wastes.
Autoclaving is not suitable for cytotoxic, pathological, radiotoxic, or other toxic chemical
wastes.
3).Gas sterilization:
In this process, medical waste is placed into an empty air-tight chamber. Treated
with a sterilizing agent such as ethylene oxide or formaldehyde. Gas emitted from these
chemicals comes in contact with waste. In turn it kills harmful, infectious agents.
EPA does not recommend ethylene oxide for infectious waste because of its toxicity.
4). Chemical disinfection:
This method is preferred for liquid waste; it can also be used for solid waste. In
this method chemical agents are use for disinfection of wastes like chlorine.
Chemical treatment of waste
There are various factors considered about the effectiveness including :
 Type of disinfectant used
 Degree of contamination
 Type and morphology of microorganisms
 Chemical’s concentration, quantity, contact time and requirements for mixing
Alternatives are grinding of wastes before introduction with a liquid chemical
disinfectant. Grinding confirms sufficient subjection of chemical disinfectant to all parts
of waste. That aids in the easy disposal of residues. The resulting liquid is drained into
sewers, and solids are dumped into landfills.
5). Microwave:
Microwave technology can also disinfect waste. Wastes are first placed into a
shredder. These wastes are mixed with water and internally heated, which neutralizes
present biologicals. Microwave units are controlled through computers. That ensures
the least parameters of infection and proper equipment function. 90% of medical wastes
can be autoclaved.
The amount of residue produced is low because of shredding. Requires less
energy than incinerators.
6). Irradiation:
This method involves waste sterilization by exposing waste to cobalt sources.
Cobalt emits gamma rays that kill all the microbes in waste.
Commercial companies don’t use this technology due to high cobalt cost and operating
costs. Some queries are on the efficiency of proper disinfecting and radiating materials
with rays. It is not recommended for pathological wastes.
7).Thermal Inactivation:
This process involves heat waste at high temperatures resulting in the killing of
microbes. These methods are advised for treating large amounts of liquid waste. A
chamber is preheated to an intense specific temperature at a specific amount of time
and then released.
Benefits of Biomedical Waste Management
Cleaner and healthier surroundings.
Reduction in the incidence of hospital acquired and general infections.
Reduction in the cost of infection control within the hospital.
Reduction in the possibility of disease and death due to reuse and repackaging
of infectious disposables.
Low incidence of community and occupational health hazards.
Reduction in the cost of waste management and generation of revenue through
appropriate treatment and disposal of waste.
Improved image of the healthcare establishment and increase the quality of life
Conclusion
Safe and effective management of biomedical waste is not only a lawful
obligation but also a civic duty. Appropriate gathering and segregation of biomedical
wastes are vital. The quantity of waste generated is also critical. Lesser quantity of
biomedical waste signifies less burden on disposal work. That would be more money
and labor-saving and a more well-structured waste disposal system. We should step up
efforts to reduce the waste generation in day-to-day work in clinics and hospitals.