INTRODUCTION

Proper management of hospital waste is

an area which has assumed paramount
significance in contemporary times.
Biomedical waste can affect health of

other patients
health care workers

the community at large
Proper disposal of biomedical waste is a legal
requirement as per Biomedical Waste
( Management and Handling) Rules under sec 6,8, and
25 of environment protection act,1986.
The Gazette notification of the Ministry of Environment
and Forests, Govt of India dated 20 Jul 1998 lays down
the rules in detail.
The deadline for creation of waste management facilities
at various health care establishments was 31 Dec 2002
 ARMY SETUP
• Detailed guidelines for proper handling
of Bio-Medical waste in the Armed
forces have been issued vide O/o
DGAFMS letter No 3548/DGAFMS/DG-
3A dt 08 Jul 03.
 What is biomedical waste ?
“any waste which is generated during
diagnosis, treatment and immunization of
human beings or animals,or in research
activities pertaining thereto,or in the
production or testing of biologicals"
 Quantam of Hospital Waste
85% - non- hazardous which
includes domestic waste
15% - hazardous :
10% infectious
05% noninfectious
 Hazards of biomedical waste
• Nosocomial infection
• Risk to waste handlers,scavengers and
general public
• Injuries from sharps to health care
workers/patients
• Recycling of disposables
• Risk due to hazardous chemicals,drugs
and radioactive substances.
 Basic principles of waste
management
Minimize waste by use of 3R( Reduce, Reuse and
Recycle).
Personal Protective measures.
Proper collection, handling storage and disposal of
BMW
Optimum use of sterilisation /disinfection
measures
Steps in waste management
Waste survey
Waste categories
Segregation, handling & safe storage
Colour coding
Choice of bins
Transportation
Disposal
 Waste survey
Helps in evaluating both the type
and quantity of waste generated in
the hospital
 Waste categories
Category 1 Human anatomical waste

Category 2 Animal waste

Category 3 Microbiology and

biotechnology waste
Waste categories
Category 4 Waste sharps

Category 5 Discarded medicines

& drugs
Category 6 Soiled waste
 Waste categories
Category 7 Solid waste

Category 8 Liquid
waste
Category 9 Incineration
ash
Category 10 Chemical
waste
FOCUS ON SEGREGATION FIRST
Segregation at source and safe storage
is the key to the whole hospital waste
management process because it is at
this stage that wastes are segregated
into different streams
ADVANTAGES OF SEGREGATION

Reduces total treatment cost

Reduces the impact of this waste on the
community
Reduces the chances of infecting health
care workers
Some important points :
Segregate at the point of
generation  
Use lidded bins /buckets lined
with polythene
Label all bins with biohazard
symbol
 S E G R E G A T IO N

GENERAL IN F E C T E D P L A S T IC HUM AN SHARPS

W ASTE W ASTE W ASTE T IS S U E
Food, office & garden waste
Colour coding for segregation
Cat 6,
Category 4,7
Category 1,2,3
Category 5,9,10
 Choice of bins
• Use lidded bins /buckets lined
with polythene
• Label all bins with appropriate symbol

Biohazard Radiation Cytotoxic

Carcinogen
 WASTE COLLECTION BAGS
leak proof and puncture proof
packing - when they are 2/3rd full
Labeling to indicate the type of waste, site of
generation, name of generating hospital or
facility
 Choice of bins
• Use lidded bins /buckets lined
with polythene
• Label all bins with appropriate symbol

Biohazard Radiation Cytotoxic

Carcinogen
HANDLING OF DISPOSABLE ITEMS
Shred , cut or mutilate gloves,
syringes, IV bottles, catheters etc
Use
needle & syringe cutters
Dip
in an effective chemical
disinfectant post clipping
Personal protective equipments
a.Caps (linen) – 2 per waste handlers/ quarter
b.Mask (linen) -2 per waste handlers/ quarter
c. Aprons- 2 per waste handlers/ quarter
d.Gloves (heavy duty) – 1 per waste handlers/ quarter
e.Gum boots -1 pair per waste handlers/ quarter
f. Eye shield -1 per waste handlers/ quarter
Waste Ideal Waste
handling Handler
 Storage of waste pending for
disposal
Don’t store beyond 48hrs
Bins can be of metal or plastic
If bins are reusasble ensure cleaning and
disinfection
Containers should not be too large to
prevent spillage
Bags for waste needing incineration should
not be made of chlorinated plastic
DRUMS AT KERB
COLLECTION POINT
 PROVIDE SECURE
COLLECTION &
TRANSPORTATION
Need for secure internal and external
collection
To be transported in separate containers.
Prevent reuse of medical devices,
containers and equipment after disposal.
 ON SITE TRANSPORTATION
Covered trolleys should be
used
All bags should be fastened
Do not overfill to avoid
spillage
Waste Collection Trolley
 Activity Site Responsibility Activity

Doc, Nurse, Para

Wards & Dept Segregation in
Segregation & Patients
Green Container

General waste

Collection & Safai Section Waste collection

Transportation Central team Daily

Vermiculture
Final Disposal Vermiculture Sanitary JCO
Site Safai Section Daily
 Activity Site Responsibility Activity

Segregation Wards & Dept Dr, Nurse, Para Segregation in

Red Container

Infectious waste

Collection & Safai Section Waste collection

Transportation Central team Daily

Final Disposal Kerbside Sanitary JCO

Safai Section Incineration
 Activity Site Responsibility Activity

Segregation in
Segregation Wards & Dept Dr, Nurse, Para Blue Container

Chemical Treatment
Plastic waste

Collection & Safai Section Waste collection

Transportation Central team Daily

Mutilation Daily
Final Disposal Kerbside Sanitary JCO
Safai Section Vendors
- fortnight
 Activity Site
Responsibility Activity

Segregation Wards & Dept

Dr, Nurse, Para
Mutilation
of needle

Sharps Puncture Proof

Container

Collection & Safai Section

Transportation Waste collection
Central team Trolley weekly

Kerbside Sanitary JCO Mutilation &

Final Disposal
Safai Section Deep Burial
ENSURE WORKER SAFETY

Education

Training

Personal protective equipments

TREATMENT
The term treatment refers to
processes that modify the waste in
some way before it is taken to its final
disposal place
AIMS OF TREATMENT
• To disinfect the waste so that it is no
longer the source of the pathogenic organisms.
• To reduce the bulk in order to reduce requirement for
storage and transportation.
• To make the waste unrecognizable for aesthetic
reasons.
• To make recyclable items unusable
ex – cutting the syringes and damaging the
needles.
 Treatment Techniques
Chemical disinfection
Autoclave
Hydroclave
Microwave Incineration
 Chemical disinfection
Disinfectant Cl2available Reqd. Contact Amount in
chlorine period 1 L of water
Min.
Sodium 5% 0.5% 30 100ml
hypochlorite
Calcium 70% 0.5% 30 7.0g
hypochlorite

NaOCl tab 0.5% 30 4 tab

Chloramine 25% 0.5% 30 20g

Autoclave
Wet thermal disinfection process
Recyclable items
Used for microbial cultures(3)
&sharps(4)
Trained manpower is required
Hydroclave
High temperature, high pressure steam is used
Hydrolyze the organic components of the waste
Remove the water content (dehydrate) the waste
Reduce the waste substantially in volume (80%)
Reduces the mass of waste significantly (50%) 
 Microwave
High fequency are usedwaves
 Incineration
Process of burning solids at high
temperature in a furnace(1,2,3,5)
Used for waste that cannot be recycled,
reused/disposed offs
Static grate single chamber incineration
Drum/brick incinerator
Rotatory klins
Newer methods
Thermal processes
Plasma torch
Superheated steam
Chemical processes
Non chlorine technologies
Peroxyacetic acid
Ozone gas
Metal catalysts
Alkaline hydrolysis technology
Newer methods
A) Ionizing radiations
Electron beam technology
B)Biological methods
E-M technology Lactobacillus
Phototrophic bacteria
Yeast
Vermiculture technique Microbial
flora
Earthworms(work managers)
 Final disposal
• Deep burial
• Land filling
• Masonry tank for sharps
 Best methods of disposal by
residue type
Incinerator Ash, Sanitary Landfill (if testing has shown it to be non-
Other Solids hazardous, based on environmental regulations.
Otherwise, it should be disposed in a secured waste
landfill.)

Liquids Sanitary sewer (if it has been diluted and/ or

neutralized and it is acceptable to local authorities
except for cytotoxic drugs.)

Anatomical Burial with lime (if not incinerated.)

Movement of Waste
1. Point of generation
2. Collection at point of generation
3. Kerb collection area
4. Final treatment option
5. Secured landfill area
6. Vermicomposting area
7. Recyclables to vendor
BMW Management Committee
Sr registrar & OC troops – O/IC
Senior Pathologist – member
PM - member
QM - member
OC SHO - member
CWM - member
Sanitary JCO - member
NCO i/c safai sec - member
Functions of the committee
To quantify the waste
To ascertain the requirements
To ensure proper segregation
of waste
To arrange transportation of waste
to central waste collection area
Functions of the committee….
To notify any needle stick injury
immediately esp. in suspected or
confirmed HIV / AIDS cases
To display precautions/ DO’s & DON’Ts
near the work place
Training and education
Maintenance of records
To prepare detailed SOP
Other points to be taken care of
Proper storage
Maintenance of records and reports
Accident reporting
Training of personnel Evaluation of
waste management in the hospital
Recommended scales of items for BMW
management in Armed Forces
Plastic containers Gum boots
Metal drums (Iron) Eye shields
Biodegradable bags Weighing scale – spring
Needle-syringe destroyer balance
Trolley (Hand cart) Weighing scale –with
Cap platform
Mask Plastic shredder
Apron (Water proof) Autoclave/microwave
Gloves (Heave duty) Sodium hypochlorite
solution
 ANNUAL REPORT
Every occupier/operator shall submit an annual
report to the prescribed authority in Form II by 31
January every year, to include information about
the categories and quantities of bio-medical
wastes handled during the preceding year. The
prescribed authority shall send this information
in a compiled form to the Central Pollution
Control Board by 31 March every year.
MAINTENANCE OF RECORDS
(1) Every authorized person shall maintain records
related to the generation, collection,
reception, storage, transportation, treatment,
disposal and/or any form of handling of bio-
medical waste in accordance with these rules
and any guidelines issued.
(2) All records shall be subject to inspection and
verification by the prescribed authority at any
time.
 ACCIDENT REPORTING
When any accident occurs at any institution or
facility or any other site where bio-medical
waste is handled or during transportation of
such waste, the authorized person shall report
the accident in Form Ill to the prescribed
authority forthwith.
 REMEMBER
Don’t be in a haste
To dispose hospital waste
You, in white clad
Remember that is bad
For man and nature alike
Giving the germs a hike
So, think for a while
Dispose it off in style
Use coloured bags or bins
And wash off all your sins
But , just in a haste
Don’t make a paste
Of all that hospital waste.
THANKS
Your hearing won’t go
waste