Biomedical Waste Presents a Serious Health Problem Risks Include: Outright Injury to Workers Exposure to Infectious Agents Psychological

Trauma Regulatory Actions Legal Actions Environmental Issues The Risks involve: Medical Staff Healthcare Workers Maintenance and Housekeeping Staff Disposal Company Staff Landfill Employees Innocent and Unaware Public (Kids) Regulatory Definitions of Biomedical Wastes 2) "Biomedical waste" means solid waste of the following types: (a) "Animal waste," which includes waste animal carcasses, body parts, and bedding of animals that were known to have been deliberately infected or inoculated with human pathogenic microorganisms during research. (b) "Liquid human body fluids" means waste that includes waste liquid emanating or derived from humans including but not limited to human blood and blood products, serum and plasma, sputum, drainage secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid and amniotic fluid that exceeds fifty milliliters per container, storage vessel, or plastic bag and cannot be and has not been directly discarded into a sanitary sewage system. (c) "Cultures and stocks" means waste that includes waste cultures and stocks of microbiological agents infectious to humans, human serums and discarded live and attenuated vaccines infectious to humans, human blood specimens, and laboratory wastes that are contaminated with these agents or specimens. (d) "Biosafety level 4 disease waste," which includes wastes contaminated with blood, excretions,

exudates, or secretions from humans or animals who are isolated to protect others from highly communicable infectious diseases that are identified as viruses assigned to Biosafety Level 4 by the Centers for Disease Control, National Institute of Health, Biosafety (e) "Pathological waste," which includes waste human source biopsy materials, tissues, and anatomical parts that emanate from surgery, obstetrical procedures, autopsy, and laboratory procedures. "Pathological waste" does not include teeth or formaldehyde or other preservative agents, human corpses, remains, and anatomical parts that are intended for interment or cremation. Sharps Waste "Sharps waste," which includes waste hypodermic needles, syringes, IV tubing with needles attached, scalpel blades, and lancets that have been used in animal or human patient care or treatment in medical research. E. Sharps shall be contained for storage, transportation, treatment, and disposal in leak-proof, rigid, puncture-resistant containers which are taped closed or tightly lidded to preclude content loss.

I.

Environmental Legislation The Environment (Protection) Act, 1986 The Biomedical Waste (Management & Handling) Rules, 1998 The Municipal Solid Waste (Management & Handling) Rules, 2000 The Hazardous Waste (Management & Handling) Rules, 1989 The National Environmental Tribunal Act, 1995 The Air (Prevention and Control of Pollution) Act, 1981

BIOMEDICAL WASTE (MANAGEMENT & HANDLING) RULES 1998 Amended on 2000 Rules for Segregation & Packing of BMW

 Bio-medical waste shall not be mixed with other wastes. Bio-medical waste shall be segregated into containers/bags at the point of generation in accordance with Schedule II (next slide) prior to its storage, transportation, treatment and disposal. The containers shall be labeled according to Schedule III .

Schedule-I
CATEGORIES OF BIO-MEDICAL WASTE

Option Category No. 1

Waste Category Human Anatomical Waste (human tissues, organs, body parts)

Treatment & Disposal incineration @/deep burial*

Category No. 2

Animal Waste (animal tissues, organs, body parts carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals, colleges, discharge from hospitals, animal houses) Microbiology & Biotechnology Waste (Wastes from laboratory cultures, stocks or microorganisms live or vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, wastes from production of biologicals, toxins, dishes and devices used for transfer of cultures) Waste Sharps (needles, syringes, scalpels, blade, glass, etc. that may cause punture and cuts. This includes both used and unused sharps) Discarded Medicines and Cytotoxic drugs (Waste comprising of outdated, contaminated and discarded medicines)

incineration@/deep burial*

Category No. 3

local autoclaving/micro-waving/incineration@

Category No. 4

disinfection (chemical treatment @@@/auto claving/microwaving and mutilation/shredding##

Category No. 5

incineration@/destruction and drugs disposal in secured landfills

Category No. 6

Soiled Waste (items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, bedding, other material contaminated with blood) Solid Waste (Waste generated from disposal items other than the sharps such a tubings, catheters, intravenous sets etc.) Liquid Waste (Waste generated from laboratory and washing, cleaning, housekeeping and disinfecting activities)

incineration@autoclaving/microwaving

Category No. 7

disinfection by chemical treatment@@ autoclaving/microwaving and mutilation/shredding##

Category No. 8

disinfection by chemical treatment@@ and discharge into drains

Category No. 9

Incineration Ash Ash from incineration of any bio-medical waste)

disposal in municipal landfill

Category No. 10

Chemical Waste (Chemicals used in production of biologicals, chemicals used in production of biologicals, chemicals used in disinfection, as insectricides, etc.)

chemical treatment@@ and discharge into drains for liquids and secured landfill for solids

Note :

There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated.

Deep burial shall be an option available only in towns with population less than five lakhs and in rural areas.

@@

Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It musts be ensured that chemical treatment ensures disinfection.

##

Multilation/shredding must be such so as to prevent unauthorised reuse.

Schedule-II
COLOUR CODING AND THE TYPE OF CONTAINER FOR DISPOSAL OF BIO MEDICAL WASTES

Colour Coding

Type of Container

Waste Category Categories 1, 2, 3 & 6. Categories 3, 6, 7 Cat. 4, Cat. 7 Categories 5, 9, 10

Treatment options

Yellow

Plastic Bag

Incineration/ deep burial

Red

Disinfected container/Plastic bag

Autoclaving/Micro-waving/Chemical Treatment

Blue/White Translucent

Plastic Bag /punctproof containers

Autoclaving/Micro-waving/ Chemical Treatment & Destruction / shredding

Black

Plastic Bag

Disposal in secured landfill.

Notes: 1. Colour coding of waste categories with multiple treatment options as defined in schedule 1, shall be selected depending on treatment option chosen, which shall be as specified in Schedule I. 2. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics. 3. Categories 8 and 10 (liquid) do not require containers/bags. 4. Category 3, if disinfected locally need not be put in containers/bags.

Rules for Transportation & Storage of BMW.

If a container is transported from the premises where bio-medical waste is generated to any waste treatment facility outside the premises, the container shall, apart from the label prescribed in Schedule III, also carry information prescribed in Schedule IV. Notwithstanding anything contained in the Motor Vehicle Act, 1988, or rules there under, untreated biomedical waste shall be transported only in such vehicles as may be authorized for the purpose by the competent authority as specified by the government.

No untreated bio-medical waste shall be kept/stored beyond a period of 48 hours. Provided that if for any reason it becomes necessary to store the waste beyond such period, the authorized person must take permission of the prescribed authority and take measures to ensure that the waste does not adversely affect human health and the environment.

 Schedule-III
LABEL FOR BIO-MEDICAL WASTE CONTAINERS/BAGS
CYTOTOXIC HAZARD SYMBOL

BIOHAZARD SYMBOL

BIOHAZARD CYTOTOXIC

HANDLE WITH CARE

Note : Lable shall be non-washable and prominently visible.

Basic Rules

1. Biohazard or Biomedical Waste must be separated from normal domestic waste 2. Separation of waste is the responsibility of the waste generator at 3. Waste in Biohazard is considered Infectious by default. 4. The disposal company or transporter can refuse to pick up mixed waste. Regulations obligate him to refuse. By county, state regulations Biomedical waste cannot be compacted and there are relatively strict regulations regarding the transport of biomedical waste. 5.Personnel handling biomedical waste are required to have appropriate protection. the point of origin.

Recommendations Some suggestions which would act as remedial measures for the Improvements in health-care waste management are given below :-

1. Specific personnel need to be deputed to monitor the bio-medical waste management. 2. By assessing the need of man power and other things for the BMWM of hospital and by fulfilling of all the requirements. 3. Quality assessment of bio-medical waste management be done from time to time. Regular quality analysis by independent authorities. 4. The build-up of a comprehensive system, addressing responsibilities, resource allocation, handling and disposal. This is a long-term process, sustained by gradual improvements;

5. Awareness raising and training about risks related to health-care waste, and safe and sound practices. 6. Clear directives in the form of a notice to be displayed in all concerned areas in local languages. 7. Issuance of all protective clothes such as, gloves, aprons, masks etc. without fail. 8. Maintenance of Record registers for this purpose. 9. Regular medical check-up (half-early) of staff associated with BMWM. 10. Tracking of Bio Medical Waste upto point of Disposal. 11. Segregated collection and transportation - The use of colour coding and labelling of hazardous waste including local language. 12. Safety of handling. 13. Selection of safe and environmentally-friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste. 14. Proper treatment and final disposal. 15. Government commitment and support is needed to reach an overall and long-term improvement of the situation, although immediate action can be taken locally.