BIO-MEDICAL WASTE

MANAGEMENT

K.M.NAGARAJ
REFIONAL SR. ENVIRONMENTAL OFFICER
KARNATAKA STATE
POLLUTION CONTROL BOARD
 Development of
Bio-medical Waste
Management
 The Hon’ble Supreme Court’s direction to 50 & above
bedded hospitals in Delhi, during 1996
 Standards & Guidelines for the hospital waste
management prepared by Central Pollution Control
Board
 Bio-medical Waste (Management & Handling) Rules,
1998 notification under Environment (Protection) Act,
1986
 Bio-medical Waste (Management & Handling)
(Amendment) Rules, 2000
 Bio-medical Waste (Management & Handling)
(Second Amendment) Rules, 2000
 Bio-medical Waste (Management & Handling)
(Third Amendment) Rules, 2003
 Features of
Bio-medical Waste Rules
 Duty of Occupier
 Annual Report
 Authorisation
 Advisory Committee
 Maintenance of Records
 Accident Reporting
 Appeal
 Segregation, Packaging, Transportation
& Storage
• It shall be the duty of every occupier of HCE to
ensure that bio medical waste is handled with out
adverse effect to human health and environment.
• Bio medical waste shall be treated and disposed
of in accordance with schedule.
• Bio medical waste shall not be mixed with other
wastes.
• No untreated bio-medical waste shall be kept
stored beyond a period of 48 hours.
• Every occupier of HCE shall make an application
in Form 1 for grant of authorization.
• Every occupier /operator shall
submit an annual report to the
prescribed authority in Form 2 by
31st of Jan every year.
• Every person shall maintain
records of waste generation and
disposal.
 First Amendment in BMW Rules :
Schedule VI
Schedule for Waste Treatment Facilities like
Incinerator/Autoclave/Microwave System
A. Hospitals and nursing homes in By 30th June,2000 or earlier
towns with population of 30 lakhs &
above
B. Hospitals and nursing homes
in towns with population of
below 30 lakhs

(a) With 500 beds and above By 30th June, 2000 or earlier
(b) With 200 beds and above but less By 31st December, 2000 or earlier
than 500 beds
(c) With 50 beds and above but less than By 31st December,2001 or earlier
200 beds
(d) With less than 50 beds By 31st December,2002 or earlier

C. All other institutions generating bio- By 31st December,2002 or earlier

medical waste not included in A and
B above
 Second Amendment in
Bio-Medical Waste Rules

Prescribed Authority
The prescribed authority for enforcement of the
provisions of these rules shall be the State
Pollution Control Boards in respect of States
and the Pollution Control Committees in respect of
the Union territories and all pending cases with a
prescribed authority appointed earlier shall stand
transferred to the concerned State Pollution
Control Board, or as the case may be, the Pollution
Control Committees.
Municipal Bodies / other Organisations:
Municipal Corporations, Municipal Boards or Urban
Local Bodies, as the case may be, shall be
responsible for providing suitable common
disposal/incineration sites for the biomedical wastes
generated in the area under their jurisdiction and in
areas outside the jurisdiction of any municipal body, it
shall be the responsibility of the occupier generating
bio-medical waste/operator of a bio-medical
waste treatment facility to arrange for suitable
sites individually or in association, so as to
comply with the provisions of these rules.

The Municipal body of the area shall continue to

pick up and transport segregated non bio-
medical solid waste as well as duly
treated bio-medical wastes for disposal at
Other Treatment Technologies

Occupier/operator wishing to use other State-of-

the-art technologies shall approach the
Central Pollution Control Board to get the
standards laid down to enable the prescribed
authority to consider grant of authorisation.
 The category of wastes
Category Description Final disposal
No
1 Human anatomical waste
Incineration
2 Animal anatomical waste Incineration
3 Microbiological waste Incineration
4 Waste sharps Recycling / Sharp pit
5 Discarded medicines Secured Landfill
6 Soiled waste Incineration
7 Solid waste Recycling / Secured
8 Liquid waste Public sewer
9 Incineration ash Secured Landfill

10 Chemical Waste Incineration / Landfill

Categories of Bio-Medical Waste
Waste Waste class and description Treatment and
Category disposal systems

No.1 Human Anatomical Wastes, Incineration @ /

Human tissues, organs, waste body parts deep burial*

No.2 Animal Wastes - do -

Wastes consisting of animal tissue,
organs, body parts, carcasses, body fluid,
blood and blood products, items
contaminated with blood and fluids,
wastes from surgery treatment and
autopsy and wastes of experimental
animals used in research, waste
generated by veterinary hospitals,
colleges, animal houses and livestock
farms

Contd..
Waste Waste class and description Treatment and disposal
Category systems

No.3 Microbiology & Biotechnology Waste Local Autoclaving /

Wastes from laboratory, culture stocks ormicrowaving/incineratio
specimens of micro-organisms, live orn @
attenuated vaccines, human and animal
cell culture used in research and
infectious agents from research and
industrial laboratories, wastes from
production of biological dishes and
devices used for transfer of cultures

No.4 Waste Sharps Disinfection using

Needles, syringes, scalpels, blades,chemical
glass, etc that are capable of causingtreatment/autoclaving/m
puncture and cuts. This includes bothicrowaving and
used and unused sharps mutilation.shredding
and disposal in
landfill / recycling (for
PVC, plastics and
glasswares)
Contd..
Waste Waste class and description Treatment and
Category disposal systems

No. 5 Discarded Medicines Incineration @ or

Wastes comprising of outdated,destruction and
contaminated and discarded medicines. disposal in landfills

No. 6 Soiled Wastes Incineration @

Wastes generated from soiled cotton,autoclaving/microw
dressings, plaster casts, linens, beddings,aving
material contaminated with blood
including the packaging materials
No. 7 Solid Waste Disinfection by
(Wastes generated from disposable items chemical
other than the waste sharps such as treatment@@
tubings, catheters, intravenous sets etc.) autoclaving/microw
aving and
mutilation/shreddin
g ##

Contd..
Waste Waste class and description Treatment and
Category disposal systems

No. 8 Liquid Waste Disinfection by

(waste generated from laboratory and chemical
washing, cleaning, house-keeping and treatment@@ and
disinfecting activities) discharge into
drains.
No. 9 Incineration Ash Disposal in
(ash from incineration of any bio-medical municipal landfill
waste)
No. 10 Chemical Waste Chemical
(chemicals used in production of treatment@@and
biologicals, chemicals used in discharge into
disinfection, as insecticides, etc.) drains for liquids
and secured landfill
for solids

@@ Chemical treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It
must be ensured that chemical treatment ensures disinfection.
## Multilation/shredding must be such so as to ;prevent unauthorised reuse.
@ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be
incinerated.
* Deep burial shall be an option available only in town with population less than five lakhs and in rural
 Segregation of waste with colour coding
Sl Colour Container Waste Category to Disinfection in the End treatment of
No Code be put in health care facility the waste at the
common facility
1 YELLOW Plastic Bag Category 1 or 2 Waste category 3 Incineration only
Category 3 and category 6 shall at common
Category 6 be disinfected with facility
1% Sodium
hypochlorite
solution
2 RED Plastic Bag Category 7 No disinfection Shall be
( Non infected required autoclaved,
plastic and glass) shredded and
sent for recycling
3 WHITE / Puncture proof Category 4 Shall be disinfected Shall be
BLUE container with 1% Sodium autoclaved and
hypochlorite disposed in
solution sharp pit or may
be sent for
recycling
4 BLACK Plastic Bag Category 5 No disinfection Only for secured
Category 10 required landfill
(solid only)

NOTE: The expired / discarded medicines in liquid or semi solid state shall be safely sent back to the manufacturer by
the hospital / facility.
Health Care Facility- In Hospital
Segregation and storage
of
bio-medical waste
 Standards for Incineration
A. Operating Standards
 Combustion Efficiency (CE) shall be atleast
99.0%.
 The combustion efficiency is computed as
follows:
%CO2
C.E. = ——————— × 100
% CO2 + % CO
 The temperature of the primary chamber shall be
800 ± 50°C.
 The secondary chamber gas residence time shall
be atleast 1 (one) second at 1050 ± 50°C with the
B. Emission
minimum 3% Standards
oxygen in the stack gas.
 Particulate matter 150 mg/Nm3 (12% CO2
correction)
 Nitrogen oxides 450 mg/Nm3 -do-
 HCl 50 mg/Nm3 -do-
 Minimum stack height shall be 30 meters above
ground Contd..
Note :
 Suitably designed air pollution control devices shall
be installed/retrofitted with the incinerator to achieve
the above emission limits, if necessary.
 Wastes to be incinerated shall not be chemically
treated with any chlorinated disinfectants.
 Chlorinated plastics shall not be incinerated.

 Toxic metals in incineration ash shall be limited within

the regulatory quantities as defined under the
Hazardous Waste (Management and Handling Rules),
1989.
 Only low sulphur fuel like L.D.O./L.S.H.S./Diesel shall
be used as fuel in the incinerator.
 SCHEDULE III (see Rule 6)
LABEL FOR BIO-MEDICAL WASTE
CONTAINERS/BAGS

Bio hazardous Cytotoxic

“Clarification pertaining to categories of waste.” may be

specified in rules i.e. container of which category of
waste shall have particular Symbol.
 Management of Mercury
• While issuing Authorisation to HCF following conditions
are imposed.
• Preventive measures shall be taken against the possible
discharges /emissions of mercury and the solid waste
containing Mercury due to the breakage of
thermometers/pressure/other measuring equipments.
• Spilled mercury waste shall be collected carefully stored
and sent back to the manufacturers.
• Precautionary measures shall be taken by the HCF so
as not to mix up with the BMW/other wastes
INCINERATOR
Mechanical Feeding
Device
 Standards for Waste
Autoclave
A. When operating a gravity flow autoclave,
medical waste shall be subjected to :
 A temperature of not less than 121°C and a
pressure of 15 pounds per square inch gauge
(psi) for an autoclave residence time of not less
than 60 minutes;
 A temperature of not less than 135°C and a
pressure of 31 psi for an autoclave residence
time of not less than 45 minutes; or
 A temperature of not less than 149°C and a
pressure of 52 psi for an autoclave residence
time of not less than 30 minutes; Contd..
B. When operating a vacuum autoclave,
medical wastes shall be subjected to a
minimum of one pre-vacuum pulse to purge
the autoclave of all air. The waste shall be
subjected to the following:

 A temperature of not less than 121°C and a

pressure of 15 psi per an autoclave
residence time of not less than 45 minutes;
or

 A temperature of not less than 135°C and a

pressure of 31 psi for an autoclave
residence time of not less than 30 minutes;
Contd..
C. Medical waste shall not be considered properly
treated unless all time / temperature / pressure
indicators indicate that the required time /
temperature / pressure were reached during the
autoclave process. If for any reasons, time /
temperature / pressure indicator indicates that the
required temperature, pressure or residence time was
not reached, the entire load of medical waste must be
autoclaved again until the proper temperature,
pressure and residence time were achieved.

• Recording of operational parameters

 Each autoclave shall have graphic or computer
recording devices which will automatically and
continuously monitor and record dates, time of day,
load identification number and operating parameters
throughout the entire length of the autoclave cycle.
Contd..
AUTOCLAVE
 Standards for
Microwaving
 Microwave treatment shall not be used for cyto-
toxic, hazardous or radioactive wastes,
contaminated animal carcasses, body parts, and
large metal items.

 The microwave system shall comply with the

efficacy test/routine tests and a performance
guarantee may be provided by the supplier before
operation of unit.

 The microwave should completely and consistently

kill the approved biological indicator at the
maximum design capacity of each microwave unit.
Biological indicators for microwave shall be Bacillus
Subtilis spores using vials or spore strips, with at
least 1 × 104 spores per millilitre.
 Liquid waste
The effluents generated from the hospital shall conform
to the following limits :
Parameter Permissible Limit
pH 6.5 – 9.0
Suspended solids 100 mg/l
Oil and grease 10 mg/l
BOD 30 mg/l
COD 250 mg/l
Bio-assay test 90% survival of fish after
96 hours in 100% effluent
Note:
These limits are applicable to those hospitals which are either
connected with sewers without sewage treatment plant or not
connected to public sewers at all. For discharge into public sewers
having terminal treatment facility, the general standards as notified
under the Environment (Protection) Act shall be applicable.
 Standards for Deep
1. Burial
A Pit or trench should be dug about 2 meter
deep. It should be half filled with waste, then
covered with lime within 50 c of the surface,
before filling the rest of the pit with soil.

2. It must be ensured that animals do not have

any access to burial. Covers of galvanised
iron/wire meshes may be used.

3. On each occasion, when wastes are added to

the pit; a layer of 10 cm of soil shall be added
to over the wastes.

4. Burial must be performed under close and

dedicated supervision. Contd..
5. The deep burial site should be relatively
impermeable and no shallow well should be
close to the site.

6. The pits should be distant from habitation,

and sited so as to ensure that no
contamination occurs of any surface water or
ground water. The area should not be prone
to flooding or erosion.

7. The location of the deep burial site will be

authorized by the prescribed authority.

8. The institution shall maintain a record of all

pits for deep burial.
 Guidelines for setting of
Common Bio-Medical
Waste Treatment
Facilities (CBWTF)
1. LOCATION OF CBWTF
- Away from residential area/sensitive area

2. LAND REQUIRED FOR CBWTF

- Minimum one acre land (comments
received from various SPCBs)

3. COVERAGE AREA OF CBWTF

- Up to 10000 beds and radius of 150 km.
4. TREATMENT EQUIPMENT IN CBWTF
 Autoclave (Pre-vacuum horizontal feeding)/
Hydroclave / Microwave
 Incineration (for waste belonging to categories 1,2 and
5 only)
 Shredder
 Sharp pit (with drawing details)/Encapsulation/
Recovery of metal in some factory may be looked into
 Facility for bin washing, floor washing, vehicle
washing
 Effluent Treatment Plant
 Secured land fill (Until a secured land fill comes up in
the area, space within the CBWTF facility shall be
used)
5. INFRASTRUCTURE SET-UP OF CBWTF
 Treatment Equipment Room
 Waste Storage Room
 Site Security
 Administrative Room
 Generator Set
 Parking
 Sign Board
 Green Belt
 Washing Room
 Control of odour and pests/insects
 Waste Accepted
 Waste Removed
 Logbook for equipment
 Site records

7. COLLECTION AND TRANSPORTATION

OF BIO-MEDICAL WASTES
 Collection of waste from hospitals
 Transportation to CBWTF
 Guidelines for vehicle
8. DISPOSAL OF TREATED BIO-MEDICAL WASTE

Waste Category Disposal Method

Plastic waste after disinfection and Recycling or
shredding municipal landfill
Disinfected sharps (except syringes)
(i) If encapsulated Municipal Landfill
(ii) If non-encapsulated Municipal Landfill/
Recycling
Incineration ash Secured landfill
Other treated solid wastes Municipal Landfill
Oil & grease Incineration
Treated waste water Recycling or
sewer/drain
9. COST TO BE CHARGED BY THE CBWTF
OPERATOR TO THE HEALTHCARE FACILITIES

10. SETTING UP AND OPERATION OF CBWTF

 Submit detailed working plan to the Prescribed

Authority
 Prescribed Authority to evaluate the working
plan
 Setting up of the CBWTF
 Duty of the hospitals to handover the
segregated waste as per the Rules
 Submit quarterly report of stack emission
test/validation test/water effluent test
 Guidelines for
Bio-Medical Waste
Incinerator
 Incinerator at CBWTF only
 Air Pollution Control Device (APCD) must be with incinerator
 High Pressure Venturi Scrubber as recommended APCD
 Individual installation of incinerator to be discouraged

Also, Guidelines for:

 Incinerator room
 Operator of the incinerator
 Guidelines for
Bio-Medical Waste
Incinerator
 Design Criteria
 Placement of Thermocouples
 Automated Waste Feeding
 Graphic or Computer Recording Devices
 Specifications of APCD
 Material Specifications
 Structural Design of Stack
 Safety Provisions

and ensure compliance with the emission

 GUIDELINES ON
“Common Bio-medical Waste
Treatment Facility ”
and
“Design & Construction of
Bio-medical Waste
Incinerators ” available at:

www.cpcb.nic.in
 Issues on BMW
Management
 The level of the segregation to be further
upgraded
 Creation of awareness through workshops/
Training Programmes within healthcare
facilities
 Small HCFs and HCFs in rural areas too needs
to be focussed
 Common Bio-medical Waste Treatment
Facilities (CBWTF) to be encouraged
 CPCB’s Guidelines on CBWTF and Incinerator
to be followed

Contd..
 Reduction in generation of BMW in healthcare
facilities
 Recyclability of certain wastes to be explored
 State-of-the-art technology for treatment of bio-
medical waste to be developed
It is prudent to take special precautions
to avoid exposure to harmful pathogens
at any cost ignoring all the pressures
what-so-ever. Otherwise, the mankind
will suffer.

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