BIO

MEDICAL

WASTE

MANAGEMENT

Dr. M. Balasubramanian

Asst. Prof. of STD, Stanley Medical College

IMA Former State Secretary

PHYSICIAN

ADD YEARS TO LIFE &

ADD LIFE TO YEARS

OF THE PATIENTS

DOCTORS -- SAVIOURS OF MANKIND

HOSPITALS – TEMPLES OF HEALING

MEDICAL PROFESSION -- NOBLE

DOCTORS ARE GUIDED BY ETHICS

BUT GOVERNED BY LAW

ACCOUNTABLE TO THE PATIENT

ANSWERABLE TO THE COMMUNITY

NOSO COMIAL INFECTIONS

HOSPITAL ACQUIRED INFECTIONS

PROPER DISPOSAL

OF HOSPITAL WASTE

– SOCIAL RESPONSIBILITY

POLLUTION CONTROL BOARD

HOSPITAL as INDUSTRYTIIC

LOAN

HOSPITALS

CLASSIFIED UNDER

OBNOXIOUS & HAZARDOUS INDUSTRY

CATEGORY

HOSPITALS, Mines, Cements, Fertilizers & Chemicals, Distilleries, Tanneries

Hotels, Cinema Theatre, Lime Kilns, Stone Crushing unit

NIL – No toxic substance, No effluent, No fugitive emissions, No use of fuel

HON’BLE SUPREME COURT OF INDIA

Writ Petition No 888 of 1996

Public Interest Litigation

Mrs. Almitra H. Patel vs. Union of India

Pathetic Situation of Solid Waste Management Practices

Obligatory function of Urban Local Bodies

Resulting in problems of Health & Sanitation

No solution in sight.

Hon’ble Supreme Court after several hearings, constituted a committee

INTERIM REPORT OF THE COMMITTEE

Domestic / Trade Waste

Construction Waste

Industrial Waste

Infectious & Hospital Waste. Adverse impact on Human Health. Grossly neglected. Do not discharge their duties for safe disposale. Infectious waste & sharps get mixed up with Domestic Waste. Incinerators in certain Hospitals only – Often single chamber not affectively functioning. Ministry of Environment, Govt. of India to issue mandatory instructions to rectify with a time frame.

Tamilnadu Pollution Control Board

  O/o District Environment Engineer,

TN Pollution Control Board

 Proc. No. DEE/TNPC Bd/TLR/BMW/INV/2001 Dated

 

Sub : TNPC Board – Hazardous Substance Management – Failure to install Bio Medical Waste Treatment and disposal facility within the stipulated time schedule – Show Cause Notice – issued.

 

Ref : The Bio Medical Waste (M & H) Rules 1998 as amended in 2000 notified under the Environment (Protection) Act 1986. 

Hence you are directed to show cause within fifteen

days from the date of receipt of this notice so as to why

penal for an offence punishable under Section 15 of

Environment (Protection) Act, 1986 should not be

initiated against you for not having complied with and

contravening the said provisions of the Bio Medical

Waste (Management & Handing) Rules 1998 as

amended in 2000 and also to issue direction for

closure of the unit and stoppage of power supply

etc., under Section (5) of the Environment

(Protection) Act, 1986.

DISTRICT ENVIRONMENTAL ENGINEER

Tamilnadu Pollution Control Board.

SCHEDULE VI (see rule 5)

SCHEDULE FOR WASTE TREATMENT FACILITIES

LIKE INCINERATOR / AUTOCLAVE / MICROWAVE SYSTEM

 A.Hospitals and Nursing Homes in towns with population of 30 lakhs and above 30th June 2000 or earlier

B. Hospitals and Nursing Homes in towns 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 than 500 beds

by 31st December, 2000 or earlier

(c) with 50 beds and above but less than 200 beds

by 31st December, 2001 or earlier

(d) with less than 50 beds by 31st December, 2002 or earlier

C. All other institutions generating bio-medical waste not included in A and B above by 31st December, 2002 or earlier

BIO MEDICAL WASTE MANAGEMENTPROGRAMME PLANNING

1. Willingness

2. Self Motivation

3. Investments – Person, Place, Financial

4. Identifying Nodal Person – ICC – BMWM Committee.

5. Waste Survey

6. Evaluation of Existing Practice

7. Training

8. Implementing Segregation

9. Reporting and Feed Back

10. Review after one year.

HOSPITAL WASTES

Non Infectious Infectious

Non Sharps Sharps

Solids Liquids

Incinerable Non Incinerable(Autoclave, Microwave)

Biodegradable Non Biodegradable

SCHEDULE – 1 (See Rule 5)

CATEGORIES OF BIO MEDICAL WASTE

OPTION WASTE CATEGORY TREATMENT & DISPOSAL

Category No. 1 Human Anatomical Waste Incineration / deep burial

Category No. 2 Animal Waste Incineration / deep burial

Category No. 3 Microbiology & Biotechnology Waste

Local autoclaving / microwaving / incineration

Category No. 4 Waste Sharps Disinfection by chemical treatmet / atoclaving / microwaving and mutilation / shredding

Category No. 5 Discarded Medicines and Cytoxic drugs

Incineration / destruction and drugs disposal in secured landfills

Category No. 6 Solid Waste Incineration / autoclaving / microwaving

Category No. 7 Solid Waste Disinfection by chemical treatment / autoclaving / microwaving and mutilation / shredding

Category No. 8 Liquid Waste Disinfection by chemical treatment and discharge into drains.

Category No. 9 Incineration Ash Disposal in municipal landfill

Category No. 10 Chemical Waste Chemical treatment and discharge into drains for liquids and secured land for solids

SCHEDULE – II (See Rule 6)

COLOUR CODING AND TYPE OF CONTAINER

FOR DISPOSAL OF BIOMEDICAL WASTES

COLOUR CODING

TYPE OF CONTAINER

WASTE CATEGORY

TREATMENT OPTIONS as per Schedule I

Yellow Plastic Bag Cat.. 1, 2, 3 and 6

Incineration / deep burial

Red Disinfected container / Plastic Bag

Cat. 3, 6, and 7 Autoclaving / Microwaving / Chemical Treatment

Blue / White Translucent

Plastic Bag / puncture proof container

Cat. 4, Cat. 7 Autoclaving / Microwaving / Chemical treatment and destruction shredding

Black Plastic Bag Cat. 5, 9 and 10 (Solid)

Disposal in secured landfill

PLASTIC WASTEIV SetsTubings

Blood & Urine bagsSyringes

SEGREGATION OF WASTE

No

Sharps

In this

bag

RED BAG OR CONTANIER

SEGREGATION OF WASTE

INFECTIOUS WASTESoiled bandagesDressingsCotton SwabsSanitary Pads

YELLOWBAG OR CONTAINER

No

Plastics

In this

bag

SEGREGATION OF WASTE

Needles and Ampoules to be put

in the separate puncture proof bin provided

SEGREGATION OF WASTE

   

 

Do not dispose dressings in patients bin / Ask for disposal bags.

Ensure all the plastics and gloves are cut and put into bleach solution.

Ensure all used injections are cut using needle cutters.

Ensure compliance of this scheme during ward visits

DOCTORS

NURSES

Put cut gloves and plastic in bleach solution.

Put all other infectious waste, such as pathological

waste, bandages, dressings, cotton etc… in yellow bin.

Always cut needles with the needle cutter and

disinfect with bleach solution.

All sharps to be put in needle cutter container.

Help patients understand the scheme.

LAB TECHNICIANS

Use gloves during all tests.

Reusable items to be soaked in bleach and heated at high a temperature.

Media plates to be put in separate bleach solution.

Cut gloves, syringes to be put in red coloured bin with bleach.

Needles to be cut with needle cutter and disinfected with bleach.

Sharps to be put in needle cutter container.

WARDS BOYS / AYYAS

Cut all tubes.

Cut all gloves.

Check if waste in bleach in only plastic or

glass. If not, report to the supervisor.

Help patients understand the scheme

Segregate waste as per category

Put waste in correct bin wiz. Plastic/rubber waste in Red, Anatomical soiled waste in Yellow, Non-infectious general waste in Black and Sharps in Blue Puncture Proof Container. Ensure colour bags of the same colour as bins.

Ensure that the plastic bag has bio-hazard symbol and label.

Remove plastic bags when ¾ full, tie the bags properly. Ensure bag is properly tied / sealed to avoid spilling.

Remove bags by Wheel Barrows only to the waste storage site.

Cut the needle (disposable) before throwing it.

Wear protective gear while handling waste.

Always snipe the IV bottle, cut the IV sets, and fingers of gloves before throwing it in the bin or sending it back to the store.

Always keep your record book on waste activity up to date.

DO’S  

Put the waste indiscriminately.

Put wrong bags in bin. (Adhere to colour code.)

Fill the bags till neck. (Waste would otherwise spill over.)

Handle waste without protective clothing.

Drag the bags after removal. (Bags can burst and the site could be repulsive.)

Never recap the needle. (Never re-use needle without disinfection)

Mix non infectious waste with infectious waste.

DON’TS 

DON’T MIX INFECTIOUS WASTES WITH MUNICIPAL WASTE

SEGREGATE AS PER COLOUR CODING

AT THE POINT OF GENERATION ITSELF

REALISE THE SIGNIFICANE OF RED & YELLOW

NEVER PUT YELLOW BAG IN RED BIN

AND RED BAG IN YELLOW BIN

OUT HOUSE MANAGEMENT

Role of Common Facilitator

To collect Bio Medical Waste from Individual Hospital every day.

To transport in closed container Van safely to the Treatment plant.

To erect common offsite BMWM Treatment facility in accordance with the standard prescribe BMWM Rules and approval from Tamilnadu Pollution Control Board.

To dispose various categories of Bio Medical Waste by approved techniques.

To train the individual hospitals staffs regarding BMWM

MEMORANDUM OF UNDERSTANDING

BETWEEN IMA & G.J. MULTI CLAVE INDIA (P) Ltd

Tariff agreed – Rs. 3 per bed per day on the basis of declared bed strength of Health Care Establishment.

Comparison of Tariff -- Per bed and Per kg of Waste

(Average Bio Medical Waste Per Bed Per Day - 400 gms)

For a Hospital of 30 Beds with average occupancy of 20 Beds

Bio Medical Waste Generated 20 x 400 gms = 8Kg

Amount to be given 8 x Rs. 9 = Rs. 72/-.

Amount to be given per bed 30 x Rs. 3 = Rs. 90/-

(Bio Medical Waste from OP, Casualty & OT included)

Let us prove that we are

ECO FRIENDLY

To make others shed their hostility and become

MEDICO FRIENDLY