BM Waste Color Coding

8/6/2019 BM Waste Color Coding

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BioBio--medical Waste Managementmedical Waste Management

Issues and ChallengesIssues and Challenges

Dr. Selwyn A ColacoDr. Selwyn A Colaco

Chief Operating OfficerChief Operating OfficerNarayana Hrudayalaya Hospitals, BangaloreNarayana Hrudayalaya Hospitals, Bangalore


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I. Environmental LegislationI. Environmental Legislation

The Air (Prevention and Control of Pollution) Act, 1981The Air (Prevention and Control of Pollution) Act, 1981

The Environment (Protection) Act, 1986The Environment (Protection) Act, 1986

The Hazardous Waste (Management & Handling) Rules,The Hazardous Waste (Management & Handling) Rules,

19891989 The National Environmental Tribunal Act, 1995The National Environmental Tribunal Act, 1995

The Biomedical Waste (Management & Handling) Rules,The Biomedical Waste (Management & Handling) Rules,19981998

The Municipal Solid Waste (Management & Handling)The Municipal Solid Waste (Management & Handling)Rules, 2000Rules, 2000


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BMW Rules have been adopted and notified with theobjective to stop the indiscriminate disposal ofhospital waste/ bio-medical waste and ensure thatsuch waste is handled without any adverse effect onthe human health and environment.

Implementation ofImplementation of

BIOBIO--MEDICAL WASTE RULES 1998MEDICAL WASTE RULES 1998


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Health care waste includesHealth care waste includes Waste generated by the health care facilitiesWaste generated by the health care facilities Research facilitiesResearch facilities LaboratoriesLaboratories

Biomedical waste in hospitalsBiomedical waste in hospitals 85% are non85% are non--infectiousinfectious 10% are infectious10% are infectious

5% are hazardous5% are hazardous

Implementation ofImplementation of

BIOBIO--MEDICAL WASTE RULES 1998MEDICAL WASTE RULES 1998


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Segregation and safe containment of waste at theSegregation and safe containment of waste at thehealth facility levelhealth facility level

Processing and storage for terminal disposalProcessing and storage for terminal disposal

Basic PrinciplesBasic Principles


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BioBio--medical waste shall not be mixed with other wastes.medical waste shall not be mixed with other wastes. Segregation at sourceSegregation at source both at ward and unit levelboth at ward and unit level Color coding to support segregation at sourceColor coding to support segregation at source BioBio--medical waste shall be segregated into containers/medical waste shall be segregated into containers/

bags at the point of generation in accordance with Schedulebags at the point of generation in accordance with ScheduleII (BMW Rules 1998) prior to its storage, transportation,II (BMW Rules 1998) prior to its storage, transportation,treatment and disposal.treatment and disposal.



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The containers shall be labeled according to Schedule IIIThe containers shall be labeled according to Schedule III(BMW Rules 1998)(BMW Rules 1998) Transport waste safely to pick up siteTransport waste safely to pick up site Identify destination for each type of waste and ensureIdentify destination for each type of waste and ensure

safe disposalsafe disposal Keep track of usageKeep track of usage



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Untreated biomedical waste shall be transported only inUntreated biomedical waste shall be transported only invehicles authorized for the purpose by the competent authorityvehicles authorized for the purpose by the competent authorityas specified by the government.as specified by the government.

Untreated bioUntreated bio--medical waste shall not be kept/stored beyondmedical waste shall not be kept/stored beyonda period of48 hours.a period of48 hours.

If for any reason it becomes necessary to store the wasteIf for any reason it becomes necessary to store the wastebeyond such period, measures must be taken to ensure thatbeyond such period, measures must be taken to ensure that

the waste does not adversely affect human health and thethe waste does not adversely affect human health and theenvironment.environment.

Transportation & Storage of BMWTransportation & Storage of BMW


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Use/Reuse of

equipment

Unsafe collection Unsafe disposal

Biomedical Waste ManagementBiomedical Waste Management -- IssuesIssues


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Not considered importantNot considered important

Lack of interest from senior managementLack of interest from senior management

No ownership of the processNo ownership of the process

Awareness of problemsAwareness of problems

Appreciate the need for constant monitoringAppreciate the need for constant monitoring


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Segregation of waste not taken seriously at user levelSegregation of waste not taken seriously at user levelNon compliance with color codingNon compliance with color codingMonitoring segregation at sourceMonitoring segregation at source low budgets allocatedlow budgets allocated costs are not always knowncosts are not always knownCost of color coding, staff, transport and disposalCost of color coding, staff, transport and disposalQuantification of waste generated is not accurately doneQuantification of waste generated is not accurately done



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Protection of healthcare workers not given adequateProtection of healthcare workers not given adequatethoughtthoughtClinical waste dumped with non infectious wasteClinical waste dumped with non infectious waste -- Risk forRisk forhealthcare workers and publichealthcare workers and publicWaste disposal not effective, often dumped in open landfillsWaste disposal not effective, often dumped in open landfills



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Responsibility for waste disposalResponsibility for waste disposal head of facility, buthead of facility, butdevolved to members of the waste management teamdevolved to members of the waste management teamEach healthcare workerEach healthcare worker segregation and appropriatesegregation and appropriatedisposaldisposalPrivate companiesPrivate companies from collection point in hospital tofrom collection point in hospital todisposaldisposalMedical waste segregation awareness and InformationMedical waste segregation awareness and Informationshould be available in all areas of hospitalshould be available in all areas of hospital

Biomedical Waste ManagementBiomedical Waste Management -- responsibilitiesresponsibilities


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Challenges: Need for protocol and policiesChallenges: Need for protocol and policies

To provide protection forTo provide protection for

Healthcare workersHealthcare workers

PatientsPatients

Community at largeCommunity at large -- from the risk of infectionsfrom the risk of infections

Compliance with statutory requirementsCompliance with statutory requirements

Government of IndiaGovernment of India --1998 biomedical waste management1998 biomedical waste managementand handling rules under EPAand handling rules under EPA

(compels hospitals, clinics, labs to ensure safe and environmentally(compels hospitals, clinics, labs to ensure safe and environmentallysound management of waste generated at their establishments)sound management of waste generated at their establishments)


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ChallengesChallenges

Establishing robust waste management policies within theEstablishing robust waste management policies within theorganizationorganization Organization wide awareness about the health hazardsOrganization wide awareness about the health hazards Sufficient financial and human resourcesSufficient financial and human resources Monitoring and control of waste disposalMonitoring and control of waste disposal Clear responsibility for appropriate handling and disposal ofClear responsibility for appropriate handling and disposal ofwaste.waste.


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ADRESSING THE ISSUES

1. Need to build-up of a comprehensive system, addressresponsibilities, resource allocation, handling anddisposal

2. This is a long-term process, sustained by gradual

improvements.3. Specific personnel need to be assigned to monitor the

bio-medical waste management in the hospital.4. Man power needs and other resources for the BMWM of

hospital to be addressed.5. Quality assessment of bio-medical waste management

should be done from time to time.


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6. Segregated collection and transportation - The use ofcolor coding and labeling of hazardous waste.7. Clear directives in the form of a posters and notice to

be displayed in all concerned areas in English and locallanguages.

8. Safety of handlers.9. Raising Awareness about risks related to health-care

waste; training staff and HCW on safe practices.10.Selection of safe and environmentally friendly

management options, to protect people from hazardswhen collecting, handling, storing, transporting, treatingor disposing of waste.


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11.Issue of all protective clothes such as, gloves, aprons,masks etc. to all HCW.

12.Regular medical check-up (half-yearly) of staffassociated with BMWM.

13.Maintenance of Record registers for this purpose.14.Containers should be robust and leak proof15.Tracking of Bio Medical Waste upto point of Disposal.16.Proper treatment and final disposal.


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Thank you

Any Questions?


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OptionOption Waste CategoryWaste Category Treatment & DisposalTreatment & Disposal

Category No. 1Category No. 1 Human Anatomical WasteHuman Anatomical Waste

(human tissues, organs, body parts)(human tissues, organs, body parts)

incineration @/deep burial*incineration @/deep burial*

Category No. 2Category No. 2 Animal WasteAnimal Waste

(animal tissues, organs, body parts(animal tissues, organs, body parts

carcasses, bleeding parts, fluid, blood andcarcasses, bleeding parts, fluid, blood and

experimental animals used in research,experimental animals used in research,

waste generated by veterinary hospitals,waste generated by veterinary hospitals,

colleges, discharge from hospitals, animalcolleges, discharge from hospitals, animal

houses)houses)

incineration@/deep burial*incineration@/deep burial*

Category No. 3Category No. 3 Microbiology & Biotechnology WasteMicrobiology & Biotechnology Waste

(Wastes from laboratory cultures, stocks or(Wastes from laboratory cultures, stocks or

micromicro--organisms live or vaccines, humanorganisms live or vaccines, human

and animal cell culture used in research andand animal cell culture used in research and

infectious agents from research andinfectious agents from research and

industrial laboratories, wastes fromindustrial laboratories, wastes from

production of biologicals, toxins, dishes andproduction of biologicals, toxins, dishes anddevices used for transfer of cultures)devices used for transfer of cultures)

local autoclaving/microlocal autoclaving/micro--

waving/incineration@waving/incineration@

Category No. 4Category No. 4 Waste SharpsWaste Sharps

(needles, syringes, scalpels, blade, glass,(needles, syringes, scalpels, blade, glass,

etc. that may cause punture and cuts. Thisetc. that may cause punture and cuts. This

includes both used and unused sharps)includes both used and unused sharps)

disinfection (chemical treatmentdisinfection (chemical treatment

@@@/auto claving/microwaving@@@/auto claving/microwaving

and mutilation/shredding##and mutilation/shredding##

Category No. 5Category No. 5 DiscardedMedicines and Cytotoxic drugsDiscardedMedicines and Cytotoxic drugs

(Waste comprising of outdated,(Waste comprising of outdated,contaminated and discarded medicines)contaminated and discarded medicines)

incineration@/destruction andincineration@/destruction and

dru

gs disposal in secu

reddru

gs disposal in secu

redlandfillslandfills

ScheduleSchedule--II

CATEGORIES OF BIOCATEGORIES OF BIO--MEDICAL WASTEMEDICAL WASTE


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Category No. 6Category No. 6 Soiled WasteSoiled Waste

(items contaminated with blood,(items contaminated with blood,and body fluids including cotton,and body fluids including cotton,

dressings, soiled plaster casts,dressings, soiled plaster casts,

lines, bedding, other materiallines, bedding, other material

contaminated with blood)contaminated with blood)

incineration@autoclaving/microincineration@autoclaving/micro

wavingwaving

Category No. 7Category No. 7 Solid WasteSolid Waste

(Waste generated from disposal(Waste generated from disposal

items other than the sharps such aitems other than the sharps such atubings, catheters, intravenoustubings, catheters, intravenous

sets etc.)sets etc.)

disinfection by chemicaldisinfection by chemical

treatment@@treatment@@

au

toclaving/microwaving andau

toclaving/microwaving andmutilation/shredding##mutilation/shredding##

Category No. 8Category No. 8 Liquid WasteLiquid Waste

(Waste generated from laboratory(Waste generated from laboratory

and washing, cleaning,and washing, cleaning,

housekeeping and disinfectinghousekeeping and disinfecting

activities)activities)

disinfection by chemicaldisinfection by chemical

treatment@@ and dischargetreatment@@ and discharge

into drainsinto drains

Category No. 9Category No. 9 Incineration AshIncineration Ash

Ash from incineration of any bioAsh from incineration of any bio--

medical waste)medical waste)

disposal in municipal landfilldisposal in municipal landfill

Category No. 10Category No. 10 Chemical WasteChemical Waste

(Chemicals used in production of(Chemicals used in production of

biologicals, chemicals used inbiologicals, chemicals used in

production of biologicals,production of biologicals,

chemicals used inchemicals used in disinfection, asdisinfection, asinsectricides, etc.)insectricides, etc.)

chemical treatment@@ andchemical treatment@@ and

discharge into drains for liquidsdischarge into drains for liquids

and secured landfill for solidsand secured landfill for solids


CATEGORIES OF BIOCATEGORIES OF BIO--MEDICAL WASTE (continued)MEDICAL WASTE (continued)


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Note :Note :

@@ There will be no chemical pretreatment before incineration. ChlorinatedThere will be no chemical pretreatment before incineration. Chlorinatedplastics shall not be incinerated.plastics shall not be incinerated.

** Deep burial shall be an option available only in towns with population lessDeep burial shall be an option available only in towns with population less

than five lakhs and in rural areas.than five lakhs and in rural areas.

@@@@ Chemicals treatment using at least 1% hypochlorite solution or any otherChemicals treatment using at least 1% hypochlorite solution or any other

equivalent chemical reagent. It musts be ensured that chemical treatmentequivalent chemical reagent. It musts be ensured that chemical treatment

ensures disinfection.ensures disinfection.

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


CATEGORIES OF BIOCATEGORIES OF BIO--MEDICAL WASTE (continue)MEDICAL WASTE (continue)


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ScheduleSchedule--IIII

COLOUR CODING AND THE TYPE OF CONTAINER FOR DISPOSAL OF BIOCOLOUR CODING AND THE TYPE OF CONTAINER FOR DISPOSAL OF BIO

MEDICAL WASTESMEDICAL WASTES

ColourColourCodingCoding

Type ofType ofContainerContainer

WasteWasteCategoryCategory Treatment optionsTreatment options

YellowYellow Plastic BagPlastic BagCategoriesCategories1, 2, 3 & 6.1, 2, 3 & 6.

Incineration/ deep burialIncineration/ deep burial

RedRedDisinfectedDisinfectedcontainer/Plasticcontainer/Plasticbagbag

CategoriesCategories3, 6, 73, 6, 7

Autoclaving/MicroAutoclaving/Micro--waving/Chemicalwaving/ChemicalTreatmentTreatment

Blue/WhiteBlue/WhiteTranslucentTranslucent

Plastic BagPlastic Bag/puncture proof/puncture proofcontainerscontainers

Cat. 4,Cat. 4,Cat. 7Cat. 7

Autoclaving/MicroAutoclaving/Micro--waving/ Chemicalwaving/ ChemicalTreatment & Destruction / shreddingTreatment & Destruction / shredding

BlackBlack Plastic BagPlastic BagCategoriesCategories5, 9, 105, 9, 10

Disposal in secured landfill.Disposal in secured landfill.

Notes:1. Colour coding of waste categories with multiple treatment options asdefined in schedule 1, shall be selected depending on treatment optionchosen, which shall be as specified in Schedule I.2. Waste collection bags for waste types needing incineration shall notbe made of chlorinated plastics.3. Categories 8 and 10 (liquid) do not require containers/bags.

BM Waste Color Coding

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