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Biomedical waste management

Biomedical waste management. Presenter: Dr.L.Karthiyayini Moderator: Dr. A.Mehendale . Framework. Definition Burden of biomedical waste Sources of waste Types of health care waste & its health hazards Legislations Waste generation Principles of managing waste Waste minimization

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Biomedical waste management

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  1. Biomedical waste management Presenter: Dr.L.Karthiyayini Moderator: Dr. A.Mehendale

  2. Framework • Definition • Burden of biomedical waste • Sources of waste • Types of health care waste & its health hazards • Legislations • Waste generation • Principles of managing waste • Waste minimization • Managing sharps • Chemical disinfectants • Handling of health care waste • Waste segregation & labeling • Waste storage & transport • Waste treatment & disposal • Infection control • BWM at MGIMS • BMWM in national programs • Biomedical waste audit

  3. Definition “Any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological” [Source: Biomedical Waste (Management and Handling) Rules, 1998 of India]

  4. MAGNITUDE OF THE PROBLEM GLOBALLY: • Developed countries generate 1 to 5 kg/bed/day • Developing countries: 1-2kg/pt/day WHO Report: • 85% non hazardous waste • 10% infective waste • 5% non-infectious but hazardous. (Chemical, pharmaceutical and radioactive) • 2002, 22 countries, health care facilities not using proper disposal 18%-64%

  5. Hazardous waste generation

  6. INDIA: • No national level study • Hospitals generate 1-2 kg/bed/day • BMW generation : • 4,05,702 kg/day • 2,91,983 kg/day is disposed • 28% of the wastes is untreated • 53.25% HCE – not authorized

  7. Top 5 biomedical waste generating states

  8. Sources of biomedical wastes Major Sources: • Govt. hospitals/private hospitals/nursing homes/ dispensaries. • Primary health centres. • Medical colleges and research centres/ paramedic services. • Veterinary colleges and animal research centres. • Blood banks/mortuaries/autopsy centres. • Biotechnology institutions.

  9. Minor Sources: • Physician’s/ dentist’s clinics • Animal houses/slaughter houses. • Blood donation camps. • Vaccination centres. • Acupuncturists/psychiatric clinics/cosmetic piercing. • Funeral services. • Institutions for disabled persons

  10. Health hazards of various waste

  11. CATEGORIES OF BIO MEDICAL WASTE

  12. LEGISLATIONS ENVIRONMENTAL REGULATIONS FROM MoEF: • Environment protection act,1986: • Bio-medical waste management rules,1998(RENEWED 2011) • Municipal solid waste rules,2000 • Hazardous waste rules,1989 • EIA Notification, July 2004

  13. Bio-Medical Waste Rules 2011 • Elaborate, stringent and several new provisions have been added • Not applicable: • Radioactive waste, • Hazardous waste, • Municipal solid waste • Battery waste

  14. Accident reporting must • HCE- BMWM unit & meetings • Mandatory treatment & disposal • Adequate treatment facilities • Promote new technologies • Omitted- Incinerator & deep burial • District level monitoring committee • Allocation : Funds & Equipments • Lacking: guidelines for linen & mattress, blood bags & pressurized containers

  15. Schedules • Schedule I :Categories of Biomedical waste • Schedule II :Color coding • Schedule III :Labels for Hazardous waste • Schedule IV :Label for transport of BMW container/bags • Schedule V :Standards for – incineration , autoclaving, sewerage, deep burial • Schedule VI :Deadlines for implementation

  16. SCHEDULE IIILABEL FOR TRANSPORT OF BIO-MEDICAL WASTE CONTAINERS BAGS

  17. SCHEDULE-IV LABEL FOR TRANSPORT OF BIO-MEDICAL WASTE CONTAINERS BAGS • Day... ...Month ….……. Year…………Date of generation • Waste category No ... Waste Class ……… • Waste description …………………………………………………. • Sender's Name & Address • Receiver's Name & Address . • In case of emergency please contact……….

  18. Forms • FORM-I : Application for authorization/ renewal of authorization • FORM II : Annual report(To be submitted to the prescribed authority by 31 January every year • FORM III :- Accident reporting • FORM IV: Authorization granting format • FORM V : Application for filing appeal against order passed by the prescribed authority • FORM VI: Operator of CBMWTF filing against HCE- if no proper segregation

  19. ANNEXURE-I

  20. ANNEXURE-II • GUIDELINES FOR DESIGN AND CONSTRUCTION OF BIO-MEDICAL WASTE INCINERATOR • Air Pollution Control Device (APCD) • Emission limit - 150 mg/Nm3 (corrected to 12% CO2) for Particulate Matter

  21. BMW Rules 2011 vs. 1998

  22. COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIOMEDICAL WASTES

  23. Colour Coding and Type of Container for Disposal of BMW

  24. Number of CTF against HCEs in major states

  25. PRINCIPLES OF MANAGING HEALTH CARE WASTE • Waste minimization • Safe reuse & recycling • Managing sharps

  26. Waste minimization • Source reduction • Management and control measures at hospital level • Stock management of chemical and pharmaceutical products

  27. SAFE REUSE & RECYCLING Sterilization methods for reusable items: Thermal sterilization • Dry sterilization - Exposure to 160 °C for 120 minutes or 170 °C for 60 minutes in a “Poupinel” oven. • Wet sterilization - Exposure to saturated steam at 121°C for 30 minutes in an autoclave. Chemical sterilization • Ethylene oxide - Exposure to an atmosphere saturated with ethylene oxide for 3–8 hours, at 50–60°C, in a reactor tank • Glutaraldehyde - Exposure to a glutaraldehyde solution for 30 minutes

  28. Managing sharps Auto disable syringes

  29. Disposables syringes

  30. Glass syringes

  31. In 2000, WHO estimation-injections with contaminated syringes caused: • 21 million hepatitis B virus (HBV) infections (32% of all new infections) • two million hepatitis C virus (HCV) infections (40% of all new infections) • 260 000 HIV infections (5% of all new infections). • One needle stick injury risks: • 30% -HBV • 1.8% -HCV • 0.3% -HIV. 

  32. Handling of health care waste

  33. Waste generation globally

  34. Quantity of waste generation in a 30 bedded CHC

  35. Average composition of hospital waste in India

  36. Steps of waste management

  37. Segregation

  38. Collection

  39. Storage

  40. Transport

  41. DEEP BURIAL PIT

  42. Disinfectants commonly used for disinfection of materials contaminated with blood & body fluids

  43. Infection control • Hand washing • Personnel protective equipment • Safe handling of waste • Prevention of needle stick injuries • Environmental cleaning & spillage management • Proper training to health care workers • Immunization of health care workers

  44. Hospital waste management structure

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