Biomedical Waste Management

Biomedical Waste Management

Biomedical waste, (BMW), consists of
solids,
liquids,
sharps, and
laboratory waste
that are potentially infectious or dangerous

Occupational Hazard
It must be properly managed to protect
the general public,
specifically healthcare and
sanitation workers
who are regularly exposed to biomedical waste
 Types of Waste Generated
Two types
– General Waste
– Biomedical Waste

Classified into
– Non-infectious Waste
– Infectious Waste
ELEMENTS OF BMW MANAGEMENT

Segregation
Transportation
Pre-treatment
Treatment
Final Disposal
 Categories (Schedule -1)
Option Waste Category

Category No. 1 Human Anatomical Waste

(human tissues, organs, body parts)

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)
Category No. 3 Microbiology & Biotechnology Waste
(Wastes from laboratory cultures, stocks or micro-
organisms live or vaccines, human and animal cell
culture used in research and infectious agents from
research and industrial laboratories, wastes from
production of biological, toxins, dishes and devices
used for transfer of cultures , vacutainers)
 Categories conti
Option Waste Category
Category No. 4 Waste Sharps
(needles, syringes, scalpels, blade, glass,
etc. that may cause puncture and cuts. This
includes both used and unused sharps)

Category No. 5 Discarded Medicines and Cytotoxic

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(Waste comprising of outdated,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

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)
 Categories conti
Option Waste Category
Category No. 7 Solid Waste
(Waste generated from disposal items other than the
sharps such as tubings, catheters, intravenous sets
etc.)
Category No. 8 Liquid Waste
(Waste generated from laboratory and washing,
cleaning, housekeeping and disinfecting activities)

Category No. 9 Incineration Ash

Ash from incineration of any bio-medical waste)

Category No. 10 Chemical Waste

(Chemicals used in production of biological, chemicals
used in production of biological, chemicals used in
disinfection, as insecticides, etc.)
 Segregation (Schedule –II)
Color Type of Waste Category Treatment options as
Coding Container per Schedule-I
Yellow Plastic bag Category 1, 2 and Category 3, Incineration/deep burial
6
(infected non plastic waste)
Blue Disinfected Category 7 Autoclaving/Microwaving/
container/Plastic (plastic waste) Chemical Treatment
bag
Plastic bag Unbroken glass Disposal in secured landfill
White
Black Plastic bag Category 5, 9 and Category 10 Disposal in secured landfill
(general waste)
White Puncture proof Category 4, Autoclaving/Microwaving
container (sharps and glass) Chemical Treatment and
destruction/shredding
 BIOHAZARD SYMBOL CYTOTOXIC HAZARD SYMBOL

BIOHAZARD
CYTOTOXIC

HANDLE WITH CARE

Note: Label will be non-washable and prominently visible.

 Segregation in In-Patient Departments
• For an effective waste management practice segregation has
to done at the point of generation itself.
• Therefore bins for both infectious and non-infectious waste are
placed in all the wards.
• Bin is kept beside the bed side to collect only the non-
infectious waste like fruit peels, papers etc., unless the patient
is classified as infectious.
• Bins for the infectious wastes will be kept in a specific location
(for example the nursing station) so that it is easy to carry
them to the patient where the dressing is being done or the
soiled dressings generated from the patients be carried to the
infectious waste bin in a tray from the point of generation.
Segregation in Intensive Care Unit
• The bins for infectious and non-infectious waste will be
located near the nurses' duty room in the ICU to prevent
the spread of infection amongst the patients.
• The IV tubing’s and catheters and used syringes will be
kept separately in a container from where they are
disposed
• All the sharps and glass ampoules will also be placed in
separate puncture proof containers. The syringes and
the needles will be disposed into PPC .
• All these bins will be cleaned after every shift or the
moment these bins become 3/4th full.
 Segregation in Operation Theatres
• The waste generated in OT is decontaminated and disposables properly
disinfected and destroyed
• Bins for infectious waste will be lined with yellow bags and these bins will
contain contaminated swabs, soiled bandages and amputated body parts.
• The bags with waste will be sealed and stored outside the O.T to prevent
liberation of bacteria during handling.
• Used instruments and sharps will be
- Counted after surgery
- Washed under running tap water
- Placed in a tray, sealed in bags and sent for autoclaving
• A separate container for IV sets, tubing's catheters gloves and syringes will be
provided in the O.T.
• After shredding these disposables will be treated with a chemical disinfectant
for at least an hour and then sent for their final disposal
• A bin for general waste is kept in the O.T. in which all the packaging material
will be collected.
• In the changing room contaminated laundry will be placed in the laundry bag
which will be sealed in waterproof bags and sent to the laundry for cleaning.
 Segregation in Out Patient Departments
• The OPD also includes casualty/emergency ward.
• Each room in the OPD should have bins for infectious waste which
includes soiled bandages, another bin for general waste and the third bin
for the disposable items and used gloves which can be mutilated and
disinfected at regular intervals by a nursing-aid attendant
• The used needles and syringes will be placed separately in PPC
• There should be a tray for needles and other sharps. While treating a
patient in the emergency the hospital staff should always wear protective
clothing and gloves as the patient could be a carrier of any infectious
disease
• The waste disposal scheme in this area is as follows
– Segregation of the waste into different categories
– Provide specific collection and disinfection systems for each type of waste
generated.
– There will be distinct containers for different types of waste
– The design of containers should depend on the type of waste and disinfection
method
– The number of bins should be proportional to the waste generated in the
casualty
 Transportation
 The waste is transported in covered trolleys
having biohazard symbol.
 It is collected twice a day or whenever the
container is 3/4th full.
 The plastic bag also has a label indicating the
source of generation & type of waste.
 The outsourced agency (Semramkey) vans
come once a day around 2.00 pm to collect
waste and it is weighed before collection.
 On Site Transportation of Waste
• Segregated wastes have to be transported
within the facility from the point of generation
to the final waste disposal site.
• All bags should be fastened, small trolleys can
be used or the bin themselves be carried.
• Care must be taken to avoid spills.
• Non­-infectious waste should not be
transported with infectious waste.
 Label for Transportation (Schedule –IV)
LABEL FOR TRANSPORT OF BIO-MEDICAL WASTE CONTAINERS/BAGS
Waste Category No. ...................... Day ................. Month ................
Waste Class ................................. Year ..........................................
Waste Description ......................... Date of generation .......................
Sender's Name & Address ............... Receiver's Name & Address ............
.................................................. .................................................
................................................. .................................................
Phone No. ................................... Phone No. ...................................
Telex No. .................................... Telex No. ....................................
Fax No. ...................................... Fax No. ......................................
Contact Person ............................ Contact Person ............................
In case of emergency please contact:
Name & Address ...........................
.................................................
.................................................
Phone No. ...................................

Note : Label will be non-washable and prominently visible.

 Guidelines for Transport of Waste
• Each shift housekeeping staff will collect the waste from a
particular area, it will be wheeled downstairs to the ground
floor where it will be weighed and transferred to the
appropriate colored bin in the waste holding room. This will
be done each shift.
• Housekeeping staff should wear a protective mask, heavy
duty gloves, and rubber boots.
• A large plastic bag will be used to line the wheel-able bin to
prevent any liquid leaks from the waste bags from soiling the
bin.
• This plastic bag is to be replaced each shift.
• To keep the bin sterile and odourless, the wheel-able bin will
be cleaned and disinfected with Sodium hypochlorite solution
once in 24 hrs.
 Storage of Waste
• Blue, Yellow and Black waste will be held in
the bins kept permanently in waste holding
room. Sufficient no. of bins will be kept to
store waste for a period of 48 hrs.
• Kitchen waste will be placed in designated
bins and will be stored for a maximum of 48
hrs.
• All plastic bags are to be tied securely and the
lid of the bin is to be firmly shut.
 Handling of Infectious Waste
• Infectious waste has to be kept separately in bins with lid and
lined with Yellow Colored polythene bags wherever needed.

The following special precautions are to be adopted with respect

to infectious wastes
– Proper labelling of waste containers minimize confusion in handling
and disposal of waste
– Under no circumstances should the infectious waste be mixed with
the non-infectious waste
– The bag lining the bin should be only 3/4th full to ensure that the
waste does not spilt out
– While carrying the bag containing infectious waste it has to be seated
/ tied.
– The bags containing infectious waste should be collected and stored
at the BMW storage area, finally disposed off to the BMW collection
agency for incineration.
 Handling of Disposal Items
• Disposable items include single use products i.e.
– syringes, IV bottles, catheters, rubber gloves and. sharps, (sharps have
to. be treated separately)
• As such items are often recycled and have the risk of being
reused illegally, it is imperative that chemical disinfection be
followed to minimize the risk of infected / contaminated
disposal items prior to collection / segregation.
The following on site disinfection procedure should be followed
prior to their collection & segregation
– The disposables of HIV, Hepatitis B&C, ESBL +ve, VRE +ve
patients are dipped for a minimum duration of 1 1/2 to 2
hour in the chemical disinfectant solution of 1% NAOCL
(Sodium Hypochlorite) .
– Bins that are used for chemical disinfection are a set of twin
bins, one inside the other, with the inner one being
perforated and easily extractable.
– Disposable items like the gloves, syringes, IV bottles,
catheters ICD,s etc have to be shredded cut or mutilated to
avoid reuse under any circumstance. The fingers of the used
gloves should be cut, and the same should be done for other
disposable items.
– Once the disposable items have been snipped they have to
be dipped in an effective chemical disinfectant for a
sufficient time
– Extreme care should be taken while handling the needles
and syringes, since most injuries occur between the point of
use and disposal.
– Blood bags /sharps should be handled with proper
protection.
– This helps ensure, that the bleach solution in the outside bin
permeates the inner bin containing the disposable items and
minimizes contact when the contents are being removed.
 Waste Treatment

Final treatment is done by the waste

treatment agency (Sembramky agency)
Treatment of the Biomedical Waste will
be done by the following methods
– Incineration
– Autoclaving
– Microwaving
Training and Awareness of Personnel
• Training is a vital step in the process of implementing a
waste management system. Through awareness and
training programmes, existing mindsets are changed or
broadened. Proper training will make the transition to the
new scheme easier.
• The training program involves:
• Teaching
• Discussions
• Feedback
• Training and awareness programme is to train and
promote awareness of staff regarding waste segregation
& disposal - a new concept in Hospital Waste
Management.