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By Caroline Karunya Ponnarasi Kanagaraj Group-IV IIIrd year 3/18/2015 done by LORD JESUS 1 BIO-MEDICAL WASTE MANAGEMENT IN INDIA

Biomedical waste

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Page 1: Biomedical waste

By

Caroline Karunya Ponnarasi Kanagaraj

Group-IV

IIIrd year

3/18/2015 done by LORD JESUS 1

BIO-MEDICAL WASTE

MANAGEMENT IN INDIA

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INTRODUCTION• Biomedical Waste (BMW):

– Any solid or liquid waste which may present a threat to humans, including non-liquid tissue, body parts, blood, blood products, and body fluids from humans and other primates; laboratory and veterinary wastes which contain human disease-causing agents; and discarded sharps.

• Sources of generation of Bio-medical wastes:

– Hospitals, Nursing Homes, Veterinary Hospitals, Dental Clinics, Pathological & Diagnostic Laboratories, Blood Bank etc.

• Type of Health Care Waste:

– These are of two types (i) Infectious Wastes (ii) Non-infectious Wastes3/18/2015 done by LORD JESUS 2

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HEALTH CARe WASTES• INFECTIOUS HEALTH CARE WASTES (Bio-medical Waste):

– Human anatomical / surgical waste, Animal waste

– Pathological waste including tissues, organs, blood and body fluids, microbiologicalcultures, Cotton,Swabs etc.

– Used Syringes, I.V. tubes, Blood bags and other items contaminated with blood and bodyfluids.

– Items such as plaster, casts and bandages, when contaminated by blood and pus.

– Waste from isolation wards.

The amount of infectious waste is near about 25% of the total wastes generated from a health careestablishment.

• NON-INFECTIOUS HEALTH CARE WASTE:– Non-infectious waste is broadly classified as Kitchen waste and Office wastes. It is

similar to household waste. Non-infectious wastes constitutes nearly 75% of the total wastes generated from a health care unit.

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BIO-MEDICAL SURVEY• The All India Institute of Hygiene and Public Health, Kolkata conducted a

study on Hospital Waste Management in W.B., sponsored by the WBPCB in theyear 1996-97 and concluded that:– General waste containing food wastes, paper, plastics, floor sweeping, discarded

glassware, earthen pot etc. constitute bulk (56-78% by weight) of the hospital waste.

– Waste generated in large government hospitals in Kolkata, is 1044 gms/bed/day whereaswaste generated in large government hospitals in districts is comparatively low at 397gms/bed/day.

– Certain salvageable items like saline bottles, surgical gloves, I.V. fluid bottles syringesetc. are disposed

– after use in the wards without distorting or damaging. As a result, there remains apossibility of reuse of the said items.

– Incinerable waste constitutes 19-30% (by weight) of the total waste generated.

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HEALTH IMPACTS OF BIO-MEDICAL WASTE

• Exposure to infectious BMW can result in disease or injury. It maycontain:– infectious agents, toxic or hazardous chemicals or pharmaceuticals, radio active

wastes and waste sharps.

• The infectious wastes may contain any of the great variety of pathogenicmicroorganisms. Pathogens in infectious wastes may enter the humanbody through a number of routes like a puncture or cut in the skin,mucous membranes, by inhalation or ingestion.

• Sharps may not only cause cuts and punctures but also infect the woundsif they are contaminated with pathogens. Because of this dual risk – ofinjury and disease transmission – sharps are considered as averyhazardous waste class.

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HEALTH IMPACTS OF BIO-MEDICAL WASTE

• Poor hospital waste management may cause the following:– Hepatitis B & C

– HIV infection

– Gastro-enteric infection

– Respiratory infection

– Blood stream infection

– Skin infection

– Radioactive toxicity

– Health problems associated with air and water pollution.

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HEALTH IMPACTS OF BIO-MEDICAL WASTE

Decomposing waste may generate foul odour inside the hospital premises andsurrounding area.

Drains may be clogged with waste materials creating an unhygienic environment inthe surrounding hospital premises. This phenomenon may also help in the breedingof mosquitoes/flies that might contribute to the spread of infectious diseases.

Waste dump may attract stray animals and birds that might spread waste materialsleading to an unaesthetic and unhygienic environment.

Indiscriminate disposal of pharmaceutical products (antibiotics and cytotoxic drugs)and discharge of

untreated wastewater generated from the health care units could have disastrousecological effects.

Open dump of waste may decompose to produce leachate that might contaminateground water.

Uncontrolled and open burning of wastes can generate dioxins and furans, thuspolluting the air.3/18/2015 done by LORD JESUS 7

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Rules framed for the BMW management

• Realizing the seriousness of the problem associated with the poor management of the bio-

medical wastes , the Ministry of Environment and Forests (MoEF), Govt. of India, notified

the Bio-Medical Waste(Management and Handling) Rules in July 1998 under the

Environment (Protection) Act, 1986, through a Gazette notification [S.O. 630(E)].

• Thereafter, the Bio-Medical Waste (Management and Handling) Rules were amended twice in

the year 2000 and the last amendment was made in the year 2003.

• The first amendment was published on 6th March 2000 vide S.O. 210(E), the second

amendment was published on 2nd June 2000 vide the Gazette Notification S.O. 545(E) and

third Amendment was published on 17thSeptember 2003 vide Gazette Notification S.O.

1069(E).

• The main objective of the rules are to ensure proper segregation, collection, transportation

and disposal of the infectious BMW in order to safe guard the public health of the

society.3/18/2015 done by LORD JESUS 9

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Segregation of Bio-medical Wastes

Bags/Bins Type of wastes Treatment

Yellow Bags Anatomical waste incineration (for cities with population more than 5lakhs) or Deep Burial Pit

Red Bags Infectious wastes Autoclaving or Micro Waving followed byShredding

Blue/White Punctureproof containers

Sharp wastes Mutilating and disinfecting by Chemical treatmentand then Autoclaving or Micro Waving

Black bins For normal MSW/kitchen wastes

Disposal in MSW disposal ground

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Yellow Bag(Incineration/Deep burial)

Blue Bag(Autoclaving)

Puncture proof Containerfor sharp waste(Autoclaving after chemicaltreatment)

Human Anatomical waste (Humantissue, organs, Placenta,body parts)Specimens from

laboratory/researchcentreSurgical Waste

Blood contaminated CottonBlood contaminated BandagesSoiled PlastersBlood contaminated DressingAnatomical waste (Animal tissue,organs, body parts, etc.)Discarded medicine (solid)

SyringesUrine bagsCathetersI.V. fluid bottleBlood BagsStents

GlovesApronsAny other tubing

NeedlesCut glassBladesScalpelsSlidesLancetsGeneral wastes of health care unit keptin Black coloured bagSegregated incinerable wastes keptin Yellow

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Segregated incinerable wastes kept in Yellow coloured bag

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Segregated Autoclavable wastes

kept in Blue coloured bag

General wastes of health care

unit kept in Black coloured bag

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TREATMENT AND DISPOSAL OF BMW

• The Bio-medical Wastes are broadly classified into :

– incinerable wastes

– autoclavable wastes.

• The incinerable wastes :

treated by incinerator or through deep burial pit as per the provisions of the Rules.

The waste incinerator shall have a dual chamber i.e. primary chamber & secondary

chamber.

The temperature of the primary chamber shall be 800 ± 50 0C and the temperature of

the secondary chamber shall be 1050 ± 50 0C.

The incinerator shall have adequate pollution control devices to control environmental

pollution.

No chlorinated plastic shall be incinerated in order to prevent formation of Dioxins &

Furans.3/18/2015 done by LORD JESUS 13

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TREATMENT AND DISPOSAL OF BMW

• The autoclavable wastes(non-incinerable BMW) can be treated by Autoclave/ Microwave/Hydroclave etc.

• The waste autoclave may be of two types:

Gravity Flow Autoclave

Vacuum Autoclave.

• Normally vacuum type autoclave is used for the treatment of non-incinerable wastes. The temperature,

pressure & time which are required for treatment of BMW are either 121 0C, 15 psi & 45 minutes or 135 0C, 31 psi & 30 minutes

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Waste handling at Common facilityWaste AutoclaveA work man working with incinerator in madurai

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Incinerator with Air Pollution Control Device

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Chimney for Incinerator

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Case study• In 2003, a rag-picker, but for whose tribe Mumbai would have been a dirtier place

despite having a civic body in place, found a human hand on a garbage dump. The incident raised a hue and cry which brought to light the fact that the city’s healthcare system did not give a damn about how it disposed of its biomedical waste.

• Two years down the road, a child from a city slum, playing near the garbage dump, picked up a thing with a pointy end and playfully sprayed his friend with its content. That cost his 7-year-old pal his eye, all in innocent but decidedly deadly fun. When a social worker took up the blinded boy’s cause, it once again focused attention on biomedical waste management practices in the city. The law demands the segregation of such waste, and placing them in differently coded bags for disposal.

• These two cases relate to what was seen and done on garbage heaps. Things that ought not to have arrived there at all had found their way there. The hospital concerned and the city’s solid waste managers had failed again.

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Nine years on, have there been any noticeable improvements in this scary scenario?

• NO

• WHY???

• Lets think!!!!

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conclusion

• As a future doctors try to practice and imply in your own hospital.

• Encourage your collegues to know about this and make them to follow this law.

• Don’t become a reason for: a healthy to become unhealthy

“Let the waste of the “sick” not contaminate the lives of “The Healthy”

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