Presentation

on

Common Bio Medical Waste / Hospital Waste Management Operations In India

By

CH.LAKSHMINARAYANA

SMS ENVOCARE LTD.,INDIA

CONTENT OF THE PRESENTATION

1. BIOMEDICAL WASTE:

2. HOSPITAL WASTE:

3. NEED FOR COMMON BIOMEDICAL WASTE MANAGEMENT FACILITIES

4. REGULATORY NORMS FOR BIOMEDICAL WASTE MANAGEMENT IN INDIA

5. INFRASTRUCTURE

6. PROCESS FLOW & OBJECTIVES OF CBMWF

7. OPERATIONS

8. TECHNICAL SPECIFICATIONS OF EQUIPMENTS

BIOMEDICAL WASTE

• Bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, and including categories mentioned in Schedule I;

• Bio-medical waste treatment facility" means any facility wherein treatment. disposal of bio-medical waste or processes incidental to such treatment or disposal is carried out.

HOSPITAL WASTE

• Medical waste is all waste materials generated at health care facilities, such as hospitals, clinics, physician's offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories.

CATEGORIES OF BIO-MEDICAL WASTE

Category No. 1

Human Anatomical Waste:

Human tissues, organs, body parts

Treatment/Disposal: Incineration

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

Treatment/Disposal: Incineration

Microbiology &

Biotechnology Waste

Wastes from laboratory cultures,

human and animal cell culture,

infectious agents from research and

industrial laboratories, wastes from

production of biologicals, etc

Treatment/Disposal:

Disinfection at source by Chemical

treatment/ autoclaving /microwaving/after

treatment final disposal at secured land fill

Category No. 3

Waste Sharps: Needles, syringes, scalpels,

blade, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps

Treatment/Disposal: Disinfecting(chemical

treatment/autoclaving/ microwaving and mutilation/ shredding-Sharp Disposal Pits

Category No. 4

Discarded Medicines and

Cytotoxic drugs:

Waste comprising of outdated, contaminated and discarded medicines

Treatment/Disposal:

Incineration@/disposal in secured landfills.

Category No. 5

Soiled Waste:

Items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, bedding, other material contaminated with blood)

Treatment/Disposal:

Incineration@

Category No. 6

Solid Waste: Waste generated from

disposal items other than the sharps such a tubings, catheters, intravenous sets etc.

Treatment/Disposal: Disinfecting by chemical

treatment/autoclaving/ microwaving and mutilation/ shredding# #

Category No. 7

Chemical Waste : Chemicals used in

production of Biologicals /chemicals used in disinfection as insecticides.

Treatment/Disposal: Disinfecting by chemical

treatment and discharge into drains.

Category No. 8

NEED FOR COMMON BIOMEDICAL WASTE MANAGEMENT FACILITIES

• This waste can not be mixed with other waste. • Different categories required different treatment • It is infectious waste. • It Can create epidemics

REGULATORY NORMS FOR BIOMEDICAL WASTE MANAGEMENT IN INDIA

Ministry of Environment and Forests has revised the Bio Medical Waste (Management and Handling) Rules promulgated under the Environment Protection Act of 1986. These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form. The Rules now called the Bio Medical Wastes (Management and Handling) Rules 2011.

INFRASTRUCTURE FOR FACILITY

1. Incinerators

2. Autoclaves

3. Shredders

4. DG set & Power Room

5. Transportation vehicles

6. Intermediate storage sheds

7. Treated waste storage shed

8. Segregation room

9. Site security building

15

10. ADM & laboratory building

11. Treatment equipment room

12. Weigh bridge

13. Effluent treatment plant

14. Vehicle cleaning facility

15. Parking shed

16. Green belt

17. Wash room for workers

18. Work shop

19. Fire & safety

Collection &

Transportation Waste

Receiving Autoclave

Incineration

landfill

Rejects

Yellow Bags

Air Pollution

Control Units

Ash

Stack

Shredder Red Bags

Process Flow Diagram at Facility

Mixed Waste

Sharp Pit

PROJECT- OBJECTIVES

To collect & Transport the Biomedical Waste From Health Care Facilities.

To ensure proper storage of the wastes as per their classification, characterization and compatibility.

To decide the treatment and disposal scheme of wastes as per the regulations

To optimize the treatment and disposal cost by management practices and provide the economical services to the hospitals.

To conduct the public awareness program To Dispose Incinerator Bottom Ash in scientific

manner at Secured Landfills. Pollution Free facility. Saving Natural Resources by recycling systems. To register all the health care facilities as the member

of the CBMWTSDF 17

OPERATIONS

MARKETING

A marketing team shall be responsible for:-

To Register the Health Care Units as Member of facility.

To Visit HCU for trouble shootings.

Take feedback from doctors for quality on services for continual improvements.

Provide necessary training to the hospital staff handling waste at the health care

Units.

Supply barcoded biodegradable bags to track the necessary information and

keep it in records.

Bags shall have the details of the wastes which type of waste can be put in.

To Show the Tele Film On Bio Medical Waste Management.

Distribution of bills at door step and payment collection services

19

RECORD KEEPING

All the records of receipt, treatment and disposal of waste

will be maintained as per the prescribed guidelines

Log book will be maintained for incinerator, autoclave,

shredder etc.

All the records will be maintained in electronic media also.

The master & daily operation data shall be maintained in

software.

Data log sheet shall be maintained at vehicle level.

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ENCOURAGE SEGREGATION AT SOURCE

Waste will be segregated at source in the color coded bags as

per norms by providing the training & in printed bags by the

HCU.

Sturdy, re-usable, color coded containers will be encouraged

where ever possible.

Waste will be segregated at all patient care activity areas,

diagnostic service areas, operation theatres, labour rooms,

treatment rooms etc.

Provide training to the staff of all HCU’s.

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SEGREGATION OF HEALTH CARE WASTE

ALL BODY PARTS YELLOW BIN

TRANSPORT VEHCILES AND TROLLEYS

on-site waste collection service will be provided.

Collection schedule will be circulated in advance.

Specially designed collection vehicle will pick up the waste daily

basis.

More frequent collection will be provided for larger

establishments if desired.

Special pack body vehicles for Collection will be provided with

GPS tracking system.

Vehicles will be provided with mobile phones and PPE’S and

TREM card

Every vehicle will be provided with one trained driver and

one helpers, which ensures the safe collection

The collection vehicle reach the facility by evening and the

treatment starts immediately, leaving no chances for

storage.

The incinerable waste (yellow bag) is unloaded near the

incinerator

The autoclave waste (red bag) is unloaded near the

autoclave

TRANSPORT VEHCILES AND TROLLEYS

Transportation Fleet

I

D

Transportation Fleet &

Trolleys

TECHNICAL SPECIFICATIONS OF EQUIPMENTS

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1. Type & Model "controlled air Oil Fired

Incinerator Model BMW-200

2. Type of Waste Common Bio Medical Waste

3. Burning Capacity 200 kgs/hr.

4. Auxiliary Fuel Diesel

5. Type of Burner Operation Monoblock fully automatic

burners

6. Temperature Primary

Chamber Secondary Chamber

800°C+50°C 1050°C+50°C

DETAILS OF INCINERATOR

INCINERATOR

I

D

PC

C

INCINERATOR

SCC

Recirculation

Pump

V

S

P

a

c

k

B

e

d

I

D

FST

AUTOCLAVE & BABY BOILER

Type of autoclave

Fully automatic horizontal in shape with auto &

manual lock system having high pressure

55Psi/high vacuum 712 mm WC type steam

sterilizer with saturated steam temp, of

150°C.

Capacity 300kg

Material of Construction

of PCC & SCC

The casing will be of S.S. - 316L grade with

Glass wool insulation covered with polished

S.S. with PLC.

Operating System PLC

Baby Boiler Details

Baby boiler: L.D.O./H.S.D. fired PLC regulated

standard company non IBR of 150kg/hr. dry

steam capacity with design temp. &

pressure of 200°C and 9kg/sq.cm

respectively

• operating temperature of 121/134º C and a

working pressure of 1.2/2.1 kg/cm2.

• The unit shall have a single door with

radial locking system.

• The autoclave shall be controlled

with computers.

• The equipment shall be provided with indicators

and recording system for residence time,

temperature and pressure.

AUTOCLAVE

AUTOCLAVE

SHREDDERS

The shaft is made of high strength steel alloys fitted with

cutters having angular way.

Cutters are made of High speed steel which is heat treated to

avoid damage due to sharp, shreded waste, syringes, scalpels,

glass vials, I.V. sets, rubber gloves, plastic materials, etc.

Special Hoppers designed for shredder with Ramp assistance

to push the material in cutting chamber.

Trolley is provided for handling shredded material.

External paneling covers are fitted for operator’s safety.

The shredder is supplied with control unit.

SHREDDERS

Sharp Pit Encapsulation

• The sharp management pit shall

be developed in phase manner.

• This underground pit is

constructed with RCC .

• It is covered from top, provided

with the air ventilation pipe.

• The sharps are disposed in to this

pit for longer period.

• Once the pit is full the new pit

shall be constructed.

SHARP-DISPOSAL PIT

EFFLUENT TREATMENT PLANT

The effluent treatment plant treats the liquid effluent from all

sources like:

Waste water from autoclave sterilization

Liquid waste from shredders

Waste water after disinfecting the transport vehicles

Waste water from scrubber installed in the incinerator

Floor washing etc.

The ETP system shall be designed with zero-discharge process.

It shall have physico-chemical treatment followed by PSF and ACF.

EFFLUENT TREATMENT PLANT

I

D

Bags are not labeled as per BMW rules. The labels should contain all the

details.

Needles should be separated by using needle cutter or burner and to be

given in puncture proof container, these are not being given accordingly.

Anatomical waste is not being given in yellow colour bags in some cases.

Bottles/ sharps/Metal containers are not segregated, this will damage the

refractory.

Gloves/ syringes found in yellow bags without segregation.

some times general waste is coming along with biomedical waste.

Subsequently increasing diesel consumption for incineration.

OBSERVATIONS AT ALL BMW FACILITIES

BMW bags are not packed properly and there are leakages.

Colour coded bags are not being used as prescribed. Yellow bags for

incineration and Red bags for autoclave.

IV sets/IV Bottles/syringes etc. being sold to unauthorized vendors.

OBSERVATIONS AT ALL BMW FACILITIES

,

CLASSIFICATION OF HEALTH CARE WASTE:

Hazardous waste (10-15%)

Non-hazardous waste (70-80%) I

Infectious (15-20%)

Other hazardous (5-7%)

Sources of Bio-Medical Waste

Govt. hospitals ,Private hospitals, Nursing homes

Physicians/Dentist clinics , Dispensaries

PHC Medical research &training establishment, Mortuaries

Blood banks, collection centers , laboratories

Animal houses, slaughter houses.

Conclusion

Prevent and minimize waste generation

Reuse or recycle the waste, to the extent possible.

Treat waste by safe and environmentally sound methods.

Dispose off the final residue by land fill in confined and carefully designed sites.

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THANK YOU

For Further Information Please Contact:- Ch.Lakshminarayana SMS Envocare Ltd. 20, IT Park | Parsodi |Nagpur |Maharashtra | India Ph +91 -712-6665000 Fax +91-712-6665100 Mb.+91-9922901553 Mail:-lakshminarayana.chimalkonda @smsl.co.in Web:-www.smsenvocare.co.in