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“BIOMEDICAL WASTE MANAGEMENT- REGULATORY COMPLAINCE &

MANAGEMENT OF BMW FACILITIES ”

Dr LAKSHMI RAGHUPATHYFormer Director, MoE&F

Adviser, Environment Managment

FAQ – BIOMEDICAL WASTES • What is biomedical waste?• Is bio-medical was infectious?• Need for mgt of bio-medical wastes• Why segregate?• What does the color code signify?• Why use separate containers?• What is the safe method for Sharps disposal?• What is the maximum storage time for BMW?• What is Treatment & Disposal facility?• What are the advantages of Common facility?• How and where to locate facility ?• How to transport BMW to common facility?• How to reduce BMW?

WHAT IS BIOMEDICAL WASTE? BIOMEDICAL WASTES are wastes, which are 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 biologicals and including categories mentioned in Schedule 1

� Bio-medical wastes are infectious and hazardous - need to be managed carefully

BIOMEDICAL WASTESREGULATIONS

• BIOMEDICAL WASTES (M&H) RULES 1998 - E(P) ACT 1986 as amended in 2000, 2003– MOE&F- NODAL AGENCY– PRESCRIBED AUTHORITY-IMPLEMENTATION

These rules provide a system for regulating handling BMW which includes collection, segregation at source, norms for packaging labeling and options for treatment and disposal along with the standard for treatment technologies.– For proper management & Handling of Bio-Medical Waste. – Applicable to all persons who generate, collect, receive,

store, transport, treat, dispose or handle bio-medical waste in any form.

BIOMEDICAL WASTE HANDLING(CRADLE TO GRAVE)

• CHARACTERIZATION• QUANTIFICATION• SEGREGATION• STORAGE• TRANSPORTATION• TREATMENT• DISPOSAL

BIOMEDICAL WASTE CATEGORIES10 WASTE CATEGORIES

CAT1 HUMAN ANATOMICALCAT2 ANIMALCAT3 MICROBIOLOGY &BIOTECHNOLOGYCAT4 WASTE SHARPSCAT5 CYTOTOXICDRUGS & DISCARDED MEDICINES CAT6 SOILDWASTECAT7 SOLID WASTECAT8 LIQUID WASTECAT9 INCINERATIONASHCAT10 CHEMICAL

SEGREGATION , PACKAGING TREATMENT & DISPOSAL

CATEGORY WASTE TYPE CONTAINER TREATMENT & DISPOSAL1. HUMAN ANATOMICAL (Y P) INCINERATION/DEEP BURIAL2. ANIMAL WASTE (Y,P) INCINEARTION/DEEP BURIAL3. MICROBIOLOGY (Y,R) AUTOCLAVING/MICROWAVING

& BIOTECH /INCINERATION4. WASTE SHARPS [B,W] DISINFECTION(CHEM)

/AUTOCL/MICRO/SHREDDING5. DISCARDED MED INCINERATION/DESTRUCTION & CYTO-Drugs [BLUE] /SECURED LANDFILL6. SOILED (YELLOW) INCINERATION/AUTOCL

/MICROWAVING7. SOLID [R,B,W] CHEM.DISINFEC/AUTOCL/MICROWAV/ (DISPOSABLES) SHREDDING8. LIQUID CHEM DISINFEC & DISCHARGE INTO

DRAINS9. INCINERATION ASH [Bl] MUNICIPAL LAND FILLS10. CHEMICAL [Bl] CHEM TREATMENT DRAINS/ LANDFILL

BIOMEDICAL WASTESREGULATIONS

• WASTE CAT 1,2,3 & 6 - YELLOW - PLASTIC BAGS INCINERATION & BURIEL

• WASTE CAT 3,6 & 7 - RED-DISINFEC CONT & PLASTIC BAGS

- CHEMICAL DIS. AUTOCL, MICRO.

• CAT4 & 7 - BLUE /WHITE/TRANS-PLASTIC BAGS- - - CHEMCIAL ,SHREDDING, AUTOCL,

MICRO,

• CAT5,9 &10 - BLACK-PLASTIC BAG

- SECURED LANDFILL

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COMPLIANCE STATUSComprehensive Rules but poor compliance there are many aspects in the rules that required to be complied with � Authorisation not completed in many states� Storage provisions have not provided in most of

the heath care institutions� Dedicated vehicles for transportation of

biomedical wastes are not provided in many states

� Treatment disposal facilities have been set up but not achieving prescribed Standards

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BIO-MEDICAL WASTE MANAGEMENT

Steps taken by the States/UTs: Inventorization of all bio-medical waste

generators - hospitals, nursing homes, clinics etc. Ensure that hospitals seek authorisation. Action against violation of the rules Facilitate Creation of Common Treatment and

Disposal Facilities for Biomedical Waste.

Bio-Medical Waste (Management & Handling) Rules,1998

• As per Rule 8 , Every Occupier of an institution generating, collecting, receiving, storing, transporting, treating, disposing and /or handling bio-medical waste in any other manner, except such occupier of clinics, dispensaries, pathological laboratories, blood banks providing treatment / service to less than 1000 (one thousand) patients per month, shall make an application in Form I to the prescribed authority (DPCC) for grant of authorization.

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DEADLINES FOR SETTING UP BIOMEDICAL WASTE TREATMENT

FACILITIES� According to BMW Rules 1998 deadline for

setting up of treatment facilities: Metros with population >30 lakhs -30.06.2000

Cities with population < 30 lakhs Hospitals and Nursing Homes >500 beds -30.06.2000 Hospitals and Nursing Homes 200-500 beds -31.12.2000 Hospitals and Nursing Homes 50-200 beds -31.12.2001 Hospitals and Nursing Homes <50 beds -31.12.2002 All others -31.12.2002

Operators of Common BMW Treatment Facilities in Delhi

(CBMWTF)• DPCC has authorized 2 Operators to create

Common BMW Treatment Facilities in Delhi • 1. M/s Metro Bio- Care Waste Management

Pvt. Ltd., 55, Railway Road, Samaipur Industrial Area, Delhi -42.

• 2. M/s Synergy Waste Management Pvt. Ltd, Near Okhla STP, Sukhdev Vihar, Okhla, Delhi -20.

• Both the Operators have been authorized for collection of BMW from the Health Care Units in Delhi, for transportation of collected waste to the Common treatment site & for the treatment as per BMW Rules.

COMMON BMW FACILITIES • Facilties : Total - 157- Operation- 149

STATE FACILITIES STATE FACILITIES

AP 11 KARNATK 11

ASSAM 2 KERALA 1

BIHAR 3 MAHARSTR 34

CHANDGRH 1 MP 17

CHTTSGRH 5 MEGHALYA 1

DDNH 1 ORISSA 2

DELHI 2 PUNJAB 4

GUJARAT 12 RAJAST 6

HARYANA 3 TN 11

HP 2 UTTRACHL 2

J&K 2 UP 20

JHARKND 1 WB 4

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OPTIMIZATION OF BIO-MEDICAL WASTE MANAGEMENT

Large health care units to have a treatment disposal facility of their own

Large units with spare capacity in their to be shared with smaller units

Treatment facilities to accept waste form small waste generators .

Common Treatment Disposal Facilities under PPP. Local medical association to assist in cooperative

ventures. State Govts. & municipal bodies to join hands

– Sites allotted for common incineration facilities – Treated bio-medical wastes to be picked up by municipal

bodies.

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NEWER APPROACHES FOR BMW MANAGEMENT

Effective collection system to be put in place within and outside health care units

Ensure proper segregation and packaging

Pollution prevention thru ESTWaste reduction Use of safe substitutes for

hazardous subs in use

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NEWER TECHNOLOGIES

NEWER TECHNOLOGIES TO BE ADOPTED FOR BMW NON INCINERATION TECHNOLOGY

[AUTOCLAVING & HYDROCLAVING & MICROWAVING]

USE OF REUSABLES WHERE POSSIBLE INSTEAD OF DISPOSABLES

SAFE SUBSTITUTES FOR MERCURY MODERNIZATION OF THE OPERATING

PLANTS

REQUIEMENTS FOR BIOMEDICAL WASTES MGT

• Facilitating the process of BMW Mgt• Precautionary principles & preventive approach• Training & awareness programmes• Appropriate qualification & training• Allocation of responsibilities • Providing infrastructure and equipments• Budget allocation • Co-ordination and cooperation with other

institutions

ISSUES ON BIOMEDICAL WASTES MANAGEMENT

ISSUES• Adequate attention not given• Indiscriminate Disposal• Segregation Lacking• Unscruplus Recycling• No Treatment & Disposal Facility• No Training Awareness• Monitoring Mechanisms Lacking• Lack of infrastructure in hospitals to tackle the problem

of bio-medical wastes.• Inadequate/NIL allocation of funds.• Lack of training for nurses and other para-medical staff.• Absence of personal protective gears like gloves etc.,

while segregating and transporting wastes.

ACTION POINTSSOLUTIONS• Follow regulations• Use re-usables • Prescribe safe recycling• Waste minimization• Integral part of hospital management system• Awareness & education• Management monitoring mechanisms• Penalty & punishments • Utilisation of spare capacity of existing incinerators and

other facilities in the hospitals by small units. Also utilisation of incinerators in the private sector industries for treatment of Hospitals Wastes..

Inclusion of Biomedical waste management as a part of medical curriculum

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Thank You