Bio-Medical Waste (Management and

Handling) Rules 1998

Presented By:

Ashish Singh

MBA – Power Management

500033217

Let The Waste Of The “SICK”

Not Contaminate The Lives Of

“THE HEALTHY”

What is Bio – Medical Waste

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

Biologicals" means any preparation made from organisms or micro-organisms or product of metabolism and biochemical reactionsintended for use in the diagnosis, immunisation or the treatment ofhuman beings or animals or in research activities pertaining thereto;

Specific to hospitals Bio-medical waste is defined as waste that isgenerated during the diagnosis, treatment or immunization of humanbeings and are contaminated with patient’s body fluids (such assyringes, needles, ampoules ,organs and body parts, placenta,dressings, disposables plastics and microbiological wastes).

What is Bio – Medical Waste

Waste Sharps e.g.: Needles Discarded medicines

Human anatomical waste Solid waste e.g.: cotton swabs

History

In the late 1980’s

Items such as used syringes washed up on several East Coast beaches USA

HIV and HPV virus infection

Lead to development of Biomedical Waste Management Law in USA

However in India the seriousness about the management came into lime light only after 1990’s

Sources of Health Care Waste

Government/private hospitals

Nursing homes

Physician/dentist office or clinic

Dispensaries

Primary health care centers

Medical research and training centers

Animal/ slaughter houses

Labs/ research organizations

Vaccinating centers

Bio tech institutions/ production units

Definition

Hospital waste: refers to all waste, biological or non biological, that is discarded and is not intended for further use

Medical waste: refers to materials generated as a result of patient diagnoses, treatment, immunization of human beings or animals

Infectious waste: are the portion of medical waste that could transmit an ‘infectious disease’.

Pathological waste : waste removed during surgery/ autopsy or other medical procedures including human tissues, organs, body parts, body fluids and specimens along their containers.

Magnitude of the Problem

GLOBALLY- Developed countries generate 1 to 5 kg/bed/day

Developing countries: meager data, but figures are lower. 12kg/pt./day

WHO Report: 85% non hazardous waste

: 10% infective waste

: 5% non-infectious but hazardous. (Chemical, pharmaceutical and radioactive)

INDIA:-No national level study

- local or regional level study shows hospitals generate

roughly 1-2 kg/bed/day

Classification of Bio-Medical Wastes

Non-Infectious waste, 80%

Pathological and Infectious

waste, 15%

Chemical and Pharmaceutical

waste, 3%Sharps, 1%

Radioactive,Cytotoxic and heavy metals,

1%

Classification of Health Care Waste

Infectious Waste

Lab cultures

Waste from isolation wards

Tissues(swabs)

Materials/ equipment of infected patients

Pathological Waste

Excreta

Human tissues/fluids

Body parts

Blood or body fluids

Cont.

Sharp Waste

Needles

Infusion Sets

Scalpels

Knives Blades

Broken Glass

Geno toxic Waste

Waste Containing Cytotoxic

Drugs(often Used In Cancer

Therapy)

Geno toxic Chemicals

Cont.

Pharmaceutical Waste

Expired Pharmaceuticals

Contaminated Pharmaceuticals

Banned Pharmaceuticals

Cont.

Chemical Waste

Lab reagents

Film developer

Expired disinfectants

Expired solvents

Waste with High Content of Heavy Metals

Waste with high content of heavy metals

Batteries

Broken thermometers

Blood pressure gauges etc.

Cont.

Pressurized Containers

Gas cylinders

Gas cartridges

Aerosol cans

Radioactive Waste

Radiotherapy/lab research liquids

Contaminated glass wares,

packages, absorbent papers

Hospital Waste Disposal

Hospital waste management is a

part of hospital hygiene and

maintenance activities. In fact

only 15% of hospital waste

i.e. "Biomedical waste" is hazardous,

not the complete.

But when hazardous waste is not

segregated at the source of

generation and mixed with

nonhazardous waste, then 100%

waste becomes hazardous

Who’s at Risk

Doctors and Nurses

Patients

Hospital Support Staff

Waste Collection and Disposal Staff

General Public

Environment

Need for BMW Management

The hospital waste, in addition to the risk for patients and personnel who handle these wastes poses a threat to public health and environment

Health hazards of BMW :

Type of Waste Health Hazard

Human/ Animal Waste/ Solid Waste HIV,HBV,HCV, Hgic fevers, cholera, salmonellosis, shigellosis, rabies,

leptospirosis, anthrax, TB, pneumonia, septicemia

Sharps HIV, HBV, HCV, Injuries

Cytotoxic/ radioactive waste Cancer, Genetic Mutation, birth defect

Chemical Waste Poisonings, Dermatitis, Conjunctivitis, Bronchitis

Need for BMW Management

Nosocomial infections to patients from poor infection control

practices and poor waste management.

Drugs which have been disposed of, being repacked and

sold off to unsuspecting buyers.

Risk of air, water and soil pollution directly due to waste, or

due to defective incineration emissions and ash.

Risk of infection outside hospital for waste handlers and

scavengers, other peoples.

India: Extent of the Problem

>95,000 hospitals and healthcare facilities in India

4.2 lakh kg of biomedical waste is generated on a daily basis.

Three million tonnes of medical wastes generated every year.

Expected to grow 8% annually.

2,91,983 kg/day BMW is disposed. which means that almost 28% of the wastes is left untreated and not disposed finding its way in dumps or water bodies and re-enters our system.

Karnataka tops the chart with 62,241 kg/day of BMW.

Only 179 CTF to treat the BMW in the country.

No. of HCF/CBWTF violated BMW rules 5472

No. of show cause notice/ Directions issued to defaulter HCE/CBWTF 3585

Cont.

CHHATTISGARH(Annual report on BMW, 2011, CPCB)

No. of HCE- 740

No. of Bed- 14678

Total quantity of BMW generated(Kg/day) approximately 4492Kg/Day

BMW treated 4492Kg/Day

No. of HCF/CBWTF violated BMW rules 20

No. of show cause notice/ Directions issued to defaulter HCE/CBWTF 20

No. CBWTF 06

No. of HCE using CBWTF/ Private agencies 446

No. of HCE having own treatment facility & Disposal facility 181

No. of HCE applied for authorization 478

No. of HCE granted authorization 425

No. of treatment equipment's

INCINERATOR’S 14

AUTOCLAVES 305

OVEN 7

SHREDDERS 358

Present Practice Within Many Of The Hospitals

Around 40% of the hospitals in the

country are dumping the BMW with

Municipal garbage

Waste is not segregated at the site

3585 hospitals have been served

notice for acting as defaulters of

these rules.

No proper treatment options

No regulated disposal plan/sites

Bio – Medical Waste Rules 1998

The Government of India as contemplated under Section 6,8 and 25 of the Environment (Protection) Act,1986, has made the Biomedical Wastes (Management & Handling) Rules, 1998.

The rules are applicable to every institution generating biomedical waste which includes hospitals, nursing homes, clinic, dispensary, veterinary institutions, animal houses, laboratory, blood bank.

The rules are applicable to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form.

Bio-Medical Waste Rules 1998

Definition

According to bio medical waste rules ,1998 of India“ bio-medical waste” means any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production or testing of bio medicals.

Any unwanted residual material which cannot be discharged directly, or after suitable treatment can be discharged in the atmosphere or to a receiving water source, or used for landfill is waste. (Wilson, 1981)

Bio-Medical Waste (Management and Handling)

Rules by Govt. of India , 1998

Revised in 2011

Now known as BMW Rules, 2011

2011 1998

Every occupier generating BMW, irrespective of the quantum of wastes

comes under the BMW Rules and requires to obtain authorisation

Occupiers with more than 1000 beds required to obtain authorisation

Duties of the operator listed Operator duties absent

Treatment and disposal of BMW made mandatory for all the HCEs

Rules restricted to HCEs with more than 1000 beds

A format for annual report appended with the Rules

No format for Annual Report

Form VI i.e. the report of the operator on HCEs not handing over the BMW

added to the Rules

Form VI absent

Duty of the Occupier

It is the duty of every occupier i.e. head of an institution generating bio-medical waste, to take all steps to ensure that such waste is handledwithout any adverse effect to human health and the environment.

Provides training to HCW engaged in handling BMW

Duties The operators now have to ensure that the BMW is collected from all the

HCEs and is transported, handled, stored, treated and disposed in an environmentally sound manner. The operators also have to inform the prescribed authority in form VI if any HCEs are not handing the segregated BMW as per the guidelines prescribed in the rules.

Operator of the Bio - medical Waste Treatment Facility to apply for Grant of Authorization in form –I to MPPCB (The Prescribed Authority).

Cont.

Occupier / institution generating, collecting, receiving, storing, transporting, treating, disposing and/or handling Bio-medical waste To apply for Grant of Authorization in form –I to MPPCB which is the Prescribed Authority.

Bio-medical Waste shall be treated and disposed of in accordance with the Schedule -I and in compliance with the standards prescribed in Schedule –V.

Every Occupier, shall set- up the requisite Bio-medical Waste Treatment Facilities like incinerator, Autoclave, Microwave system for treatment of waste, or, ensure requisite treatment of waste at common or any other waste treatment facility

l records subject to the inspection & verification by the MPPCB

Accident during handling & Transportation of BMW needs to be reported by the authorized person in Form – III to MPPCB forthwith

Setting up BMW Treatment Facility

Occupier set up adequate treatment facilities like autoclave /microwave/incinerator/ hydroclave, shredder prior to commencement of itsoperation or ensure that the wastes are treated at a common bio medicalwaste treatment facility or an authorized waste treatment facility.

The new Rules have omitted incinerator as one of the pre requisites foron-site treatment of BMW. The omission is owing to the variousenvironmental impacts of incineration.

Promotion of new technologies for treatment and disposal of waste

Deep burial for disposal of BMW has also been removed from the Rules. The Rules says it can be an option only in rural areas with no access to CTF with prior approval from the prescribed authority.

Health Waste Characterization

Hospital Waste

Non Hazardous

(= 75-90%)

Hazardous Waste

(= 10-25%)

Infectious

Others

(Radioactive, Cytotoxic)

Types of WasteLiquid Wastes

Approx. Quantity : 4 to 250 liters / bed / day

Sewage from isolation wards, ICU’s toilets & urinals, Bed-bath, bathroom and hospital’s laundry

Wash waters from laboratories, OPD, Dressing rooms & Operation theaters.

Solid Wastes

Approximate Quantity : 0.3 to 3.5 kg/bed/day

Garbage 55%(Bulk Density :330 kg/m3,Cal.Value:1000 K.cal / kg, Moisture :40%)

Bio – Medical Waste 13% Wasted body remains 05%

(Blood, Cultures, Anatomical) Pharmaceutical and Chemical Wastes 02% Pathological Wastes 06%

Sharp Objects 20% Pressurized Containers & Discarded Instruments 02% Radio actives Wastes 0.3%

Schedule I – Categories of Bio-Medical Waste

Waste Category Waste Type Treatment & Disposal

Category 1Human Anatomical waste (human tissues, organs,

body partsIncineration/deep burial

Category 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

Incineration/deep burial

Category 3

Microbiology & Biotechnology Wastes: Wastes from clinical samples, pathology, biochemistry, hematology, blood bank, laboratory cultures, stocks specimens of micro-organisms, live or attenuated vaccines human

and animal cell culture used in research and infectious agent from research and industrial laboratories, waste

from production of biologicals, toxins, dishes and devices used for transfer of cultures

Disinfection at source by chemical treatment or by

Autoclaving / Microwaving / followed by Mutilation /

shredding and after treatment final disposal in secured landfills or disposal of recyclable waste

(plastic or glass ) through registered or authorized

recycler

Cont.

Waste Category Waste Type Treatment & Disposal

Category 4

Waste Sharps (needles, glass syringes or syringes with fixed needles, scalpels ,blades, glass etc.) that may cause puncture and cuts(Includes both used and

unused sharps).

Disinfection (chemical treatment / destruction by needle & tip cutter,

autoclaving/microwave and mutilation/shredding and final

disposal through CBWTF / landfills

Category 5

Discarded Medicines & Cytotoxic drugs (Wastes comprising of outdated, contaminated and discarded

medicines)

Disposal in secured landfills or Incineration

Category 6

Soiled Waste (Items contaminated with blood, & body fluids including cotton, dressings, soiled plaster casts, linens, beddings, other material contaminated with

blood)Incineration

Cont.

Waste Category Waste Type Treatment & Disposal

Category 7

Infectious Solid Waste (waste generated from disposable items other than the waste sharps such as

tubing's, hand gloves, saline bottles with IV tubes, catheters, glass, intravenous sets etc.

Disinfection by chemical Treatment / autoclaving

/Microwaving followed by mutilation / shredding & final disposal through registered

recycler

Category 8

Chemical Waste ( Chemicals used in production of

biologicals, chemicals used in disinfection as insecticides etc.)

Chemical treatment and discharge into drains for liquids and secured landfill for solids

Category 9Incineration Ash (ash from incineration of any

bio-medical waste)Disposal in municipal landfill

Category 10

Chemical Waste (chemicals used in production of

biological, chemicals, used in disinfect ion, as

insecticides, etc.)

Chemical treatment & discharge into drain for liquid & secured

landfill for solids

Schedule – II

Color Coding and Type of Containers for

different Bio-Medical Wastes

Color Coding Type of Container Waste Category Treatment/ Disposal

YellowNon Chlorinated Plastic

Bag1, 2, 5, 6 Incineration/ Deep Burial

Red

Non chlorinated plastic bag / puncture proofContainer for sharps 3, 4, 7

Chemical Treatment / Autoclaving / Microwaving and followed by

Mutilation & shredding and disposal in landfills or disposal of

recyclable waste

BlueNon Chlorinated Plastic

Bags/ Containers8

Chemical Treatmentand discharge into drains for

liquids and secured landfill for solids

BlackNon Chlorinated Plastic

BagsMunicipal Waste

Disposed as per the Municipal Solid Waste

Schedule – III

Label for Bio-Medical Waste Containers/ Bags

Bio-Hazard Cytotoxic

Handle with Care

Note: Label shall be non-washable and prominently visible

Bio-Hazard SymbolCytotoxic Hazard

Symbol

Segregation and Packing

Bio-medical waste shall not be

mixed with other wastes

Bio-medical waste shall be

segregated into containers/

bags at the point of generation

in accordance with Schedule II

The containers shall be labeled

according to Schedule III.

Management of Hospital Waste

Black Dustbin & Bags

Paper waste, food waste and other non infectious wastes

generated from the hospitals should be stored in black

coloured bags / containers & Disposed as per MSW

management rules, 2000

Waste Disposal – Black Bin

For Noninfectious - Solid waste

Paper/Plastic

Kitchen Waste/Food

Outer Packing/

Cardboard

Wrappers

General/ Kitchen Waste

Waste Disposal – Yellow BinSoiled Linen,

Contaminated Gowns, Drapes

Bandages

Dressing

Discarded medicine/cytotoxic

drugs

Animal Waste

Swaps

Cont.

Human/Animal tissue organs or body parts

Animal carcasses

Any non plastic soiled waste( contaminated with blood/ body

fluids )

Cotton dressings, bandages

Linen beddings

Soiled plaster casts, Soiled paper

Used/ removed sutures

Waste Disposal – Red Bin

All infectious waste sharp, non

sharp & sharps plastic waste

Urine bag

Gloves

Drains

Pathological Waste

Plastic Culture Plates & Tubes

Microbiology & Laboratory Waste, Waste Sharps

Infectious Solid Waste (Category 3, 4, 7)

Wastes from clinical samples, pathology, biochemistry,

hematology, blood bank, laboratory cultures, stocks

specimens of micro-organisms, live or attenuated vaccines

human and animal cell culture used in research and

infectious agent from research and industrial laboratories,

waste from production of biologicals, toxins, dishes and

devices used for transfer of cultures.

Waste Sharps (needles, glass syringes or syringes with fixed

needles, scalpels ,blades, glass etc.) that may cause

puncture and cuts(Includes both used and unused sharps).

Infectious Solid Waste (waste generated from disposable items other than the waste sharps such as Gloves, tubing, saline bottles with tubes, Catheters, Urine bags, Blood bags, Syringes, Suction tips, Infected plastic containers, Rubber base materials, Retraction cords.

Personnel Safety Devices

The use of protective gears should be made mandatory for all the personnel

handling waste.

Storage

In an area away from general traffic and accessible only to

authorized personnel

DO NOT store for more than 48 hours

If for any reason it becomes necessary to store the waste

beyond such period take measures to ensure that the waste

does not adversely affect human health and environment

Transport

Transport by wheeled trolleys/containers /

carts only in vehicles authorized for the

purpose

They should be

Easy to load and unload

No sharp edges

Easy to clean

Trolleys ,Wheelbarrows: covered

Disinfect daily

Transportation and Storage

If a container is transported from

the premises where bio-medical

waste is generated to any waste

treatment facility outside the

premises, the container shall,

apart from the label prescribed

in Schedule III, also carry

information prescribed in

Schedule IV.

Schedule – IV

Label for Transportation of Bio-Medical Waste

Containers/ Bags

Waste Category No. Day ……….. Month …………..

Waste Class Year ………………………………..

Waste Description Date of Generation …………

Sender’s Name and Address Receiver’s Name and 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.

Schedule – V

Treatment and Disposal

Standard For Treatment And Disposal of BMW

Standard For Incinerator

Standard For Autoclave

Standard For Microwave

Please Remember

The Primary responsibility of

the disposal of the Bio-Medical Waste

lies with the Generator

And Also Do Not Forget That

Bio-medical waste shall not be mixed with other Wastes such as Municipal Waste

Segregate the Bio-medical Waste in separate containers at point of generation (schedule-II) and label as prescribed (schedule-III)

Biomedical waste that are to be transported, must be securely packed, and Labeled as per (schedule-IV)

Transportation of BM Waste is allowed only in vehicles authorized by the prescribed Authority

A day -to -day record of the Quantity under different categories of the Bio – Medical Waste generated in premises must be maintained

No untreated Bio-medical Waste shall be kept stored beyond 48 Hrs.

Legal Aspects

The Contravention Of The Act, Rules, Orders &

Directions may lead to legal action

The punishment may lead to the imprisonment

up to 5 years with fine up to Rs. 1 lakh

For failure or continued contravention a

fine @ Rs.5000 /Day may be charged

If the failure or the contravention continues

beyond one year, the imprisonment may

be extended up to 7 years.

Incineration

Combustion efficiency (CE) shall be at

least 99.00%.

The Combustion efficiency is

computed as follows:

C.E. = %𝑪𝑶𝟐

% 𝑪𝑶𝟐+% 𝑪𝑶X 100

The temperature of the primary

chamber shall be 800 +/-500 C

The secondary chamber gas residence

time shall be at least 1 (one) second

at 1050 +/- 500 C

Drawbacks:

toxic products like furnaces and

dioxins can cause air pollution

Bio-Medical Wastes Destruction by Double

Chambered Incinerator

Details of Double Chambered Incinerator

Incinerator Ash Disposal

Emission Standards

Parameters Concentration mg/Nm3 at

(12% CO2 correction)

Particulate Matters 150

Nitrogen Oxide 450

HCl 50

• Minimum stack height shall be 30 meters above ground

• Volatile organic compounds in ash shall not be more than 0.01%

Autoclave

A temperature of not less than

121 0C and pressure of 15 pounds

per square inch (psi)for an

autoclave residence time of

not less than 60 minutes

Validation test : Spot testing by

Bacillus steareo-thermophilus spores

on a spores strip with at least

1 x 104 Spores/ml

Routine test : Chemical indicator

strip/tape

Standard for Microwaving

Should kill bacteria and other pathogenic organism

Biological indicator bacillus subtilis

CHEMICAL PROCESSES

Dissolved chlorine dioxide, bleach (sodium hypochlorite), peracetic acid,or dry inorganic chemicals.

To enhance exposure of the waste to the chemical agent, chemicalprocesses often involve shredding, grinding, or mixing.

Treatment Technologies

Treatment Technologies

Incineration Autoclave MicrowaveChemical

DisinfectionPlasma

Pyrolysis

Investment/Operating

CostHigh Moderate High Low High

Suitability of the Waste

Not for Radioactive

All except Pathological

All Except Cytotoxic,

RadioactiveLiquid Waste All

Ease of Operation

No Yes Yes Yes No

Waste Volume

ReductionSignificant Less Significant - Significant

OdourProblems

Yes Slight Slight Slight -

Environmental Friendly

No Yes Yes No Yes

Authorization

Every occupier of an institution generating, collecting, receiving, storing, transporting, treating and /or handling Biomedical Waste shall apply on Form 1 for Authorization to the Board.

The State Pollution Control Board are declared as prescribed Authority for grant of Authorization. The Board grants authorizations after satisfying itself.

Application for Authorization

To

The Prescribed Authority

(Name of the State Govt./ UT Administration)Address:

Particulars of ApplicantName of the Applicant(In block letters & in full)

Name of the Institution:Address:Tele No., Fax No. Telex No.

Activity for which authorisation is sought:

GenerationCollectionReceptionStorageTransportationTreatmentDisposalAny other form of handling

Please state whether applying for rash authorisation or for renewal:(In case of renewal previous authorisation-number and date)

Cont.

Address of the institution handling bio-medical wastes:Address of the place of the treatment facility:Address of the place of disposal of the waste:

Mode of transportation (in any) of bio-medical waste:Mode(s) of treatment:

Brief description of method of treatment and disposal (attach details):

Category (see Schedule 1) of waste to be handledQuantity of waste (category-wise) to be handled per month

Declaration I do hereby declare that the statements made and information given above are

true to the best of my knowledge and belief and that I have not concealed anyinformation.

I do also hereby undertake to provide any further information sought by theprescribed authority in relation to these rules and to fulfil any conditionsstipulated by the prescribed authority.

Date : Signature of the Applicant

Place : Designation of the Applicant

Annual Report

Every occupier/operator submit an annual report to the prescribed authority in Form II by 31 January every year, to include information about the categories and quantities of bio-medical wastes handled during the preceding year. The prescribed authority shall send this information in a compiled form to the Central Pollution Control Board by 31 March every year.

Maintenance of Records and Accident Reporting

Every authorized person shall maintain records related to BMW

All records shall be subjected to inspection and verification by the prescribed authority at any time

In any accidents, the authorized person shall report the accident in Form III along with the remedial action taken to the prescribed authority forth with

Setting Up A Cell or Unit for BMW Management

The BMW 2011, Rules have also made mandatory for all the HCEs with 30 or more beds to set up a cell or unit to deal with the BMW management. The cell has to meet every six months and minutes of the meeting have to be submitted along with the Annual Report to the prescribed authority

Do’s and Don'ts

Do’s The used product should be segregated The used product should be mutilated The used product is treated prior to disposal Use protective gear when handling waste Collect waste when the bin is 3/4 the full Clean spills with disinfectant Use trolleys & do not drag waste bags

Don’ts Reuse plastic equipment Mix plastic equipment with other wastes Burn plastic waste Avoid needle stick injuries Avoid using common lift to move waste Avoid spillage

BMW Management Committee

Head of the hospital : chairman Waste Mix officer (dev. and implementation plan) Members: HOD’s of all department Nursing superintendent, Head nurse, Sanitary inspector Chief pharmacist, Radiation officer Supply officer, Financial officer

Responsibility of BMC

Day to day control of segregation, transport & disposal of BMW

Co-ordinate with the store officer for continuous supply of basicitems for BMWM

Prepare guidelines for BMWM & distribute to all department

Prepare BMW posters to raise awareness

Arrange training programs on BMWM & safety measures for all categories of HCW

Co-ordinate with HOD/In-charge of Dept. where deficiencies are pointed out

Co-ordinate with Chhattisgarh Environment Conservation Board)

BMW Spills and Surface Disinfection

Proper spill handling:

Notify people in the area

Don appropriate PPE

Place absorbent material on spill

Apply appropriate disinfectant – allow sufficient contact time (30 min)

Pick up material (watch for glass – use tongs or dust pan); dispose of material into biomedical waste

Reapply disinfectant and wipe

For large/high hazard spills use 10% hypochlorite

For routine disinfection of surfaces where BMW is handled, use a 1:10 solution of freshly diluted bleach or 1% hypochlorite (ethanol evaporates too quickly!)

Hand Washing

Hand washing is the single most effective

way to stop the spread of disease.

Make certain that jewelry is limited to

wedding rings, certain areas such as

OR< C-section, Cath Lab and NBN allow

no jewelry. Nails should be kept short and

clean.

Gloves do not replace hand washing. Hand

sanitizer may be used if no visible soiling is

present and the sinks cannot be readily accessed.

This is in every patient room. It can also be used

when the water is out of service.

Inspect your hands each time they

are washed. Only use hospital approved soaps

and lotions, do not bring in any from home

Alcohol based hand rubs at point of care

Sinks and clean running water

Training

Steps to Effective Hand washing

Thorough hand washing after any

procedure involving nursing care or

close contact with the patient is

essential.

Alcohol based hand antiseptics gaining

importance where washing with water

and soap are not practicable.

Bio-Medical Waste Management - Issues

Not considered important

Lack of interest from senior management

No ownership of the process

Awareness of problems

Appreciate the need for constant monitoring

Segregation of waste not taken seriously at user level

Non compliance with color coding

Monitoring segregation at source – low budgets allocated – costs are not always known/nor worked out properly

Cost of color coding, staff, transport and disposal is a major deterrent

Quantification of waste generated is not accurately done

Bio-Medical Waste Management – Challenges

Establishing robust waste management policies within the Health Care Facility/organization

Organization wide awareness about the health hazards

Sufficient financial and Trained human resources needed

Monitoring and control of waste disposal

Clear responsibility and traceability for appropriate handling and disposal of waste.

Addressing the Issues

Need to build-up of a comprehensive system, address responsibilities, resource allocation, handling and disposal

This is a long-term process, sustained by gradual improvements.

Specific personnel need to be assigned to monitor the bio-medical waste management in the hospital.

Man power needs and other resources for the BMWM of hospital to be addressed.

Quality assessment of bio-medical waste management should be done from time to time.

Segregated collection and transportation – need for Non-ambiguous color coding and labeling of wastes.

Containers should be robust and leak proof

Tracking of Bio Medical Waste up to point of Disposal.

Proper treatment and final disposal.

Cont.

Clear directives in the form of a posters and notice to be displayed in all concerned areas in English and local languages.

Safety of handlers is a big concern that is still not addressed adequately.

Raising Awareness about risks related to health-care waste; training staff & Waste handlers on safe practices.

Selection of safer & environmentally friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing waste.

Issue of all protective clothing such as, gloves, aprons, masks etc. to all HCW & Waste handlers.

Regular medical check-up (half-yearly) of staff associated with BMWM.

Maintenance of Record registers for this purpose.

Conclusion

Bio-medical waste programme cannot be successfully implemented without the willingness, self-motivation, and co-operationfrom all sections of employees of any health care setting.

If we want to protect our environment and health of community we must sensitize our selves to this important issue not only in the interest of health managers but also in the interest of community.

Individual participation is required.

Municipality and government should pay importance to disposal of waste economically.

Thus educating and motivating oneself first is important and then preach others about it.

Lets Make This World A Better Place to Live In

THANK YOU