bm waste mgmt issues challenges040609 (2)

7/23/2019 BM Waste Mgmt Issues Challenges040609 (2)

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Bio-medical WasteBio-medical Waste

ManagementManagement

Issues and ChallengesIssues and Challenges

Dr. Selwyn A ColacoDr. Selwyn A Colaco

Chief Operating OcerChief Operating Ocer!arayana "rudayalaya "ospitals#!arayana "rudayalaya "ospitals#BangaloreBangalore


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I. Environmental LegislationI. Environmental Le

gislation

The Air (Prevention and Control of Pollution) Act,The Air (Prevention and Control of Pollution) Act,

19811981

The Environment (Protection) Act, 1986The Environment (Protection) Act, 1986

The Hazardou !ate ("ana#ement $ Handlin#)The Hazardou !ate ("ana#ement $ Handlin#)%ule, 1989%ule, 1989

The &ational Environmental Tri'unal Act, 199The &ational Environmental Tri'unal Act, 199

The Biomedical Waste (Management & Handling)The Biomedical Waste (Management & Handling)

Rules, 1998Rules, 1998 The Municipal Solid Waste (Management &The Municipal Solid Waste (Management &

Handling) Rules, 2Handling) Rules, 2


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BMW Rules ha!e "een adopted and noti#ed$ith the o"%ecti!e to stop the indisciminate

disposal o' hospital $aste "iomedical $asteand ensue that such $aste is handled $ithoutan* ad!ese e+ect on the human health anden!ionment

Implementation ofIm

plementation of

BIO-MEDICAL WASTE RULES !!"BIO-MEDICAL WASTE RULES !!"


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*

Health care +ate includeHealth care +ate include !ate #enerated ' the health care facilitie!ate #enerated ' the health care facilitie %eearch facilitie%eearch facilitie -a'oratorie-a'oratorie

.iomedical +ate in ho/ital.iomedical +ate in ho/ital 80 are noninfectiou80 are noninfectiou 10 are infectiou10 are infectiou

0 are hazardou0 are hazardou

Implementation ofIm

plementation of

BIO-MEDICAL WASTE RULES !!"BIO-MEDICAL WASTE RULES !!"


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3e#re#ation and afe containment of +ate at3e#re#ation and afe containment of +ate atthe health facilit levelthe health facilit level

Procein# and tora#e for terminal di/oalProcein# and tora#e for terminal di/oal

Basi# $rin#iplesBasi# $rin#

iples


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.iomedical +ate hall not 'e mi4ed +ith other.iomedical +ate hall not 'e mi4ed +ith other+ate5+ate53e#re#ation at ource 'oth at +ard and unit level3e#re#ation at ource 'oth at +ard and unit levelColor codin# to u//ort e#re#ation at ourceColor codin# to u//ort e#re#ation at ource.iomedical +ate hall 'e e#re#ated into.iomedical +ate hall 'e e#re#ated into

container7 'a# at the /oint of #eneration incontainer7 'a# at the /oint of #eneration in

accordance +ith 3chedule (."! %ule 1998) /rioraccordance +ith 3chedule (."! %ule 1998) /rior

to it tora#e, tran/ortation, treatment andto it tora#e, tran/ortation, treatment and

di/oal5di/oal5

Basi# $rin#iplesBasi# $rin#

iples


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The container hall 'e la'eled accordin# toThe container hall 'e la'eled accordin# to3chedule (."! %ule 1998)3chedule (."! %ule 1998)Tran/ort +ate afel to /ic: u/ iteTran/ort +ate afel to /ic: u/ itedentif detination for each t/e of +ate anddentif detination for each t/e of +ate and

enure afe di/oalenure afe di/oal;ee/ trac: of ua#e;ee/ trac: of ua#e

Basi# $rin#iplesBasi# $rin#iples


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9/23


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Biome&i#al Waste Management -Biome&i#al Waste Management -

Iss'esIss'es

@ &ot conidered im/ortant&ot conidered im/ortant

-ac: of interet from enior mana#ement-ac: of interet from enior mana#ement

&o o+nerhi/ of the /roce&o o+nerhi/ of the /roce

A+arene of /ro'lemA+arene of /ro'lem

A//reciate the need for contant monitorin#A//reciate the need for contant monitorin#


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3e#re#ation of +ate not ta:en erioul at uer3e#re#ation of +ate not ta:en erioul at uer

levellevel&on com/liance +ith color codin#&on com/liance +ith color codin#"onitorin# e#re#ation at ource lo+ 'ud#et"onitorin# e#re#ation at ource lo+ 'ud#et

allocated cot are not al+a :no+nallocated cot are not al+a :no+nCot of color codin#, ta>, tran/ort and di/oalCot of color codin#, ta>, tran/ort and di/oaluanti=cation of +ate #enerated i not accurateluanti=cation of +ate #enerated i not accuratel

donedone


Iss'esIss'es


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Protection of healthcare +or:er not #iven ade?uateProtection of healthcare +or:er not #iven ade?uate

thou#htthou#htClinical +ate dum/ed +ith non infectiou +ate Clinical +ate dum/ed +ith non infectiou +ate

%i: for healthcare +or:er and /u'lic%i: for healthcare +or:er and /u'lic

!ate di/oal not e>ective, often dum/ed in o/en!ate di/oal not e>ective, often dum/ed in o/enland=llland=ll


Iss'esIss'es


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%e/oni'ilit for +ate di/oal head of facilit,%e/oni'ilit for +ate di/oal head of facilit,

'ut devolved to mem'er of the +ate mana#ement'ut devolved to mem'er of the +ate mana#ement

teamteamEach healthcare +or:er e#re#ation andEach healthcare +or:er e#re#ation and

a//ro/riate di/oala//ro/riate di/oalPrivate com/anie from collection /oint in ho/italPrivate com/anie from collection /oint in ho/ital

to di/oalto di/oal"edical +ate e#re#ation a+arene and"edical +ate e#re#ation a+arene and

nformation hould 'e availa'le in all area ofnformation hould 'e availa'le in all area ofho/italho/ital


responsi(ilitiesresponsi(ilities


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C)allenges* +ee& for proto#ol an&C)allenges* +ee& for proto#ol an&

poli#ies,poli#ies,

To /rovide /rotection forTo /rovide /rotection for Healthcare +or:erHealthcare +or:er

PatientPatient

Communit at lar#e from the ri: of infectionCommunit at lar#e from the ri: of infection

@ Com/liance +ith tatutor re?uirementCom/liance +ith tatutor re?uirement@ Bovernment of ndia 1998 'iomedical +ateBovernment of ndia 1998 'iomedical +ate

mana#ement and handlin# rule under EPAmana#ement and handlin# rule under EPA

#ompels )ospitals #lini#s la(s to ens're safe anompels )ospitals #lini#s la(s to ens're safe an&environmentall/ so'n& management of 0asteenvironmentall/ so'n& management of 0astegenerate& at t)eir esta(lis)ments1generate& at t)eir esta(lis)ments1


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C)allengesC)allenges

Eta'lihin# ro'ut +ate mana#ement /olicieEta'lihin# ro'ut +ate mana#ement /olicie

+ithin the or#anization+ithin the or#anizationr#anization +ide a+arene a'out the healthr#anization +ide a+arene a'out the health

hazardhazard

3uDcient =nancial and human reource3uDcient =nancial and human reource"onitorin# and control of +ate di/oal"onitorin# and control of +ate di/oalClear re/oni'ilit for a//ro/riate handlin# andClear re/oni'ilit for a//ro/riate handlin# and

di/oal of +ate5di/oal of +ate5


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A%E33&B THE 33


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A%E33&B THE 33


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A%E33&B THE 33aociated +ith ."!"5

15"aintenance of %ecord re#iter for thi/ur/oe51*5Container hould 'e ro'ut and lea: /roof15Trac:in# of .io "edical !ate u/to /oint of

i/oal5

165Pro/er treatment and =nal di/oal5


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$han% you

Any &uestions'

S ) & l IS ) & l I


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OptionOption Waste CategoryWaste Category Treatment & DisposalTreatment & Disposal

Category No. 1Category No. 1 Human Anatomical WasteHuman Anatomical Waste(human tissues, organs, body parts)(human tissues, organs, body parts)

incineration @/deep burial*incineration @/deep burial*

Category No. 2Category No. 2 Animal WasteAnimal Waste(animal tissues, organs, body parts(animal tissues, organs, body partscarcasses, bleeding parts, fluid, blood andcarcasses, bleeding parts, fluid, blood andexperimental animals used in research,experimental animals used in research,waste generated by veterinary hospitals,waste generated by veterinary hospitals,colleges, discharge from hospitals, animalcolleges, discharge from hospitals, animalhouses)houses)

incineration@/deep burial*incineration@/deep burial*

Category No. 3Category No. 3 Microbiology & Biotecnology WasteMicrobiology & Biotecnology Waste(Wastes from laboratory cultures, stocks or(Wastes from laboratory cultures, stocks ormicro-organisms live or vaccines, humanmicro-organisms live or vaccines, humanand animal cell culture used in research andand animal cell culture used in research andinfectious agents from research andinfectious agents from research andindustrial laboratories, wastes fromindustrial laboratories, wastes fromproduction of biologicals, toxins, dishes andproduction of biologicals, toxins, dishes and

devices used for transfer of cultures)devices used for transfer of cultures)

local autocla!ing/micro"local autocla!ing/micro"#a!ing/incineration@#a!ing/incineration@

Category No. 4Category No. 4 Waste $arpsWaste $arps(needles, syringes, scalpels, blade, glass,(needles, syringes, scalpels, blade, glass,etc. that may cause punture and cuts. Thisetc. that may cause punture and cuts. Thisincludes both used and unused sharps)includes both used and unused sharps)

disin%ection cemical treatmentdisin%ection cemical treatment@@@/auto cla!ing/micro#a!ing@@@/auto cla!ing/micro#a!ingand mutilation/sredding''and mutilation/sredding''

Category No. 5Category No. 5 Discarded Medicines and Cytoto(ic drugsDiscarded Medicines and Cytoto(ic drugs

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

incineration@/destruction andincineration@/destruction and

drugs disposal in secureddrugs disposal in securedland%illsland%ills

S#)e&'le-IS#)e&'le-I

CATE2ORIES O3 BIO-MEDICAL WASTECATE2ORIES O3 BIO-MEDICAL WASTE

S ) & l IS ) & l I


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Category No. 6Category No. 6 $oiled Waste$oiled Waste(items contaminated with blood,(items contaminated with blood,

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

incineration@autocla!ing/microincineration@autocla!ing/micro#a!ing#a!ing

Category No. 7Category No. 7 $olid Waste$olid Waste(Waste generated from disposal(Waste generated from disposalitems other than the sharps such aitems other than the sharps such a

tubings, catheters, intravenoustubings, catheters, intravenoussets etc.)sets etc.)

disin%ection by cemicaldisin%ection by cemicaltreatment@@treatment@@autocla!ing/micro#a!ing andautocla!ing/micro#a!ing and

mutilation/sredding''mutilation/sredding''

Category No. 8Category No. 8 )iuid Waste)iuid Waste(Waste generated from laboratory(Waste generated from laboratoryand washing, cleaning,and washing, cleaning,housekeeping and disinfectinghousekeeping and disinfectingactivities)activities)

disin%ection by cemicaldisin%ection by cemicaltreatment@@ and discargetreatment@@ and discargeinto drainsinto drains

Category No. 9Category No. 9 +ncineration As+ncineration Assh from incineration of any bio-sh from incineration of any bio-medical waste)medical waste)

disposal in municipal land%illdisposal in municipal land%ill

Category No. 10Category No. 10 Cemical WasteCemical Waste(!hemicals used in production of(!hemicals used in production ofbiologicals, chemicals used inbiologicals, chemicals used inproduction of biologicals,production of biologicals,

chemicals used in disinfection, aschemicals used in disinfection, asinsectricides, etc.)insectricides, etc.)

cemical treatment@@ andcemical treatment@@ anddiscarge into drains %or liuidsdiscarge into drains %or liuidsand secured land%ill %or solidsand secured land%ill %or solids


CATE2ORIES O3 BIO-MEDICAL WASTE #ontin'e&1CATE2ORIES O3 BIO-MEDICAL WASTE #ontin'e&1

S ) & l IS ) & l I


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,ote -,ote -

@@ Tere #ill be no cemical pretreatment be%ore incineration. ClorinatedTere #ill be no cemical pretreatment be%ore incineration. Clorinatedplastics sall not be incinerated.plastics sall not be incinerated.

** Deep burial sall be an option a!ailable only in to#ns #it population lessDeep burial sall be an option a!ailable only in to#ns #it population lesstan %i!e las and in rural areas.tan %i!e las and in rural areas.

@@@@ Cemicals treatment using at least 01 ypoclorite solution or any oterCemicals treatment using at least 01 ypoclorite solution or any otereui!alent cemical reagent. +t musts be ensured tat cemical treatmenteui!alent cemical reagent. +t musts be ensured tat cemical treatment

ensures disin%ection.ensures disin%ection.

'''' Multilation/sredding must be suc so as to pre!ent unautorised reuse.Multilation/sredding must be suc so as to pre!ent unautorised reuse.


CATE2ORIES O3 BIO-MEDICAL WASTE #ontin'e1CATE2ORIES O3 BIO-MEDICAL WASTE #ontin'e1

S#)e&'le IIS#)e&'le II


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S#)e&'le-IIS#)e&'le-II

COLOUR CODI+2 A+D T4E T5$E O3 CO+TAI+ER 3OR DIS$OSALCOLOUR CODI+2 A+D T4E T5$E O3 CO+TAI+ER 3OR DIS$OSAL

O3 BIO MEDICAL WASTESO3 BIO MEDICAL WASTES

ColourColour

CodingCoding

Type ofType of

ContainerContainer

WasteWaste

CategoryCategory

Treatment optionsTreatment options

(ellow(ellow )lastic Bag)lastic BagCategorieCategories *# +# ,s *# +# , . .

Incineration/ deep 0urialIncineration/ deep 0urial

2ed2edDisinfectedDisinfectedcontainer/)lasticontainer/)lasti

c 0agc 0ag

CategorieCategories ,# # 3s ,# # 3

Autocla4ing/Micro-Autocla4ing/Micro-wa4ing/Chemical $reatmentwa4ing/Chemical $reatment

Blue/WhitBlue/Whitee$ransluce$ranslucentnt

)lastic Bag)lastic Bag/puncture proof/puncture proofcontainerscontainers

Cat. 5#Cat. 5#Cat. 3Cat. 3

Autocla4ing/Micro-wa4ing/Autocla4ing/Micro-wa4ing/Chemical $reatment Chemical $reatment Destruction / shreddingDestruction / shredding

Blac%Blac% )lastic Bag)lastic BagCategorieCategorie

s 6# 7# *8s 6# 7# *8Disposal in secured land9ll.Disposal in secured land9ll.

Notes:1. Colour coding of waste categories with multiple treatmentoptions as dened in schedule 1, shall be selected depending ontreatment option chosen, which shall be as specied inSchedule I.2. Waste collection bags for waste tpes needing incineration

shall not be made of chlorinated plastics.!. Categories " and 1# $li%uid& do not re%uire containers'bags.

bm waste mgmt issues challenges040609 (2)

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