Bio-medical Waste

Management
Issues and Challenges

Dr. Selwyn A Colaco

Chief Operating Officer

Narayana Hrudayalaya Hospitals,
Bangalore

I. Environmental Legislation

The Air (Prevention and Control of Pollution) Act,

1981
The Environment (Protection) Act, 1986
The Hazardous Waste (Management & Handling)
Rules, 1989
The National Environmental Tribunal Act, 1995
The Biomedical Waste (Management & Handling)
Rules, 1998
The Municipal Solid Waste (Management &
Handling) Rules, 2000

Implementation of
BIO-MEDICAL WASTE RULES 1998

BMW Rules have been adopted and notified

with the objective to stop the indiscriminate
disposal of hospital waste/ bio-medical waste
and ensure that such waste is handled without
any adverse effect on the human health and
environment.

Implementation of
BIO-MEDICAL WASTE RULES 1998
Health care waste includes
Waste generated by the health care facilities
Research facilities
Laboratories
Biomedical waste in hospitals
85% are non-infectious
10% are infectious
5% are hazardous

Basic Principles
Segregation and safe containment of waste at
the health facility level
Processing and storage for terminal disposal

Basic Principles
Bio-medical waste shall not be mixed with other
wastes.
Segregation at source both at ward and unit level
Color coding to support segregation at source
Bio-medical waste shall be segregated into
containers/ bags at the point of generation in
accordance with Schedule II (BMW Rules 1998) prior
to its storage, transportation, treatment and
disposal.

Basic Principles
The containers shall be labeled according to
Schedule III (BMW Rules 1998)
Transport waste safely to pick up site
Identify destination for each type of waste and
ensure safe disposal
Keep track of usage

Transportation & Storage of BMW

Untreated biomedical waste shall be transported only
in vehicles authorized for the purpose by the
competent authority as specified by the government.
Untreated bio-medical waste shall not be kept/stored
beyond a period of 48 hours.
If for any reason it becomes necessary to store the
waste beyond such period, measures must be taken to
ensure that the waste does not adversely affect human
health and the environment.

Biomedical Waste Management Issues

Use/Reuse of
equipment

Unsafe collection

Unsafe disposal

Biomedical 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

Biomedical Waste Management Issues

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
Cost of color coding, staff, transport and disposal
Quantification of waste generated is not accurately
done

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Biomedical Waste Management Issues

Protection of healthcare workers not given adequate
thought
Clinical waste dumped with non infectious waste Risk for healthcare workers and public
Waste disposal not effective, often dumped in open
landfills

12

Biomedical Waste Management responsibilities

Responsibility for waste disposal head of facility,
but devolved to members of the waste management
team
Each healthcare worker segregation and
appropriate disposal
Private companies from collection point in hospital
to disposal
Medical waste segregation awareness and
Information should be available in all areas of
hospital

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Challenges: Need for protocol and

policies
To provide protection for
Healthcare workers
Patients
Community at large - from the risk of infections
Compliance with statutory requirements
Government of India -1998 biomedical waste
management and handling rules under EPA
(compels hospitals, clinics, labs to ensure safe and
environmentally sound management of waste
generated at their establishments)

Challenges
Establishing robust waste management policies
within the organization
Organization wide awareness about the health
hazards
Sufficient financial and human resources
Monitoring and control of waste disposal
Clear responsibility for appropriate handling and
disposal of waste.

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ADRESSING THE ISSUES

1. Need to build-up of a comprehensive system,
address responsibilities, resource allocation,
handling and disposal
2. This is a long-term process, sustained by gradual
improvements.
3. Specific personnel need to be assigned to monitor
the bio-medical waste management in the
hospital.
4. Man power needs and other resources for the
BMWM of hospital to be addressed.
5. Quality assessment of bio-medical waste
management should be done from time to time.

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ADRESSING THE ISSUES

6. Segregated collection and transportation - The
use of color coding and labeling of hazardous
waste.
7. Clear directives in the form of a posters and
notice to be displayed in all concerned areas in
English and local languages.
8. Safety of handlers.
9. Raising Awareness about risks related to healthcare waste; training staff and HCW on safe
practices.
10.Selection of safe and environmentally friendly
management options, to protect people from
hazards when collecting, handling, storing,
transporting, treating or disposing of waste.
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ADRESSING THE ISSUES

11.Issue of all protective clothes such as, gloves,
aprons, masks etc. to all HCW.
12.Regular medical check-up (half-yearly) of staff
associated with BMWM.
13.Maintenance of Record registers for this
purpose.
14.Containers should be robust and leak proof
15.Tracking of Bio Medical Waste upto point of
Disposal.
16.Proper treatment and final disposal.

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Thank you
Any Questions?

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Schedule-I
CATEGORIES OF BIO-MEDICAL WASTE
Option

Waste Category

Treatment & Disposal

Category No. 1

Human Anatomical Waste

(human tissues, organs, body parts)

incineration @/deep burial*

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)

incineration@/deep burial*

Category No. 3

Microbiology & Biotechnology Waste

(Wastes from laboratory cultures, stocks or
micro-organisms live or vaccines, human
and animal cell culture used in research and
infectious agents from research and
industrial laboratories, wastes from
production of biologicals, toxins, dishes and
devices used for transfer of cultures)

local autoclaving/microwaving/incineration@

Category No. 4

Waste Sharps
(needles, syringes, scalpels, blade, glass,
etc. that may cause punture and cuts. This
includes both used and unused sharps)

disinfection (chemical treatment

@@@/auto claving/microwaving
and mutilation/shredding##

Category No. 5

Discarded Medicines and Cytotoxic drugs

(Waste comprising of outdated,
contaminated and discarded medicines)

incineration@/destruction and
drugs disposal in secured
landfills
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Schedule-I
CATEGORIES OF BIO-MEDICAL WASTE (continued)
Category No. 6

Soiled Waste
(items contaminated with blood,
and body fluids including cotton,
dressings, soiled plaster casts,
lines, bedding, other material
contaminated with blood)

incineration@autoclaving/micro
waving

Category No. 7

Solid Waste
(Waste generated from disposal
items other than the sharps such a
tubings, catheters, intravenous
sets etc.)

disinfection by chemical
treatment@@
autoclaving/microwaving and
mutilation/shredding##

Category No. 8

Liquid Waste
(Waste generated from laboratory
and washing, cleaning,
housekeeping and disinfecting
activities)

disinfection by chemical
treatment@@ and discharge
into drains

Category No. 9

Incineration Ash
Ash from incineration of any biomedical waste)

disposal in municipal landfill

Category No. 10

Chemical Waste
(Chemicals used in production of
biologicals, chemicals used in
production of biologicals,
chemicals used in disinfection, as
insectricides, etc.)

chemical treatment@@ and

discharge into drains for liquids
and secured landfill for solids
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Schedule-I
CATEGORIES OF BIO-MEDICAL WASTE (continue)
Note :
@

There will be no chemical pretreatment before incineration. Chlorinated

plastics shall not be incinerated.

Deep burial shall be an option available only in towns with population less
than five lakhs and in rural areas.

@@

Chemicals treatment using at least 1% hypochlorite solution or any other

equivalent chemical reagent. It musts be ensured that chemical treatment
ensures disinfection.

##

Multilation/shredding must be such so as to prevent unauthorised reuse.

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Schedule-II
COLOUR CODING AND THE TYPE OF CONTAINER FOR DISPOSAL
OF BIO MEDICAL WASTES
Colour
Coding

Type of
Container

Waste
Category

Yellow

Plastic Bag

Categorie
s 1, 2, 3
Incineration/ deep burial
& 6.

Red

Autoclaving/MicroDisinfected
Categorie
waving/Chemical Treatment
container/Plasti
s 3, 6, 7
c bag

Blue/Whit
e
Transluce
nt

Plastic Bag
/puncture proof
containers

Black

Cat. 4,
Cat. 7

Treatment options

Autoclaving/Micro-waving/
Chemical Treatment &
Destruction / shredding

Categorie
Plastic Bag
Disposal in secured landfill.
s 5, 9, 10
Notes:
1. Colour coding of waste categories with multiple treatment
options as defined in schedule 1, shall be selected depending on
treatment option chosen, which shall be as specified in
Schedule I.
2. Waste collection bags for waste types needing incineration
shall not be made of chlorinated plastics.
3. Categories 8 and 10 (liquid) do not require containers/bags.

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