Priti Razdan, Amarjeet Singh Cheema

Bio-Medical Waste Management System

Priti Razdan, Amarjeet Singh Cheema

Abstract : Hospitals produce waste, which is increasing over the years in its
amount and type. The hospital waste, in addition to the risk for patients and
personnel who handle them also poses a threat to public health and environment.
The main functions of the Bio-Medical Waste Management (BMWM) system (one
of the modules of a Hospital Management Information System) is to ensure proper
handling, segregation, mutilation, disinfection, storage, transportation and final
disposal of Bio-Medical waste. This paper presents the design of the BMWM
within the overall scheme of a Hospital Management Information System.
The BMWM system generates alerts under exceptional conditions such as
violation of segregation guidelines, waste not treated with in a defined period,
violation of trolley route for waste collection, etc. It ensures the segregation and
transportation of waste bags at the point of generation according to bag colour and
trolley mapping so that mixing of bags can be avoided. A digital weighing
machine with direct interface to the system takes the weight of the waste bags. It
also provides various crosscheck mechanisms for reducing theft/ pilferage
occurrences, at the time of storage of the waste in the Department area.
This proposed module will be implemented in Government of National Capital
Territory of Delhi (GNCTD) hospitals, Post Graduate Institute of Medical
Education & Research, Chandigarh (PGIMER) and Sawai Maan Singh Hospital
(SMS), Jaipur as part of HMIS system being developed for them.

Keywords: Bio-Medical waste, segregation, disposal, waste handler, Bio

hazardous waste, Radio Frequency Identification.

1. Introduction

Bio-Medical Waste is any waste generated during the diagnosis, treatment or immunization
of human beings or in research activity [1]. The waste produced in the course of health care
activities carries a higher potential for infection and injury than any other type of waste [2].
Bio-Medical waste generated in the hospital falls under two major Categories - Non
Hazardous and Bio Hazardous. Constituents of Non Hazardous waste are Non-infected
plastic, cardboard, packaging material, paper etc. Bio hazardous waste again falls into two
types (a) Infectious waste- sharps, non sharps, plastics disposables, liquid waste, etc. (b)
Non infectious waste-radioactive waste, discarded glass, chemical waste, cytotoxic waste,
incinerated waste etc
Approximately 75-90% of the Bio-Medical waste is non-hazardous and as harmless as any
other municipal waste. The remaining 10-25% is hazardous and can be injurious to humans
or animals and deleterious to environment. It is important to realise that if both these types
are mixed together then the whole waste becomes harmful.[3]
Major hospitals contribute substantially to the quantum of Bio-Medical waste generated.
Smaller hospitals, nursing homes, clinics, pathological laboratories, blood banks, etc also
contribute a major chunk.

Proceedings of ASCNT – 2009, CDAC, Noida, India, pp. 26 – 31

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This paper presents various aspects of Bio-Medical waste System which has been designed
by us. It is divided into following sections. Section 2 elaborates major issues in the Bio-
Medical waste management. Section 3 describes the “Bio-Medical Waste (management
and handling) Rules, 1998 of the Ministry of Environment and Forests. Section 4 discusses
the salient features of the BMWM system developed.

2. Bio-Medical Waste: Management Issues

A major issue related to current Bio-Medical waste management in many hospitals is that
the implementation of Bio-Waste regulation is unsatisfactory as some hospitals are
disposing of waste in a haphazard, improper and indiscriminate manner.
Lack of segregation practices, results in mixing of hospital wastes with general waste
making the whole waste stream hazardous. Inappropriate segregation ultimately results in
an incorrect method of waste disposal.
A bag not securely tied results in scattering of Bio-Medical waste. Bio-Medical waste
scattered in and around hospitals invites flies, insects, rodents, cats and dogs that are
responsible for spread of communicable diseases like plague and rabies.
Most importantly there is no mechanism to ensure that all waste collected and segregated,
reaches its final destination without any pilferage. Additional hazard includes recycling of
disposables without even being washed. [5].
Usage of same wheel barrow for transportation of all categories of waste is also a cause of
infection spreading. Most of the times there is no monitoring of trolley routes, resulting in
trolley movement around patient care units posing a serious health hazard.
There is no mechanism for ensuring waste treatment within prescribed time limits. Note
that, Bio-Medical waste if not handled properly and within the stipulated time period could
strike in the form of fatal infections.
In some hospitals there is no proper training of the employees in hazardous materials
management and waste minimization aspects. This indicates the lack of even basic
awareness among hospital personnel regarding safe disposal of Bio-Medical waste.

3. Bio-Medical Waste Rules, 1998

Keeping in view inappropriate Bio-Medical waste management, the Ministry of

Environment and Forests notified the “Bio-Medical Waste (management and handling)
Rules, 1998” in July 1998. In accordance with these Rules (Rule 4), it is the duty of every
“occupier” i.e. a person who has the control over the institution and or its premises, to take
all steps to ensure that waste generated is handled without any adverse effect to human
health and environment.
Handling, segregation, mutilation, disinfection, storage, transportation and final disposal
are vital steps for safe and scientific management of BMW in any establishment [3].
Schedule I of the Bio-Medical rules contains the categories of Bio-Medical Waste [4]
(Refer to Table1). Schedule II contains the Colour coding and the type of container for
disposal of different Bio Medical waste categories [4]. (Refer to Table2).

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Priti Razdan, Amarjeet Singh Cheema

Table1. Schedule I of the Bio- Medical Waste Rules

Option Treatment & Disposal Waste Category

Cat. No. 1 Incineration /deep burial Human Anatomical Waste (human tissues,
organs, body parts)
Cat. No. 2 Incineration /deep burial 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)
Cat. No. 3 Local autoclaving/ micro Microbiology & Biotechnology waste (wastes
waving/ incineration from laboratory cultures, stocks or specimens of
micro-organisms live or attenuated vaccines,
human and animal cell culture used in research
and infectious agents from research and industrial
laboratories, wastes from production of
biological, toxins, dishes and devices used for
transfer of cultures)
Cat. No. 4 Disinfections (chemical Waste Sharps (needles, syringes, scalpels blades,
treatment glass etc. that may cause puncture and cuts. This
/autoclaving/micro includes both used & unused sharps)
waving and mutilation
shredding
Cat. No. 5 Incineration / destruction Discarded Medicines and Cytotoxic drugs
& drugs disposal in (wastes comprising of outdated, contaminated
secured landfills and discarded medicines)
Cat. No. 6 Incineration, Solid Waste (Items contaminated with blood and
autoclaving/micro body fluids including cotton, dressings, soiled
waving plaster casts, line beddings, other material
contaminated with blood)
Cat. No. 7 Disinfections by Solid Waste (waste generated from disposable
chemical treatment items other than the waste sharps such as tubing,
autoclaving/micro catheters, intravenous sets etc.)
waving& mutilation
shredding.
Cat. No. 8 Disinfections by Liquid Waste (waste generated from laboratory
chemical treatment and & washing, cleaning , house-keeping and
discharge into drain disinfecting activities)
Cat. No. 9 Disposal in municipal Incineration Ash (ash from incineration of any
landfill bio-medical waste)
Cat. No. 10 Chemical treatment & Chemical Waste (chemicals used in production
discharge into drain for of biological, chemicals, used in disinfect ion, as
liquid & secured landfill insecticides, etc)
for solids

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Table2. Schedule II of the Bio-Medical Waste Rules

Colour Type of Containers Waste Treatment Options as per

Coding Category Schedule 1
Yellow Plastic bag 1,2,3,6 Incineration/deep burial
Red Disinfected 3,6,7 Autoclaving/Micro waving/
Container/ Plastic bag Chemical Treatment
Blue/ White Plastic bag/ puncture 4,7 Autoclaving/Micro waving/
translucent proof container chemical treatment and
destruction/shredding
Black Plastic bag 5,9,10 Disposal in secured landfill
(Solid)

4. The Bio-Medical Waste Management System of e-Sushrut

e-Sushrut, the hospital management Information system developed by C-DAC is a web
based system developed using J2EE architecture (Figure 1). It consists of various modules
which broadly belong to three main groups Patient Care, Support Services and Back
Office. Bio-Medical Waste Management (BMWM) system is one of the important
modules of the support services group of HMIS.

Fig.1 HMIS Architecture

BMWM module aims to track the hospital waste within the hospital, right from its
generation, segregation, transportation and disposal, as required under the provisions of the
Bio-Medical Waste (Management and Handling) Act 1998 and rules framed there under.
The module makes the record keeping and tracking of waste easy along with generating
reports for perusal of the hospital management and any designated monitoring agency like
Delhi Pollution Control Committee (D.P.C.C.). The major components are described in the
following subsections.

4.1 Segregation
The segregation of Bio-Medical waste is the key to successful Bio- Medical waste
management. This aspect is taken care in the BMWM by capturing information regarding

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the waste material like solid waste, sharp waste, chemical waste etc, collected from various
locations in the hospital at the waste generation point itself.
Weighing machines are made available to the staff to weigh the waste bags properly for
correctness of data.. A digital weighing machine with direct interface to the system is also
used for this.
A trend analysis of the waste generation based on the reports generated by the BMWM
module helps the hospitals in arriving at an approximate amount of waste, category wise at
various points. This approximation is then used to ascertain the correctness of the quantity
of actual waste collected (category wise) in different areas and entering it into the online
BMWM system.
The weight approximation trends also help in gradually developing the judgement of the
hospital staff and guides them to tie the bags once they are filled ¾ of its capacity.
The system ensures the segregation of waste bags at the point of generation in accordance
with Schedule I of Bio-Medical Waste rules.

4.2 Transportation
For monitoring malpractice of waste, BMWM modules cross-checks the waste information
gathered from each point and ensures total handover of the waste at the storage area.
The system has the provision to implement at least two checking-barriers between sources
of waste to its destination. Here bags are weighed and checked to ensure that the waste is
not re-circulated nor deviates from its designated path of movement.
The BMWM module also contains a mechanism to define and enforce the trolley schedule
and route. Each trolley can be dedicated to collect only a particular type of waste from the
bins. Bins are located at a stationery location where as trolley is moving from department
to department for collection of waste.

The trolleys are attached with Radio Frequency Identification (RFID) tags for monitoring
the trolley movement. Complete Trolley routes as well as Zero Tolerance Area routes are
installed with RFID readers. This is to ensure that the transportation of waste is as per its
defined path and also enforce the transportation of waste away from patient care units.

4.3 Disposal
Every hospital generating Bio-Medical waste needs to set up requisite Bio-Medical waste
treatment facilities to ensure proper treatment of waste. As per the guidelines no untreated
Bio-Medical waste is to be kept stored beyond a period of 48 hours.
The BMWM module handles all aspects related to fuel filling, complaints lodging, etc of
the Waste disposal equipments for ensuring smooth functioning of the Bio-Medical waste
treatment facilities. The module is also able to generate alerts under exceptional conditions
such as waste not treated with in stipulated time.
Additionally online help will be available that gives exact references to the guidelines from
“Bio-Medical Waste (management and handling) Rules, 1998”. This will help the users in
proper waste generation, segregation, transportation, handling, disposal, etc.

5. Conclusion

Bio-Medical waste management system is closely coupled with User Management for role
permissions, Alert Management, Material Management for items, Equipment Maintenance
etc. It ensures strict adherence to schedules of the Environment (Protection) Act by the

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Ministry of Environment & Forest, Govt. of India. It ensures that, as far as possible staff
adheres to the governmental guidelines related to Bio-Medical Waste Management for
doing their routine activities.
The BMWM module is ready for implementation at Guru Gobind Singh Hospital,
Raghubir Nagar, Delhi (pilot hospital of the GNCTD project).

Acknowledgment

This work was part of the HMIS project development. We express our gratitude to the
Health and Family Welfare Department of Delhi Government for awarding the HMIS
project of GNCTD hospitals to C-DAC Noida. We are thankful to the GNCTD project
module committee members Dr.Vijay Rai, Nodal Officer(IT), H&FW Department, Delhi
Government, Dr.Vandana Bagga, Guru Gobind Singh Hospital, Delhi and Dr Ravinder
Agrawal, Nodal Officer(IT), G.B.Pant Hospital, Delhi for helping us understand the
complete domain of waste Management.

References

[1] Govt of India, Ministry of Environment and Forests Gazette notification No 460 dated
July 27, New Delhi:1998:10-20
[2] Park K. Hospital Waste Management. Park’s Textbook of Preventive and Social
Medicine. M/s Banarasidas Bhanot Publications, New elhi. 18th Edn, 2005: 595-598.
[3] Biomedical Waste Management - An Emerging Concern in Indian Hospitals.
Author(s): Virendar Pal Singh, Gautam Biswas, Jag Jiv Sharma Vol. 1, No. 1 (2007-
07 - 2007-12).
http://www.indmedica.com/journals.php?journalid=11&issueid=98&articleid=1324&a
ction=article. Last accessed on 6th February 2009.
[4] http://envfor.nic.in/legis/hsm/biomed.html - Website of the MINISTRY OF
ENVIRONMENT & FORESTS. Last accessed on 6th February 2009.
[5] National AIDS Control Organisation. Manual of Hospital infection control, New
Delhi, 1998;50-66

About Authors

Ms. Priti Razdan has graduated in Electronics Engineering from Pune

University in the year 1994. She has also done a Diploma in Advanced
Computing from C-DAC, Delhi. Since 1997, she has been associated with the
Health Informatics Group of C-DAC. In her career span of more than a decade
she has had the opportunity to be exposed to the in depth workflow of
Government as well as Super speciality Indian hospitals.

Mr. Amarjeet Singh Cheema, is an Electrical & Electronics Engineer. He has

done his Post Graduation Diploma in Software Design from Electronics
Research & Development Centre, Noida. He started his career with C-DAC
Noida in the year 2001. He has trained himself as a Functional Analyst in health
domain and has done a number of successful implementations in the same area.
He has worked on various technologies C/C++, Pro C, Power Builder, Java-
J2EE (Struts Framework), Visual Basic, Oracle.

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