BIOMEDICAL

WASTE
 Introduction
O Medical care – vital in our life and health.
O BMW -emerged as issue of concern world over.
O BMW real problem for
MAN, COMMUNITY,& ENVIRONMENT
O Safe scientific cost effective methods BMW management –
need of hour.
Magnitude of the Problem
O The quantity of biomedical waste generated per bed
per day will vary depending upon the type of health
problems, the type of care provided and the hospital
waste management practices.
O It varies from 1–2 kg in developing countries to 4.5
kg in developed countries such as USA.
O 10–15% of the waste is infectious in developed
countries whereas it varies from 45.5 to 50% in India,
requiring special handling
O According to one of the estimate Pakistan generates
2.0kg of waste per bed per day. This waste includes
used syringes, blades, used gloves, chemicals and
drugs etc
 Definition
• Waste generated O Any waste which consists
wholly or partly of human
during the or animal tissue, blood,
diagnosis, testing, other body fluids,
excretion, drugs or other
treatment, pharmaceutical products,
research or swabs or dressings, or
production of syringes, needles or other
sharp instruments, being
biological waste which unless
products for rendered safe may prove
hazardous to any person
humans or coming into contact with it
animals (WHO)
Household Biomedical Waste
O HBW include expired drugs, bandages, syringes,
sanitary napkins, disposable diapers, expired
cosmetics, blood stained cloths, used bottles of
syrups/tablets/ear-drops/eye-drops, used
ointment tubes, empty pain killer spray cans,
contaminated meat, ear buds, dead animals, etc
O The quantities of HBW vary from countries to
countries and houses to houses.
O The quantities have been estimated to vary
between 0 and 3 % of MSW by weight.
O The variability depends on development of a
country and income of individual.
 Categories of Biomedical
Waste
O Human anatomical waste: (tissues,
organs, body parts)
O Animal waste: (including animals
used in research and waste
originating from veterinary
hospitals and animal houses).
O Microbiological and biotechnology
waste: (including waste from lab
cultures, stocks or specimens of
microorganisms, live or attenuated
vaccines, wastes from production
of biologicals, etc.)
O Waste sharps: (used/unused
needles, syringes, lancets, scalpels,
blades, glass etc.)
O Discarded medicines and cytotoxic
drugs.
O Soiled wastes: (items contaminated
with blood and body fluids,
including cotton dressings, linen,
plaster casts, bedding etc.)
O Solid wastes: (wastes generated
from disposable items other than
waste sharps such as tubing,
catheters, i.v. sets, etc.)
O Liquid waste: (waste generated
from washing, cleaning, house
keeping and disinfection activities
including these activities in labs).
O Incineration ash: (from incineration
of any biomedical waste)
O Chemical waste: (chemicals used in
production of biological and
disinfection).
 Segregation
O Segregation is the essence of waste
management and should be done at the
source of generation of BMW.
O The responsibility of segregation should be
with the generator of BMW i.e, doctor,
nurses, technician etc
O The BMW should be segregated as per
categories mention in the rules
 Segregation
O Segregation is carried out in biomedical
waste management mainly following
reasons:
(1) to avoid contamination of non-infectious
waste by infection,
(2) to avoid entry of toxic waste like lead,
mercury and radioactive substance, and
(3) Entry of chlorinated waste which ultimately
leads to generation of dioxins and furans.
 Collection of BWW
O The collection should not be stored for more
than 24 hours.
O It is the duty of every “occupier” to take all the
steps to ensure that the waste generated is
handled without any adverse effect to human
health and environment.
O Handling, segregation, mutilation, disinfection,
storage , transportation and final disposal are
the vital steps for safe and scientific
management of BMW in any establishment.
 Transportation
O Within hospital, waste route must be design
to avoid the passage of waste through
patient care areas.
O Separate time should be embarked for
transportation of BMW to reduce the
chances of its mixing with general waste.
O Desiccated wheel containers, trolly or carts
should be used to transport the
waste/plastic bags to the site of
storage/treatment
 Cont..
O Trolleys should be thoroughly cleaned and
disinfected in the event of any spillage.
O Hazardous BMW needing transport to a long
distance should be kept in containers and
should have proper labels
 Cont..
O The transport is done through desiccated
vehicles constructed for the purpose having
fully enclosed body, lined internally with
stainless steel and to provide smooth and
impervious surface which can be cleaned.
O The driver compartments should be
separated from the load department with
bulkhead
 Incineration
O All the waste should not be incinerated and the
following categories need to be avoided for
safety and environmental considerations:
O large amounts of reactive chemical waste,
O pressurized gas containers,
O halogenated plastics,
O Sealed ampoules,
O waste with heavy metals like mercury, cadmium
and lead,
O Silver compounds, and
O photographic/radiographic wastes.
 Hybrid treatments
O These are the treatment units in where two or more
treatment processes are carried out simultaneously. Typical
examples include hydro clave wherein shredding and
autoclaving is carried out simultaneously.
O Another example includes microwaving and autoclaving
being carried out in single equipment.
 Microwaving
O Microwave treatment should
not be used for cytotoxic,
hazardous or radioactive
wastes, contaminated animal
carcasses, body parts and large
metal items.
O Presence of metal leads to
sparkling and possibly health
hazards.
O The microwaving demands
comparatively higher
investment and proper
segregation of waste.
 Deep Burial
O Deep burial pits are recommended and used in rural
and isolated areas where it is not prudent to invest
huge amount of money.
O A deep burial pit/trench is dug approximately two
meters deep.
O The biomedical waste shall be half filled and covered
with lime followed by soil.
O Proper covers of sheet metal or wire meshes may be
used.
O When wastes are inserted to the pit, a layer of
approximately 10 cm of soil should be spread to
cover the wastes.
O The deep burial site should be relatively impermeable
 Chemical Treatment
O Chemical treatment can be both on- and off site.
While it is recommended to use disinfectant a
point of generation with respect to sharps, other
wastes can be disinfected
O Chemical treatment is the choice where power is
not available to operate autoclave or any other
equipment which demands power.
O Chemicals are added to the waste to kill or
inactivate the pathogens in biomedical waste
O 1% (of active chlorine) sodium hypochlorite is
most commonly used disinfectant
Radioactive Waste
O Containers of radioactive waste should be
marked as ‘RADIOACTIVE WASTE’ with the
radiation symbol. The container should be
labeled with information required by statute
such as origin of the waste, period of
storage required, quantity, responsible
person, etc.
 Treatment
O Treatment processes can result in the generation of
secondary radioactive wastes (spent resins,
contaminated filters, sludge, ash) and they should be
managed appropriately.
O Conditioning is used for converting radioactive waste
to a form which is more suitable for handling.
O The operations include
(1) placing the waste in suitable containers,
(2) immobilization of radioactive waste in concrete,
(3) and providing additional packaging.
 Precautions for handling
radioactive waste
O Disposal of sharps containing radioactive residues shall be
carried out after storing the same until radiation reaches
permissible limits,
O Radioactive solid waste should not be treated by autoclave or
microwave,
O Solid radioactive waste like bottles, glassware, and containers
shall be deformed/mutilated before disposal to avoid reuse,
O Radioactive waste of shall be stored for decay in labeled
containers, under lead shielding, until radiation reaches
permissible limits,
O Spilled radioactive waste shall be retained in suitable
containers until the radiation reaches permissible limits, and
O Patient’s excreta after diagnostic procedures shall be checked
frequently for radioactive contamination.
 Management Issues
Enforcement of rules pertaining to biomedical waste in developing
countries are difficult for the following reason:
O Attitude of health care
O Quacks in professions professionals to discard as it is
O Profession being practiced and where it is
by numerous doctors from home andO Pressure to increase profits,
O poor law enforcement by local
garage without formal trade license,
O bodies which can take action for
Practice is intentionally not registered causing nuisance,
in any government organization O The behavior of waste throwing
is deep registered in unconscious
to avoid income tax mind, and
O Lack of importance given for
education in waste management.