HOSPITAL WASTE MANAGEMNT

ELAMATHI.TIII-MBBS

CELESTRIANS

Definitions• Health care waste: Any waste generated

consequent to health care activity including those at home

• Biomedical Waste: As per Biomedical waste (Management and Handling)Rules 1998 of India, it is def. as a waste generated during diagnosis, treatment, immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals.

Sources of health care waste:• Government & private

hospitals • Nursing homes• Physician’s & Dentist’s

clinics• Dispensaries• Medical research &

training establishments• Mortuaries • Blood banks• Laboratories• Vaccinating centers• Bio-technology institutions

Classification of Health care waste

• Infectious waste• Pathological

waste• Sharps• Pharmaceutical

waste• Genotoxic waste• Chemical waste• Waste with high

content of heavy metals

• Pressurized containers

• Radioactive waste

Images:

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Health Hazards of Health care waste: Who’s at Risk ?• Doctors and nurses• Patients and visitors• Hospital support staff• Waste collection and

disposal staff• General public and• the Environment

Health hazards :• Hazards from infectious

waste & sharps• Hazards from chemical

& pharmaceutical waste

• Hazards from genotoxic waste

• Hazards from radio-active waste

• Public sensitivity

Treatment & disposal of health care waste:

• Incineration• Chemical

disinfection• Wet & dry thermal

treatment• Microwave

irradiation• Land disposal • inertization

Incineration• It is a high temperature dry oxidation process, that reduces

organic & combustible waste to inorganic incombustible waste. This process requires no pre- treatment

• This process reduces the waste-volume and weight.Suitable waste:•Low heating volume (>2,000 kcal/kg) & (>3,500 kcal/kg)•Combustible matter >60%•Non-combustible solid <5%•Non-combustible fine <20%•Moisture content <30%

Unsuitable waste:

•Large amnt. of reactive chemical waste•Pressurized gas containers•Ag salts photographic or radioactive waste•Halogenated waste eg., PVC•Wastes with high Hg & Cd content•Sealed ampules & ampules containing heavy metals

Types of incinerator:

•Double-chamber pyrolytic incinerators

•Single-chamber furnaces

•Rotary kilns operating at high temp.

Incinerator simpler diagram:

Double chambered incinerator:

Chemical disinfection:• In this process chemicals are added to waste• This is the most suitable method for treating liquid waste

e.g.., blood, urine, stool etc. & Solid waste e.g., microbial cultures, sharps etc.

• The types of chemicals used for disinfection of health-care waste are mostly aldehydes, chlorine compounds, ammonium salts, and phenolic compounds. 

• The use of ozone (O3) for disinfection of waste is currently being investigated. 

Wet thermal treatment(steam disinfection):

•Shredded infectious waste-high temperature- high pressure steam •This process is similar to autoclaving

Screw-feed technology:

•Dry thermal disinfection process•Waste shredded- rotating auger-heated

Wet and dry thermal treatment:

Microwave irradiation:•Microwave of frequency-2450 MHz, wavelength- 12.24 nm•Water present in the waste is heated by microwave•Mechanism of disinfection- heat conduction

Land disposal: •Acceptable route of disposal•Two types:open dumps sanitary landfills•Advantages of sanitary landfills over open dumpsGeological isolation of wasteAppropriate engineering preparation Organized depositDaily coverage of waste

Landfill image

Bio-Medical waste management(BMW) in India:

• Bio-Medical waste (Management and Handling) rule 1998, prescribed by the Ministry of Environment and Forests, Govt. of India, came into force on 20th July 1998.

• This rule applies to those who generate, collect, receive, store, dispose, treat or handle Bio-Medical waste in any manner.

• Generators: Administrative medical officer of health care facilities.

• Occupier/Operator : Authorized person of any health care facility- who deals with BMW in accordance with rules

• Waste audit: A survey of wastes generated in different health care settings is a basic- pre-requistte for planning & implementing a waste management endeavor.

Schedule-IClassification and management of BMW

in IndiaCategory Waste Type Treatment and Disposal

Method

Category 1 Human Wastes (Tissues, organs, body parts Incineration / deep burial

Category 2 Animal Waste Incineration / deep burial

Category 3 Microbiology and Biotechnology waste

Autoclave/microwave/incineration

Category 4 Sharps

Disinfection (chemical treatment)+/autoclaving/microwaving and mutilation shredding

Category 5 Discarded Medicines and Cytotoxic Drugs

Incineration/ destruction and drugs disposal in secured landfills

Schedule-I ( contd.,)Category Waste Type Treatment and Disposal Method

Category 6

Contaminated solid waste(Items contaminated with blood & body fluids including cotton, dressings, soiled plaster casts, lines, beddings ,etc.)

Incineration/autoclaving / microwaving

Category 7 Solid waste (disposable items other than sharps)

Disinfection by chemical treatment+ microwaving/autoclaving & mutilation shredding

Category 8

Liquid waste (generated from laboratory washing, cleaning, housekeeping and disinfecting activity)

Disinfection by chemical treatment+ and discharge into the drains

Category 9 Incineration ash Disposal in municipal landfill

Category10 Chemical Wastes (liquid & solid)Chemical Treatment + and discharge in to drain for liquids and secured landfill for solids

Schedule-IIColour coding and type of container for

disposal of bio-medical wastes:CATEGORIES- 5,9 AND 10 (SOLID)

CATEGORIES- 3,6 AND 7

CATEGORIES- 1,2,3 AND 6

CATEGORIES- 4 AND 7

SEGREGATION

COLOR CODE TYPE OF CONTAINER

WASTE CATEGORY

TREATMENT OPTIONS

Yellow Plastic bags 1, 2, 3 and 6 Incineration/deep burial

Red Disinfected container/plastic

bag

3, 6 & 7 Autoclaving/Micro Waving/Chemical

treatment

Blue/white transparent

Plastic bags/puncture

proof container

4 & 7 Autoclaving/Micro waving/chemical

treatment, Destruction & shredding

Black Plastic bag 5, & 9, AND 10 (SOLID)

Disposal in secured land fills

Colour coding as per schedule-II

Waste collection bags for waste types needing incineration shall not be made of chlorinated plasticsCategory 8,10 (liquid) does not require containers/bagsCategory 3 if disinfected locally need not be in containers/bags

Categories of Bio-Medical Waste in India

Mnemonics- HAM Was Discarded Soil LICking

H - Human anatomical WastesA - Animal WastesM - Microbiology and Biotechnology WasteWas - waste SharpsDiscarded - Discarded medicines and cytotoxic WastesS - Solid wastes (Contaminated with blood)S - Solid waste (disposables) other than sharpsL - Liquid wasteI - Incineration wasteC - Chemicals waste

Schedule – IIILabel for Bio-Medical Waste Containers/

Bags

Bio-Hazard CytotoxicHandle with Care

Note: Label shall be non-washable and prominently visible

SCHEDULE -VI

SCHEDULE FOR WASTE TREATMENT FACILITIES LIKE INCINERATOR/ AUTOCLAVE/ MICROWAVE SYSTEM

The contravention of the Act , Rules, Orders & directions may

lead to legal action• For failure or continued contravention a

fine @ Rs.5000 /Day may be charged.

• The punishment may lead to the imprisonment up to 5 years with fine up to Rs. 1 lakh.

• The failure or the contravention continues beyond one year, the imprisonment may be extended up to 7 years.

conclusion• Thus refuse disposal cannot be solved without public

education.• 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.• Start disposing waste first from within your home, then

outside home, then neighborhood, then your street, your area, city and then the nation and the world.

LET THE WASTE OF THE “SICK” NOT CONTAMINATE THE LIVES OF

“THE HEALTHY”.

K.park

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