Biomedical waste management in India is important to prevent disease transmission. The types of biomedical waste include infectious waste like human tissues and sharps, and non-infectious waste like packaging. Improper management can spread hepatitis, HIV, and other diseases. The Bio-Medical Waste Rules were created in 1998 to regulate segregation, storage, transportation, treatment and disposal of wastes. Case studies show that some hospitals failed to properly dispose of wastes, putting public health at risk. Strong enforcement of waste management practices is still needed.

1. By
Caroline Karunya Ponnarasi Kanagaraj
Group-IV
IIIrd year
3/18/2015 done by LORD JESUS 1
BIO-MEDICAL WASTE
MANAGEMENT IN INDIA

2. INTRODUCTION
• Biomedical Waste (BMW):
– Any solid or liquid waste which may present a threat to humans,
including non-liquid tissue, body parts, blood, blood products, and body
fluids from humans and other primates; laboratory and veterinary wastes
which contain human disease-causing agents; and discarded sharps.
• Sources of generation of Bio-medical wastes:
– Hospitals, Nursing Homes, Veterinary Hospitals, Dental Clinics,
Pathological & Diagnostic Laboratories, Blood Bank etc.
• Type of Health Care Waste:
– These are of two types (i) Infectious Wastes (ii) Non-infectious Wastes
3/18/2015 done by LORD JESUS 2

3. HEALTH CARe WASTES
• INFECTIOUS HEALTH CARE WASTES (Bio-medical Waste):
– Human anatomical / surgical waste, Animal waste
– Pathological waste including tissues, organs, blood and body fluids, microbiological
cultures, Cotton,Swabs etc.
– Used Syringes, I.V. tubes, Blood bags and other items contaminated with blood and body
fluids.
– Items such as plaster, casts and bandages, when contaminated by blood and pus.
– Waste from isolation wards.
The amount of infectious waste is near about 25% of the total wastes generated from a health care
establishment.
• NON-INFECTIOUS HEALTH CARE WASTE:
– Non-infectious waste is broadly classified as Kitchen waste and Office wastes. It is
similar to household waste. Non-infectious wastes constitutes nearly 75% of the total
wastes generated from a health care unit.
3/18/2015 done by LORD JESUS 3

4. BIO-MEDICAL SURVEY
• The All India Institute of Hygiene and Public Health, Kolkata conducted a
study on Hospital Waste Management in W.B., sponsored by the WBPCB in the
year 1996-97 and concluded that:
– General waste containing food wastes, paper, plastics, floor sweeping, discarded
glassware, earthen pot etc. constitute bulk (56-78% by weight) of the hospital waste.
– Waste generated in large government hospitals in Kolkata, is 1044 gms/bed/day whereas
waste generated in large government hospitals in districts is comparatively low at 397
gms/bed/day.
– Certain salvageable items like saline bottles, surgical gloves, I.V. fluid bottles syringes
etc. are disposed
– after use in the wards without distorting or damaging. As a result, there remains a
possibility of reuse of the said items.
– Incinerable waste constitutes 19-30% (by weight) of the total waste generated.
3/18/2015 done by LORD JESUS 4

5. HEALTH IMPACTS OF BIO-MEDICAL WASTE
• Exposure to infectious BMW can result in disease or injury. It may
contain:
– infectious agents, toxic or hazardous chemicals or pharmaceuticals, radio active
wastes and waste sharps.
• The infectious wastes may contain any of the great variety of pathogenic
microorganisms. Pathogens in infectious wastes may enter the human
body through a number of routes like a puncture or cut in the skin,
mucous membranes, by inhalation or ingestion.
• Sharps may not only cause cuts and punctures but also infect the wounds
if they are contaminated with pathogens. Because of this dual risk – of
injury and disease transmission – sharps are considered as a
veryhazardous waste class.
3/18/2015 done by LORD JESUS 5

6. HEALTH IMPACTS OF BIO-MEDICAL WASTE
• Poor hospital waste management may cause the following:
– Hepatitis B & C
– HIV infection
– Gastro-enteric infection
– Respiratory infection
– Blood stream infection
– Skin infection
– Radioactive toxicity
– Health problems associated with air and water pollution.
3/18/2015 done by LORD JESUS 6

7. HEALTH IMPACTS OF BIO-MEDICAL WASTE
 Decomposing waste may generate foul odour inside the hospital premises and
surrounding area.
 Drains may be clogged with waste materials creating an unhygienic environment in
the surrounding hospital premises. This phenomenon may also help in the breeding
of mosquitoes/flies that might contribute to the spread of infectious diseases.
 Waste dump may attract stray animals and birds that might spread waste materials
leading to an unaesthetic and unhygienic environment.
 Indiscriminate disposal of pharmaceutical products (antibiotics and cytotoxic drugs)
and discharge of
 untreated wastewater generated from the health care units could have disastrous
ecological effects.
 Open dump of waste may decompose to produce leachate that might contaminate
ground water.
 Uncontrolled and open burning of wastes can generate dioxins and furans, thus
polluting the air.3/18/2015 done by LORD JESUS 7

8. 3/18/2015 done by LORD JESUS 8

9. Rules framed for the BMWmanagement
• Realizing the seriousness of the problem associated with the poor management of the bio-
medical wastes , the Ministry of Environment and Forests (MoEF), Govt. of India, notified
the Bio-Medical Waste(Management and Handling) Rules in July 1998 under the
Environment (Protection) Act, 1986, through a Gazette notification [S.O. 630(E)].
• Thereafter, the Bio-Medical Waste (Management and Handling) Rules were amended twice in
the year 2000 and the last amendment was made in the year 2003.
• The first amendment was published on 6th March 2000 vide S.O. 210(E), the second
amendment was published on 2nd June 2000 vide the Gazette Notification S.O. 545(E) and
third Amendment was published on 17thSeptember 2003 vide Gazette Notification S.O.
1069(E).
• The main objective of the rules are to ensure proper segregation, collection, transportation
and disposal of the infectious BMW in order to safe guard the public health of the
society.3/18/2015 done by LORD JESUS 9

10. Segregation of Bio-medical Wastes
Bags/Bins Type of wastes Treatment
Yellow Bags Anatomical waste incineration (for cities with population more than
5
lakhs) or Deep Burial Pit
Red Bags Infectious wastes Autoclaving or Micro Waving followed by
Shredding
Blue/White Puncture
proof containers
Sharp wastes Mutilating and disinfecting by Chemical treatment
and then Autoclaving or Micro Waving
Black bins For normal MSW/
kitchen wastes
Disposal in MSW disposal ground
3/18/2015 done by LORD JESUS 10

11. 3/18/2015 done by LORD JESUS 11
Yellow Bag
(Incineration/Deep burial)
Blue Bag
(Autoclaving)
Puncture proof Container
for sharp waste(Autoclaving
after chemicaltreatment)
Human Anatomical waste
(Human
tissue, organs, Placenta,
body parts)
Specimens from
laboratory/research
centre
Surgical Waste
Blood contaminated Cotton
Blood contaminated Bandages
Soiled Plasters
Blood contaminated Dressing
Anatomical waste (Animal
tissue,
organs, body parts, etc.)
Syringes
Urine bags
Catheters
I.V. fluid bottle
Blood Bags
Stents
Gloves
Aprons
Any other tubing
Needles
Cut glass
Blades
Scalpels
Slides
Lancets
General wastes of health care
unit kept
in Black coloured bag
Segregated incinerable wastes
kept
in Yellow

12. Segregated incinerable wastes
kept in Yellow coloured bag
3/18/2015 done by LORD JESUS 12
Segregated Autoclavable wastes
kept in Blue coloured bag
General wastes of health care
unit kept in Black coloured bag

13. TREATMENT AND DISPOSAL OF BMW
• The Bio-medical Wastes are broadly classified into :
– incinerable wastes
– autoclavable wastes.
• The incinerable wastes :
 treated by incinerator or through deep burial pit as per the provisions of the Rules.
 The waste incinerator shall have a dual chamber i.e. primary chamber & secondary
chamber.
 The temperature of the primary chamber shall be 800 ± 50 0C and the temperature of
the secondary chamber shall be 1050 ± 50 0C.
 The incinerator shall have adequate pollution control devices to control environmental
pollution.
 No chlorinated plastic shall be incinerated in order to prevent formation of Dioxins &3/18/2015 done by LORD JESUS 13

14. TREATMENT AND DISPOSAL OF BMW
• The autoclavable wastes(non-incinerable BMW) can be treated
by Autoclave/ Microwave/Hydroclave etc.
• The waste autoclave may be of two types:
 Gravity Flow Autoclave
 Vacuum Autoclave.
• Normally vacuum type autoclave is used for the treatment of non-
incinerable wastes. The temperature,
pressure & time which are required for treatment of BMW are either
121 0C, 15 psi & 45 minutes or 135 0C, 31 psi & 30 minutes
3/18/2015 done by LORD JESUS 14

15. 3/18/2015 done by LORD JESUS 15
Waste handling at Common facilityWaste Autoclave
A work man working with incinerator in madurai

16. Incinerator with Air Pollution Control Device
3/18/2015 done by LORD JESUS 16
Chimney for Incinerator

17. Case study
• In 2003, a rag-picker, but for whose tribe Mumbai would have been a dirtier place
despite having a civic body in place, found a human hand on a garbage dump. The
incident raised a hue and cry which brought to light the fact that the city’s healthcare
system did not give a damn about how it disposed of its biomedical waste.
• Two years down the road, a child from a city slum, playing near the garbage dump,
picked up a thing with a pointy end and playfully sprayed his friend with its content.
That cost his 7-year-old pal his eye, all in innocent but decidedly deadly fun. When a
social worker took up the blinded boy’s cause, it once again focused attention on
biomedical waste management practices in the city. The law demands the segregation
of such waste, and placing them in differently coded bags for disposal.
• These two cases relate to what was seen and done on garbage heaps. Things that ought
not to have arrived there at all had found their way there. The hospital concerned and
the city’s solid waste managers had failed again.
3/18/2015 done by LORD JESUS 17

18. Nine years on, have there been any noticeable improvements in this
scary scenario?
• NO
• WHY???
• Lets think!!!!
3/18/2015 done by LORD JESUS 18

19. conclusion
• As a future doctors try to practice and imply in your own
hospital.
• Encourage your collegues to know about this and make
them to follow this law.
• Don’t become a reason for: a healthy to become
unhealthy
“Let the waste of the “sick” not contaminate the lives of “The
Healthy”
3/18/2015 done by LORD JESUS 19

20. 3/18/2015 done by LORD JESUS 20

21. 3/18/2015 done by LORD JESUS 21