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Biomedical Waste

Transcript: Biomedical Waste What effect does the contamination of biomedical waste have on water? 1 Present all the details Water 2 In the late 1980s there were a series of syringe wash ups on beaches along the East Coast of the United States, which were mistakenly attributed to health care facilities. The federal Medical Waste Tracking Act (MWTA) was passed and the EPA attempted to set standards for managing the infectious waste component of medical waste that they renamed regulated medical waste. Few states adopted its stringent guidelines. The MWTA expired in the early 1990s, making each state responsible for establishing its own classification and management guidelines for medical waste. There are very few documented cases of disease transmission from contact with medical waste. The notable exception is needle stick, or "sharps" injuries. Paralleling the concern over beach wash ups of medical waste, was a growing awareness of the increase in HIV-AIDS and other cases of infectious diseases being diagnosed and treated in health care settings. Noting that there are multiple risks inherent in medical waste including toxic chemicals and radioactive materials. Medical waste in the ocean creates biohazards. Medical waste is defined by the Environmental Protection Agency as anything that contains bodily fluids or wastes, such as surgical gloves, needles, swabs, body organ cultures and even bloody bandages. Medical waste can come from hospitals or veterinary clinics, as well as laboratories and research facilities involving stem cell research or those creating chemicals or medicines for health care use. Sometimes, such types of waste end up in the ocean, and are potential hazards, not only to the ocean environment, but to humans who come into contact with it. Some medical waste in the ocean may be contaminated with blood or other body fluids of individuals diagnosed with acquired immune deficiency syndrome, more commonly known as AIDS. Think Quest, a student resource and information portal, believes that many medical companies and facilities around the globe wantonly toss medical waste and garbage into the ocean for easy disposal. 3 All separated design elements Customize: The World is Watching Where are You? ? Question Time? Thank Your Audience! Goodbye Now!

BIOMEDICAL WASTE MANAGEMENT

Transcript: ABSTRACT The waste produced in the course of health care activities carries a higher potential for infection and injury than any other type of waste. The present scenario of biomedical waste (BMW) management in Indian hospitals is grim. However there is an emerging concern regarding biomedical waste management, particularly as a result of notification of Bio Medical Waste (Management and Handling) Rules, 1998 which makes it mandatory for the health care establishments to ensure that such waste is handled without any adverse effect to human health and environment. This presentation intends to create awareness amongst the personnel involved in health care services. Bio-medical waste (BMW) means any waste generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, including categories mentioned in Schedule I of BMW Management (BMWM) and Handling Rules 1998 In 2011, it was estimated that gross generation of BMW in India was 4,05,702 kg/day of which only 2,91,983 kg/day was disposed, which means that almost 28% of the wastes was left untreated. Objectives of Bio Medical Waste Management To prevent transmission of disease from patient to patient From patient to health worker and vice versa To prevent injury to the health care worker and workers and workers in support services, while handling biomedical waste To prevent general exposure to the harmful effects of the cytotoxic, genotoxic and chemical biomedical waste. Due to increase in the population, the amount of biomedical waste generation also increased it requires attention.. Within the domain of municipal solid waste, biomedical waste acquires a special dimension, since it is infectious and hazardous. Biomedical waste is generated in hospitals, nursing homes, clinics, medical laboratories, blood banks, animal houses etc. Such a waste can also be generated at home if health care is being provided there to a patient (e.g. injection, dressing material etc.) Impacts of BMW on social environment and health It is important to understand the impacts of biomedical waste (BMW) on the social environment and on health. Improper management of BMW could lead to infections and other health hazards. The infectious agents can enter a healthy body through Puncture, Abrasion or cut in the skin; Through mucous membranes; Inhalation; Ingestion. BMW rules were formed under Environment Protection Act, 1986 by the Ministry of Environment and Forest; Government of India. Biomedical Waste Management and Handling rules,1998 implemented on 20th July 1998. Further amendments of the Biomedical Waste (Management & Handling) Rules 1998, were done by Government of India in the year 2000 , 2003 , 2008 & 2011. In accordance with these rules, it is the duty of every “occupier” i.e. a person who has the control over the institution or its premises, to take all steps to ensure that waste generated is handled without any adverse effect to human health and environment. The hospitals, nursing homes, clinics, dispensaries, pathological laboratories etc., are therefore required to set in place the biological waste treatment facilities. It is however not incumbent that every institution has to have its own waste treatment facility. The rule also envisages that common facility or any other facilities can be used for waste treatment. However it is incumbent on the occupier to ensure that the waste is treated with in a period of 48 hours. Bio Medical Waste (Management and Handling) Rules have SIX schedules. NOTES Colour coding of waste categories with multiple treatment options as defined in Schedule I, shall be selected depending on treatment option chosen, which shall be as specified in Schedule I. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics. Categories 8 and 10 (liquid) do not require containers/bags. Category 3 if disinfected locally need not be put in containers/bags. STANDARDS FOR WASTE AUTOCLAVING STANDARDS FOR INCINERATORS STANDARDS OF MICROWAVING STANDARDS FOR DEEP BURIAL Specifically colored plastic bag should be kept in its container. Bins and bags should bear the bio hazard symbol. As soon as three fourth of the bag is full of waste it should be removed from the container, tied tight with a plastic string and properly labeled. Under no circumstances, an infectious waste should be mixed with the non-infectious waste. Collection of disposable items (syringes, I/V bottles, catheters, rubber gloves etc) should be undertaken when they have been mutilated (cut) chemically disinfected (by dipping in 1% hypochlorite solution for 30min.) Syringe barrel should always be separated from the plunger before disinfection. .Needles should be destroyed with needle destroyer. All other sharps must be strongly disinfected (chemically) before they are shredded or finally disposed. Sharps should be kept in puncture proof containers and

Biomedical Waste

Transcript: Device recycling Redesigning prosthesis so that they can be used multiple times. Once a medical machine breaks down or becomes out-dated, allow for the machine to be used for medical students to practice or recycle the parts Innovation Design products that will either readily decompose without harming the environment or make them reusable. Pharmaceuticals Invent new drugs that not only temporarily remove the illness but instead begins permanent immunity. Biomedical Waste is treated by steam, incineration, or an alternative process approved by the department, prior to disposal. Treatment should occur within 30 days of collection from the generator. Biomedical Waste Why the current regulations do not solve the problem of biomedical waste Current Regulations An alternative treatment process, such as chemical, gas, dry heat, or microwave shredding, should be considered by the department upon receipt of a written request. "Biomedical waste." Regulated medical waste resources locator. Florida Bureau of Community Environmental Health. Web. 29 Oct 2012. <http://www.envcap.org/statetools/rmw/fl-rmw.cfm>. Unknown, . "Degree Programs For Biomedical Engineers : Online And Campus Schools: Career Information." College Grad. QuinStreet Inc, n.d. Web. 18 Oct 2012. NC State University Department of Biomedical Engineering, . "Biomedical Engineering." What can I do with a major in..?. NC State University, 10 2011. Web. 18 Oct 2012. By: Andrew Rushing Solutions Any solid or liquid waste which may present a threat of infection to humans including nonliquid tissue, body parts, blood, blood products, and body fluids which contain human-disease agents Every day approximately 4.2 lakh (1 lakh=100,000) kg of biomedical waste is produced and there are only 157 facilities authorized to treat this waste. Sources of Biomedical Waste Needles Outdated medical equipment Used prostheses Factory emissions from producing products Biomedical waste may be disposed into a sanitary sewer system, an on site sewage treatment and disposal system, or other system approved to receive such waste by the DEP or the department, if aerosol formation is minimal. Definition The Government has set up waste management rules which need to be followed by all the hospitals in the country but around 15,000 hospitals have been served a notices for violating these rules. References Recycling

Biomedical Waste

Transcript: Classification of Biomedical Waste HOW are those affected? Problems Identified Effects of Biomedical Waste Pharmaceuticals Waste generated during : Diagnosis and treatment Immunization of human beings or animals In research activities pertaining thereto or in the production or testing of biologicals [1] Waste from : Surgery Isolation wards Equipments that have been in contact with infected patients, excreta, etc.. DATA COLLECTION [7months] What is Biomedical Waste? The autoclave operates on the principle of the standard pressure cooker. The process involves using steam at high temperatures. The steam generated at high temperature penetrates waste material and kills all the micro organism Biomedical Treatment Techniques: 28 hospitals 156 BHUs (Basic Health Units) 654 Outreach clinics (Ministry of Health, 2014) Objective of the Study: CASE STUDY Amount of waste produced in percentage (2015) Cottons Plasters Bandages Tubes Containers, etc.. Environmental Pollution(air, water and soil) Unpleasant Smell Growth and Multiplication of Vectors Spread of Communicable diseases Infection of non-communicable diseases Injuries from sharps Radioactive Biomedical Waste Drugs Expired/outdated pharmaceuticals products Lack of proper training for waste management team Less Supply of protective gears for dealing with waste Only one Operator for the Autoclave machine Lack of Autoclave bags Lack of proper route for transportation of waste to Autoclave site No inspection to assure health and policies Techniques for Treatment of Biomedical waste MEDICAL WASTE MANAGEMENT AT JIGME DORJI WANGCHUCK NATIONAL REFERRAL HOSPITAL, THIMPHU 1. Govt. of India, Ministry of Environment and Forests Gazette notification No 460 dated July 27, New Delhi: 1998: 10-20 2. Mathur P, Patan S, Shobhawat S. Need of Biomedical Waste Management System in Hospitals - An Emerging issue - A Review. Curr World Environ 2012;7(1):117-124. Infectious waste. Hazardous waste Radioactive waste. General waste. Sharps. Pharmaceuticals. Pressurized containers 3. Num Num Choden, MEDICAL WASTE MANAGEMENT AT JIGME DORJI WANGCHUCK NATIONAL REFERRAL HOSPITAL,THIMPHU. Outline AutoClaving Sonam Wangmo 02042013023 Tashi Phuntsho 02042013024 Decontaminate waste by destroying pathogens. Quantity of Biomedical Waste Produced REFERENCES Sharps Appropriate rules and regulations should be introduced Defined roles and responsibilities Improve waste storage facilities at the autoclave sites Timely and effective inspection Appropriate location for the placenta pit Proper Transportation mode By: Num Num Choden Who and What are affected by Biomedical waste? SOURCES OF Biomedical Waste Infectious Waste Lack of roles and Responsibilities Lack of waste storage facilities at the autoclave sites improper location of placenta pit How the medical waste is located, segregated, autoclaved, incinerated and whether the waste managing personnel follow the recommended procedure. Study conducted by Phub Gyem (PGDPA) 2016: Royal Institute of management . Biomedical Waste [2] Stopped Using Incinerator Started Using Autoclave Usage of Placenta Pit General Biomedical Waste Needles Infusion sets Scalpels Blades Knives Broken glass/tubes Biomedical Waste DEFINITION. SOURCES CONTENTS QUANTITY MANAGEMENT ENVIRONMENTAL RELEVANCE CASE STUDY by Num Num Choden Incineration Technology High temperature thermal process employing combustion of the waste under controlled condition for converting them into inert material and gases. RECOMENDATIONS Problems Identified Health Care Workers Waste Handlers Scavengers retrieving items from dump site Children who come in contact with the contaminated waste Communities residing near waste sites Environment Absorbent papers Swaps Glassware Syringes Vials Unwanted solution of radio nuclides, etc. Hospital Count in the country Medical Colleges and Research Centers Management of Biomedical Waste 1. Waste Collection 2. Segregation 3. Transportation and Storage 4. Treatment and Disposal 5. Transportation to final disposal site. 6. Final Disposal Nursing Home Blood Banks and Blood Donation Camp Hospitals Animal Veterinary and Animal Research Center Clinics Amount of waste produced at Jigme Dorji Wangchuk National Referral Hospital (2015)

BIOMEDICAL WASTE

Transcript: Disposal Procedures for Liquid Waste Activities involved in Pyrolytic incinerators- • Removal of ashes left inside the pyrolytic chamber (after cooling down). • Loading of waste packages to be incinerated. • Ignition of fuel burner in post-combustion chamber. • Ignition of the pyrolytic fuel burner to start waste burning in the pyrolytic chamber. • Stopping the fuel burners after completion of waste and gas burning, and letting the incinerator cool down. Liquid waste generated from hospital is adversely affected in quality when compared to sewage generated . Microbiology, Biotech. , Chemical waste Liquid Waste Contaminated Waste(Recyclable) Incineration Thank You! Glassware Microbiology, Biotechnology and other Laboratory Waste Disposal Procedures for Infectious Liquid Waste Waste generated from disposal items such as tubing, bottles, urine bags , gloves etc. Collected in Red coloured non- chlorinated plastic bags or container Autoclaving or micro-waving followed by shredding. Treated waste sent to authorized recyclers. Plastic waste should not be sent to landfill sites. Collected in White(Translucent) puncture proof, leak proof and tamper proof containers Autoclaving followed by shredding in metal or concrete container. Final disposal to iron foundries or sanitary landfill or designated concrete waste sharp pit. Waste sharps including metals Adequate for Infectious waste (including sharps) and pathological waste Efficient treatment; elimination of all pathogens. Pharmaceutical and chemical residues Incinerator capacity: Available capacities 200kg/day-10 tonnes/day.(Generally, 1 tonne/day used) BIOMEDICAL WASTE Among the various hazardous waste the important ones are formaldehyde, solvents (Xylene,Acetone, Ethanol, Methanol), mercury from broken thermometers and radioactive isotopes The various unused or discarded solvents can be stored in gallon drums and then incinerated Radioactive wastes are usually generated from nuclear medicine department and clinical laboratories.These materials can be retained on the site until they have been decayed to non hazardous level or they can be transported off site for land disposal.Waste is disposed of using the process of vitrification which encases the high radiation liquid in glass so that the liquid does not leach out during burial. Broken or discared and contaminated glass are collected in blue cardboard boxes with blue coloured marking Disinfection followed by recycling Disposal Procedures for Chemically Hazardous Liquid Waste AS PER WHO STANDARDS CLASSIFICATION OF WASTES Human tissues, Organs , Body Parts Pharmaceutical liquid waste (discarded/unused/expiry date medicines) Provision for storage Handles waste without adverse effect Pre-treat the waste Training on handling waste annually Immunisation of co-worker Ensure segregation of liquid chemical waste at source Ensure treatment and disposal of liquid waste If they are in small amounts, they can be diluted with water and discharged to the sewers. They can also either be transported off site to a secured land fill or returned to the supplier or small amounts can be incinerated. Waste Water Treatment Plant Human Anatomical Waste and Soiled waste Segregation and Management of Liquid Waste Photographic chemicals (Fixer and developer) Collected in Yellow Coloured non-chlorinated bags or container Incineration or Plasma Pyrolysis treatment may be used Contaminated linen, mattresses, beddings to be disinfected by non-chlorinated chemical before incineration PYROLYTIC /DOUBLE CHAMBER INCINERATION Waste generated during diagnosis, treatment or immunisation of human beings Segregation,Packaging and Treatment of Solid Waste Pharmaceutical wastes -Antibiotics,cytotoxic drugs Lab cultures, toxins Alcohol, Sulphuric Acid, Ammonia Collected in Yellow Coloured autoclave safe plastic bags or container Pre-treat to sterlize with non- chlorinated chemicals as per WHO guidelines before incineration. Waste sharps -Needles,syringes with fixed needles, blades BIOMEDICAL WASTE Human Anatomical Waste Expired/Discarded Medicines Duties of Occupier Incineration reduces organic and combustible waste to inorganic, incombustible matter Reduction of waste volume and weight Incinerators designed especially for treatment of health-care waste should operate at temperatures between 900 and 1200°C Pyrolytic Incinerators are widely used Pathological waste must be treated with chemical disinfectants,neutralized and then can be flushed into the sewage system Chemical waste need to be first neutralized with appropriate reagents before being flushed into the sewer Hence, these wastes should be first segregated and and then has to be disinfected or neutralized, with an approved chemical decontamination agent at the site of generation Eco-line system will be used for 40- Bedded Hospital. The neutralized liquid waste will be treated with the Sewage waste in the STP The quality parameters of effluent before treatment in STP is as mentioned Collected in

BIOMEDICAL WASTE MANAGEMENT

Transcript: 4.) Chemical Wastes 2.) Infectious Waste Disposal 5.) Pharmaceutical waste By: Darren Balbas WASTE DISPOSAL - Soiled waste (contaminated with blood & bloody fluids, plaster, cotton, wound dress) - Solid wastes (disposable) - waste that does not pose any particular biological, chemical, radioactive or physical hazard - Biodegradable & Non-Biodegradable - waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites CHEMICAL SPILL KIT - Human tissues, organs or fluids, body parts and contaminated animal carcasses B) Toxic Exposure - General domestic, office type waste, non-infectious biodegradable General Waste is Collected by the Municipality everyday TYPES & CLASSIFICATION OF WASTE End - may cause intoxication, either by acute or by chronic exposure, and injuries, including burns. Intoxication can result from absorption of a chemical or pharmaceutical through the skin or the mucous membranes, or from inhalation or ingestion used for cleaning up body fluids and secretions D) Air Pollution 3.) General Waste Disposal 7.) Radioactive waste 2.) Sharps Wastes WHO ARE AT RISK Any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals -Injuries to the skin, the eyes, or the mucous membranes of the airways can be caused by contact with flammable, corrosive, or reactive chemicals. - arising as a result of the release of particulate matter during medical waste incineration - Must be impervious, rigid and puncture proof, leak-proof, closable and non-reusable Definition of Biomedical Waste Types & Classifications of Waste People at Risks Health Risks Waste Disposal & Collection Biohazard kit & Chemical spill kit WASTE COLLECTION General public 8.) Non-hazardous or general waste Healthcare workers 3.) Pathological Wastes Bio-Medical Waste - Syringes, needles, disposable scalpels and blades, etc - Generated as a result of diagnosis or treatment of patient that is capable of producing disease WASTE DISPOSAL C) Injuries - Burns BIOHARZARD SPILL KIT TYPES & CLASSIFICATION OF WASTE General Waste is collected and transported to municipal Bin A) Sharps-Inflicted injuries Sanitary Workers HEALTH RISKS Medical Waste is collected by "Beah" every Tuesday TYPES & CLASSIFICATION OF WASTE - solvents & reagents used for laboratory preparations, disinfectants, sterilants and heavy metals contained in medical devices (e.g. mercury in broken thermometers) & batteries BIOMEDICAL WASTE MANAGEMENT Nitrile gloves Apron or thumb loop gown Face mask/eye shield IPA wipes Disposal bag Absorbent pads Tweezers Easy to follow illustrated instructions on pack -100 x 2.5g SoChlor TAB Chlorine tablets -500g SoChlor NaDCC Granules -1 liter diluter -10 pairs nitrile gloves -10 aprons -10 clinical waste bags -10 x scoops and scrapers -Illustrated instructions / poster -Recording card HEALTH RISKS 1) Sharps Disposal 6.) Cytotoxic waste AGENDA Waste Disposal Hospital Patients - single use spill pack for protection against hazardous chemicals and contaminating fluids 1.) Infectious Wastes - products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials - expired, unused & contaminated drugs and vaccines

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