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