Hospital Waste Management PDF

Hospital Waste Management Let the wastes of the sick not contaminate the lives of the healthy - K. Park  What is Biomedical Waste? According to Biomedical Waste (Management and Handling) Rules, 1998 of India- “Biomedical waste” (BMW) means any waste, wh...

Hospital Waste Management Let the wastes of the sick not contaminate the lives of the healthy - K. Park  What is Biomedical Waste? According to Biomedical Waste (Management and Handling) Rules, 1998 of India- “Biomedical waste” (BMW) means any waste, which is generated during diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals.  Waste in Health Care Administrative Non-risk or general waste Housekeeping (75-90%) Maintenance Health Care Waste Hazardous waste Remaining all (10-25%)  Why to Manage BMW ? Due to the following risks- 1) Injuries from sharps leading to infection to all health personnel and waste handlers 2) Nosocomial infection in patients 3) Risk of infection in the vicinity and outside hospital 4) Hazard from chemical and drugs 5) Selling of repacked disposables by unscrupulous elements 6) Risk of water, air and soil pollution directly due to waste or defective incineration, emissions and ash  History 1992 United Nations Conference on Environment and Development (UNCED) recommended-  Prevent and minimize waste production  Reuse or recycle the waste to the extent possible  Treat waste by safe and environmentally sound method  Dispose off final residue by landfill ↓ 1996 In India, Supreme court judgement on 1st March ordered about segregation of hazardous medical waste, its disinfection in coordination with CPCB, for which incinerator or other alternative method should be installed  History 1998 In India, Biomedical Waste (Management and Handling) rule by Ministry of Environment and Forest; came into force on 28th July under the purview of Environment Protection Act, 1986 Rule applies to those who generate, collect, receive, store, dispose, treat or handle biomedical waste in any manner ↓ 2016 Act was superceded by Biomedical Waste Management Rules on 28th March-  Inclusion of vaccination camp, blood donation camp, surgical camp  Phasing out use of chlorinated bags, gloves  Recent Changes 2018 Bio-medical Waste Management (Amendment) Rules  Exception of blood bags for phasing out chlorinated bags  Bar code system in accordance with CPCB  In chemical treatment, 1-2% sodium hypochlorite should be used  Classification of Hospital Waste Waste Category Description Example Infectious waste Waste suspected to Laboratory culture, waste from isolation contain pathogens ward, swabs, materials come in contact with infected patients, excreta Pathological waste Human tissue and Body parts, blood and other body fluids, fluids fetuses Sharps Sharp Waste Needle, blade, scalpels, knives, broken glass  Classification of Hospital Waste Waste Category Description Example Pharmaceutical Waste containing Expired medicine, contaminated bottles and waste pharmaceuticals boxes containing pharmaceuticals Genotoxic waste Waste containing Cytotoxic drugs (often used in cancer substances with therapy), genotoxic chemicals genotoxic property Chemical waste Waste containing Laboratory reagents, film developers, expired chemical substance disinfectants, solvents  Classification of Hospital Waste Waste Category Description Example Waste with high Batteries, broken thermometers, blood content of heavy - pressure measuring instruments metals Pressurized Gas cylinders, gas cartridges, Aerosol cans containers Radioactive waste Waste containing Unused liquids from radiotherapy or radioactive substances laboratory research, contaminated glassware packages or absorbent papers, urine and excreta from patients treated or tested with unsealed radio isotopes  TREATMENT OF HOSPITAL WASTE- INCINERATION High temperature dry oxidation process Reduction of organic and combustible waste to inorganic, incombustible matter; Waste is reduced in both weight and volume No pre-treatment required Waste to be incinerated Waste not to be incinerated Wastes which cannot be Pressurized gas containers recycled, reused or Large amount of reactive chemical wastes, disposed off in a land-fill silver salts and photographic or radiographic wastes site Halogenated plastic i.e. PVC Waste with high mercury or cadmium content, such as broken thermometers, used batteries and lead-lined wooden panels Sealed ampules or ampules containing heavy metals TREATMENT OF HOSPITAL WASTE- CHEMICAL DISINFECTION Chemicals are added to waste to kill or inactivate the pathogens it contains, this treatment usually results in disinfection rather than sterilization. Waste to be incinerated  Most suitable -Liquid waste such as blood, urine, stools or hospital sewage  Solid wastes including microbiological cultures, sharps etc can be done TREATMENT OF HOSPITAL WASTE- THERMAL TREATMENT WET THERMAL TREATMENT – Steam disinfection is based on exposure of shredded infectious waste to high temperature, high pressure steam and similar to the autoclave sterilization process. Appropriate for anatomical waste and animal carcasses. SCREW-FEED TECHNOLOGY- it is a non-burn, dry thermal disinfection process in which waste is shredded and heated in a rotating auger. The waste is reduced by 80% in volume and by 20-30% by weight. Appropriate for infectious waste and sharps. TREATMENT OF HOSPITAL WASTE-MICROWAVE IRRADIATION Most microorganisms are destroyed by the action of microwave of a frequency of about 2450 MHz and a wave-length of 12.24 nm. The water contained within the waste is rapidly heated by the microwaves and the infectious components are destroyed by heat conduction TREATMENT OF HOSPITAL WASTE-LAND DISPOSAL Municipal Disposal Sites Open Dumps Health care waste should not be deposited on or around open dumps as risk of either people or animals coming into contact with infectious pathogens is obvious. Sanitary Landfills  Geological isolation  Appropriate engineering preparation  Presence of Staff on site  Organized deposit  Daily coverage of waste TREATMENT OF HOSPITAL WASTE-INERTIZATION Minimizing the risk of toxic substances contained in the wastes migrating into the surface water or ground water Mixing waste with cement and other substances water Mixture to Homogenous mass 5% cement 15% lime Pharma 15% ceutical waste Pellets and cubes transported to storage site 65%  Biomedical Waste Management Rules SCHEDULE Related with I Categorisation of BMW (Part 1) Management of BMW (Part 2) II Standards for treatment and disposal of BMW III Prescribe authorities and corresponding duties IV Label of containers or bags (Part A) Label for transportation of BMW bags and containers (Part B)  Biomedical Waste Segregation - Category Yellow Red Blue White  Waste Segregation- Type of Waste Yellow Red White Blue Human anatomical waste, animal Recyclable Waste sharps Glassware anatomical waste, soiled waste contaminated including metals-  Broken/ contaminated/ waste- Needles, discarded glass Expired/discarded medicines  Tubing, syringes with  Medicine vials and bottles, fixed needles ampoules except those Chemical waste, liquid waste  IV tubes and Scalpel contaminated with Discarded linen, mattresses, sets, catheter, Blades cytotoxic waste contaminated beddings  Urine bag  syringe Metallic body implant Microbiology, biotechnology and  Gloves other clinical laboratory waste  Waste Segregation- Type of Container Yellow Red White Blue Yellow coloured non-chlorinated Red coloured non- Puncture-proof, Cardboard boxes with blue plastic bags or containers chlorinated plastic leak proof, coloured markings bags or containers tamper-proof For liquid waste, separate white containers collection system leading to effluent treatment system For laboratory waste, autoclave- safe plastic bags and containers  Waste Disposal Yellow Red White Blue Incineration Autoclaving Autoclaving Disinfection Plasma pyrolysis Microwaving Dry heat sterilization Autoclaving Deep burial Hydroclaving -Followed by shredding or Microwaving mutilation or encapsulation -Followed by shredding in metal container/ cement Hydroclaving or mutilation or concrete combination of - Finally sent for recycling sterilization and -Final disposal to iron shredding foundries, landfill, waste sharp pit - Treated waste recycled  Steps of Biomedical Waste Management 1 Segregation and Pretreatment at the site of generation Collection of segregated waste from all areas of 2 hospital 3 Transportation of waste from hospital to storage site 4 Weighing of bags at storage sites 5 Transportation for final disposal THANK YOU