Bio Medical Waste Management

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BIOMEDICAL WASTE MANAGEMENT

ABBREVATIONS USED: USED:
BIOMEDICAL WASTE MANAGEMENT : BMW Mgt  MANAGEMENT : Mgt


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CONTENTS :
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

DEFINITION NECESSITY COMPONENTS TYPES STEPS IN WASTE MANAGEMENT BIOMEDICAL WASTE Mgt PROCESS COST OF BMW Mgt WASTE TREATMENT AND DISPOSAL OCCUPATIONAL HAZARDS AND SAFETY MEASURES INDIAN SCENARIO CONCLUSIONS RECOMMENDATIONS AND FOLLOW UP REFERENCES
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DEFINITION:


BIOMEDICAL WASTE means any solid ,liquid waste including its container and any intermediate product , which is generated during the diagnosis, treatment or immunization of human begins or animals or in research pertaining thereto or in the production or testing thereof. thereof.

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NECESSITY: NECESSITY:


Biomedical waste must be properly managed to protect the general public , specifically healthcare and sanitation workers who are regularly exposed to biomedical waste as an occupational hazard. hazard.

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COMPONENTS OF BIOMEDICAL WASTE:
1.Human anatomical waste (tissues ,organs, body parts); parts); 2.Animal waste (as above, generated during research or experimentation , from veterinary hospitals etc.); etc. 3.Microbiology and biotechnology waste, such as, laboratory cultures ,micro-organisms, human ,microand animal cell cultures , toxins etc.; etc.; 4.Waste sharps ,such as , syringes ,scalpels, broken glass; glass; 5.Discarded medicines; medicines;

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6.Soiled waste , such as dressing, bandages, plaster casts ,material contaminated with blood etc ; 7.Solid waste (disposable items like tubes etc) 8.Liquid waste generated from any of the infected areas; areas; 9.Incineration ash; ash; 10. 10.Chemical waste. waste.

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BIOMEDICAL WASTE:

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TYPES OF BIOMEDICAL WASTE :

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STEPS IN WASTE MANAGEMENT :


Waste survey :determines the point of
generation, the type of waste at each point and level of generation. generation.



Waste segregation : consists of
placing different types of wastes in different containers at the point of generation. generation.

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Waste accumulation and storage : occurs
between the point of waste generation and site of waste treatment and disposal. disposal.



Waste transportation : when medical waste
is not treated on site, untreated waste must be transported from the generation facility to another site for treatment and disposal. disposal.

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Waste treatment : is mainly required to disinfect or decontaminate the waste, right at the source so that it is no longer the source of pathogenic organisms. Waste disposal : vary in their capabilities, cost, availability to generation and impact on the environment.
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AREA ± WISE FREQUENCY OF WASTE SURVEY :
       






Wards (each one of them) Out patients department Operation theatre Intensive care unit Emergency unit Dialysis unit Radiation unit Laboratories (pathological , biochemical Pharmacy) chemist¶ dispensation unit Kitchen
Administrative unit and central store

Each shift Each shift Each operation / surgical procedure Each shift Each shift Each procedure Each procedure Each shift Once a day Twice, after every meal
Once a day



Surrounding premises and garden once a day
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BIOMEDICAL WASTE MANAGEMENT PROCESS :


Handling, segregation, mutilation, disinfection, storage, storage, transportation and final disposal are vital steps for safe and scientific management of biomedical waste in any establishment. establishment.



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The key to minimization and effective management of bio-medical biowaste is SEGREGATION (separation) AND IDENTIFICATION OF WASTE by sorting them into COLOUR CODED plastic bags or containers. containers.
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COLOUR CODING- BIOMEDICAL WASTE CODING(MANAGEMENT AND HANDLING ) RULES,1998 (SCHEDULE II) :
COLOUR CODING TYPE CONTAINER OF WASTE CATEGORIES
Cat 1 human anatomical waste, Cat 2 animal waste, Cat 3 microbiology waste, Cat 6 soiled waste. waste. Cat 3 microbiological Cat 6 soiled Cat 7 solid waste (Waste IV tubes 15 catheters, etc.) etc.

YELLOW

Plastic bags

RED
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Disinfected container Plastic bags

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BLUE/ WHITE

Plastic bag/puncture proof containers

Cat 4 waste sharps Cat 7 plastic disposable tubings,etc. tubings,etc.

BLACK

Plastic bag/puncture proof containers

Cat 5 discarded medicines Cat 9 incineration ash Cat 10 chemical waste

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COST OF BIOMEDICAL WASTE MANAGEMENT :
Two types of costs are required to be incurred by external. hospitals for BMW Mgt, internal and external.  Internal cost includes cost for segregation, mutilation, disinfection, internal storage and transportation including hidden cost of protective equipment. equipment.  External cost involves off site transport of waste, treatment and final disposal. disposal.  Govt. of India in its pilot project for hospital waste mgt in Govt. Govt. Govt. hospitals has estimated Rs.85 lakhs as capital cost Rs. in 1000 bedded super specialty teaching hospital which includes on site final -MEDICAL WASTE MANAGEMENT . disposal of BMW BMW. 08-0508-05-2009 BIOBIO 17


WASTE TREATMENT AND DISPOSAL :
1.

INCINERATION : High temperature
thermal process employing combustion of the waste under controlled condition for converting them into inert material and gases. gases.

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TYPES OF INCINERATION: INCINERATION:






Double-chamber pyrolytic incinerators specially designed to burn infectious health-care waste. Single-chamber furnaces with static grate, used only if pyrolytic incinerators are not affordable. Rotary kilns operating at high temperature, capable of causing decomposition of genotoxic substances and heat-resistant chemicals.
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2.


DISINFECTION:
CHEMICAL DISINFECTION : Recommended for liquid wastes as well as chemical wastes involving the use of at least 1% hypochlorite solution with other equivalent reagents like phenolic compounds, iodine etc. for a etc. minimum contact period of 30 minutes. minutes. THERMAL DISINFECTION: generally used for treating solid waste.



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3. AUTOCLAVE TREATMENT : A low heat process in which steam is brought into direct contact with the waste material for duration sufficient to disinfect the material. material. 4. HYDROCLAVE TREATMENT : Steam sterilization process which can treat the same waste as the autoclave plus the waste sharps. sharps.
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5. MICROWAVE TREATMENT : A wet
thermal disinfection process in which the microwave heats the targeted material from inside out, providing a high level of disinfection. disinfection.

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6.LAND FILLING :  Open dumps : not recommended  Sanitary landfills : Disposing of certain types of health-care waste (infectious waste and small quantities of pharmaceutical waste) in sanitary landfills is acceptable.

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OCCUPATIONAL HAZARDS AND SAFETY MEASURES :
Occupational hazards : 1. Contact with infected material like pathological waste, used gloves etc. etc. 2. Contact with stool, urine, blood, pus etc., etc. of the patients during cleaning job. job. 3. Accidental cut or punctures from infected sharps such as scalpels, knives etc. etc.
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Safety measures :  Clear directives in the form of a notice to be displayed in all the concerned areas. areas.  Sterilization of all equipments and their issue accordingly. accordingly.  Provision of disinfectant, soap etc., of the etc. right quality and clean towels / tissue paper. paper.
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IMPORTANT PRECAUTIONS :

Never transfer sharps directly from person to person

Never needles

recap

the

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Never overload bins used for storing Bio Medical Waste
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Do not inhale chemicals directly. Use always mask.

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Keep away sharps medicines from children Never transfer sharp directly
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DISPLAY OF THE BIO-HAZARDOUS SYMBOL AND BIOTHE TYPES OF WASTE TO BE PUT IN EACH CONTAINER AS PER SCHEDULE-II : SCHEDULE-

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INDIAN SCENARIO :
Legislation: Bio-Medical Waste Regulations 1998 ‡ Classified in ten categories; ‡ Color coding and types of containers for different categories and their corresponding treatment & disposal option with standards.  Generation: 0.33 million tons/year  Prevalent Practice : ‡ Poorly managed incinerators;««..or back yard burners? ‡ Open burial pits posing a threat to public; ‡ Sharps collected/reused without cleaning or sterilization.


After a Sristi¶s (NGO) intervention in 1997, Court directed Central Pollution Control Board to emphasize on non-burn technology
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CONCLUSIONS :


Safe and effective management of waste is not only a legal necessity but also a social responsibility. responsibility. Lack of concern, motivation, awareness and cost are some of the problems faced in the proper biomedical waste management. management. Clearly there is a need for education as to the hazards associated with the improper waste disposal. disposal. A LESSER amount of biomedical waste means a lesser burden on waste disposal work, cost saving and a more efficient disposal system. system.









Hence, health care providers should always try to reduce the waste generation in day to day work in the clinic or at 08-0508-05-2009 BIOBIO-MEDICAL WASTE MANAGEMENT 34 the hospital. hospital.

RECOMMENDATIONS AND FOLLOW UP :


All health care facilities generating Bio-medical waste shall strictly ensure segregation, color coding and other provisions of Bio-medical waste (Management & Handling) rules, 1998 and amendments thereof. Incinerators, which do not confirm to the design and emission norms as per rules, must be modified and air pollution control system may be retrofitted to minimize the emission level.



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The operator should ensure proper operation and management (O&M) of incinerator through attainment of required temperature in both the chambers, regular operation of the incinerator, proper maintenance of the logbook and storage of the waste in isolated area, plastic incineration should not be undertaken
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Proper training and personal safety equipment / accessories should be provided to waste handling staff. Records of waste generation, treatment and disposal should be maintained by the hospital. hospital. Various regulatory agencies, hospitals, medical association and municipal corporation should work together for proper management of BioBiomedical waste in the cities / towns. towns.





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REFERENCES :


Veda Hegde, Kulkarni RD , Ajantha GS ± Biomedical waste management. management. Biomedical Waste ± Wikipedia , the free encyclopedia . Biomedical Waste Management : An infrastructural survey of hospitals ± Lt col SKM Rao , Wg Cdr RK Ranyal , Lt Col SS Bhatia , Lt Col VR Sharma .
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GLOBAL JOURNAL OF HEALTH SCIENCE : K.V.Radha, K.Kalivani, R.Lavanya. Department of chemical engineering, Anna University, Chennai. HEALTH CARE WASTE MANAGEMENT IN SOUTH ASIA:
C.Visvanathan Environmental Engineering & Management Program Asian Institute of Technology, Thailand.

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