This Presentation is all about Bio Medical Waste Management and Handling Rules 1998

1. Bio-Medical Waste
(Management and
Handling) Rules
1998
Presented By:
Ashish Singh
MBA – Power Management
500033217

2. Let The Waste Of The
“SICK”
Not Contaminate The
Lives Of
“THE HEALTHY”

3. What is Bio – Medical Waste
 Bio-medical waste" means any waste, which is generated during the
diagnosis, treatment or immunisation of human beings or animals or in
research activities pertaining thereto or in the production or testing of
biologicals, and including categories mentioned in Schedule I;
 Biologicals" means any preparation made from organisms or micro-
organisms or product of metabolism and biochemical reactions
intended for use in the diagnosis, immunisation or the treatment of
human beings or animals or in research activities pertaining thereto;
 Specific to hospitals Bio-medical waste is defined as waste that is
generated during the diagnosis, treatment or immunization of human
beings and are contaminated with patient’s body fluids (such as
syringes, needles, ampoules ,organs and body parts, placenta,
dressings, disposables plastics and microbiological wastes).

4. What is Bio – Medical Waste
Waste Sharps e.g.: Needles Discarded medicines
Human anatomical waste Solid waste e.g.: cotton swabs

5. History
 In the late 1980’s
 Items such as used syringes washed up on several East Coast
beaches USA
 HIV and HPV virus infection
 Lead to development of Biomedical Waste Management Law
in USA
 However in India the seriousness about the management came
into lime light only after 1990’s

6. Sources of Health Care Waste
 Government/private hospitals
 Nursing homes
 Physician/dentist office or clinic
 Dispensaries
 Primary health care centers
 Medical research and training centers
 Animal/ slaughter houses
 Labs/ research organizations
 Vaccinating centers
 Bio tech institutions/ production units

7. Definition
 Hospital waste: refers to all waste, biological or non biological, that is
discarded and is not intended for further use
 Medical waste: refers to materials generated as a result of patient
diagnoses, treatment, immunization of human beings or animals
 Infectious waste: are the portion of medical waste that could transmit an
‘infectious disease’.
 Pathological waste : waste removed during surgery/ autopsy or other
medical procedures including human tissues, organs, body parts, body
fluids and specimens along their containers.

8. Magnitude of the Problem
 GLOBALLY- Developed countries generate 1 to 5 kg/bed/day
 Developing countries: meager data, but figures are lower. 12kg/pt./day
 WHO Report: 85% non hazardous waste
: 10% infective waste
: 5% non-infectious but hazardous.
(Chemical, pharmaceutical and radioactive)
 INDIA:-No national level study
- local or regional level study shows hospitals generate
roughly 1-2 kg/bed/day

9. Classification of Bio-Medical Wastes
Non-Infectious
waste, 80%
Pathological
and Infectious
waste, 15%
Chemical and
Pharmaceutical
waste, 3%
Sharps, 1%
Radioactive,
Cytotoxic and
heavy metals,
1%

10. Classification of Health Care Waste
Infectious Waste
 Lab cultures
 Waste from isolation wards
 Tissues(swabs)
 Materials/ equipment of infected patients
Pathological Waste
 Excreta
 Human tissues/fluids
 Body parts
 Blood or body fluids

11. Cont.
Sharp Waste
 Needles
 Infusion Sets
 Scalpels
 Knives Blades
 Broken Glass
Geno toxic Waste
 Waste Containing Cytotoxic
Drugs(often Used In Cancer
Therapy)
 Geno toxic Chemicals

12. Cont.
Pharmaceutical Waste
 Expired Pharmaceuticals
 Contaminated Pharmaceuticals
 Banned Pharmaceuticals

13. Cont.
Chemical Waste
 Lab reagents
 Film developer
 Expired disinfectants
 Expired solvents
Waste with High Content of Heavy Metals
 Waste with high content of heavy metals
 Batteries
 Broken thermometers
 Blood pressure gauges etc.

14. Cont.
Pressurized Containers
 Gas cylinders
 Gas cartridges
 Aerosol cans
Radioactive Waste
 Radiotherapy/lab research liquids
 Contaminated glass wares,
packages, absorbent papers

15. Hospital Waste Disposal
 Hospital waste management is a
part of hospital hygiene and
maintenance activities. In fact
only 15% of hospital waste
i.e. "Biomedical waste" is hazardous,
not the complete.
 But when hazardous waste is not
segregated at the source of
generation and mixed with
nonhazardous waste, then 100%
waste becomes hazardous

16. Who’s at Risk
 Doctors and Nurses
 Patients
 Hospital Support Staff
 Waste Collection and Disposal Staff
 General Public
 Environment

17. Need for BMW Management
 The hospital waste, in addition to the risk for patients and personnel who
handle these wastes poses a threat to public health and environment
 Health hazards of BMW :
Type of Waste Health Hazard
Human/ Animal Waste/ Solid Waste HIV,HBV,HCV, Hgic fevers, cholera,
salmonellosis, shigellosis, rabies,
leptospirosis, anthrax, TB, pneumonia,
septicemia
Sharps HIV, HBV, HCV, Injuries
Cytotoxic/ radioactive waste Cancer, Genetic Mutation, birth defect
Chemical Waste Poisonings, Dermatitis, Conjunctivitis,
Bronchitis

18. Need for BMW Management
 Nosocomial infections to patients from poor infection control
practices and poor waste management.
 Drugs which have been disposed of, being repacked and
sold off to unsuspecting buyers.
 Risk of air, water and soil pollution directly due to waste, or
due to defective incineration emissions and ash.
 Risk of infection outside hospital for waste handlers and
scavengers, other peoples.

19. India: Extent of the Problem
 >95,000 hospitals and healthcare facilities in India
 4.2 lakh kg of biomedical waste is generated on a daily basis.
 Three million tonnes of medical wastes generated every year.
 Expected to grow 8% annually.
 2,91,983 kg/day BMW is disposed. which means that almost 28% of the
wastes is left untreated and not disposed finding its way in dumps or water
bodies and re-enters our system.
 Karnataka tops the chart with 62,241 kg/day of BMW.
 Only 179 CTF to treat the BMW in the country.
 No. of HCF/CBWTF violated BMW rules 5472
 No. of show cause notice/ Directions issued to defaulter HCE/CBWTF 3585

20. Cont.
CHHATTISGARH(Annual report on BMW, 2011, CPCB)
 No. of HCE- 740
 No. of Bed- 14678
 Total quantity of BMW generated(Kg/day) approximately 4492Kg/Day
 BMW treated 4492Kg/Day
 No. of HCF/CBWTF violated BMW rules 20
 No. of show cause notice/ Directions issued to defaulter HCE/CBWTF 20
 No. CBWTF 06
 No. of HCE using CBWTF/ Private agencies 446
 No. of HCE having own treatment facility & Disposal facility 181
 No. of HCE applied for authorization 478
 No. of HCE granted authorization 425
 No. of treatment equipment's
 INCINERATOR’S 14
 AUTOCLAVES 305
 OVEN 7
 SHREDDERS 358

21. Present Practice Within Many Of The Hospitals
 Around 40% of the hospitals in the
country are dumping the BMW with
Municipal garbage
 Waste is not segregated at the site
 3585 hospitals have been served
notice for acting as defaulters of
these rules.
 No proper treatment options
 No regulated disposal plan/sites

22. Bio – Medical Waste Rules 1998
 The Government of India as contemplated under Section 6,8 and 25 of
the Environment (Protection) Act,1986, has made the Biomedical Wastes
(Management & Handling) Rules, 1998.
 The rules are applicable to every institution generating biomedical waste
which includes hospitals, nursing homes, clinic, dispensary, veterinary
institutions, animal houses, laboratory, blood bank.
 The rules are applicable to all persons who generate, collect, receive,
store, transport, treat, dispose, or handle bio medical waste in any form.

23. Bio-Medical Waste Rules 1998
Definition
 According to bio medical waste rules ,1998 of India“ bio-medical
waste” means any waste which is generated during the
diagnosis, treatment or immunization of human beings or animals
or in research activities pertaining there to or in the production or
testing of bio medicals.
 Any unwanted residual material which cannot be discharged
directly, or after suitable treatment can be discharged in the
atmosphere or to a receiving water source, or used for landfill is
waste. (Wilson, 1981)

24. Bio-Medical Waste (Management and Handling)
Rules by Govt. of India , 1998
Revised in 2011
Now known as BMW Rules, 2011
2011 1998
Every occupier generating BMW,
irrespective of the quantum of wastes
comes under the BMW Rules and
requires to obtain authorisation
Occupiers with more than 1000 beds
required to obtain authorisation
Duties of the operator listed Operator duties absent
Treatment and disposal of BMW made
mandatory for all the HCEs
Rules restricted to HCEs with more
than 1000 beds
A format for annual report appended
with the Rules
No format for Annual Report
Form VI i.e. the report of the operator
on HCEs not handing over the BMW
added to the Rules
Form VI absent

25. Duty of the Occupier
 It is the duty of every occupier i.e. head of an institution generating bio-
medical waste, to take all steps to ensure that such waste is handled
without any adverse effect to human health and the environment.
 Provides training to HCW engaged in handling BMW
Duties
 The operators now have to ensure that the BMW is collected from all the
HCEs and is transported, handled, stored, treated and disposed in an
environmentally sound manner. The operators also have to inform the
prescribed authority in form VI if any HCEs are not handing the
segregated BMW as per the guidelines prescribed in the rules.
 Operator of the Bio - medical Waste Treatment Facility to apply for Grant
of Authorization in form –I to MPPCB (The Prescribed Authority).

26. Cont.
 Occupier / institution generating, collecting, receiving, storing,
transporting, treating, disposing and/or handling Bio-medical waste To
apply for Grant of Authorization in form –I to MPPCB which is the
Prescribed Authority.
 Bio-medical Waste shall be treated and disposed of in accordance with
the Schedule -I and in compliance with the standards prescribed in
Schedule –V.
 Every Occupier, shall set- up the requisite Bio-medical Waste Treatment
Facilities like incinerator, Autoclave, Microwave system for treatment of
waste, or, ensure requisite treatment of waste at common or any other
waste treatment facility
 l records subject to the inspection & verification by the MPPCB
 Accident during handling & Transportation of BMW needs to be
reported by the authorized person in Form – III to MPPCB forthwith

27. Setting up BMW Treatment Facility
 Occupier set up adequate treatment facilities like autoclave /microwave/
incinerator/ hydroclave, shredder prior to commencement of its
operation or ensure that the wastes are treated at a common bio medical
waste treatment facility or an authorized waste treatment facility.
 The new Rules have omitted incinerator as one of the pre requisites for
on-site treatment of BMW. The omission is owing to the various
environmental impacts of incineration.
 Promotion of new technologies for treatment and disposal of waste
 Deep burial for disposal of BMW has also been removed from the Rules.
The Rules says it can be an option only in rural areas with no access to CTF
with prior approval from the prescribed authority.

28. Health Waste Characterization
Hospital
Waste
Non
Hazardous
(= 75-90%)
Hazardous
Waste
(= 10-25%)
Infectious
Others
(Radioactive,
Cytotoxic)

29. Types of Waste
Liquid Wastes
Approx. Quantity : 4 to 250 liters / bed / day
 Sewage from isolation wards, ICU’s toilets & urinals, Bed-bath, bathroom
and hospital’s laundry
 Wash waters from laboratories, OPD, Dressing rooms & Operation
theaters.
Solid Wastes
Approximate Quantity : 0.3 to 3.5 kg/bed/day
 Garbage 55%
(Bulk Density :330 kg/m3,Cal.Value:1000 K.cal / kg, Moisture :40%)
 Bio – Medical Waste 13%
 Wasted body remains 05%
(Blood, Cultures, Anatomical)
 Pharmaceutical and Chemical Wastes 02%
 Pathological Wastes 06%
 Sharp Objects 20%
 Pressurized Containers & Discarded Instruments 02%
 Radio actives Wastes 0.3%

30. Schedule I – Categories of Bio-Medical Waste
Waste Category Waste Type Treatment & Disposal
Category 1
Human Anatomical waste (human tissues, organs,
body parts
Incineration/deep burial
Category 2
Animal Waste: Animal tissues, organs, body parts
carcasses, bleeding parts, fluid, blood and
experimental animals used in research, waste
generated by veterinary hospitals, colleges, discharge
from hospitals, animal houses
Incineration/deep burial
Category 3
Microbiology & Biotechnology Wastes: Wastes from
clinical samples, pathology, biochemistry, hematology,
blood bank, laboratory cultures, stocks specimens of
micro-organisms, live or attenuated vaccines human
and animal cell culture used in research and infectious
agent from research and industrial laboratories, waste
from production of biologicals, toxins, dishes and
devices used for transfer of cultures
Disinfection at source by
chemical treatment or by
Autoclaving / Microwaving /
followed by Mutilation /
shredding and after treatment
final disposal in secured landfills
or disposal of recyclable waste
(plastic or glass ) through
registered or authorized
recycler

31. Cont.
Waste Category Waste Type Treatment & Disposal
Category 4
Waste Sharps (needles, glass syringes or syringes with
fixed needles, scalpels ,blades, glass etc.) that may
cause puncture and cuts(Includes both used and
unused sharps).
Disinfection (chemical treatment /
destruction by needle & tip cutter,
autoclaving/microwave and
mutilation/shredding and final
disposal through CBWTF / landfills
Category 5
Discarded Medicines & Cytotoxic drugs (Wastes
comprising of outdated, contaminated and discarded
medicines)
Disposal in secured landfills or
Incineration
Category 6
Soiled Waste (Items contaminated with blood, & body
fluids including cotton, dressings, soiled plaster casts,
linens, beddings, other material contaminated with
blood)
Incineration

32. Cont.
Waste Category Waste Type Treatment & Disposal
Category 7
Infectious Solid Waste (waste generated from
disposable items other than the waste sharps such as
tubing's, hand gloves, saline bottles with IV tubes,
catheters, glass, intravenous sets etc.
Disinfection by chemical
Treatment / autoclaving
/Microwaving followed by
mutilation / shredding & final
disposal through registered
recycler
Category 8
Chemical Waste ( Chemicals used in production of
biologicals, chemicals used in disinfection as
insecticides etc.)
Chemical treatment and
discharge into drains for liquids
and secured landfill for solids
Category 9
Incineration Ash (ash from incineration of any
bio-medical waste)
Disposal in municipal landfill
Category 10
Chemical Waste (chemicals used in production of
biological, chemicals, used in disinfect ion, as
insecticides, etc.)
Chemical treatment & discharge
into drain for liquid & secured
landfill for solids

33. Schedule – II
Color Coding and Type of Containers for
different Bio-Medical Wastes
Color Coding Type of Container Waste Category Treatment/ Disposal
Yellow
Non Chlorinated Plastic
Bag
1, 2, 5, 6 Incineration/ Deep Burial
Red
Non chlorinated plastic
bag / puncture proof
Container for sharps 3, 4, 7
Chemical Treatment / Autoclaving
/ Microwaving and followed by
Mutilation & shredding and
disposal in landfills or disposal of
recyclable waste
Blue
Non Chlorinated Plastic
Bags/ Containers
8
Chemical Treatment
and discharge into drains for
liquids and secured landfill for
solids
Black
Non Chlorinated Plastic
Bags
Municipal Waste
Disposed as per the Municipal
Solid Waste

34. Schedule – III
Label for Bio-Medical Waste Containers/ Bags
Bio-Hazard Cytotoxic
Handle with Care
Note: Label shall be non-washable and prominently visible
Bio-Hazard Symbol
Cytotoxic Hazard
Symbol

35. Segregation and Packing
 Bio-medical waste shall not be
mixed with other wastes
 Bio-medical waste shall be
segregated into containers/
bags at the point of generation
in accordance with Schedule II
 The containers shall be labeled
according to Schedule III.

36. Management of Hospital Waste
Black Dustbin & Bags
 Paper waste, food waste and other non infectious wastes
generated from the hospitals should be stored in black
coloured bags / containers & Disposed as per MSW
management rules, 2000

37. Waste Disposal – Black Bin
For Noninfectious - Solid waste
Paper/Plastic
Kitchen Waste/Food
Outer Packing/
Cardboard
Wrappers
General/ Kitchen Waste

38. Waste Disposal – Yellow Bin
Soiled Linen,
Contaminated Gowns,
Drapes
Bandages
Dressing
Discarded
medicine/cytotoxic
drugs
Animal Waste
Swaps

39. Cont.
 Human/Animal tissue organs or body parts
 Animal carcasses
 Any non plastic soiled waste( contaminated with blood/ body
fluids )
 Cotton dressings, bandages
 Linen beddings
 Soiled plaster casts, Soiled paper
 Used/ removed sutures

40. Waste Disposal – Red Bin
All infectious waste sharp, non
sharp & sharps plastic waste
Urine bag
Gloves
Drains
Pathological Waste
Plastic Culture Plates & Tubes

41. Microbiology & Laboratory Waste, Waste Sharps
Infectious Solid Waste (Category 3, 4, 7)
 Wastes from clinical samples, pathology, biochemistry,
hematology, blood bank, laboratory cultures, stocks
specimens of micro-organisms, live or attenuated vaccines
human and animal cell culture used in research and
infectious agent from research and industrial laboratories,
waste from production of biologicals, toxins, dishes and
devices used for transfer of cultures.
 Waste Sharps (needles, glass syringes or syringes with fixed
needles, scalpels ,blades, glass etc.) that may cause
puncture and cuts(Includes both used and unused sharps).
 Infectious Solid Waste (waste generated from disposable items other than
the waste sharps such as Gloves, tubing, saline bottles with tubes,
Catheters, Urine bags, Blood bags, Syringes, Suction tips, Infected plastic
containers, Rubber base materials, Retraction cords.

42. Personnel Safety Devices
The use of protective gears should be made mandatory for all the personnel
handling waste.

43. Storage
 In an area away from general traffic and accessible only to
authorized personnel
 DO NOT store for more than 48 hours
 If for any reason it becomes necessary to store the waste
beyond such period take measures to ensure that the waste
does not adversely affect human health and environment

44. Transport
 Transport by wheeled trolleys/containers /
carts only in vehicles authorized for the
purpose
 They should be
 Easy to load and unload
 No sharp edges
 Easy to clean
 Trolleys ,Wheelbarrows: covered
 Disinfect daily

45. Transportation and Storage
 If a container is transported from
the premises where bio-medical
waste is generated to any waste
treatment facility outside the
premises, the container shall,
apart from the label prescribed
in Schedule III, also carry
information prescribed in
Schedule IV.

46. Schedule – IV
Label for Transportation of Bio-Medical Waste
Containers/ Bags
 Waste Category No. Day ……….. Month …………..
 Waste Class Year ………………………………..
 Waste Description Date of Generation …………
Sender’s Name and Address Receiver’s Name and Address
 Phone No. …………………. Phone No. ………………………
 Telex No. …………………… Telex No. ………………………...
 Fax No. ……………………… Fax No. ……………………………
 Contact Person …………. Contact Person ……………….
In Case of Emergency, Please Contact
 Name & Address
 Phone No.

47. Schedule – V
Treatment and Disposal
 Standard For Treatment And Disposal of BMW
 Standard For Incinerator
 Standard For Autoclave
 Standard For Microwave

48. Please Remember
The Primary
responsibility of
the disposal of the
Bio-Medical Waste
lies with the
Generator

49. And Also Do Not Forget That
 Bio-medical waste shall not be mixed with other Wastes such as
Municipal Waste
 Segregate the Bio-medical Waste in separate containers at point of
generation (schedule-II) and label as prescribed (schedule-III)
 Biomedical waste that are to be transported, must be securely packed,
and Labeled as per (schedule-IV)
 Transportation of BM Waste is allowed only in vehicles authorized by
the prescribed Authority
 A day -to -day record of the Quantity under different categories of the
Bio – Medical Waste generated in premises must be maintained
 No untreated Bio-medical Waste shall be kept stored beyond 48 Hrs.

50. Legal Aspects
 The Contravention Of The Act, Rules, Orders &
Directions may lead to legal action
 The punishment may lead to the imprisonment
up to 5 years with fine up to Rs. 1 lakh
 For failure or continued contravention a
fine @ Rs.5000 /Day may be charged
 If the failure or the contravention continues
beyond one year, the imprisonment may
be extended up to 7 years.

51. Incineration
 Combustion efficiency (CE) shall be at
least 99.00%.
 The Combustion efficiency is
computed as follows:
C.E. =
% 𝑪𝑶 𝟐
% 𝑪𝑶 𝟐+% 𝑪𝑶
X 100
 The temperature of the primary
chamber shall be 800 +/-500 C
 The secondary chamber gas residence
time shall be at least 1 (one) second
at 1050 +/- 500 C
 Drawbacks:
 toxic products like furnaces and
dioxins can cause air pollution

52. Bio-Medical Wastes Destruction by Double
Chambered Incinerator

53. Details of Double Chambered Incinerator

54. Incinerator Ash Disposal

55. Emission Standards
Parameters Concentration mg/Nm3 at
(12% CO2 correction)
Particulate Matters 150
Nitrogen Oxide 450
HCl 50
• Minimum stack height shall be 30 meters above ground
• Volatile organic compounds in ash shall not be more than 0.01%

56. Autoclave
 A temperature of not less than
121 0C and pressure of 15 pounds
per square inch (psi)for an
autoclave residence time of
not less than 60 minutes
 Validation test : Spot testing by
Bacillus steareo-thermophilus spores
on a spores strip with at least
1 x 104 Spores/ml
 Routine test : Chemical indicator
strip/tape

57. Standard for Microwaving
 Should kill bacteria and other pathogenic organism
 Biological indicator bacillus subtilis
CHEMICAL PROCESSES
 Dissolved chlorine dioxide, bleach (sodium hypochlorite), peracetic acid,
or dry inorganic chemicals.
 To enhance exposure of the waste to the chemical agent, chemical
processes often involve shredding, grinding, or mixing.

58. Treatment Technologies
Treatment Technologies
Incineration Autoclave Microwave
Chemical
Disinfection
Plasma
Pyrolysis
Investment/
Operating
Cost
High Moderate High Low High
Suitability of
the Waste
Not for
Radioactive
All except
Pathological
All Except
Cytotoxic,
Radioactive
Liquid Waste All
Ease of
Operation
No Yes Yes Yes No
Waste
Volume
Reduction
Significant Less Significant - Significant
Odour
Problems
Yes Slight Slight Slight -
Environment
al Friendly
No Yes Yes No Yes

59. Authorization
 Every occupier of an institution generating, collecting, receiving, storing,
transporting, treating and /or handling Biomedical Waste shall apply on
Form 1 for Authorization to the Board.
 The State Pollution Control Board are declared as prescribed Authority
for grant of Authorization. The Board grants authorizations after
satisfying itself.

60. Application for Authorization
To
The Prescribed Authority
(Name of the State Govt./ UT Administration)
Address:
 Particulars of Applicant
Name of the Applicant
(In block letters & in full)
Name of the Institution:
Address:
Tele No., Fax No. Telex No.
 Activity for which authorisation is sought:
Generation
Collection
Reception
Storage
Transportation
Treatment
Disposal
Any other form of handling
 Please state whether applying for rash authorisation or for renewal:
(In case of renewal previous authorisation-number and date)

61. Cont.

Address of the institution handling bio-medical wastes:
Address of the place of the treatment facility:
Address of the place of disposal of the waste:

Mode of transportation (in any) of bio-medical waste:
Mode(s) of treatment:
 Brief description of method of treatment and disposal (attach details):

Category (see Schedule 1) of waste to be handled
Quantity of waste (category-wise) to be handled per month
 Declaration
 I do hereby declare that the statements made and information given above are
true to the best of my knowledge and belief and that I have not concealed any
information.
 I do also hereby undertake to provide any further information sought by the
prescribed authority in relation to these rules and to fulfil any conditions
stipulated by the prescribed authority.
 Date : Signature of the Applicant
 Place : Designation of the Applicant

62. Annual Report
 Every occupier/operator submit an annual report to the
prescribed authority in Form II by 31 January every year, to
include information about the categories and quantities of
bio-medical wastes handled during the preceding year. The
prescribed authority shall send this information in a
compiled form to the Central Pollution Control Board by 31
March every year.

63. Maintenance of Records and Accident Reporting
 Every authorized person shall maintain records related to BMW
 All records shall be subjected to inspection and verification by
the prescribed authority at any time
 In any accidents, the authorized person shall report the accident
in Form III along with the remedial action taken to the prescribed
authority forth with
Setting Up A Cell or Unit for BMW Management
 The BMW 2011, Rules have also made mandatory for all the HCEs with
30 or more beds to set up a cell or unit to deal with the BMW
management. The cell has to meet every six months and minutes of the
meeting have to be submitted along with the Annual Report to the
prescribed authority

64. Do’s and Don'ts
Do’s
 The used product should be segregated
 The used product should be mutilated
 The used product is treated prior to disposal
 Use protective gear when handling waste
 Collect waste when the bin is 3/4 the full
 Clean spills with disinfectant
 Use trolleys & do not drag waste bags
Don’ts
 Reuse plastic equipment
 Mix plastic equipment with other wastes
 Burn plastic waste
 Avoid needle stick injuries
 Avoid using common lift to move waste
 Avoid spillage

65. BMW Management Committee
 Head of the hospital : chairman
 Waste Mix officer (dev. and implementation plan) Members:
 HOD’s of all department
 Nursing superintendent,
 Head nurse,
 Sanitary inspector
 Chief pharmacist,
 Radiation officer
 Supply officer,
 Financial officer

66. Responsibility of BMC
 Day to day control of segregation, transport & disposal of BMW
 Co-ordinate with the store officer for continuous supply of basic
items for BMWM
 Prepare guidelines for BMWM & distribute to all department
 Prepare BMW posters to raise awareness
 Arrange training programs on BMWM & safety measures for all
categories of HCW
 Co-ordinate with HOD/In-charge of Dept. where deficiencies are
pointed out
 Co-ordinate with Chhattisgarh Environment Conservation Board)

67. BMW Spills and Surface Disinfection
Proper spill handling:
 Notify people in the area
 Don appropriate PPE
 Place absorbent material on spill
 Apply appropriate disinfectant – allow sufficient contact time (30 min)
 Pick up material (watch for glass – use tongs or dust pan); dispose of
material into biomedical waste
 Reapply disinfectant and wipe
 For large/high hazard spills use 10% hypochlorite
 For routine disinfection of surfaces where BMW is handled, use a 1:10
solution of freshly diluted bleach or 1% hypochlorite (ethanol evaporates
too quickly!)

68. Hand Washing
 Hand washing is the single most effective
way to stop the spread of disease.
 Make certain that jewelry is limited to
wedding rings, certain areas such as
OR< C-section, Cath Lab and NBN allow
no jewelry. Nails should be kept short and
clean.
 Gloves do not replace hand washing. Hand
sanitizer may be used if no visible soiling is
present and the sinks cannot be readily accessed.
This is in every patient room. It can also be used
when the water is out of service.
 Inspect your hands each time they
are washed. Only use hospital approved soaps
and lotions, do not bring in any from home
 Alcohol based hand rubs at point of care
 Sinks and clean running water
 Training

69. Steps to Effective Hand washing
 Thorough hand washing after any
procedure involving nursing care or
close contact with the patient is
essential.
 Alcohol based hand antiseptics gaining
importance where washing with water
and soap are not practicable.

70. Bio-Medical Waste Management - Issues
Not considered important
 Lack of interest from senior management
 No ownership of the process
 Awareness of problems
 Appreciate the need for constant monitoring
 Segregation of waste not taken seriously at user level
 Non compliance with color coding
 Monitoring segregation at source – low budgets allocated – costs are
not always known/nor worked out properly
 Cost of color coding, staff, transport and disposal is a major deterrent
 Quantification of waste generated is not accurately done

71. Bio-Medical Waste Management – Challenges
 Establishing robust waste management policies within the Health
Care Facility/organization
 Organization wide awareness about the health hazards
 Sufficient financial and Trained human resources needed
 Monitoring and control of waste disposal
 Clear responsibility and traceability for appropriate handling and
disposal of waste.

72. Addressing the Issues
 Need to build-up of a comprehensive system, address
responsibilities, resource allocation, handling and disposal
 This is a long-term process, sustained by gradual improvements.
 Specific personnel need to be assigned to monitor the bio-
medical waste management in the hospital.
 Man power needs and other resources for the BMWM of
hospital to be addressed.
 Quality assessment of bio-medical waste management should be
done from time to time.
 Segregated collection and transportation – need for Non-
ambiguous color coding and labeling of wastes.
 Containers should be robust and leak proof
 Tracking of Bio Medical Waste up to point of Disposal.
 Proper treatment and final disposal.

73. Cont.
 Clear directives in the form of a posters and notice to be displayed
in all concerned areas in English and local languages.
 Safety of handlers is a big concern that is still not addressed
adequately.
 Raising Awareness about risks related to health-care waste;
training staff & Waste handlers on safe practices.
 Selection of safer & environmentally friendly management
options, to protect people from hazards when collecting, handling,
storing, transporting, treating or disposing waste.
 Issue of all protective clothing such as, gloves, aprons, masks etc.
to all HCW & Waste handlers.
 Regular medical check-up (half-yearly) of staff associated with
BMWM.
 Maintenance of Record registers for this purpose.

74. Conclusion
 Bio-medical waste programme cannot be
successfully implemented without the
willingness, self-motivation, and co-operation
from all sections of employees of any health
care setting.
 If we want to protect our environment and
health of community we must sensitize
our selves to this important issue not only
in the interest of health managers but also
in the interest of community.
 Individual participation is required.
 Municipality and government should pay importance to disposal of
waste economically.
 Thus educating and motivating oneself first is important and then
preach others about it.

75. Lets Make This World A
Better Place to Live In

76. THANK YOU