File

advertisement
1
BIO-MEDICAL
WASTE
MANAGEMENT
2
Dr kamal Deep
J.R.
First Year
3
Acc 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.
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
4










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
5






Came into force on 28th july,1988.
Prescribed by Ministry of environment & forest under the
environment protection act of India.
It safeguard the public & the health care workers from
the risk arising due to biomedical waste.
This rule apply to all persons who generate ,collect,
receive, store, transport, treat, dispose or handle
biomedical waste in anyform.
Waste shall be treated & disposed of in accordance with
schedule 1, and with the standards prescribed in
schedule V.
Biomedical waste shall be segregated into containers /
bags at the point of generation in accordance with
schedule II prior to its storage, treatment ,
transportation & disposal. The containers shall be
labelled according to schedule III.
7
GLOBALLY- Developed countries generate 1 to
5 kg/bed/day
Developing countries: meager data, but figures
are lower.
1-2kg/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
8
CATEGORIES OF BIOMEDICAL WASTE SCHEDULE – I
WASTE
CATEGORY
TYPE OF WASTE
TREATMENT AND
DISPOSAL OPTION
Category No. 1
Human Anatomical Waste (Human
tissues, organs, body parts)
[email protected] / deep
burial*
Category No. 2
Animal Waste
(Animal tissues, organs, body parts,
carcasses, bleeding parts, fluid, blood and
[email protected] / deep
experimental animals used in research,
burial*
waste generated by veterinary hospitals
and colleges, discharge from hospitals,
animal houses)
Category No. 3
Microbiology & Biotechnology Waste
(Wastes from laboratory cultures, stocks
or specimen of live micro organisms or
attenuated vaccines, human and animal Local autoclaving/
cell cultures used in research and
microwaving /
infectious agents from research and
[email protected]
industrial laboratories, wastes from
production of biologicals, toxins and
devices used for transfer of cultures)
9
Category No. 4
Waste Sharps (Needles, syringes,
scalpels, blades, glass, etc. that may
cause puncture and cuts. This
includes both used and unused
sharps)
Disinfecting (chemical
[email protected]@ /
autoclaving /
microwaving and
mutilation /
shredding##
Category No. 5
Discarded Medicine and Cytotoxic
drugs (Wastes comprising of
outdated, contaminated and
discarded medicines)
[email protected] /
destruction and drugs
disposal in secured
landfills
Category No. 6
Soiled Waste (Items contaminated
with body fluids including cotton,
[email protected] /
dressings, soiled plaster casts, lines, autoclaving /
bedding and other materials
microwaving
contaminated with blood.)
Category No. 7
Solid Waste (Waste generated from
disposable items other than the
waste sharps such as tubing,
catheters, intravenous sets, etc.)
Disinfecting by
chemical [email protected]@
/ autoclaving /
microwaving and
mutilation / shredding#
10
Category No. 8
Liquid Waste^^ (Waste generated
from the laboratory and washing,
cleaning, house keeping and
disinfecting activities)
Category No. 9
Incineration Ash (Ash from
Disposal in municipal
incineration of any biomedical waste) landfill
Chemical Waste (Chemicals used in
production of biologicals, chemicals
Category No.10
used in disinfecting, as insecticides,
etc.)
Disinfecting by
chemical [email protected]@
and discharge into
drains
Chemical treatment
@@ and discharge into
drains for liquids and
secured landfill for
solids.
11





@ : There wil be no chemical pretreatment
before inciniration. Chlorinated plastics shall not
be incinerated.
* Deep burial shall not be option available only
in town with population less than 5 lac & in rural
area.
@@ chemicals treatment using atleast 1%
hypochlorite solution or any other equivalent
chemical reagent. It must be ensured that
chemical treatment ensures disinfection.
# Multilation/ shredding must be such so as to
prevant unauthorised reuse.
^^ About 4-250 litre/bed/day.
12
About 0.3-3.5 kg/bed/day
1: GARBAGE-55%
2:BMW
 A) wasted body remains blood,cultures,
anatomical waste -5%
 B)Pharmaceutical &chemical waste-2%
 C)Pathological waste-06%
3: Sharp object -20%
4:Pressurized container & discarded
instruments- 2%
5: Radioactive wastes-0.3

Color coding
YELLOW
Type of container
PLASTIC BAG
RED
Disinfected
container / plastic
bag
Blue/white translucent
Plastic bag/
Puncture proof
BLACK
Plastic bag
Waste category
treatment
option
Cat 1,2,3,6
Incineration /deep
burial
Cat 3,6,7
Autoclave/microwave
/chemical treatment
Cat 4,7
Autoclave/microwave
/chemical treatment /
destruction shredding
Cat 5,9,10
Disposal in secure
landfill
15




Waste collection bags for waste type needing
incineration shall not be made of chlorinated
plastics.
Categories 8 & 10(liquid) do not require
containers / bags
Body fluids like pleural fluid are mixed with
1% bleaching powder & then disposed off.
Cat 3 if disinfected locally need not to be put
in containers / bags.
16
17
1. Know what hazards
you have
2. Purchase smallest
quantity needed, and
don’t purchase
hazardous materials if
safe alternative exists
**Use mercury-free thermometers
18
3. Limit use and access
to trained persons
with personal
protective gear
19


Don’t accumulate unneeded products
Don’t let peroxides and oxidising agents turn
into bombs
Photo of bomb robot called
into hospital to dispose of
picric acid.
20

Examples of hazard labels:
21






Job description
Posters on doors
Labels on hazards
Give feedback on use of PPE
and disposal in evaluation
Role model safe use and
disposal
Contact point who is
responsible
22
23
Slide 24
TREATMENT/DI
SPOSAL
METHOD
ADVANTAGES
–all
infect waste
 most Chemical
waste
Pharmaceutical
waste
Pyrolytic
Adequate –all
incineration infect waste
Most
pharmaceutical
waste
Chemical waste
Rotary kiln
Adequate
DISADVANTAGES
High
investment
and operating costs
Incomplete
destruction of
cytotoxics
Relative high
investment
25
ROTARY KILN
PYROLYTIC INCINERATOR
26
Singlechamber
incinerator
Good
disinfection efficiency
Drastic reduction of wt &
volume of waste
Residues disposed in
landfills
No need of high trained
operators
Low investment/operating
cost
Significant
Drum/ brick
incinerator
Drastic
Massive
reduction of wt
&volume of waste
Very low investment &
operation
emissions of atmos
pollutants
Need for periodic
removal of slag
&soot
Inefficient in
destroying
thermally resistant
chem /drugs
emission
of black smoke,
ash toxic flue gas
27
SINGLE CHAMBER
INCINERATOR
DRUM/BRICK
INCINERATION
28
Chemical
disinfection
Wet
thermal
treatment
Highly
efficient
disinfection under good
operating conditions
Chemical disinfectants
are relatively
inexpensive
Requires
highly
qualified
technicians for
operating of the
process
Uses hazardous
substances that
requires
comprehensive
safety measures
Environmentally sound Shredders are
subject to
Relatively low
frequent
investment/operating
breakdowns
costs
Poor functioning
29
CHEMICAL DISINFECTION
30
WET THERMAL TREATMENT
Off-site wet thermal (or "steam autoclave") treatment facility
31
Operating
requires
qualified technicians
Inadequate for
anatomical,
pharmaceutical,chemic
al waste ,waste that is
not steam permeable
MicroGood disinfection
High investment&
wave
efficiency under
operating costs
irradiation
appropriate
Potential operation
conditions
Maintenance
Drastic reduction in problems
waste volume
Environmentally
sound
32
MICROWAVE IRRADIATION
33
Encapsulation Simple
Low
cost
Safe
Safe burying
Low
inertisation
Relatively
Not
recommended for
non sharp infectious
waste
cost
Safe only if access to
Relatively safe site is limited and
if access to site certain precautions are
taken
is restricted
inexpensive

Not applicable to
infectious waste
34
ENCAPSULATION
35
Inertisation, Immobilisation
36


1.
2.
3.
4.
5.
6.
7.



In our hospital there is 7 generation point of waste where biomedical
waste is segregated into different buckets containing polythene of same
color as bucket.
The generation points are:
Emergency
Ward 4
Ward 6
ICU
Operation theatre
Labortory
Room no 10
From each generation point waste is carried to central point which is
emergency of TBHP.
There waste in different polythene bag is weighed and tag is applied to
the bag.
Waste from TBHP is managed by SembRamky Environment pvt ltd.
Luidhana where waste is treated in bioplant.
37
• Thus refuse disposal cannot be solved without
public education.
• 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.
• Start disposing waste first from within your
home, then outside home, then neighborhood
,then your street, your area ,city and then the
nation and the world.
• Lets make this world a better place to live
in.
38
THANK YOU
HCRW Management.ppt
7/03
Slide 39
Download