Biohazard Disposal Biomedical Waste Management Notes

Biohazard Disposal Biomedical Waste Management

Biomedical Waste Management Introduction

• Biohazard or biomedical waste (BMW) refers to hazardous waste generated in the hospital during the diagnosis or treatment of patients, or in research laboratories, including experimental activities.
• Broadly, this generated waste falls into two categories—general waste (non-hazardous solid waste, 80%) and biomedical waste (20%). Biomedical waste includes infectious waste (10%) and chemical/radioactive waste (5%).
• Infectious waste can be from viruses, toxins, blood products, etc. Examples of chemical waste include solutions used in biochemistry labs or chemicals used for sterilization/ disinfection in operation theatres.
• Radioactive materials are used in the radionuclear department for isotope scanning or for treating diseases (e.g. thyroid disorders).

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Hazards Associated With Biomedical Waste

The WHO issued a statement in 2020 mentioning that due to improper methods of medical waste disposal, 21 million hepatitis B cases, 2 million hepatitis C cases, and 2,60,000 HIV cases had occurred.

Broadly, biomedical waste can be classified as follows:

1. Infectious waste: Example: Badly infected wounds in the leg or wounds in the perineum. Dangerous pathogens may cause dangerous infections in treating doctors or nurses.
2. Chemical waste: These can produce corrosive and physical injuries.
3. Pharmaceutical waste: A few drugs, such as nicotine, warfarin and epinephrine, can be acutely

Sources of Infectious Waste:

1. Cultures of infectious agents from laboratories
2. Waste from surgeries and autopsies
3. Waste originating from infected patients in isolation wards, e.g. feces and urine in cholera
4. Waste having come in contact with infected hemodialysis patients (e.g. dialysis tubes, filters, disposable towels, gloves, aprons, etc.) toxic. Cytotoxic drugs can cause mutations and can be teratogenic. A few drugs can be carcinogenic.

4. Radioactive waste: These can produce genetic changes and tissue destruction.

Steps Of Bmw Management

1. Identify points of waste generation—wards, OPDs, operation theatres, etc.
2. Segregate (at the point of generation) into the appropriate colour-coded containers.
3. Transport to the central collection point.
4. Apply barcode and sticker. This is as per the changes implemented in 2015.
5. Weigh the BMW to help approximate the amount generated. For example, in a 1000-bedded hospital, 1 bed may produce 500 g of BMW. Thus, all the waste in all different coloured containers are weighed.
6. Transport by a vehicle to the final treatment plant with a GPS system to track the vehicle and ensure proper disposal of the BMW. Treatment and/or disposal of waste should be done within 48 hours of generation.

Please note:

• Liquid BMW is collected from a separate line from all points and then joined together and collected in the effluent treatment plant (ETP).
• About 500 ml of HYPO is put in the sump to disinfect the liquid. Every month, a sample from this sump is sent to the pollution board for analysis to determine the efficacy of the system.

Segregation Of Biomedical Waste

According to BMW guidelines (2016), segregation should be done with containers of four different colours.

Each container is designated for a particular waste category:

1. Yellow: Human tissues—pathology specimens, sponges, cotton, dressing materials, any item soaked with blood, sanitary pads, body fluids, tissue paper, masks, caps, bedding materials, expired drugs, cytotoxic drugs, discarded drugs, infected aspirated fluid from the body, liquids from floor washings or from laboratories. A separate sticker -C- is put for cytotoxic materials. Stickers are also put for COVID materials.
2. Red: Disposable plastic materials that can be recycled—wastes generated from gloves, tubes, catheters, urine bags, etc.
3. Black: Paper, packing material, wrappers, glove covers, etc. These can be recycled.
4. White: Sharp objects—blades, scalpels, syringes with needles, suture material needles, etc.
5. Blue: Glass materials—broken ampules, discarded materials from labs or wards, metallic body implants.

Bmw Rules In India

The Ministry of Environment and Forests formulated a BMW rule in 1998 that classified waste and segregated them into colour-coded containers. The new BMW guidelines (2016, with amendments added in 2018 and 2019) describe the following:

1. Every hospital should have a final disposal and recycling unit and a common biomedical waste treatment facility (CBMWTF).
2. Only if there is no CBMWTF within 75 km can a hospital create its own disposal facility.
3. Hospitals should have a biomedical committee that meets once in 6 months and submits an annual report to licensing authorities.
4. Doctors, nurses, and all healthcare workers should be educated about BMW management services.
5. Hospital committees should inspect the waste disposal area and functioning of the unit.
6. If required, audits can be done with CCTV cameras.