Transcript Bio Medical Waste Management

BIO
MEDICAL
WASTE
MANAGEMENT
Dr. M. Balasubramanian
Asst. Prof. of STD, Stanley Medical College
IMA Former State Secretary
PHYSICIAN
ADD YEARS TO LIFE &
ADD LIFE TO YEARS
OF THE PATIENTS
DOCTORS -- SAVIOURS OF MANKIND
HOSPITALS – TEMPLES OF HEALING
MEDICAL PROFESSION -- NOBLE
DOCTORS ARE GUIDED BY ETHICS
BUT GOVERNED BY LAW
ACCOUNTABLE TO THE PATIENT
ANSWERABLE TO THE COMMUNITY
NOSO COMIAL INFECTIONS
HOSPITAL ACQUIRED INFECTIONS
PROPER DISPOSAL
OF HOSPITAL WASTE
– SOCIAL RESPONSIBILITY
POLLUTION CONTROL BOARD
TIIC
LOAN
HOSPITAL as INDUSTRY
HOSPITALS
CLASSIFIED UNDER
OBNOXIOUS & HAZARDOUS INDUSTRY
CATEGORY
HOSPITALS, Mines, Cements, Fertilizers &
Chemicals, Distilleries, Tanneries
Hotels, Cinema Theatre,
Stone Crushing unit
Lime
Kilns,
NIL – No toxic substance, No effluent, No
fugitive emissions, No use of fuel
HON’BLE SUPREME COURT OF INDIA
Writ Petition No 888 of 1996
Public Interest Litigation
Mrs. Almitra H. Patel vs. Union of India
 Pathetic Situation of Solid Waste Management Practices
 Obligatory function of Urban Local Bodies
 Resulting in problems of Health & Sanitation
 No solution in sight.
Hon’ble Supreme Court after several hearings, constituted a committee
INTERIM REPORT OF THE COMMITTEE
Domestic / Trade Waste
Construction Waste
Industrial Waste
Infectious & Hospital Waste.
 Adverse impact on Human Health.
 Grossly neglected.
 Do not discharge their duties for safe disposale.
 Infectious waste & sharps get mixed up with Domestic Waste.
 Incinerators in certain Hospitals only – Often single chamber
not affectively functioning.
 Ministry of Environment, Govt. of India to issue mandatory
instructions to rectify with a time frame.
Tamilnadu Pollution Control Board
O/o District Environment Engineer,
TN Pollution Control Board
Proc. No. DEE/TNPC Bd/TLR/BMW/INV/2001
Dated
Sub : TNPC Board – Hazardous Substance Management –
Failure to install Bio Medical Waste Treatment and disposal
facility within the stipulated time schedule – Show Cause
Notice – issued.
Ref : The Bio Medical Waste (M & H) Rules 1998 as
amended in 2000 notified under the Environment
(Protection) Act 1986.
Hence you are directed to show cause within fifteen
days from the date of receipt of this notice so as to why
penal for an offence punishable under Section 15 of
Environment (Protection) Act, 1986 should not be
initiated against you for not having complied with and
contravening the said provisions of the Bio Medical
Waste (Management & Handing) Rules 1998 as
amended in 2000 and also to issue direction for
closure of the unit and stoppage of power supply
etc.,
under
Section
(5)
of
the
Environment
(Protection) Act, 1986.
DISTRICT ENVIRONMENTAL ENGINEER
Tamilnadu Pollution Control Board.
SCHEDULE VI (see rule 5)
SCHEDULE FOR WASTE TREATMENT FACILITIES
LIKE INCINERATOR / AUTOCLAVE / MICROWAVE SYSTEM
A.Hospitals and Nursing Homes in towns with population of 30
lakhs and above
30th June 2000 or earlier
B. Hospitals and Nursing Homes in towns in towns with
population of below 30 lakhs
(a) with 500 beds and above
by 30th June, 2000 or earlier
(b) with 200 beds and above but less than 500 beds
by 31st December, 2000 or earlier
(c) with 50 beds and above but less than 200 beds
by 31st December, 2001 or earlier
(d) with less than 50 beds
by 31st December, 2002 or earlier
C. All other institutions generating bio-medical waste not
included in A and B above
by 31st December, 2002 or earlier
BIO MEDICAL WASTE MANAGEMENT
PROGRAMME PLANNING
1. Willingness
2. Self Motivation
3. Investments – Person, Place, Financial
4. Identifying Nodal Person – ICC – BMWM Committee.
5. Waste Survey
6. Evaluation of Existing Practice
7. Training
8. Implementing Segregation
9. Reporting and Feed Back
10. Review after one year.
HOSPITAL WASTES
Non Infectious
Biodegradable
Infectious
Non Biodegradable Non Sharps
Solids
Incinerable
Sharps
Liquids
Non Incinerable
(Autoclave, Microwave)
SCHEDULE – 1 (See Rule 5)
CATEGORIES OF BIO MEDICAL WASTE
OPTION
WASTE CATEGORY
TREATMENT & DISPOSAL
Category No. 1
Human Anatomical Waste
Incineration / deep burial
Category No. 2
Animal Waste
Incineration / deep burial
Category No. 3
Microbiology & Biotechnology
Waste
Local autoclaving / microwaving /
incineration
Category No. 4
Waste Sharps
Disinfection by chemical treatmet /
atoclaving / microwaving and
mutilation / shredding
Category No. 5
Discarded Medicines and
Cytoxic drugs
Incineration / destruction and
drugs disposal in secured landfills
Category No. 6
Solid Waste
Incineration / autoclaving /
microwaving
Category No. 7
Solid Waste
Disinfection by chemical treatment
/ autoclaving / microwaving and
mutilation / shredding
Category No. 8
Liquid Waste
Disinfection by chemical treatment
and discharge into drains.
Category No. 9
Incineration Ash
Disposal in municipal landfill
Category No. 10
Chemical Waste
Chemical treatment and discharge
into drains for liquids and secured
land for solids
SCHEDULE – II (See Rule 6)
COLOUR CODING AND TYPE OF CONTAINER
FOR DISPOSAL OF BIOMEDICAL WASTES
COLOUR
CODING
TYPE OF
CONTAINER
WASTE
CATEGORY
TREATMENT OPTIONS
as per Schedule I
Yellow
Plastic Bag
Cat.. 1, 2, 3
and 6
Incineration / deep
burial
Red
Disinfected
container /
Plastic Bag
Cat. 3, 6, and 7 Autoclaving /
Microwaving / Chemical
Treatment
Blue / White
Translucent
Plastic Bag /
puncture proof
container
Cat. 4, Cat. 7
Autoclaving /
Microwaving / Chemical
treatment and
destruction shredding
Black
Plastic Bag
Cat. 5, 9 and
10 (Solid)
Disposal in secured
landfill
SEGREGATION OF WASTE
RED BAG OR CONTANIER
No
Sharps
PLASTIC WASTE
IV Sets
Tubings
Blood & Urine bags
Syringes
In this
bag
SEGREGATION OF WASTE
YELLOW
BAG OR CONTAINER
No
INFECTIOUS WASTE
Soiled bandages
Dressings
Cotton Swabs
Sanitary Pads
Plastics
In this
bag
SEGREGATION OF WASTE
Needles and Ampoules
to be put
in the separate
puncture proof bin provided
SEGREGATION OF WASTE
DOCTORS
Do not dispose dressings in patients bin / Ask for
disposal bags.
Ensure all the plastics and gloves are cut and put
into bleach solution.
Ensure all used injections are cut using needle
cutters.
Ensure compliance of this scheme during ward
visits
NURSES
 Put cut gloves and plastic in bleach solution.
 Put all other infectious waste, such as pathological
waste, bandages, dressings, cotton etc… in yellow bin.
 Always cut needles with the needle cutter and
disinfect with bleach solution.
 All sharps to be put in needle cutter container.
 Help patients understand the scheme.
LAB TECHNICIANS
 Use gloves during all tests.
 Reusable items to be soaked in bleach and heated at
high a temperature.
 Media plates to be put in separate bleach solution.
 Cut gloves, syringes to be put in red coloured bin with
bleach.
 Needles to be cut with needle cutter and disinfected with
bleach.
 Sharps to be put in needle cutter container.
WARDS BOYS / AYYAS
 Cut all tubes.
 Cut all gloves.
 Check if waste in bleach in only plastic or
glass. If not, report to the supervisor.
 Help patients understand the scheme
DO’S
 Segregate waste as per category
 Put waste in correct bin wiz. Plastic/rubber waste in Red,
Anatomical soiled waste in Yellow, Non-infectious general waste
in Black and Sharps in Blue Puncture Proof Container. Ensure
colour bags of the same colour as bins.
 Ensure that the plastic bag has bio-hazard symbol and label.
 Remove plastic bags when ¾ full, tie the bags properly. Ensure
bag is properly tied / sealed to avoid spilling.
 Remove bags by Wheel Barrows only to the waste storage site.
 Cut the needle (disposable) before throwing it.
 Wear protective gear while handling waste.
 Always snipe the IV bottle, cut the IV sets, and fingers of gloves
before throwing it in the bin or sending it back to the store.
 Always keep your record book on waste activity up to date.
DON’TS
 Put the waste indiscriminately.
 Put wrong bags in bin. (Adhere to colour code.)
 Fill the bags till neck. (Waste would otherwise spill
over.)
 Handle waste without protective clothing.
 Drag the bags after removal. (Bags can burst and the
site could be repulsive.)
 Never recap the needle. (Never re-use needle without
disinfection)
 Mix non infectious waste with infectious waste.
DON’T MIX INFECTIOUS WASTES WITH MUNICIPAL WASTE
SEGREGATE AS PER COLOUR CODING
AT THE POINT OF GENERATION ITSELF
REALISE THE SIGNIFICANE OF RED & YELLOW
NEVER PUT YELLOW BAG IN RED BIN
AND RED BAG IN YELLOW BIN
OUT HOUSE MANAGEMENT
Role of Common Facilitator
 To collect Bio Medical Waste from Individual Hospital every
day.
 To transport in closed container Van safely to the Treatment
plant.
 To erect common offsite BMWM Treatment facility in
accordance with the standard prescribe BMWM Rules and
approval from Tamilnadu Pollution Control Board.
 To dispose various categories of Bio Medical Waste by
approved techniques.
 To train the individual hospitals staffs regarding BMWM
MEMORANDUM OF UNDERSTANDING
BETWEEN IMA & G.J. MULTI CLAVE INDIA (P) Ltd
Tariff agreed – Rs. 3 per bed per day on the basis of declared
bed strength of Health Care Establishment.
Comparison of Tariff -- Per bed and Per kg of Waste
(Average Bio Medical Waste Per Bed Per Day - 400 gms)
For a Hospital of 30 Beds with average occupancy of 20 Beds
Bio Medical Waste Generated 20 x 400 gms = 8Kg
Amount to be given 8 x Rs. 9 = Rs. 72/-.
Amount to be given per bed 30 x Rs. 3 = Rs. 90/(Bio Medical Waste from OP, Casualty & OT included)
Let us prove that we are
ECO FRIENDLY
To make others shed their hostility and
become
MEDICO FRIENDLY