BIOMEDICAL WASTE MANAGEMENTREGULATORY COMPLAINCE & MANAGEMENT OF BMW FACILITIES

Dr LAKSHMI RAGHUPATHY
Former Director, MoE&F Adviser, Environment Managment

FAQ BIOMEDICAL WASTES

What is biomedical waste? Is bio-medical was infectious? Need for mgt of bio-medical wastes Why segregate? What does the color code signify? Why use separate containers? What is the safe method for Sharps disposal? What is the maximum storage time for BMW? What is Treatment & Disposal facility? What are the advantages of Common facility? How and where to locate facility ? How to transport BMW to common facility?

WHAT IS BIOMEDICAL WASTE?

BIOMEDICAL WASTES are wastes, which are generated during the diagnosis, treatment or immunization 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 1 u Bio-medical wastes are infectious and hazardous - need to be managed carefully

BIOMEDICAL WASTES REGULATIONS

BIOMEDICAL WASTES (M&H) RULES 1998 - E(P) ACT 1986 as amended in 2000, 2003 MOE&F- NODAL AGENCY PRESCRIBED AUTHORITY-IMPLEMENTATION
These rules provide a system for regulating handling BMW which includes collection, segregation at source, norms for packaging labeling and options for treatment and disposal along with the standard for treatment technologies. For proper management & Handling of Bio-Medical Waste. Applicable to all persons who generate, collect, receive, store, transport, treat, dispose or handle bio-medical waste in any form.

BIOMEDICAL WASTE HANDLING (CRADLE TO GRAVE)

CHARACTERIZATION QUANTIFICATION SEGREGATION STORAGE TRANSPORTATION TREATMENT DISPOSAL

BIOMEDICAL WASTE CATEGORIES

10 WASTE CATEGORIES
CAT1 HUMAN ANATOMICAL CAT2 ANIMAL CAT3 MICROBIOLOGY &BIOTECHNOLOGY CAT4 WASTE SHARPS CAT5 CYTOTOXICDRUGS & DISCARDED MEDICINES CAT6 SOILDWASTE CAT7 SOLID WASTE CAT8 LIQUID WASTE CAT9 INCINERATIONASH CAT10 CHEMICAL

SEGREGATION , PACKAGING TREATMENT & DISPOSAL

CATEGORY WASTE TYPE 1. HUMAN ANATOMICAL 2. ANIMAL WASTE 3. MICROBIOLOGY & BIOTECH 4. WASTE SHARPS 5. 6. 7. 8. 9. 10. DISCARDED MED & CYTO-Drugs SOILED SOLID (DISPOSABLES) LIQUID INCINERATION ASH CHEMICAL CONTAINER TREATMENT & DISPOSAL (Y P) INCINERATION/DEEP BURIAL (Y,P) INCINEARTION/DEEP BURIAL (Y,R) AUTOCLAVING/MICROWAVING /INCINERATION [B,W] DISINFECTION(CHEM) /AUTOCL/MICRO/SHREDDING INCINERATION/DESTRUCTION [BLUE] /SECURED LANDFILL (YELLOW) INCINERATION/AUTOCL /MICROWAVING [R,B,W] CHEM.DISINFEC/AUTOCL/MICROWAV/ SHREDDING CHEM DISINFEC & DISCHARGE INTO DRAINS [Bl] MUNICIPAL LAND FILLS [Bl] CHEM TREATMENT DRAINS/ LANDFILL

BIOMEDICAL WASTES REGULATIONS

WASTE CAT 1,2,3 & 6 - YELLOW - PLASTIC BAGS INCINERATION & BURIEL WASTE CAT 3,6 & 7 - RED-DISINFEC CONT & PLASTIC BAGS - CHEMICAL DIS. AUTOCL, MICRO. CAT4 & 7 - BLUE /WHITE/TRANS-PLASTIC BAGS- - CHEMCIAL ,SHREDDING, AUTOCL, MICRO, CAT5,9 &10 - BLACK-PLASTIC BAG - SECURED LANDFILL

COMPLIANCE STATUS
Comprehensive Rules but poor compliance there are many aspects in the rules that required to be complied with
u Authorisation not completed in many states u Storage provisions have not provided in most of the heath care institutions u Dedicated vehicles for transportation of biomedical wastes are not provided in many states u Treatment disposal facilities have been set up but not achieving prescribed Standards
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BIO-MEDICAL WASTE MANAGEMENT

Steps taken by the States/UTs: Inventorization of all bio-medical waste generators - hospitals, nursing homes, clinics etc. Ensure that hospitals seek authorisation. Action against violation of the rules Facilitate Creation of Common Treatment and Disposal Facilities for Biomedical Waste.

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Bio-Medical Waste (Management & Handling) Rules,1998

As per Rule 8 , Every Occupier of an institution generating, collecting, receiving, storing, transporting, treating, disposing and /or handling bio-medical waste in any other manner, except such occupier of clinics, dispensaries, pathological laboratories, blood banks providing treatment / service to less than 1000 (one thousand) patients per month, shall make an application in Form I to the prescribed authority (DPCC) for grant of authorization.

DEADLINES FOR SETTING UP BIOMEDICAL WASTE TREATMENT FACILITIES

u According to BMW Rules 1998 deadline for setting up of treatment facilities:
Metros with population >30 lakhs -30.06.2000

Cities with population < 30 lakhs

Hospitals and Hospitals and Hospitals and Hospitals and All others Nursing Nursing Nursing Nursing Homes >500 beds -30.06.2000 Homes 200-500 beds -31.12.2000 Homes 50-200 beds -31.12.2001 Homes <50 beds -31.12.2002 -31.12.2002

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 DPCC has authorized 2 Operators to create Common BMW Treatment Facilities in Delhi 1. M/s Metro Bio- Care Waste Management Pvt. Ltd., 55, Railway Road, Samaipur Industrial Area, Delhi -42. 2. M/s Synergy Waste Management Pvt. Ltd, Near Okhla STP, Sukhdev Vihar, Okhla, Delhi 20. Both the Operators have been authorized for collection of BMW from the Health Care Units in Delhi, for transportation of collected waste to the Common treatment site & for the treatment as per BMW Rules.

Operators of Common BMW Treatment Facilities in Delhi (CBMWTF)

COMMON BMW FACILITIES

Facilties : Total - 157- Operation- 149
STATE AP ASSAM BIHAR CHANDGRH CHTTSGRH DDNH DELHI FACILITIES 11 2 3 1 5 1 2 STATE KARNATK KERALA MAHARSTR MP MEGHALYA ORISSA PUNJAB FACILITIES 11 1 34 17 1 2 4

GUJARAT HARYANA
HP J&K JHARKND

12 3
2 2 1

RAJAST TN
UTTRACHL UP WB

6 11
2 20 4

 Large health care units to have a treatment disposal facility of their own Large units with spare capacity in their to be shared with smaller units Treatment facilities to accept waste form small waste generators . Common Treatment Disposal Facilities under PPP. Local medical association to assist in cooperative ventures. State Govts. & municipal bodies to join hands
Sites allotted for common incineration facilities Treated bio-medical wastes to be picked up by municipal bodies.

OPTIMIZATION OF BIO-MEDICAL WASTE MANAGEMENT

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 Effective collection system to be put in place within and outside health care units Ensure proper segregation and packaging Pollution prevention thru EST Waste reduction Use of safe substitutes for hazardous subs in use 16

NEWER APPROACHES FOR BMW MANAGEMENT

NEWER TECHNOLOGIES
NEWER TECHNOLOGIES TO BE ADOPTED FOR BMW
NON INCINERATION TECHNOLOGY [AUTOCLAVING & HYDROCLAVING & MICROWAVING] USE OF REUSABLES WHERE POSSIBLE INSTEAD OF DISPOSABLES SAFE SUBSTITUTES FOR MERCURY MODERNIZATION OF THE OPERATING 17 PLANTS

REQUIEMENTS FOR BIOMEDICAL WASTES MGT

Facilitating the process of BMW Mgt Precautionary principles & preventive approach Training & awareness programmes Appropriate qualification & training Allocation of responsibilities Providing infrastructure and equipments Budget allocation Co-ordination and cooperation with other institutions

ISSUES ON BIOMEDICAL WASTES MANAGEMENT

ISSUES Adequate attention not given Indiscriminate Disposal Segregation Lacking Unscruplus Recycling No Treatment & Disposal Facility No Training Awareness Monitoring Mechanisms Lacking Lack of infrastructure in hospitals to tackle the problem of bio-medical wastes. Inadequate/NIL allocation of funds. Lack of training for nurses and other para-medical staff. Absence of personal protective gears like gloves etc., while segregating and transporting wastes.

ACTION POINTS
SOLUTIONS Follow regulations Use re-usables Prescribe safe recycling Waste minimization Integral part of hospital management system Awareness & education Management monitoring mechanisms Penalty & punishments Utilisation of spare capacity of existing incinerators and other facilities in the hospitals by small units. Also utilisation of incinerators in the private sector industries for treatment of Hospitals Wastes.. Inclusion of Biomedical waste management as a part of medical curriculum

Thank You
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