Bio medical waste management:

Definition:
Any waste generated during the diagnosis,
treatment or immunization of human beings or
animals or in research activities.
Importance:
wastes produced in the course of health care
activities carries a higher potential for
infection.
It is essential to have safe and reliable method
for its handling.
Inadequate and inappropriate handling of
health care waste will have serious impact on
the environment.

Sources of health care waste:

Government hospitals.
Private hospital.
Nursing homes.
Clinics.
Primary health centers.
Medical research and training centers.
Laboratories.
Vaccination centers.
Bio-technology units.
Research organizations.

Types of hospital waste:

Waste Category

Example

Infectious waste

Tissue swabs, wastes from isolation wards, Laboratory cultures,

equipments that are in contact with infected patients.

Pathological waste

Human tissues or fluids e.g. Body parts, blood and other body
fluids, Fetuses.

Sharps

Needles, Infusion sets, Scalpels, Knives, Blades, Broken glass.

Pharmaceutical waste

Expired Pharmaceuticals, Bottles, Boxes

Genotoxic waste

Cytotoxic drugs (Used in cancer therapy), Genotoxic Chemicals

Chemical waste

Laboratory reagents film developer, expired Disinfectants,

Solvents

Metallic wastes

Batteries, broken thermometers, BP gauges etc

Pressurized containers

Gas cylinders, Gas cartridges, Aerosol cans.

Radioactive wastes

Unused liquids from radiotherapy, Absorbent papers, Urine and

excreta from patients treated with unsealed radionuclide.

Hazards associated with hospital

wastes:
Groups
at
risk
for
infections
associated hospital wastes are:
Staff nurses, Physicians, health care
auxiliaries,
hospital
maintenance
personnel.
Patients and Visitors in health care
establishments.
Workers in Laundries, waste disposal
facilities, Scavengers etc.

1. Hazards from infectious wastes and sharps.

Pathogens may enter the body through cuts,
abrasions in the skin, Mucous membranes by
inhalations or by ingestion.
e.g. HIV, Hepatitis B & C
2. Hazards from chemical and pharmaceutical
waste.
.Chemicals used in health care establishments
are toxic, corrosive, flammable, explosive in
nature.
.they causes intoxication, injuries including burns.
.Disinfectants used in large quantities are
corrosive and toxic in nature.

3. Hazards from genotoxic wastes.

Exposure to genotoxic wastes occur
during the preparation or treatment
with particular drug or chemical.
the main path of exposure is inhalation
of dust or aerosols, absorption through
the skin, inghestion of food accidentally
contaminated with cytotoxic drugs,
chemicals or wastes etc.
4. Hazards from radioactive wastes.
the type of disease caused by
radioactive waste is determined by the
type and extent of exposure.

5. Public sensitivity.
Apart from health hazards, the general
public is very sensitive to visual impact
of health care waste particularly
anatomical wastes.
Decontamination of hospital wastes.
1. Incineration: It is a high temperature
dry oxidation process, that reduces
organic and combustible waste to
inorganic incombustible matter results
in significant reduction of waste volume
and weight.

Types of incinerators:
a. Double chamber incinerators to burn infectious
health care waste.
b. Single chamber furnaces.
c. Rotary Kilns operating at high temperatures capable
of decomposing heat resistant chemicals.
2. Chemical disinfection:
.Chemicals are added to kill or inactivate the
pathogens results in disinfection rather than
sterilization.
.It is suitable for treating liquid wastes such as blood,
urine, stools or hospital sewage
.Some solid wastes can also be disinfected with certain
limitations.

3. Wet and Dry thermal treatment.

I. Wet thermal treatment (Steam disinfection):
. Infectious wastes are subjected to high
temperature, high pressure steam and is
similar to autoclave sterilization process.
. this process is inappropriate for the
treatment of anatomical wastes, chemicals
and pharmaceutical waste.
II. screw-feed technology:
. wastes such as sharps infectious wastes are
heated in a rotating auger.
. waste is reduced by 80% in volume and 2035% in weight.

4. Microwave irradiation.
Microorganisms are generated by the
action of microwave of a frequency of
about 2450 MHz and a wavelength of
12.24 nm
Water in the waste is rapidly heated by
the microwaves and the infectious
components are destroyed by heat
conduction.
5. Land disposal.
Municipal disposal sites: There are 2
types

health care wastes should not be

deposited on or around open dumps to
prevent the risk of either people or
animals coming into contact with
infectious agents.
Advantage of sanitary landfill is
geological isolation of waste from the
environment.
6. Inertization:
It involves mixing waste with cement
and other substances before disposal in
order to minimize the risk of toxic
substances contained in the wastes

Segregation, transportation and

disposal:
Color coding and type of container for
disposal
of bio medical
wastes.
Type of
Waste category
Treatment and
Color
codin container
g

disposal

yello
w
Red

Plastic bag

Disinfected
Cat 3, Cat 6, Cat
container/Plasti 7
c bag

Autoclaving/Microwa
ving/Chemical
treatment

Blue/
Whit
e

Plastic
Cat 4, Cat 7
bag/Puncture
proof container

Autoclaving/Microwa
ving/Chemical
treatment and
destruction

Plastic bag

Disposal in secured

Cat 1, Cat 2, Cat

3, Cat 6

Cat 5, Cat 9, Cat

Incineration/Deep
burial

Categories of bio medical wastes in India

Categ
ory

Wastes

Treatmen
t and
disposal

Category
1

Human anatomical wastes (Human tissues, Incineration/D

organs, body parts).
eep burial

Category
2

Animal wastes (Animal tissues, organs, Incineration/D

bleeding parts, fluids, blood and experimental eep burial
animals used in research, discharge from
hospital etc)

Category
3

Microbiology and biotechnology waste (wastes

from laboratory culture, specimens of microorganisms, Vaccines, toxins, production of
biological wastes etc)

Category
4

Waste sharps (Needles, Syringes, Scalpels, Disinfection/A

Blades, Glass etc that may cause puncture utoclaving/Mic
and cuts.)
rowaving

Category
5

Discarded medicines and cytotoxic drugs Incineration,

(Wastes
comprising
of
outdated, Disposal
in
contaminated and discarded medicines.)
secured

Local
autoclaving/
Microwaving/In
cineration

Categ
ory

Wastes

Treatment and
disposal

Category Solid Waste (Items contaminated with

6
blood and fluids including cotton,
dressings, Soiled plaster casts, linen,
Beddings, other material
contaminated with blood)

Incineration/autoclavi
ng/Microwaving

Category Solid waste ( Wastes generated from

7
disposable items other than the waste
sharps such as tubings, catheters,
intravenous sets etc.)

Disinfection by
chemical
treatment/Autoclavin
g/Microwaving

Category Liquid waste (Waste generated from

8
laboratory washings, cleaning,
housekeeping and disinfecting
activities.)

Disinfection by
chemical treatment
and discharge into
drains

Category Incineration ash (Ash from incineration

9
of any bio medical waste.)

Disposal in municipal
landfill

Category Chemicals used in production of

10
biologicals, Chemicals uesd in
disinfection, as insecticides etc.

Chemical treatment
and discharge into
drains for liquids and
secured landfill for