Biomedical Waste Management Project, Definition, Assignment, PDF -_0.1

Biomedical Waste Management Project, Definition, Assignment, PDF

Biomedical waste Management: Any waste generated during the diagnosis, treatment, or immunization of humans or animal is referred to as biomedical waste.Check Biomedical waste Management project here.

Biomedical Waste Management

Table of Contents

Biomedical Waste Management

Biomedical waste management involves the proper handling, disposal, and treatment of waste materials generated in healthcare facilities, research laboratories, and other medical settings. It refers to a collection of practises intended to reduce the risks connected with biomedical waste, such as infectious diseases and environmental damage. In this essay, we will look at the significance of biomedical waste management as well as the key principles and practices involved.

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Biomedical Waste Management Project Definition

Bio-medical waste management was first governed by the Bio Medical Waste Management and Handling Rule, 1998, and its following changes. The Bio-medical Waste Management and handling regulation 2016 is now in effect. Bio-medical waste is any waste generated during the diagnosis, treatment, or immunization of humans or animals, or during related research activities, as well as the manufacture or testing of biological products in health facilities. The term “bio medical waste” refers to all waste generated by healthcare facilities that, if illegally disposed of, could harm either human health or the environment as a whole. All rubbish that endangers human health or the environment is considered contagious and must be treated as such.

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Biomedical Waste Definition

Biomedical waste, also known as healthcare waste or medical waste, refers to any waste material that contains biological or infectious agents. This includes discarded items such as used syringes, needles, bandages, laboratory cultures, human tissues, blood, and other bodily fluids. Biomedical waste may also include non-biological materials like chemicals, pharmaceuticals, and radioactive substances used in medical procedures.

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Importance of Biomedical Waste Management

Proper biomedical waste management is essential for several reasons:

a) Preventing the Spread of Infections: Biomedical waste, especially infectious materials, can harbor pathogens that pose a risk to human health. Effective management practices, such as segregation, disinfection, and proper disposal, minimize the potential for disease transmission among healthcare workers, patients, and the general public.

b) Environmental Protection: Biomedical waste contains hazardous substances that can contaminate soil, water bodies, and the air if not managed properly. By implementing appropriate waste management strategies, the release of toxic chemicals, pathogens, and pharmaceutical residues into the environment can be minimized, safeguarding ecosystems and public health.

c) Compliance with Regulations: Governments and regulatory bodies have established guidelines and regulations for biomedical waste management to ensure public safety and environmental protection. Healthcare facilities are legally obligated to adhere to these regulations to avoid penalties and maintain their reputation.

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Biomedical Waste Management Principle

a) Segregation: The first step in effective waste management is the segregation of different types of biomedical waste. This involves categorizing waste into different color-coded containers based on their characteristics, such as infectious, sharp, chemical, or pharmaceutical waste. Segregation facilitates proper handling, treatment, and disposal of waste materials.

b) Collection and Storage: Biomedical waste should be collected and stored in secure containers that are leak-proof, puncture-resistant, and labeled appropriately. These containers should be placed at designated locations within healthcare facilities to ensure safe and convenient waste disposal.

c) Transportation: Biomedical waste must be transported from healthcare facilities to treatment or disposal facilities in a manner that prevents leakage, spillage, or exposure. Specialized vehicles and trained personnel should be employed for the transportation of biomedical waste, following strict safety protocols.

d) Treatment and Disposal: Biomedical waste requires proper treatment to inactivate pathogens and reduce its potential harm. Common treatment methods include incineration, autoclaving (steam sterilization), chemical disinfection, and microwaving. After treatment, the waste can be disposed of through landfilling, deep burial, or other approved methods.

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Best Practices in Biomedical Waste Management

a) Staff Training: Healthcare personnel should receive regular training on the proper handling, segregation, and disposal of biomedical waste. Training should include awareness about potential hazards, infection control measures, and the use of personal protective equipment (PPE).

b) Monitoring and Auditing: Regular monitoring and auditing of biomedical waste management practices ensure compliance with regulations and identify areas for improvement. This includes tracking waste generation, segregation practices, storage conditions, and treatment processes.

c) Public Awareness: Public awareness campaigns can help educate the general population about the proper disposal of biomedical waste generated at home, such as sharps or expired medicines. Clear instructions and convenient collection systems can be provided to encourage responsible waste disposal.

d) Collaboration and Partnerships: Governments, healthcare facilities, waste management authorities, and environmental organizations should collaborate to establish effective biomedical waste management systems.

Biomedical Waste Management Assignment Explanation

Any garbage that contains infectious or possibly contagious elements is considered biomedical waste. These wastes are produced when humans and animals are diagnosed, treated, and immunized. There are both solid and liquid kinds of biomedical waste. Biomedical waste examples include: Waste sharps, including broken glass, scalpels, lancets, syringes, and used needles, bodily parts or recognisable human tissues (as a result of amputation), Veterinary hospital trash and animal tissues, used gloves, dressings, bandages, other medical equipment, contaminated areas’ liquid waste, and waste from the lab. Biomedical wastes must be treated and disposed of differently than ordinary waste.

Types of Biomedical Waste

Biomedical waste is divided into eight categories by the World Health Organization (WHO):

  • Infectious Waste
  • Sharps objects
  • Pathological Waste
  • Pharmaceutical Waste
  • Genotoxic Waste
  • Radioactive Waste
  • Chemical Waste
  • General/Other Waste

Biomedical Waste Management in Hospital

Biomedical waste in Hospitals include waste from human anatomy, including tissues, organs, and body parts animal waste produced by veterinary hospitals during research, wastes from microbiology and biotechnology, Sharps waste, such as used scalpels, syringes, and hypodermic needles, discarded medications, cytotoxic medications, trash that has been contaminated with blood, such as dressings, bandages, plaster casts, tubes, and catheters, liquid waste from each affected region, and Chemical wastes and incinerator ash.

Utilizing various sorts of containers to collect biological waste from places like operating rooms, labs, wards, kitchens, and hallways is part of the process. It is important to arrange the bins and containers such that 100% collection is obtained.

Biomedical Waste Management Project/ Assignment

Introduction to bio-medical waste (bmw).

All human endeavours result in garbage. We are all aware that this waste could be toxic and needs to be disposed of properly. Polluted water, land, and air, as well as industrial and agricultural waste. Both humans and the environment may be at risk from it.

Similar to this, hospitals and other healthcare institutions produce large amounts of garbage that can spread diseases to anyone who handle it or come into touch with it, including HIV, Hepatitis B and C, and Tetanus.

Definition of BioMedical Waste

Any waste that is produced during the diagnosis, treatment, or immunization of humans or animals, in related research activities, or in the manufacturing or testing of biologicals, as defined by the Biomedical Waste (Management and Handling) Rules, 1998 of India.

Classification of BioMedical Waste

Medical waste is divided into eight categories by the World Health Organization (WHO): general waste, pathological waste, radioactive waste, chemical waste, infectious to possibly contagious waste, sharps waste, pharmaceutical waste, and waste in pressurized containers.

Sources of Biomedical Waste

Hospitals generate waste, which has grown in both quantity and variety over time. In addition to being a risk to patients and the staff who manage them, hospital waste also poses a risk to the environment and public health.

  • hospitals, whether public or private, nursing homes, or dispensaries.
  • primary care facilities.
  • paramedical services, medical schools, and research facilities.
  • Animal research facilities and veterinary colleges.
  • mortuaries, blood banks, and autopsy facilities.
  • Institutes for biotechnology.
  • unit of production.
  • clinics for doctors and dentists.
  • slaughterhouses for animals.
  • camps for blood donation.
  • vaccine facilities.
  • Psychiatric facilities, cosmetic piercing, and acupuncturists.
  • funeral arrangements.
  • institutions for people with disabilities.

Treatment of Biomedical Waste Management

1. chemical processes.

These procedures make use of disinfectant-acting compounds. Examples of such compounds include ozone, hydrogen peroxide, per-acetic acid, sodium hypochlorite, dissolved chlorine dioxide, and dry inorganic chemicals. The majority of chemical reactions require neutralising agents and a lot of water.

2. Thermal Processes

Heat is used in these procedures to disinfect. Low-heat systems and High-heat systems have been divided into two categories based on the temperature at which they function. Steam, hot water, or electromagnetic radiation are used in low-heat systems (which run between 93 and 177°C) to heat and cleanse the waste.

3. Mechanical Processes

To make trash handling easier or to process waste in conjunction with other treatment stages, these methods are used to alter the physical shape or features of the waste. The key two mechanical operations are

  • Compaction: used to lessen the amount of waste
  • Shredding: used to prevent the reuse of plastic and paper waste by destroying it. A shredder can only be used with waste that has been disinfected.

4. Irradiation Processes

Wastes should be exposed to ultraviolet or ionising radiation in a sealed space. To make the garbage unidentifiable in these systems, post shredding is necessary.

5. Biological Processes

treating medical waste with biological enzymes. In addition to decontaminating the waste, it is asserted that biological reactions will also cause the elimination of all organic components, leaving only plastics, glass, and other inert materials in the residues.

Health Hazards of Biomedical Waste Management

The WHO reports that the average life expectancy in the world is rising. However, the number of fatal infections is rising. According to a WHO research, infectious diseases claim the lives of more than 50,000 people every day.

Ineffective waste management is one of the factors contributing to the rise in infectious diseases. The majority of viruses, bacteria, and parasites that cause illness are found in blood, body fluids, and bodily secretions, which are components of biomedical waste.

Biomedical Waste Management Assignment Project PDF

Here we give bio medical waste management assignment project pdf for the students. check now

Bio Medical Waste Management

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What are the 4 types of biomedical waste?  

Infectious, hazardous, radioactive, and normal medical waste are the four main categories.

What are the types of biomedical waste management?  

Incineration is one of the several technologies that can be utilised for treatment. Chemical eradication, Thermal Wet Treatment, Radiation from microwaves, Disposal of Land, and Inertization.

What is biomedical waste and its types classify?  

There are two categories for biomedical waste: 2. Hazardous garbage, followed by non-hazardous waste Non-hazardous waste: Page 5 About 75% to 90% of the properties of biomedical waste are identical to those of household garbage and are not dangerous in any way.

What is called biomedical waste?  

Any waste generated during the diagnosis, treatment, or immunisation of humans or animals used in research operations, the manufacture or testing of biological products, or in health camps is referred to as biomedical waste (BMW).

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Biomedical Waste Management and Its Importance: A Systematic Review

Himani s bansod.

1 Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Prasad Deshmukh

2 Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

The waste generated in various hospitals and healthcare facilities, including the waste of industries, can be grouped under biomedical waste (BMW). The constituents of this type of waste are various infectious and hazardous materials. This waste is then identified, segregated, and treated scientifically. There is an inevitable need for healthcare professionals to have adequate knowledge and a proper attitude towards BMW and its management. BMW generated can either be solid or liquid waste comprising infectious or potentially infectious materials, such as medical, research, or laboratory waste. There is a high possibility that inappropriate management of BMW can cause infections to healthcare workers, the patients visiting the facilities, and the surrounding environment and community. BMW can also be classified into general, pathological, radioactive, chemical, infectious, sharps, pharmaceuticals, or pressurized wastes. India has well-established rules for the proper handling and management of BMW. Biomedical Waste Management Rules, 2016 (BMWM Rules, 2016) specify that every healthcare facility shall take all necessary steps to ensure that BMW is handled without any adverse effect on human and environmental health. This document contains six schedules, including the category of BMW, the color coding and type of containers, and labels for BMW containers or bags, which should be non-washable and visible. A label for the transportation of BMW containers, the standard for treatment and disposal, and the schedule for waste treatment facilities such as incinerators and autoclaves are included in the schedule. The new rules established in India are meant to improve the segregation, transportation, disposal methods, and treatment of BMW. This proper management is intended to decrease environmental pollution because, if not managed properly, BMW can cause air, water, and land pollution. Collective teamwork with committed government support in finance and infrastructure development is a very important requirement for the effective disposal of BMW. Devoted healthcare workers and facilities are also significant. Further, the proper and continuous monitoring of BMW is a vital necessity. Therefore, developing environmentally friendly methods and the right plan and protocols for the disposal of BMW is very important to achieve a goal of a green and clean environment. The aim of this review article is to provide systematic evidence-based information along with a comprehensive study of BMW in an organized manner.

Introduction and background

The amount of daily biomedical waste (BMW) produced in India is enormous [ 1 ]. People from all segments of society, regardless of age, sex, ethnicity, or religion, visit hospitals, which results in the production of BMW, which is becoming increasingly copious and heterogeneous [ 2 ]. BMW produced in India is about 1.5-2 kg/bed/day [ 3 ]. BMW include anatomical waste, sharps, laboratory waste, and others and, if not carefully segregated, can be fatal. Additionally, inappropriate segregation of dirty plastic, a cytotoxic and recyclable material, might harm our ecosystem [ 4 ]. Earlier, BMW was not considered a threat to humans and the environment. In the 1980s and 1990s, fears about contact with infectious microorganisms such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV) prompted people to consider the potential risks of BMW [ 5 ]. BMW is hazardous in nature as it consists of potential viruses or other disease-causing microbial particles; it may be present in human samples, blood bags, needles, cotton swabs, dressing material, beddings, and others. Therefore, the mismanagement of BMW is a community health problem. The general public must also take specific actions to mitigate the rising environmental degradation brought on by negligent BMW management. On July 20, 1998, BMW (Management and Handling) Rules were framed. On March 28, 2016, under the Environment (Protection) Act, 1986, the Ministry of Environment and Forest (MoEF) implemented the new BMW Rules (2016) and replaced the earlier one (1988). BMW produced goes through a new protocol or approach that helps in its appropriate management in terms of its characterization, quantification, segregation, storage, transport, and treatment.

According to Chapter 2 of the Medical Waste Management and Processing Rules, 2016, “The BMW could not be mixed with other wastes at any stage while producing inside hospitals, while collecting from hospitals, while transporting, and should be processed separately based on classification.” The COVID-19 pandemic has now transformed healthy societies worldwide into diseased ones, resulting in a very high number of deaths. It also created one significant problem: improper handling of the medical waste produced in the testing and treatment of the disease [ 6 ]. In India, BMW generated due to COVID-19 contributed to about 126 tonnes per day out of the 710 tonnes of waste produced daily [ 7 ]. 

The basic principle of the management of BMW is Reduce, Reuse, and Recycle-the 3Rs. Out of the total amount of BMW generated, 85% is general (non-hazardous) waste, and the remaining 15% is hazardous. As BMW contains sharps and syringes, the pathogens can enter the human body through cuts, abrasions, puncture wounds, and other ways. There might also be chances of ingestion and inhalation of BMW, which can lead to infections. Some examples of infections are Salmonella, Shigella, Mycobacterium tuberculosis, Streptococcus pneumonia, acquired immunodeficiency syndrome (AIDS), hepatitis A, B, and C, and helminthic infections [ 8 ]. This systematic review is conducted to obtain essential, up-to-date information on BMW for the practical application of its management. The highlight of the management of BMW is that the “success of BMW management depends on segregation at the point of generation” [ 9 ].

The findings have been reported following the principles and criteria of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). The systematic review has been conducted according to these standards and principles.

Search Sources/Search Strategy

We used the MeSH strategy to obtain articles from PubMed and ResearchGate employing the following terms: (“Biomedical/waste” [Majr] OR “Biomedical Waste/source” [Majr] OR “Biomedical Waste/hazards” [Majr] OR “Biomedical Waste/segregation” [Majr] OR “Biomedical Waste/rules” [Majr] OR “Biomedical Waste/laws” [Majr] OR “Biomedical Waste/environment” [Majr]). Specifically, for management-related studies, the search terms (“Management/steps” [Majr] OR “Management/handling” [Majr] OR “Management/coding” [Majr] OR “Color coding/segregation” [Majr] OR “Treatment/method” [Majr] OR “Autoclaving/waste” [Majr] OR “Incineration/waste” [Majr]) were used. We obtained the most pertinent research papers and used them in different arrangements using the Boolean operators “AND” and “OR.”

Inclusion and exclusion criteria

We focused on papers written in the English language, published within the last decade, relevant to the central questions of this review article, and that are systematic reviews such as randomized clinical trials and observational studies. We, however, excluded papers published in languages other than English, irrelevant to the questions, and related to topics other than BMW.

Search outcomes

After the initial screening, we narrowed the search results down to 264 papers. A total of 42 duplicate papers were removed. Subsequently, publications were refined by the title/abstract, and we eliminated a few studies due to the lack of full text and/or related articles. Finally, after assessing 27 items for eligibility, we included 11 papers in our review. Figure ​ Figure1 1 is the flow chart for article selection formulated on PRISMA.

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PRISMA: Preferred Reporting Items for Systematic Review and Meta-analysis, PMC: PubMed Central

Need for BMW management in hospitals

BMW threatens the health of medical staff, hospital-visiting patients, and people in the nearby community. Improper disposal leads to severe hospital-acquired diseases along with an increased risk of air and water pollution. Due to open-space waste disposal practices, animals and scavengers might get infected, leading to the scattering of waste and the spreading of infections. In countering such activities, four major principle functions of BMW management are applicable: the placement of bins at the source of generation of BMW, segregation of BMW, removal or mutilation of the recyclable waste, and disinfection of the waste [ 10 ]. BMW management methods aim predominantly to avoid the generation of waste and, if generated, then recover as much as possible [ 11 ].

BMW management rules in India

On March 28, 2016, under the Environment (Protection) Act, 1986, the MoEF notified the new BMW Rules, 2016 and replaced the earlier Rules (1988). BMW produced goes through a new protocol or approach which helps in the appropriate management of waste, i.e., its characterization, quantification, segregation, storage, transport, and treatment, all of which aim to decrease environmental pollution [ 12 ]. Problems with the improper management of BMW also shed light on the scavengers who, for recycling, segregate the potentially hazardous BMW without using gloves or masks. Strict rules have been implemented to ensure that there is no stealing of recyclable materials or spillage by some humans or animals and that it is transported to the common BMW treatment facility [ 10 ]. The first solution to stop the spread of hazardous and toxic waste was incineration. Incineration is required in all hospitals and healthcare facilities that produce BMW. However, due to the absence of services that provide certified incinerators in a few countries, BMW has to be sent to landfills, which leads to land contamination and harms the environment [ 13 ]. Incinerators used for disposal might also lead to environmental pollution. Numerous toxins are formed during incineration, which are the products of incomplete combustion. Thus, some new standards have been issued to resolve this problem and safeguard the environment and public health [ 14 ].

Steps in the management of BMW

BMW management needs to be organized, as even a single mistake can cause harm to the people in charge. There are six steps in the management of BMW [ 15 ]: surveying the waste produced; segregating, collecting, and categorizing the waste; storing, transporting, and treating the waste. Segregation is the separation of different types of waste generated, which helps reduce the risks resulting from the improper management of BMW. When the waste is simply disposed of, there is an increased risk of the mixture of waste such as sharps with general waste. These sharps can be infectious to the handler of the waste. Further, if not segregated properly, there is a huge chance of syringes and needles disposed of in the hospitals being reused. Segregation prevents this and helps in achieving the goal of recycling the plastic and metal waste generated [ 16 ]. According to Schedule 2, waste must be segregated into containers at the source of its generation, and according to Schedule 3, the container used must be labeled. The schedules of BMW (Management and Handling) Rules, 1998, which were initially ten in number, have now been reduced to four [ 17 ]. The collection of BMW involves the use of different colors of bins for waste disposal. The color is an important indicator for the segregation and identification of different categories of waste into suitable-colored containers. They must be labeled properly based on the place they have been generated, such as hospital wards, rooms, and operation theatres. It is also very important to remember that the waste must be stored for less than 8-10 hours in hospitals with around 250 beds and 24 hours in nursing homes. The storage bag or area must be marked with a sign [ 16 ]. 

Figure ​ Figure1 1 shows the biohazard signs that symbolize the nature of waste to the general public.

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Biohazards are substances that threaten all living things on earth. The biohazard symbol presented in Figure ​ Figure1 1 was remarked as an important public sign, signaling the harms and hazards of entering the specified zone or room [ 18 ]. Along with the biohazard sign, the room door must have a label saying “AUTHORISED PERSONNEL ONLY.” The temporary storage room must always be locked and away from the general public's reach. The waste is then collected by the vehicles daily. A ramp must be present for easy transportation. The waste collected is then taken for treatment. The loading of wastes should not be done manually. It is very vital to properly close or tie the bag or the container to avoid any spillage and harm to the handlers, the public, and the environment. The transport vehicle or trolley must be properly covered, and the route used must be the one with less traffic flow [ 19 ].

BMW handling staff should be provided with personal protective equipment (PPE), gloves, masks, and boots. BMW retrievers must be provided with rubber gloves that should be bright yellow. After usage, the importance of disinfecting or washing the gloves twice should be highlighted. The staff working in or near the incinerator chamber must be provided with a non-inflammable kit. This kit consists of a gas mask that should cover the nose and mouth of the staff member. The boots should cover the leg up to the ankle to protect from splashes and must be anti-skid [ 16 ]. According to the revised BMW management rules, 2016, it is mandatory to provide proper training to healthcare facility staff members on handling BMW. The training should be mandatorily conducted annually. Along with the management step of the color coding for segregation, it is also important for the staff to be trained in record keeping. This practice of record-keeping helps track the total amount of waste generated and the problems that occurred during the management process, thus helping improve segregation, treatment, and disposal [ 20 ].

Color coding for segregation of BMW

Color coding is the first step of BMW management. Different wastes are classified into different types, and therefore, they must be handled and disposed of according to their classification. The bins used for waste disposal in all healthcare facilities worldwide are always color-coded. Based on the rule of universality, bins are assigned a specific color, according to which the waste is segregated. This step helps avoid the chaos that occurs when all types of waste are jumbled, which can lead to improper handling and disposal and further result in the contraction of several diseases [ 21 ]. The different kinds of categories of waste include sharp waste such as scalpels, blades, needles, and objects that can cause a puncture wound, anatomical waste, recyclable contaminated waste, chemicals, laboratory waste such as specimens, blood bags, vaccines, and medicines that are discarded. All the above-mentioned wastes are segregated in different colored bins and sent for treatment [ 22 ]. Yellow bins collect anatomical waste, infectious waste, chemical waste, laboratory waste, and pharmaceutical waste, covering almost all types of BMW. Different bins and various types of sterilization methods are used depending on how hazardous the waste is. The best tools for sterilization are autoclaves. Red bins collect recyclable contaminated wastes, and non-chlorinated plastic bags are used for BMW collection. Blue containers collect hospital glassware waste such as vials and ampoules. White bins are translucent where discarded and contaminated sharps are disposed of. Sharp wastes must always be disposed of in puncture-proof containers to avoid accidents leading to handlers contracting diseases [ 23 , 24 ]. 

Figure ​ Figure3 3 illustrates the different colored bins used for the segregation of BMW.

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BMW management refers to completely removing all the hazardous and infectious waste generated from hospital settings. The importance of waste treatment is to remove all the pathogenic organisms by decontaminating the waste generated. This helps in the prevention of many severe health-related issues that can be caused because of the infective waste. It is a method used to prevent all environmental hazards [ 25 ].

Methods for the treatment of BMW

There are many methods that are used for the treatment of BMW. One of the most economical ways of waste treatment is incineration, which is just not some simple “burning” but the burning of waste at very high temperatures ranging from 1800℉ to 2000℉ to decrease the total mass of decontaminated waste by converting it into ash and gases, which is then further disposed of in landfills [ 25 , 26 ]. Important instructions associated with the use of incinerators are as follows: chlorinated plastic bags must not be put inside the incinerators as they can produce dioxin [ 26 ]. Metals should not be destroyed in an incinerator. The metals present in BMW are made of polyvinyl chloride. When these metals are burned, they produce a huge amount of dioxin. Dioxins are very toxic chlorinated chemical compounds, as dioxins, when released into the environment, can lead to environmental pollution and a higher incidence of cancer and respiratory manifestations [ 14 ].

Autoclaving is an alternate method of incineration. The mechanism of this process involved sterilization using steam and moisture. Operating temperatures and time of autoclaving is 121℃ for 20-30 minutes. The steam destroys pathogenic agents present in the waste and also sterilizes the equipment used in the healthcare facility [ 25 ]. Autoclaving has no health impacts and is very cost-friendly. It is recommended for the treatment of disposables and sharps, but the anatomical, radioactive, and chemical wastes must not be treated in an autoclave [ 27 ]. Chemical methods are the commonest methods that include chemicals such as chlorine, hydrogen peroxide, and Fenton’s reagent. They are used to kill the microorganisms present in the waste and are mainly used for liquid waste, such as blood, urine, and stool. They can also be used to treat solid waste and disinfect the equipment used in hospital settings and surfaces such as floors and walls [ 28 ]. Thermal inactivation is a method that uses high temperatures to kill the microorganisms present in the waste and reduce the waste generated in larger volumes. The temperature differs according to the type of pathogen present in the waste. After the treatment is done, the contents are then discarded into sewers [ 29 ].

Very serious environmental and health hazards can be triggered if hospital waste is mixed with normal garbage, which can lead to poor health and incurable diseases such as AIDS [ 30 ]. The needle sticks can be highly infectious if discarded inappropriately. Injury by these contaminated needles can lead to a high risk of active infection of HBV or HIV [ 31 ]. The groups at increased risk of getting infected accidentally are the medical waste handlers and scavengers. Sharps must properly be disposed of in a translucent thin-walled white bin. If sharps are discarded in a thin plastic bag, there is a high chance that the sharps might puncture the bag and injure the waste handler [ 32 ]. It can also be the main cause of severe air, water, and land pollution. Air pollutants in BMW can remain in the air as spores. These are known as biological air pollutants. Chemical air pollutants are released because of incinerators and open burning. Another type of threat is water pollutants. BMW containing heavy metals when disposed of in water bodies results in severe water contamination. The landfills where the disposal takes place must be constructed properly, or the waste inside might contaminate the nearby water bodies, thus contaminating the drinking water. Land pollution is caused due to open dumping [ 33 ]. BMW must also be kept away from the reach of rodents such as black rats and house mice, which can spread the pathogens to the people living nearby [ 34 ].

Many promising steps were taken to minimize the volume of waste discarded from the source, its treatment, and disposal. The 3R system encourages the waste generators to reuse, reduce, and recycle. Everyone must be aware of the 3Rs because this approach can help achieve a better and cleaner environment [ 35 ]. Unfortunately, most economically developing countries cannot correctly manage BMW. Very few staff members of healthcare facilities are educated about proper waste management. The waste handlers are also poorly educated about the hazards of waste [ 36 ]. Every member helping in the waste management process must be made aware of the dangers of BMW to avoid accidents that harm the environment and living beings [ 37 ].

Conclusions

BMW is generated by healthcare facilities and can be hazardous and infectious. Improper handling can lead to health hazards. Collection, segregation, transportation, treatment, and disposal of BMW are important steps in its management. The color coding of bins, the use of technologies such as incineration and autoclaving, and attention to environmental impacts are also highly crucial. BMW management aims to reduce waste volume and ensure proper disposal. All those involved should strive to make the environment safer.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

Bio-Medical Waste Management

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assignment of biomedical waste management

  • Ajay Garg 2  

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Bio-Medical Waste Management is governed by country or state-specific legislation, with its own rules. It pertains to waste containing infectious materials, originating from hospitals and laboratories, different from regular or hazardous waste. It can be solid, semi-solid, or liquid. Hospitals classify waste as bio-medical, general, or others. The management process involves segregation, collection, pre-treatment, transportation, and storage. Proper treatment of hospital wastewater is vital to prevent adverse environmental effects and infectious diseases in humans. Effluent Treatment Plants (ETP/STP) help remove organic matter and solids from water before reusing or discharging it into the environment.

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Garg A. Monitoring tools for setting up the hospital project: initial planning, building and equipment. India: Springer Singapore; 2023a.

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Garg A. Monitoring tools for setting up the hospital project: department-wise planning. India: Springer Singapore; 2023b.

Garg A, Dewan A. Manual of hospital planning and designing for medical administrators, architects, and planners. India: Springer Singapore; 2022. Chapter 46, Biomedical waste management. p. 473–7.

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Biomedical Waste Management: A Study on Assessment of Knowledge, Attitude and Practices Among Health Care Professionals in a Tertiary Care Teaching Hospital

Divya Rao 1 , M. R. Dhakshaini 2 , Ameet Kurthukoti 3 and Vidya G. Doddawad 4

1 Department of Health System Management Studies, JSS University, Mysuru.

2 Department of Prosthodontics, Vice Principal, JSS Dental College, JSS University, Mysuru.

3 Dental Health Officer, Department of Health and Family Welfare, Government of Karnataka.

4 Department of Oral Pathology and Microbiology, JSS Dental College, JSS University, Mysuru.

Corresponding Author E-mail:  [email protected]

DOI : https://dx.doi.org/10.13005/bpj/1543

Biomedical waste (BMW) generated in our nation on a day to day basis is immense and contains infectious and hazardous materials.  It is crucial on the part of the employees to know the hazards of the biomedical waste in the work environment and make its disposition effective and in a scientific manner. It is critical that the different professionals engaged in the healthcare sector have adequate Knowledge, Attitudes and Practices (KAP) with respect to biomedical waste management. Many studies across the country have shown that there are still deficiencies in the KAP of the employees in the organizations and hence it is necessary to make the appraisal of the same. To ascertain the levels of and the expanse of gaps in knowledge, attitudes and practices among doctors, post graduates, staff nurses, laboratory technicians and house-keeping staffs in a tertiary care teaching hospital in Mysuru, Karnataka. A cross sectional study was carried out using questionnaire as the study tool among the health care professionals in a tertiary care teaching hospital. The study demonstrated gaps in the knowledge amongst all the cadres of the study respondents. The knowledge in relation to BMW Management including the hospital BMW protocols was more desirable among doctors, but practical facets were better in nurses and the lab technicians. Knowledge, Attitude and Practice amongst the different cadres of staff members were found to be significant statistically.

Attitude; Biomedical Waste; Healthcare personnel;   Knowledge; Practice

assignment of biomedical waste management


Rao D, Dhakshaini M. R, Kurthukoti A, Doddawad V. G. Biomedical Waste Management: A Study on Assessment of Knowledge, Attitude and Practices Among Health Care Professionals in a Tertiary Care Teaching Hospital. Biomed Pharmacol J 2018;11(3).


Rao D, Dhakshaini M. R, Kurthukoti A, Doddawad V. G. Biomedical Waste Management: A Study on Assessment of Knowledge, Attitude and Practices Among Health Care Professionals in a Tertiary Care Teaching Hospital. Biomed Pharmacol J 2018;11(3). Available from:

Introduction

Health care waste is a unique category of waste by the quality of its composition, source of generation, its hazardous nature and the need for appropriate protection during handling, treatment and disposal. Mismanagement of the waste affects not only the generators, operators but also the common people too. 1

‘Bio-medical waste’ (BMW) means any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research pertaining thereto or in the production or testing thereof. 2

Due to the increase in the procedures that are carried out at the various health care setups, excessive amounts of waste have been generated at the centers of care.

India approximately  generates 2 kg/bed/ day 3 and this biomedical waste encompasses wastes like anatomical waste, cytotoxic wastes, sharps, which when inadequately segregated could cause different kinds of deadly infectious  diseases like Human immunodeficiency virus(HIV) hepatitis C and B infections, etc, 4   and also cause disruptions in the environment, and adverse impact on ecological balance. 5,6

Adequate knowledge amongst the health care employees about the biomedical waste management rules and regulations, and their understanding of segregation, will help in the competent disposal of the waste in their respective organizations. 7

Acceptable management of biomedical waste management begins from the initial stage of generation of waste, segregation at the source, storage at the site, disinfection, and transfer to the terminal disposal site plays a critical role in the disposal of waste. Hence adequate knowledge, attitudes and practices of the staff of the health care institutes play a very important role. 8,4,9

Teaching institutes play a critical role in the health care setup as it is from these places that the future health care professionals and all those persons involved in the care giving to the community are trained. 10

Studies documented from different parts of the country; still convey that there are gaps in the Knowledge, lacunae in the attitudinal component and inconsistency in the practice aspects which are matters of concern among the health care professionals. 8,11-15  With this background, the study was carried out to assess the current knowledge, attitude and practices of the health care workers like doctors, post graduates, interns, staff nurses, laboratory technicians and house-keeping staff in a tertiary care teaching hospital with regard to the management of BMW.

To assess the levels of knowledge, attitudes and practices among doctors, post graduates, interns, staff nurses, laboratory technicians and house-keeping staff in the different departments of a tertiary care teaching hospital.

To assess the gaps in knowledge, attitudes and practices among these health care workers in the different departments of a tertiary care teaching hospital.

Methodology

Study design

Cross-sectional study.

Study setting

Tertiary care teaching hospital

Study population

Staff working in the different departments of the hospital.

 

Eligibility Criteria

All consenting individuals amongst the different cadres of staff were included into the study. There were 2056 eligible participants, which was taken as the sampling frame.

 

 

Sample Size

Expecting that 50% of the study population had precise knowledge (considering the outcome variable) about the rules and legislation of biomedical waste management, 16  with an allowable error of 10%, at 95% confidence interval, and accounting for the finite population correction for 2,056 participants, a minimum sample size of 472 was calculated.

Sampling Strategy

The study population was classified according to the different strata based on their designation as doctors, postgraduates (junior residents), interns, staff nurses, laboratory technicians and house-keeping staff. Allocation of the population according to the strata.

Doctors 55
Post Graduates 83
Interns 29
Staff Nurses 172
Laboratory Technicians 37
House Keeping Staff 96
Total 472

Ethical Approval

The ethical clearance for the study was obtained from the Institutional Ethics Committee.

Materials and Methods

The tool used for the study was a pre-tested, semi-structured closed ended questionnaire which encompassed 42 questions on Knowledge, Attitudes and Practices.

The questions on knowledge appraised the participant’s knowledge on attributes related to the colour coding and their implications, identification of biomedical hazard symbol, waste categories, and hospital policies for biomedical waste management.

The questions on attitude were related to matters like, was biomedical waste hazardous, its management additional burden on their work or if their appropriate management burden on the finances of the hospital, and also on legislative measures for waste management.

The questions on practice appraised if the study respondents had received any training on biomedical waste management, if they were immunized against hepatitis B and if disinfection of sharps were carried out at the point of generation.

The literature review was done based on which the questionnaire was formulated according to the requirements of the study. The questionnaire was pretested and validated by a post-test and a pilot survey was conducted with a sample of 60 respondents, with representations from the various strata of the study respondents. The study tool consisted of 12 questions assessing the knowledge with yes/no/not sure responses, 10 questions assessing the attitude with agree/disagree/no comment as answers and 20 questions assessing the practices with yes/ no responses.

The participants filled up the self-administered questionnaires without scope for undue help.

The questionnaire was adapted from English to local language by an experienced professional who is involved in translating of health survey questionnaires to accommodate the housekeeping staff. The questionnaire was also back translated to English for checking of possible discrepancies and incorporating if any changes were required. The identity of the study respondents were maintained anonymous   at various stages of the study.

The results were evaluated across 3 domains for all the cadres of the study population.

The results are Displayed as Under

Statistical Methods

Data was analysed using MS-Excel and R version 3.4.3.  Percentages (with 95% confidence intervals) were calculated and the same are presented graphically. Chi-square test was performed to test the association between the different cadres related to their knowledge, attitude and practices towards BMW

Knowledge Score

The knowledge regarding general information about HCW was assessed, the mean score was highest in doctors (10) followed by nursing staff (9.3) and least in housekeeping staff (7.5). This is found to be statistically significant.

Table 1: The participant’s knowledge on biomedical waste management.

Doctors 82 (79,85) 13 (11,16) 5 (3,6)
Post  Graduates 69 (65,74) 22 (18,26) 9 (6,13)
Interns 64(58,70) 12 (8,16) 24 (19,30)
Nursing 74 (72,77) 18 (16,21) 8 (8,9)
Technicians 71 (62,79) 16 (11,25) 13 (7,20)
House Keeping Class IV 64 (59,69) 25 (21,30) 11 (8,14)

Overall, the study respondents showed satisfactory knowledge regarding biomedical waste management. The knowledge about BMW among doctors was the distinctively better, followed by that of nurses, technicians, post graduates, interns and housekeeping staff (in order). The gaps in knowledge were in the areas regarding the fate of the waste after it was segregated, and as well as who was the regulator for the safe transportation of biomedical waste from the hospital.

Table 2: The participant’s attitudes towards biomedical waste management.

Doctors 79 (75,82) 17 (14,21) 4 (2,6)
Post  Graduates 74 (69,78) 18 (14,22) 8 (0.5,11)
Interns 79 (73,84) 15 (10,21) 6 (3,10)
Nursing 82 (79,84) 17 (15,19) 1 (0.5,2)
Technicians 71 (61,79) 19 (12,28) 10 (0.5,18)
House Keeping Class IV 63 (57,68) 32 (27,38) 5 (3,8)

The mean attitude score was 9.20 for the nurses and 9.18 out of 10 for the doctors. Favourable attitude was shown by most of the study respondents towards biomedical waste management. The best attitudes were displayed by the nurses showed, subsequently by doctors, interns, postgraduates, the laboratory technicians, and house keeping staff (in order). It was concerning that the lacuna in this domain was that biomedical waste management was considered as additional burden on work.

Table 3: The participant’s practices regarding biomedical waste management.

Doctors 69 (64,72) 10 (8,13) 15 (13,17) 6 (5,8)
Post  Graduates 52 (48,55) 20 (18,24) 24 (22,28) 4 (2,5)
Interns 54 (49,59) 16 (13,21) 23 (19,28) 7 (4,9)
Nursing 83 (79,85) 11 (9,13) 2 (1,3) 4 (3,5)
Technicians 66 (59,73) 16 (20,32) 15 (11,21) 3 (1,6)
House Keeping Class IV 72 (69,76) 22 (19,25) 4 (2,5) 2 (1,4)

The mean practice score was 17.30 for the nurses and 16.50 for the housekeeping staff and 15.27out of 20 for the doctors, in the study. Though greater number of the study respondents displayed favourable biomedical waste management practices, it was noted that the nurses had the best practices, followed house keeping staff, doctors, technicians, interns and junior residents (in order). It was noted that the staff ware following the preventive measures of immunisation against Hepatitis B, and also routine health check-ups were conducted for the staff. Explicit training on BMW management was desired by most of the staff.

Chi-Square Test

The null hypothesis which was to be tested here was “The two attributes were independent”. Here three hypotheses were there to be tested:

Cadre and knowledge are independent.

(Chi-square = 160.8,  Degrees of freedom=10, p-value < 0.0001)

Cadre and attitudes are independent.

(Chi-square = 95.6, Degrees of freedom=10, p-value < 0.0001)

Cadre and practices are independent.

(Chi-square = 538.45, Degrees of freedom=15, p-value < 0.0001)

The present cross-sectional study recognized certain inadequacies in the knowledge component amongst the different cadres of health care workers, though greater than 50% of the study respondents, across cadres, demonstrated satisfactory or good knowledge, attitudes and practices. The knowledge component of the doctors was more desirable compared to their practices whereas visa versa was true for nurses and lab technicians. The knowledge component was low amongst the housekeeping staff; which was identical to the results from other similar studies conducted previously. 10,13,16 

The attitude towards BMW management of housekeeping staff was low. Low level of knowledge was mainly attributed to new staff coming on rotation to the hospital and also to comparably low educational levels of the housekeeping staff. Training of all cadres of staff will help in the analytical evaluations for suitable and applicable management of biomedical waste. 10,13,16 

The practice of recapping the needles was very low across cadres. Recapping of needles is one of the important risk factor for needle stick injuries; the prevalence was very low in the organization. This may be associated to the awareness of the staff and also due to the adequate number of needle cutters in the various patient care areas of the hospital.

Higher practice scores found in the house keeping staff and nursing staff in the present study may be due to higher responsibilities assigned to them in handling of BMW which was similar to findings of previous studies. 1,17 Overall 8.1 % of the study respondents attended the external training programmes on BMW management on their own accord, but others too (~ 59%) of them communicated their willingness to do the same if opportunities arose in the future. 10,13,16

Conclusions

Overall, the knowledge, attitudes and practices towards biomedical waste management among the study respondents was satisfactory.

Knowledge, attitudes and practices toward biomedical waste management were better among the nurses and doctors than the other cadre of staff.

Knowledge, Attitudes and Practices of the study respondents are dependent on the cadre that they belong too.

This study was a modest attempt to evaluate the KAP of the health care workers towards BMW. We recommend further studies on a larger stratum across hospitals to evaluate the awareness of health care workers towards BMW.

Recommendations

Training programs need to focus on empowering the healthcare professionals on biomedical waste management with broad scope and practical knowledge in all aspects. The ethical requirements and the institutional level policies form the directional pathway for the practical components in the organization. The right practices and other activities of BMW management and its ramifications in the form of avoiding of injuries, importance of vaccinations and following of universal precautions can be achieved when adequately supported by IEC (information, education and communication) strategies like handouts, stickers, charts, celebrations of various days like hand hygiene day and other days etc can help in bettering the practices of the employees of the organizations. Training the staff with checklists and regular inspections can bring about accountability in the staff.

All health care professionals regardless of their designation, experience and qualification , designation must be included in these interventions, so that it can avoid  cross infections among the professionals and patients in the health care sector.

Conflicts of Interest

There is no conflicts of interest.

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21 Biomedical wastes: Definition, sources, classification, collection, segregation, Treatment and disposal

Dr. J. Rajesh Banu

1.Objectives:  

  • To know what is biomedical waste and its source of generation To gain knowledge about the different types of biomedical waste. To explain the steps of biomedical waste management
  • To describe the proper mode of collecting and segregating the biomedical waste To understand the risks of biomedical waste, its method of treatment and disposal

2.   Biomedical Waste: Definition:

Bio-medical waste means “any solid and/or liquid waste produced during diagnosis, treatment or vaccination of human beings or animals. Biomedical waste creates hazard due to two principal reasons: infectivity and toxicity. Figure 1 shows some of the biomedical waste

Figure 1.Biomedical waste

3.  Sources:

The source of biomedical waste is the place or the location at which biomedical waste has been generated. The source of biomedical waste is classified into two types based on the quantity of waste generated. They include major and minor source. Major source generates more amount of biomedical waste compared to minor source and also there is regular generation of biomedical waste in the major source which includes government hospitals, private hospitals, nursing home and dispensaries. Minor source includes physicians and dental clinics. Figure 2 shows the details of the various source of biomedical waste generation

Figure 2 Sources of biomedical waste

4. Classification:

The classification of the biomedical waste is carried out based on its characteristics, source of generation and the level of hazard to the environment. The biomedical waste is classified into two types:

1. Non hazardous waste

2. Hazardous waste

4.1 Non-hazardous waste:

About 75% to 90 % of biomedical waste characteristics were similar to that of domestic waste and are non-risky in nature. This waste is generated mainly from the organization and maintenance of hospital and health care centers.

4.2 Hazardous waste:

The remaining 10 – 25% of biomedical waste falls under the hazardous waste categories. The hazardous waste contains infectious characteristics of about 15% – 18 % and toxicity characteristics of about 5% – 7%. The various hazardous wastes includes,

Infectious waste: Waste containing pathogens; e.g. excreta; laboratory cultures; isolation wards waste; swabs, materials, or equipments that have been in contact with infected patients.

Pathological waste: Human tissues or fluids e.g. body parts; blood and other body fluids; fetuses.

Pharmaceutical waste: Waste containing pharmaceuticals; e.g. pharmaceuticals that are expired or no longer needed; contaminated pharmaceuticals (bottles, boxes).

Genotoxic waste: Waste containing cytostatic drugs (often used in cancer therapy)/ genotoxic chemicals.

Chemical waste: Waste containing chemical substances e.g. laboratory reagents; film developer; disinfectants and solvents that are expired or no longer needed.

Wastes with high content of heavy metals: Batteries, Broken thermometers, blood pressure gauges, Pressurized containers, gas cylinders, gas cartridges, aerosol cans.

Radioactive waste from radiotherapy: Waste containing radioactive substances e.g. unused liquids from laboratory research; contaminated glassware, packages or absorbent paper; urine and excreta from patients treated or tested with uncapped radionuclide

5. Biomedical Waste management:

Proper management of biomedical waste is highly essential since it induces various risk to the human health and to the surrounding ecosystem that leads to the ecological hazard, professional hazard and public hazard. Steps involved in biomedical waste management was shown in Figure 3

Figure 3. Steps involved in biomedical waste management

5.1 Segregation

To avoid mixing of the biomedical waste with other, a container should be set to the side with colour coding bags at the point of generation. The sorting or separation of waste into different categories is referred as segregation. Segregation will decrease or minimize the risks in addition to rate of managing and disposal. Segregation is the most important and critical step in bio-medical waste management. Only, effective segregation can confirm the effective bio-medical waste management.

5.1.1 How does segregation help?

Segregation plays an effective role in handling and treatment of waste. It reduces the quantity of waste and if done effectively, it can avoid the mixing of biomedical waste with any other type of waste especially municipal waste. Segregation will avoid the reuse of certain biomedical waste like used  syringes, needles and other plastics. Some materials like plastics can be recycled after proper disinfection and these can be reused for non-food grade products.

During segregation process, the biomedical waste must be separated under the following categories shown in Table 1. Category no.1 includes the Human anatomical waste in which the human tissues, organs, body parts are considered. Animal waste falls under the Category No. 2. It includes Animal tissues, organs, body parts, carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals and colleges, discharges from hospitals, animal houses. Category No. 3 is the Microbiology & Biotechnology waste which contain Wastes from laboratory cultures, stocks or specimen of live microorganisms or attenuated vaccines; human and animal cell cultures used in research; infectious agents from research and industrial laboratories; wastes from production of biologicals, toxins and devices used for transfer of cultures. The Category No. 4 includes waste Sharps in which Needles, syringes, scalpels, blades, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps. Discarded Medicine and Cytotoxic drugs falls under the Category No 5 which consists of wastes comprising of outdated, contaminated and discarded medicines. The soiled waste is included in the Category No. 6 containing items contaminated with body fluids including cotton, dressings, soiled plaster casts, lines, bedding and other materials contaminated with blood.

Table 1. Categories of Waste (Source: Biomedical Waste (Handling and management Rules 1998)

Category No 7 is the solid waste which includes waste generated from disposable items other than the waste sharps such as tubing, catheters, intravenous sets, etc. Liquid waste falls under the category no. 8, it consists of waste generated from the laboratory and washing, cleaning, housekeeping and disinfecting activities. Category No 9 includes incineration ash i.e., ash from incineration of any biomedical waste. Chemical Waste falls under Category No 10 and consists of Chemicals used in production of biologicals, chemicals used in disinfection and as insecticides etc.

5.2 Collection and storage

The collection of biomedical waste involves the installation of different colour coded containers for biomedical wastes obtained from varying sources. The containers/ bins should be placed in a location so that 100 % collection is achieved. The bins and bags that hold the biohazard symbol as shown in Figure 4 represents the nature of waste. The symbols in biomedical waste management is generally used as a warning to take precautions while exposing to those substances. The biohazard symbol was developed by the Dow Chemical Company in 1966 for their containment products.

Subsequent to collection, the biomedical waste is stored in specific containers and stored in a proper place. The extent of storage should not exceed beyond 8-10 h in big hospitals containing more than 250 bedded and 24 h in nursing homes. Each container must be clearly labelled with the location being mentioned in them. The purpose of labelling is to trace the waste at the source. Storage spot must be clear with a warning sign.

Figure 4 Symbols

Collection of the biomedical waste was carried out in its specific coloured bags. In the yellow colour bags, the categories 1,2,3 and 6 waste will be collected and this bags are made up of plastic materials. The Red bags are made up of disinfected container or plastic in which Category 3, 6 & 7 waste will be collected. The Blue/ White Translucent bags collect Category 4 & 7 waste which is made up of Plastic/ puncture proof container. The black coloured plastic bags are used for the collection of waste under category 5, 9 & 10. Figure 5 shows the collection of biomedical waste in the colour coded boxes

5.3 Transportation

The collected wastes are transported in trolleys or in enclosed wheelbarrow for treatment. The operator should ensure to avoid manual loading. The bags / Container containing biomedical wastes must be tied/ lidded before hauling for treatment. Vehicles used for transporting should be special to avoid contact to, and direct contact with the operator, scavengers and the public. While transporting the containers, it must be properly enclosed. The effects of traffic accidents should be incorporated in the design, and the driver must be trained in the actions which must be followed in case of an accidental spillage. The interior of the containers should also be rinsed thoroughly.

Figure 5. Collection of biomedical waste in a colour coded boxes (Source:  Biomedical Waste Handling and management Rules 1998)

5.3.1 Trolleys

The use of trolleys will make the elimination of infectious waste possible at the source itself, instead of accumulation a new category of waste.

5.3.2 Wheelbarrows

Wheelbarrows are used to transfer the waste from the point source to the collection centres. There are two types of wheelbarrow – covered and open. Wheelbarrows are made of steel and provided with two wheels and a handle. Open dumping should not be done. Only packed waste (in plastic bags) should be carried. To prevent corrosion, care should be taken to prevent the liquid waste from spilling into the wheelbarrow. Wheelbarrows also come in various sizes depending on the utility.

5.3.3 Chutes

Chutes are vertical conduits provided for easy transportation of biomedical waste vertically in case of establishment with more than two floors. Chutes should be produced from stainless steel. It should have a self-closing lid. These chutes have to be sterilized on a daily basis with formaldehyde vapours. The linen that are contaminated with blood or other body fluids from each floor must be bundled in soiled linen or in plastic bags before expelling into the chute.

Alternately, elevators with mechanical winches or electrical winches can be used to bring down waste containers from each floor. Chutes are essential to keep away from horizontal transport of waste thereby diminishing the routing of the waste within the premises and hence reducing the risk of secondary contamination.

5.3.4 Dustbins

It is very important to calculate the amount of waste generated at each point. Dustbins should be of such capacity so that it can be placed at this specific site and that they do not overflow between each cycle of waste collection. Dustbins have to be cleaned subsequently at each cycle of clearance of waste with disinfectants. Dustbins can be wrinkled with plastic bags, which are chlorine-free, and colour coded as per the law.

5.4 Treatment and disposal

Before its final disposal of biomedical waste, it must be disinfected. Anatomical waste can be disposed by deep burial. Syringes to be cut (with hub cutters) and chemically disinfected with1% bleaching powder solution at source of generation before final disposal into sharps pit. Infected plastics to be chemically disinfected or autoclaved, shredded and recycled and sent for final disposal into municipal dumps.

5.4.1Incineration

Most of the hazardous biomedical wastes was treated by the method of incineration to reduce organic and combustible waste to inorganic incombustible matter. Incineration is a high temperature, dry oxidation process that results in significant reduction of waste volume and weight. Wastes that cannot be reused, recycled or pose problem in disposing in landfills are treated by incineration. Examples of  wastes that cannot be incinerated are chemical wastes, wastes containing high mercury or cadmium ( broken thermometers, second-hand batteries, and lead lined wooden panels, sealed ampules or ampules containing heavy metals), silver salts, pressurized gas containers, photographic or radiographic wastes, halogenated plastics such as PVC.

The advantages of incinerator include high reduction of waste volume in addition to good disinfection competence. It helps to save the space in the landfill. The ash generated can be disposed of safely in the landfills. The major disadvantage of incineration includes high operating cost as they are energy intensive process. Also it releases a huge amount of atmospheric pollutants. The need for cyclic removal of slag and dirt, inadequacy in demolishing anti-thermal chemicals and drugs such as cyto toxic are its other disadvantages.

5.4.2 Autoclaving of Biomedical Waste

Autoclave treats the bio-medical waste through the mechanism of disinfection. The biomedical waste was subjected to following temperature and pressure based on its residence time:

i. If the autoclave residence time is not less than 60 minutes, the temperature should not be less than 121oC with the pressure of 15 pounds per square inch (psi); or

ii.  If the autoclave residence time is not less than 45 minutes, the temperature should not be less than 135oC with the pressure of 31 pounds per square inch (psi); or

iii. If the autoclave residence time is not less than 30 minutes, the temperature should not be less than 149oC with the pressure of 52 pounds per square inch (psi);

While operating a gravity flow autoclave, biomedical waste is subjected to all three condition, whereas in vacuum autoclave, the biomedical waste is first subjected to one pre-vacuum autoclave (minimum) to purge the autoclave of all air. Succeeding this first and second conditions are applied. Bacillus stearothermophilus spore dials or spore strips with at least 1 × 104 spores per ml.is used as biological indicator of autoclave. The operating conditions of autoclave include a residence time less than of 30 minutes, temperature less than 121oC or a pressure must be less than 15 psi. On reaching certain temperature, the chemical indicator strip/tape changes colour that indicates the attainment of specific  temperature. It may be essential to use more than one strip at various locations on the waste package to ensure the effectively autoclaving of inner content of the waste in the package.

5.4.3 Biomedical Liquid Waste

Before disposing the liquid form of biomedical waste into the sewer, it must be treated. Pathological waste after being treated with chemical disinfectants are flushed into the sewage system. Likewise, the chemical waste is neutralized with suitable reagents and then either flushed or treated in the sewage treatment plant. Mostly they are neutralized and dumped in sewer network. Highly skilled operators are required for this technique as it involves handling of hazardous substances. The biomedical waste effluent generated from the various source should conform to the following limits shown in Table 2. Environment (Protection) Act, 1986 prescribes the discharge limits of these waste into public sewers.

Table 2 . Disposal standard for biomedical waste  Parameters Permissible limits

5.4.4 Microwave Treatment

Microwave treatment uses a frequency and wavelength of 2450 MHz and 12.24 cm, respectively for the destruction of microorganisms. The infectious contaminants in water with biomedical waste are destroyed by heat conduction when it is rapidly heated by the microwaves. By bacteriological and  biological tests, the efficiency of the microwave disinfection was ensured regularly. The biomedical waste is evenly heated to a temperature of 97-100°C by means of microwaves in treatment chamber. Treatment of biomedical waste by microwaving can be carried out in the source itself. No shredding is required for microwave treatment of waste.

Most infectious wastes except body parts, human organs, infected animals carcasses and metal objects are suitable for treatment by microwave technique. This method shows good disinfection competence with good waste shrinking capacity. Similar to incineration this method also involves high operating costs. It is an eco-friendly process with potential operation and maintenance problems.

5.4.5    Deep Burial

Deep burial process is done in pits or trench of about 2 meters deep. The pits are half filled with waste, 50 cm soil and then with waste. The pits are covered with galvanized iron / wire meshes. When wastes are added to the pit, a layer of 10 cm of soil shall be added to enclose the waste. The deep burial site should be impermeable with no shallow well in the nearby area. The pits should be away from the habitation to avoid infection to surface or ground water. The site selected should not be a flooding or eroding zone and should be approved by the authority.

5.4.6 Inertization

Assimilation of waste with cement and other substances before disposal is called inertization process. This decreases the risk of entry of toxic substances into the surface or groundwater. A typical percentage of the mixture is 65% pharmaceutical waste, 15 % cement and 5 %water. A homogenous mass is created and cubes or pellets are produced and then stored. This process is economical and not suitable for infectious waste.

Table 3 shows the treatment and disposal method of the different categories of biomedical waste. The process such as incineration, deep burial, disinfecting process and municipal landfill disposal will be carried out. Category 1, 2, 3, 5 & 6 can be incinerated. Disinfecting process includes chemical treatment, autoclaving, microwaving and mutilation shredding was carried for waste under category 3, 4, 6, 7, 8 and 10. Category 1 and 2 can be disposed off by deep burial. Category 9 waste was disposed by municipal landfill.

Table 3. Treatment and disposal of biomedical waste (Source: Biomedical Waste (Handling and  management Rules 1998)

6   Summary

In this lecture, we have learn about:

  • The biomedical medical waste and its impact on environment
  • The classification of biomedical waste and its level of toxicity.
  • Method of segregation, collection, storage and transportation.
  • Various disposal method and treatment techniques.
  • Environmental protection training & research institute, “Bio – medical waste management self-learning document for nurses & paramedical”, (2015).
  • Kamleshtewary, Vijay kumar, Pamittiwary, “Biomedical waste management a step towards a healthy future”, Chapter 162, (2007), reffered page 927 – 932
  • Patil AD, Shekdar AV. “Health-care waste management in India” Journal of Environmental Management 63 (2001): 211–220
  • http://en.wikipedia.org/wiki/Biomedical_waste

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Assessment of Biomedical Waste Management in Health Facilities of Uttar Pradesh: An Observational Study

Affiliations.

  • 1 Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND.
  • 2 Epidemiology and Public Health, Uttrakhand Health Services, Uttarakhand, IND.
  • 3 Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, IND.
  • PMID: 34993039
  • PMCID: PMC8720173
  • DOI: 10.7759/cureus.20098

Background Biomedical waste management has recently emerged as an issue of major concern for every health facility and healthcare provider due to human and environmental hazards. As per government guidelines, every health facility, either large medical institutes or small clinics, should ensure appropriate biomedical waste management at their facilities level. Objective To assess biomedical waste management in various health care facilities of Etawah district. Methodology It was a facility-based cross-sectional assessment that included government and private health facilities. The selection of facilities was done based on a simple random sampling method. All the people in charge of concerned health care facilities were interviewed to know the current biomedical waste management situation concerning health facilities and the problems they face in biomedical waste management. Health care professionals' knowledge was also assessed. Results A total of 56 health care facilities (HCFs) from both government and private sectors were selected. Biomedical waste guidelines are mainly available at tertiary care centers (93%) and secondary care centers (51.5%). Awareness among doctors related to hazards and prevention of hazards (<0.001), knowledge of unused sharps (0.048), contact with a blood-related product (0.003), hazardous waste (<0.001), and need for training (<0.001) are statistically significant with respect to nurses. Conclusions Government of India guidelines on biomedical waste management (BMW) are in place, but the use of guidelines currently is not up to the mark or at a satisfactory level. Spreading awareness of the BMW guidelines and their strict implementation is the need of the hour.

Keywords: biomedical waste management; health care facilities; health policy; india; waste hazards.

Copyright © 2021, Dixit et al.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figure 1. Distribution of study sites

CHC: Community Health Center; PHC: Primary Health Center

Figure 2. Distribution of observation according to…

Figure 2. Distribution of observation according to the type of facility

Figure 3. Problems faced by those in…

Figure 3. Problems faced by those in charge of facilities

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  • Evaluation of biomedical waste management practices in public and private sector of health care facilities in India. Devi A, Ravindra K, Kaur M, Kumar R. Devi A, et al. Environ Sci Pollut Res Int. 2019 Sep;26(25):26082-26089. doi: 10.1007/s11356-019-05785-9. Epub 2019 Jul 5. Environ Sci Pollut Res Int. 2019. PMID: 31278642
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  • Ministry of Environment and Forests. Government of India. Draft bio-medical waste (management and handling) rules. [ Apr; 2013 ]; http://moef.nic.in/downloads/public-information/salient-features-draft-b... 2011
  • Poor Medical Waste Management (MWM) practices and its risks to human health and the environment: a literature review. Babanyara YY, Ibrahim DB, Garba T, Bogoro AG, Abubakar MY. Int J Environ Ealth Sci Eng. 2013;5:1–8.
  • Rules and management of biomedical waste at Vivekananda Polyclinic: a case study. Gupta S, Boojh R, Mishra A, Chandra H. Waste Manag. 2009;29:812–819. - PubMed
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  • DOI: 10.31031/SBB.2018.01.000522
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A Review on Biomedical Waste and its Management

  • P. Sharma , A. Sharma , +1 author Somani Ps
  • Published in Significances of… 6 June 2018
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15 References

A study : biomedical waste management in india, current perspectives on biomedical waste management: rules, conventions and treatment technologies, advantages and disadvantages of healthcare waste treatment and disposal alternatives: malaysian scenario, biomedical waste management: a study of knowledge, attitude, and practices in a tertiary health care institution in bijapur, a case study to review compliance to biomedical waste management rules in a tertiary care hospital, awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in delhi, assessment of medical waste management within selected hospitals in gaza strip palestine: a pilot study, biomedical waste management: a study of knowledge, attitude and practice among health care personnel at tertiary care hospital in rajkot, incineration or autoclave a comparative study in isfahan hospitals waste management system (2010), awareness and practices regarding biomedical waste management among health-care workers in a tertiary care hospital in delhi: comment, related papers.

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SHILLONG, Aug 21: In a new initiative aimed to improve healthcare standards, nearly 400 healthcare workers will be trained under a specialised skill-based Biomedical Waste Management (BWM) course, launched by NEHU’s Department of Biomedical Engineering (BME) in partnership with Meghalayan Medical Drugs and Services Limited (MMDSL). The programme commenced on August 19 with an inaugural event at NEHU. The week-long BWM certificate course, scheduled from August 19 to 23, aims to train the healthcare workers from government healthcare facilities across the state. Over the next 18 months, participants will undergo training in batches, focusing on enhancing their skills and knowledge in managing hospital waste, which is crucial for maintaining a safe and clean healthcare environment. Director of the Directorate of Health Services (MI) Dr FV Kharshiing, who served as the chief guest at the inaugural programme, emphasised on the importance of skill-based training, highlighting the urgent need to properly orient healthcare workers in handling hospital waste. She commended the collaborative efforts of the state government and MMDSL in leading this initiative. The course curriculum, as outlined by Dr Dinesh Bhatia, the Course Coordinator at NEHU, includes over 50% practical sessions and demonstrations, providing hands-on experience in waste management techniques. Dr Bhatia expressed his appreciation for the partnership with the state government and MMDSL, recognising the programme’s potential to significantly enhance the capacity of paramedical staff in managing healthcare facilities effectively. During the event, a comprehensive 200-page manual on Biomedical Waste Management was released and distributed to participants, providing them with a valuable resource for their ongoing education and practice.

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COMMENTS

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    The document provides a lesson plan on biomedical waste management for nursing students that includes objectives, content outline, and teaching methods. The lesson plan aims to enhance students' knowledge of biomedical waste by defining it, describing the principles and sources of waste, explaining waste categorization and management steps, and discussing treatment and disposal. The teacher ...

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    Biomedical Waste Management Rules, 2016 (BMWM Rules, 2016) specify that every healthcare facility shall take all necessary steps to ensure that BMW is handled without any adverse effect on human and environmental health. This document contains six schedules, including the category of BMW, the color coding and type of containers, and labels for ...

  10. Biomedical Waste Management: A Study on Assessment of Knowledge

    Radha R. Assessment of existing knowledge, attitude, and practices regarding biomedical waste management among the health care workers in a tertiary care rural hospital. Int J Health Sci Res. 2012;2(7):14-19. Verma L.K, Mani S, Sinha N, Rana S. Biomedical waste management in nursing homes and smaller hospitals around Delhi.

  11. PDF Biomedical Waste: An Introduction to its Management

    Dept. of Civil Engineering, Mumbai University. Abstract— Biomedical Waste, (BMW), are those potential hazardous waste materials, consisting of solids, liquids, sharps, and laboratory waste which pose a grave danger to the health of humans as well as other living organisms. And in some cases, it may be lethal too.

  12. PDF Manual for Bio Medical Waste Management

    There are 4 schedules (or parts) in the Bio-Medical Waste rules 2016: Schedule 1: Categorization and Management. Schedule 2: Standards for treatment and disposal of BMW. Schedule 3: Prescribed Authority and duties. Schedule 4: Label of containers, bags and transportation of Bio-Medical waste.

  13. PDF BIO-MEDICAL WASTE MANAGEMENT

    Category 9 Incineration ash Disposal in municipal landfills. Category 10 Chemical waste Chemical treatment discharge into drains/secured land fill Schedule II of the BMW Management Rules mention the colour coding for disposal of the wastes:- 1. Yellow - For waste category 1,2,3 and 6 2. Blue - For waste category 4 and 7 3. Black - For waste ...

  14. Biomedical wastes: Definition, sources, classification, collection

    Steps involved in biomedical waste management . 5.1 Segregation . To avoid mixing of the biomedical waste with other, a container should be set to the side with colour coding bags at the point of generation. The sorting or separation of waste into different categories is referred as segregation. Segregation will decrease or minimize the risks ...

  15. Assessment of Biomedical Waste Management in Health Facilities ...

    Objective To assess biomedical waste management in various health care facilities of Etawah district. Methodology It was a facility-based cross-sectional assessment that included government and private health facilities. The selection of facilities was done based on a simple random sampling method. All the people in charge of concerned health ...

  16. A Review on Biomedical Waste and its Management

    The purpose is to spread knowledge among the personnel involved in health care services to prevent transmission of the diseases in the society and to protect public health and environment. Biomedical waste is highly hazardous which can give rise to serious diseases that may be fatal; therefore it is a matter of global concern. Biomedical waste management is of great importance to reduce the ...

  17. PDF A Systematic Review on Biomedical Waste Management Among Staff Nurses

    biomedical waste management and associated factors. Knowledge regarding the topic was fresh and adequate and a positive correlation was established between the knowledge and attitude of the novice nurses towards practicing biomedical waste management. 54.39% students were aware that there were different categories of

  18. NEHU launches course on waste management for health workers

    By Our Reporter SHILLONG, Aug 21: In a new initiative aimed to improve healthcare standards, nearly 400 healthcare workers will be trained under a specialised skill-based Biomedical Waste Management (BWM) course, launched by NEHU's Department of Biomedical Engineering (BME) in partnership with Meghalayan Medical Drugs and Services Limited (MMDSL). The programme commenced on August 19 […]

  19. Waste management in Omsk Oblast

    Waste management in with addresses, phone numbers, and reviews. Yandex Maps shows you panoramic views, photos of the location, and how to get there by public transport, on foot, or by car.

  20. Omsk-Severnyy Map

    Omsk-Severnyy Omsk-Severnyy is an airbase of the Russian Air Force located near Omsk, Omsk Oblast, Russia.The base was home to the 64th Fighter Aviation Regiment between 1956 and 1998 with the Mikoyan MiG-31.

  21. Donets Evgenia Vladimirovna

    - Ecological safety during operations in the field of hazardous waste management. -Ural State Forest Engineering University (certificate, 2013); - Complex issues of design and reduction of SPZ of facilities and industrial hubs in the conditions of the existing urban development. Assessment of public health risks.

  22. Omsk Oblast Gov

    Equip yourself with the essential tools needed to make informed and profitable decisions with our Omsk Oblast Gov - Omsk Waste Treatment Plant - Omsk report. Note: This is an on-demand report that will be delivered upon request. The report will be delivered within 2 to 3 business days of the purchase, excluding weekends and holidays.