1. Planning & Management of Bio Medical WasteH O P E S
Planning & Management of Bio Medical Waste
MS. JAGRUTI BHATIA 1

2. The History Awareness campaign by Dr Paul Connett’s visit.
NGO and public pressure on the govt. & Policy makers.
Involvement of the medical fraternity.
Pilot project to understand the implications.
Change in law. 2

3. The Waste Plan Setting up a team Create Awareness/Sensitization
Conducting a waste audit - Identify quantum of waste category wise
Decision on end treatment options
Drawing up a facility wise detail plan
Allocating resources
Training of Trainers
Extend the program to all staff from CEO to sanitary attendants
Monitor - Implementation of plan
Record / Report
Monitoring, Review & Refresher training 21

4. The Team A responsible person designated as ‘Waste Manager’ .
Housekeeping manager / Attendant In Charge (Mukadam).
Nursing Director/Superintendent.
Infection Control Nurse, Key members from the Infection Control Team.
A representative from the management.
A representative from the Doctors / Consultants.
Sister In Charges. 22

5. Awareness
Bio Medical Waste Management
and Why Nots’???
The Whys???

6. Hospital Waste Disposal
Awareness
Hospital Waste Disposal
Health Hazard Environmental Hazard
Aesthetic Issue

7. Awareness Environmental Hazard :
Hospital waste contains a higher amount of chlorinated plastics.
Dumped in dumping grounds where rag pickers burn it leading to high levels of pollution
Burning chlorinated plastics under incomplete combustion releases many harmful pollutants key among them being Dioxins & Furans 10

8. Awareness Dioxin : A Unique Killer
Two aspects of Dioxin toxicity from the public health perspective:
- wide variety of harmful health effects
- low levels of exposure - EPA’s acceptable daily exposure 0.01 picograms/kg/day.
Gets transferred through the food chain causing various health effects
Humans routinely consume 300 to 600 times this amounts 19

9. Classification Of Hospital Waste
The Waste Plan
Classification Of Hospital Waste 23

10. Color Coding System - Segregation
Incinerator ash (sec landfill), chemical waste (neutralise), Household / kitchen waste, Non-infectious bio degradable
Plastic Bag
Bio degrad
Black
Waste Sharps
Puncture Proof cont
Blue / White
Microbiology & Biotechnology, toxins, Soiled waste(contaminated with bld & body fluids, plaster, cotton, dress), Solid Wastes (disposables) (Cat.3, 6,7)
Disinfected Container / Plastic bag
Red
Human Anatomical Waste, Discarded medicines, cytotoxic drugs (Cat. 1,2 &5)
Yellow
Waste Category
Type of Container
Color Coding 8

11. Color Coding System - Treatment
Disposal In secured landfill
- Bio degradable – vermi-composting / composting
Black
Autoclaving / Micro-waving / Chemical treatment and destruction & shredding
Blue / White
Autoclaving / Micro-waving / Chemical treatment
Red
Incineration / Deep Burial
Yellow
Treatment Options
Color Coding 9

12. Color Coding System - Segregation11

13. Conducting a waste audit
Based on the facility plan, areas for sample audit are selected for hospitals > 100 beds, for smaller hospitals all areas are covered
Is conducted in 2 phases
Before starting the training program
After waste management planning & training
The waste management team is trained to instruct, segregate & quantify waste as is the current hospital practice
Time frame one to two weeks based on the hospital size 12

14. Conducting a waste audit13

15. End treatment facility
After waste audit decision on the end facility to be developed
Should be based on type of waste generated, quantity & statutory requirement
Will also depend on available options from central facility.
Population etc. 14

16. Central Treatment Facility - Mumbai12

17. Waste Collection Hopper -Central Treatment Facility - Mumbai13

18. Implementing Waste Plan
Allocating color coded bags and bins in accordance with facility plan ensuring segregation as per the rules
TOT – explaining the plan, to also include worker safety measures
Scheduling the collection timings within the hospital
Transportation system within hospital
Developing Storage facilities in-house 15

19. Sharps Management Plan
Institute a sharps management plan
Available option:
Needle burners (are a better option)
Needle cutters after which you disinfect & discard
Disinfect in puncture proof jerry cans with disinfecting solution (like 1% Na Hypochorite) if tranporter takes authorisation from PCB for responsibility of pilferage, the better option is still to mutilate and disinfect before discard. 16

20. Color Coding System - Segregation17

21. Sharps Management Plan18

22. Transportation: Points to be remembered:
The containers to be puncture proof and bags to be sturdy, leak proof for high risk waste
The bags to be tied by the neck while transportation
Transportation trolleys and specific lifts or timings to be designated
Staff handling this to wear protective clothing, gloves, mask, aprons etc.
If bags tear or get contaminated they be placed in a new clean bags ( double bagging )
Never allow any person to put hands inside the bag
Stringent Infection Control Policies to be formed & implemented 19

23. Monitor & Review Training
Evaluation Training Tools:
Conducting pre and post training tests
Monitoring of model sessions by Trainers
Post training exams conducted for trained staff by trainers 1

24. 9

25. Records & Reports: Waste Audit & record keeping
Ward reporting format checklist
Nurse Station
Sanitation Supervisor
Program In Charge
As per the MOEF Rules,
Annual Report format (Form II, Rule 10)
Accident Reporting (Form III, Rule 12) 2

26. 5

27. 6

28. Recycling & Waste Minimization:7

29. Recycling & Waste Minimization:8

30. Worker Safety: Teach employees’ responsibility
Issuance of protective equipment like gloves, mask
Establishment of an occupational health program that includes immunization, post-exposure prophylaxis, and medical surveillance 10

31. THINK TODAY
TO ENSURE
A BETTER TOMMOROW
THANK YOU 11

32. HOPES – HELP ORGANISATION FOR PEOPLE ENVIRONMENT & SOCIETY
Contact:
HOPES – HELP ORGANISATION FOR PEOPLE ENVIRONMENT & SOCIETY
119, UDYOG BHAVAN
SONAWALA ROAD
GOREGAON (EAST)
TEL: FAX:
WEB: