1. Asst. Prof. of STD, Stanley Medical College IMA Former State Secretary
BIO
MEDICAL
WASTE
MANAGEMENT
Dr. M. Balasubramanian
Asst. Prof. of STD, Stanley Medical College
IMA Former State Secretary

2. PHYSICIAN
ADD YEARS TO LIFE &
ADD LIFE TO YEARS
OF THE PATIENTS

3. DOCTORS -- SAVIOURS OF MANKIND HOSPITALS – TEMPLES OF HEALING
MEDICAL PROFESSION -- NOBLE

4. DOCTORS ARE GUIDED BY ETHICS
BUT GOVERNED BY LAW

5. ACCOUNTABLE TO THE PATIENT ANSWERABLE TO THE COMMUNITY

6. NOSO COMIAL INFECTIONS HOSPITAL ACQUIRED INFECTIONS

7. PROPER DISPOSAL
OF HOSPITAL WASTE
– SOCIAL RESPONSIBILITY

8. POLLUTION CONTROL BOARD
HOSPITAL as INDUSTRY
TIIC
LOAN

9. OBNOXIOUS & HAZARDOUS INDUSTRY
HOSPITALS
CLASSIFIED UNDER
OBNOXIOUS & HAZARDOUS INDUSTRY 

10. CATEGORY
HOSPITALS, Mines, Cements, Fertilizers & Chemicals, Distilleries, Tanneries
Hotels, Cinema Theatre, Lime Kilns, Stone Crushing unit
NIL – No toxic substance, No effluent, No fugitive emissions, No use of fuel

11. HON’BLE SUPREME COURT OF INDIA
Writ Petition No 888 of 1996
Public Interest Litigation
Mrs. Almitra H. Patel vs. Union of India
Pathetic Situation of Solid Waste Management Practices
Obligatory function of Urban Local Bodies
Resulting in problems of Health & Sanitation
No solution in sight.
Hon’ble Supreme Court after several hearings, constituted a committee

12. INTERIM REPORT OF THE COMMITTEE
Domestic / Trade Waste
Construction Waste
Industrial Waste
Infectious & Hospital Waste.
Adverse impact on Human Health.
Grossly neglected.
Do not discharge their duties for safe disposale.
Infectious waste & sharps get mixed up with Domestic Waste.
Incinerators in certain Hospitals only – Often single chamber not affectively functioning.
Ministry of Environment, Govt. of India to issue mandatory instructions to rectify with a time frame.

13. Tamilnadu Pollution Control Board
  O/o District Environment Engineer,
TN Pollution Control Board
 Proc. No. DEE/TNPC Bd/TLR/BMW/INV/ Dated
Sub : TNPC Board – Hazardous Substance Management – Failure to install Bio Medical Waste Treatment and disposal facility within the stipulated time schedule – Show Cause Notice – issued.
Ref : The Bio Medical Waste (M & H) Rules 1998 as amended in 2000 notified under the Environment (Protection) Act 1986. 

14. DISTRICT ENVIRONMENTAL ENGINEER Tamilnadu Pollution Control Board.
Hence you are directed to show cause within fifteen days from the date of receipt of this notice so as to why penal for an offence punishable under Section 15 of Environment (Protection) Act, 1986 should not be initiated against you for not having complied with and contravening the said provisions of the Bio Medical Waste (Management & Handing) Rules 1998 as amended in 2000 and also to issue direction for closure of the unit and stoppage of power supply etc., under Section (5) of the Environment (Protection) Act, 1986.
DISTRICT ENVIRONMENTAL ENGINEER
Tamilnadu Pollution Control Board.

15. SCHEDULE FOR WASTE TREATMENT FACILITIES
SCHEDULE VI (see rule 5)
SCHEDULE FOR WASTE TREATMENT FACILITIES
LIKE INCINERATOR / AUTOCLAVE / MICROWAVE SYSTEM
 A.Hospitals and Nursing Homes in towns with population of 30 lakhs and above th June 2000 or earlier
B. Hospitals and Nursing Homes in towns in towns with population of below 30 lakhs
(a) with 500 beds and above by 30th June, 2000 or earlier
(b) with 200 beds and above but less than 500 beds
by 31st December, 2000 or earlier
(c) with 50 beds and above but less than 200 beds
by 31st December, 2001 or earlier
(d) with less than 50 beds by 31st December, 2002 or earlier
C. All other institutions generating bio-medical waste not included in A and B above by 31st December, 2002 or earlier

16. BIO MEDICAL WASTE MANAGEMENT
PROGRAMME PLANNING
Willingness
Self Motivation
Investments – Person, Place, Financial
Identifying Nodal Person – ICC – BMWM Committee.
Waste Survey
Evaluation of Existing Practice
Training
Implementing Segregation
Reporting and Feed Back
Review after one year.

17. HOSPITAL WASTES Non Infectious Infectious
Biodegradable Non Biodegradable
Non Sharps Sharps
Solids Liquids
Incinerable Non Incinerable
(Autoclave, Microwave)

18. CATEGORIES OF BIO MEDICAL WASTE
SCHEDULE – 1 (See Rule 5)
CATEGORIES OF BIO MEDICAL WASTE
OPTION
WASTE CATEGORY
TREATMENT & DISPOSAL
Category No. 1
Human Anatomical Waste
Incineration / deep burial
Category No. 2
Animal Waste
Category No. 3
Microbiology & Biotechnology Waste
Local autoclaving / microwaving / incineration
Category No. 4
Waste Sharps
Disinfection by chemical treatmet / atoclaving / microwaving and mutilation / shredding
Category No. 5
Discarded Medicines and Cytoxic drugs
Incineration / destruction and drugs disposal in secured landfills
Category No. 6
Solid Waste
Incineration / autoclaving / microwaving
Category No. 7
Disinfection by chemical treatment / autoclaving / microwaving and mutilation / shredding
Category No. 8
Liquid Waste
Disinfection by chemical treatment and discharge into drains.
Category No. 9
Incineration Ash
Disposal in municipal landfill
Category No. 10
Chemical Waste
Chemical treatment and discharge into drains for liquids and secured land for solids

19. SCHEDULE – II (See Rule 6) COLOUR CODING AND TYPE OF CONTAINER
FOR DISPOSAL OF BIOMEDICAL WASTES
COLOUR CODING
TYPE OF CONTAINER
WASTE CATEGORY
TREATMENT OPTIONS as per Schedule I
Yellow
Plastic Bag
Cat.. 1, 2, 3 and 6
Incineration / deep burial
Red
Disinfected container / Plastic Bag
Cat. 3, 6, and 7
Autoclaving / Microwaving / Chemical Treatment
Blue / White Translucent
Plastic Bag / puncture proof container
Cat. 4, Cat. 7
Autoclaving / Microwaving / Chemical treatment and destruction shredding
Black
Cat. 5, 9 and 10 (Solid)
Disposal in secured landfill

20. SEGREGATION OF WASTE RED BAG OR CONTANIER No Sharps In this bag
PLASTIC WASTE
IV Sets
Tubings
Blood & Urine bags
Syringes

21. SEGREGATION OF WASTE YELLOW INFECTIOUS WASTE Soiled bandages Dressings
BAG OR CONTAINER
SEGREGATION OF WASTE No
Plastics
In this
bag
INFECTIOUS WASTE
Soiled bandages
Dressings
Cotton Swabs
Sanitary Pads

22. puncture proof bin provided
SEGREGATION OF WASTE
Needles and Ampoules
to be put
in the separate
puncture proof bin provided

23. SEGREGATION OF WASTE

24. DOCTORS
Do not dispose dressings in patients bin / Ask for disposal bags.
Ensure all the plastics and gloves are cut and put into bleach solution.
Ensure all used injections are cut using needle cutters.
Ensure compliance of this scheme during ward visits

25. NURSES Put cut gloves and plastic in bleach solution.
Put all other infectious waste, such as pathological waste, bandages, dressings, cotton etc… in yellow bin.
Always cut needles with the needle cutter and disinfect with bleach solution.
All sharps to be put in needle cutter container.
Help patients understand the scheme.

26. LAB TECHNICIANS Use gloves during all tests.
Reusable items to be soaked in bleach and heated at high a temperature.
Media plates to be put in separate bleach solution.
Cut gloves, syringes to be put in red coloured bin with bleach.
Needles to be cut with needle cutter and disinfected with bleach.
Sharps to be put in needle cutter container.

27. WARDS BOYS / AYYAS Cut all tubes. Cut all gloves.
Check if waste in bleach in only plastic or glass. If not, report to the supervisor.
Help patients understand the scheme

28. DO’S Segregate waste as per category
Put waste in correct bin wiz. Plastic/rubber waste in Red, Anatomical soiled waste in Yellow, Non-infectious general waste in Black and Sharps in Blue Puncture Proof Container. Ensure colour bags of the same colour as bins.
Ensure that the plastic bag has bio-hazard symbol and label.
Remove plastic bags when ¾ full, tie the bags properly. Ensure bag is properly tied / sealed to avoid spilling.
Remove bags by Wheel Barrows only to the waste storage site.
Cut the needle (disposable) before throwing it.
Wear protective gear while handling waste.
Always snipe the IV bottle, cut the IV sets, and fingers of gloves before throwing it in the bin or sending it back to the store.
Always keep your record book on waste activity up to date.

29. DON’TS Put the waste indiscriminately.
Put wrong bags in bin. (Adhere to colour code.)
Fill the bags till neck. (Waste would otherwise spill over.)
Handle waste without protective clothing.
Drag the bags after removal. (Bags can burst and the site could be repulsive.)
Never recap the needle. (Never re-use needle without disinfection)
Mix non infectious waste with infectious waste.

30. DON’T MIX INFECTIOUS WASTES WITH MUNICIPAL WASTE

31. SEGREGATE AS PER COLOUR CODING AT THE POINT OF GENERATION ITSELF

32. REALISE THE SIGNIFICANE OF RED & YELLOW

33. NEVER PUT YELLOW BAG IN RED BIN AND RED BAG IN YELLOW BIN

34. OUT HOUSE MANAGEMENT Role of Common Facilitator
To collect Bio Medical Waste from Individual Hospital every day.
To transport in closed container Van safely to the Treatment plant.
To erect common offsite BMWM Treatment facility in accordance with the standard prescribe BMWM Rules and approval from Tamilnadu Pollution Control Board.
To dispose various categories of Bio Medical Waste by approved techniques.
To train the individual hospitals staffs regarding BMWM

35. MEMORANDUM OF UNDERSTANDING
BETWEEN IMA & G.J. MULTI CLAVE INDIA (P) Ltd
Tariff agreed – Rs. 3 per bed per day on the basis of declared bed strength of Health Care Establishment.
Comparison of Tariff -- Per bed and Per kg of Waste
(Average Bio Medical Waste Per Bed Per Day gms)
For a Hospital of 30 Beds with average occupancy of 20 Beds
Bio Medical Waste Generated 20 x 400 gms = 8Kg
Amount to be given 8 x Rs. 9 = Rs. 72/-.
Amount to be given per bed 30 x Rs. 3 = Rs. 90/-
(Bio Medical Waste from OP, Casualty & OT included)

36. To make others shed their hostility and become
Let us prove that we are
ECO FRIENDLY
To make others shed their hostility and become
MEDICO FRIENDLY

37. Thankyou