Biomedical waste management By group I (KHADIJAH WALI,AQSA ANWAR,ARSHAM TORKAMAN,EBRAHIM JOOSAB,FAISAL FAROOQ and ALI SOHAIL)

Learning Objectives Define biomedical waste management Classification of biomedical waste management Disposal of biomedical wastes.

Biomedical waste management Definition: “Bio Medical waste” is any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining to or in the production or testing of biologicals and categories.

Healthcare waste Definition Healthcare waste (HCW) is defined as the total waste stream from a healthcare facility (HCF) Two basic categories Healthcare General Waste (HCGW) 75-90% Healthcare Risk Waste (HCRW) 10-25%

Healthcare general waste Healthcare General Waste (HCGW) Paper Packaging Plastic packaging Food preparation And other items that haven’t been contaminated

Healthcare risk waste Healthcare Risk Waste (HCRW) Infectious waste Hazardous waste Harmful to humans and environment

SOURCE OF BIOMEDICAL WASTE Biomedical waste is generated in: hospitals, nursing homes, clinics, medical laboratories, blood banks, animal houses etc. Such a waste can also be generated at home if health care is being provided there to a patient (e.g. injection, dressing material etc.)

Components Solids: Catheters and tubes Disposable masks and scrubs Disposable tools Medical gloves Wound dressings Disposable tools, such as some scalpels and surgical staplers 8

Contd… Liquids: Blood Body fluids and tissues Cell, organ and tissue cultures 9

Contd… Sharps: Blades (Razor or Scalpel) Material made up glass such as cuvettes and slides. Needles Plastic pipettes and syringes 10

Contd… Laboratory waste: Animal carcasses Hazardous chemicals Medicinal plants Radioactive material with biological components Supernatants Cadavers,urine,feces and cytotoxic drug are not considered biomedical waste 11

classification

Classification Non hazardous: approximately 75-90% of the biomedical waste is non-hazardous and as harmless as any other municipal waste. (E.G, Plastic,Glass,Cardboared,etc) 13

Classification Hazardous waste: 10-25% is hazardous and can be injurious to humans or animals and deleterious to environment. It is important to realise that if both these types are mixed together then the whole waste becomes harmful.

Classification and management Category Waste Type Treatment and Disposal Method Category 1 Human Wastes (Tissues, organs, body parts Incineration / deep burial Category 2 Animal Waste Category 3 Microbiology and Biotechnology waste Autoclave/microwave/incineration Category 4 Sharps Disinfection (chemical treatment)+/autoclaving/microwaving and mutilation shredding Category 5 Discarded Medicines and Cytotoxic Drugs Incineration/ destruction and drugs disposal in secured landfills

Treatment and Disposal Method Contd… Category Waste Type Treatment and Disposal Method Category 6 Contaminated solid waste Incineration/autoclaving / microwaving Category 7 Solid waste (disposable items other than sharps) Disinfection by chemical treatment+ microwaving/autoclaving & mutilation shredding Category 8 Liquid waste (generated from laboratory washing, cleaning, housekeeping and disinfecting activity) Disinfection by chemical treatment+ and discharge into the drains Category 9 Incineration ash Disposal in municipal landfill Category10 Chemical Wastes Chemical Treatment + and discharge in to drain for liquids and secured landfill for solids

Waste category treatment option Management Color coding Type of container Waste category treatment option YELLOW PLASTIC BAG Cat 1,2,3,6 Incineration / deep burial RED Disinfected container / plastic bag Cat 3,6,7 Autoclave/microwave /chemical treatment Blue/white translucent Plastic bag/ Puncture proof Cat 4,7 Autoclave/microwave /chemical treatment / destruction shredding BLACK Plastic bag Cat 5,9,10 Disposal in secure landfill

Disposal Of Wastes

Containers Type Container type Bags – NO sharps, medicines or liquids Must be appropriate to contents & regulations Bags – NO sharps, medicines or liquids Sharps bins – sharps ONLY Other Rigid Bins – various e.g. High liquid-content Clinical Combustible Radioactive Special & Clinical (e.g. Cytotoxic) Waste medicines UN approvals relate to minimum standards for containing clinical waste in order to store and transport them safely. At this University, you might use both bags and rigid plastic containers for different types of waste. Read through…

Safe for Disposal to General Waste Containers – Colour Container colour Tells other staff what is in the container Tells the contractor what to do with the waste Can apply to both sacks and rigid containers Safe for Disposal to General Waste Sharps Lab plastics Cytotoxic Carcass, anatomical With clinical waste, the colour of the container can help to identify the type of waste within. Here are some of the container types / colours that you will come across at the University. Black bags should only ever be used for uncontaminated or decontaminated, non-offensive waste. For example, in some areas they are used for autoclaved laboratory plastics. Otherwise, lab plastics will go in orange bags. Carcass / anatomical material will only ever be placed in a yellow container, etc. Other coloured containers or lids may be in use in your laboratory or area. If they are, be certain that you know what they are for.

Disposal Procedure – Carcass Carcass or anatomical material Small / medium carcasses or obvious body parts Render safe first Yellow bags or containers Freeze prior to collection or keep refrigerated

Disposal Procedure – Blood Blood or body fluids Render safe first Including heavily soaked materials (e.g. swabs, dressings) Yellow containers or heavy gauge yellow bags (only if doubled and NOT leaking) Freeze prior to collection

Disposal Procedure – Sharps Including needles, scalpel blades and small pieces of glass ALWAYS USE a Sharps bin Do NOT overfill or shake Follow H&S guidance and take care (If contaminated) autoclave when bin is full

Disposal Procedure – Plastics Laboratory plastics Render safe first If non-identifiable following autoclave then non-clinical disposal [Black Bag and label “Safe for Disposal”] If identifiable still then possibly “offensive” - Orange Bag and label as for Clinical Waste Oct/Nov2006 Introduction to Biological Waste Training Session

Disposal Procedure – Glass Glassware Render safe first Designated boxes – clearly labelled “Broken Glassware – Safe for Disposal” Except if contains hazardous chemicals – special disposal route via Chemistry

Disposal Procedure – Medicines Designated medicine bins only (usually Blue Rigid container) Do not use containers intended for other uses (e.g. sharps bins) Do not pour down the drain Some medicines are considered to be Special Waste

Disposal Procedure – Special I Cytotoxic Waste Special Waste, therefore Packaging and labelling requirements Holding locations – separate containment “Pre-notification” of SEPA by contractor & Special Waste Consignment Note Extra charges Notify Waste Manager If you are dealing with cytotoxic or cytostatic medicines (for example chemotherapy drugs) then both the waste medicine and any waste from animals or humans treated with these drugs or laboratory items contaminated with them are deemed to be Special Waste. Special Waste must be kept separately from other clinical waste (sealable rigid plastic containers could be used here), stored in a locked holding location and tracked from producer to disposer due to their hazardous nature. As such, a 5-part Special Waste Consignment Note will need to be completed and SEPA (the Regulators) will need to be pre-notified that we are going to be moving this kind of waste.

Disposal Procedure – Special II Infectious Waste Wherever possible, should be rendered safe / inactivated BEFORE leaving the lab If not possible then special conditions apply: Packaging and labelling Holding locations – separate containment “Pre-notification” of SEPA Extra paperwork Extra charges Notify Waste Manager immediately Infectious is defined in the Hazardous Waste Directive as: “Substances containing viable micro-organisms or their toxins which are known or reliably believed to cause disease in man or other living organisms”. Normal practice should always be to ensure that waste leaving the laboratory or practice has been rendered NON-INFECTIOUS. If you cannot do this for some reason, then it must be classified as Special Waste. I will reiterate what I have said a couple of times already, in all normal activity using infectious agents, it is crucial to completely denature the agents – either through autoclaving or disinfection as appropriate – BEFORE they leave the laboratory.

Disposal Procedure - Reminder Key points to remember: Never fill sacks more than ¾ full Never overfill sharps bins Do NOT use anything that leaks Secure sacks with a plastic tie/seal bins before removing from lab Always use a Barcode Label and complete your Label Record Sheet Know if it is “Special Waste” & act accordingly Place in approved Holding Location (freezer)

Resources www.Wikipedia.org www.WHO.org www.google.com

THANK YOU