1. BIOMEDICAL WASTE MANAGEMENT By
Dr. Khadija N. Abdullah
Faculty of Community Health Sciences
Peshawar Medical College

2. Biomedical waste or hospital waste
WASTES
“Something which is not
Wastes
Gaseous Waste
Solid waste
Liquid Waste
put into proper
Household waste
usage at a
given time”.
Industrial waste
Biomedical waste or hospital waste

3. BIO-MEDICAL WASTE: - Any waste which is during the or generated
diagnosis, treatment
immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals.

7. CAUSES Improper:- Packaging Segregation Treatment and disposal
of waste.
biomedical

8. CLASSIFICATION OF BIOMEDICAL WASTE:

9. CLASSIFICATION OF BIOMEDICAL WASTE:
1. INFECTIOUS WASTE:
Infectious suspected pathogens viruses, fungi)
waste
to contain (bacteria,
parasites, or
in sufficient
quantity to cause diseases in susceptible hosts.

10. This category includes:-
continued…
This category includes:-
Cultures and stocks of infectious agents
from
laboratory work.
Waste patients disease.
from surgery on with
infectious
Infected animals laboratories.
from

11. 2.PATHOLOGICAL WASTE:
It consists of
tissues, parts,
organs, human animal
body
fetuses, and
carcasses,
blood, and body fluids.

12. 3. SHARPS:
These are the items that could cause cuts or puncture wounds, including;
Needles
Scalpel and other blades
Knives,
Infusion sets
Saws,
Broken glass, and nails.

13. 4. PHARMACEUTICAL WASTE
It includes expired, unused, spilt,
and contaminated:
Pharmaceutical products
Drugs
Vaccines, and sera

14. 5. GENOTOXIC WASTE:
Genotoxic waste is hazardous and may have;
highly
Mutagenic,
Teratogenic, or
Carcinogenic properties.

15. continued…
It raises serious safety problems,
both inside hospitals
and after be given
disposal, and should
special attention.
It includes certain
cytostatic
drugs, vomit, urine, or feces from patients treated with cytostatic drugs, chemicals, and radioactive material.

16. 6. CHEMICAL WASTE:
It consists of discarded
Solid
Liquid, and
Gaseous chemicals

17. Continued…
Chemical waste may be hazardous or nonhazardous.
It is considered to be hazardous if it has at least one of the following properties:
Toxic,
Corrosive (acids of pH < 2 and bases of pH> 12)
Flammable,
Reactive
Genotoxic

18. 7. WASTES WITH HIGH CONTENT OF HEAVY METALS:
It represents a subcategory of hazardous chemical waste, and is usually highly toxic.
It includes
Batteries,
Broken thermometer,
Blood-pressure gauges.

19. 8. PRESSURIZED CONTAINERS:
Many types of gas are used in health care, and are often stored in pressurized cylinders, cartridges, and aerosol cans.
Most common gases used in health care includes:
Anesthetic gases
Ethylene oxide
Oxygen
Compressed air

20. 9.
It includes the X- rays, α- and β- particles, and γ- rays emitted by radioactive substances.
positively charged electrons with significant ability to penetrate human skin, they affect health through ionization of intracellular proteins and proteinaceous components.

21. γ- Rays,
are electromagnetic
radiations similar to X- rays but to
shorter wavelength.
Their
penetrating power is high and lead shielding is required to reduce their intensity.

22. DISTRIBUTION OF BIO-MEDICAL WASTE (WHO)
Non-Infectious waste, 85%
Pathological and Infectious waste, 10%
Radioactive, Cytotoxic and heavy metals, 1%
Sharps, 1%
Chemical and Pharmaceutic al waste 3%

23. SOURCES OF BIOMEDICAL WASTE:
• It is generated primarily from health care establishments, including
• Hospitals,
• Nursing homes,
• Veterinary hospitals,
• Clinics and general practitioners,
• Dispensaries,
• Blood blanks,
• Animal houses and research institute.

24. STEPS IN THE MANAGEMENT OF BIOMEDICAL WASTE
Survey of waste generated.
Segregation of hospital waste.
Treatment of
waste.
Collection & Categorization of waste.
Transportation of waste.
Storage of waste.( Not beyond 48 hrs. )

25. BIO-MEDICAL WASTE FLOW CHART
Common Storage Point
At Hospitals
In House Segregation
(Collection, Segregation Packing
in Color Coded Poly Bags)
Generator (HOSPITALS)
Transportation
(Approved Special Vehicle
Waste Water
to TP )
Unloading and Temp Storage
Re Use
Treatment
(Incineration, Autoclaving and Shredding)
Disposal
( Recycling & Landfill)

26. Methods of disposal of bio-medical waste and their segregation
WASTE CATEGORY TYPE OF WASTE TREATMENT AND DISPOSAL OPTION
Category No. 1
Human Anatomical Waste (Human tissues, organs, body parts)
Incineration / deep burial
Category No. 2
Animal Waste
(Animal tissues, organs, body parts, carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals and colleges, discharge from hospitals,)
Incineration / deep burial
Category No. 3
Microbiology & Biotechnology Waste (Wastes from laboratory cultures, stocks or specimen of live microorganisms, human and animal cell cultures used in research and infectious agents from research and industrial laboratories, wastes from production of biological, toxins and devices used for transfer of cultures)
Local autoclaving/ microwaving / incineration

27. Category No. 4
Waste Sharps (Needles, syringes, scalpels, blades, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps)
Disinfecting (chemical / autoclaving / microwaving and mutilation / shredding
Category No. 5
Discarded Medicine and Cytotoxic drugs (Wastes comprising of outdated, contaminated and discarded medicines)
/ destruction and drugs disposal in secured landfills
Category No. 6
Soiled Waste (Items contaminated with body fluids including cotton, dressings, soiled plaster casts, lines, bedding and other materials contaminated with blood.)
/ autoclaving / microwaving
Category No. 7
Solid Waste (Waste generated from disposable items other than the waste sharps such as tubing, catheters, intravenous sets, etc.)
Disinfecting by chemical / autoclaving / microwaving and mutilation / shredding# #

28. Category No. 8
Liquid Waste (Waste generated from the laboratory and washing, cleaning, housekeeping and disinfecting activities)
Disinfecting by chemical treatment and discharge into drains
Incineration Ash (Ash from incineration of any biomedical waste)
Disposal in municipal landfill
Category No. 9
Chemical Waste (Chemicals used in production of biological, chemicals used in disinfecting, as insecticides, etc.)
Chemical treatment and discharge into drains for liquids and secured landfill for solids.
Category No.10

29. COLOR CODING FOR SEGREGATION OF BIOMEDICAL WASTE: -
COLOR WASTE TREATMENT
Human & Animal anatomical waste / Micro-biology waste and soiled cotton/dressings/linen/beddings etc.
Yellow
Incineration / Deep burial
Tubing's, Catheters, IV sets.
Autoclaving / Microwaving / Chemical treatment
Red
Waste sharps ( Needles, Syringes, Scalpels, blades etc.)
Autoclaving / Microwaving / Chemical treatment & Destruction / Shredding
Blue / White
Discarded medicines/cytotoxic drugs,
Incineration ash, Chemical waste.
Disposal in secured landfill
Black

30. `

31. 19

32. COLLECTION, TRANSPORTATION, STORAGE (WITHIN THE HOSPITAL)22

33. SAFE TRANSPORTATION IN A REGISTERED, AUTHORIZED, BMW TRANSPORTERS

34. TREATMENT AND DISPOSAL TECHNOLOGIES
Incineration
Chemical disinfection
Wet and dry thermal treatment
Microwave irradiation
Land disposal
Inertization 25

35. INCINERATION Burning the waste in simple kiln up to1000ºC
Organic and combustible waste is changed to inorganic and incombustible and finally to fly ash.
Ash is collected in thick puncture proof bags and stored for periodic dump into community landfill. 26

36. TYPES OF INCINERATOR 27 DOUBLE CHAMBER PYROLITIC
SINGLE CHAMBER FURNACES
ROTARY KILN 27

37. DOUBLE CHAMBER PYROLITIC

38. SINGLE CHAMBER FURNACES

39. ROTARY KILN
ROTARY KILN

40. 31

41. CHEMICAL DISINFECTION
 Destruction of most of pathogens from liquids.
 By using chemical disinfectants such as bleaching powder, glutaraldehyde, alcohols or quaternary ammonium compounds.
 Best for treating liquid wastes such as blood,urine,stools or hospital sewage.

42. 33

43. WET THERMAL TREATING (AUTOCLAVE)
The infectious wastes are steam heated at specified temperature and pressure for specific period of time.
Decontamination occurs when steam penetrates the waste.
pressure etc is used.

45. DRY THERMAL TREATMENT (SCREW FEED TECHNOLOGY)
Waste is treated in a rotating auger.
Waste is reduced by 80% in volume and % in weight.
Suitable for treating infectious wastes and sharps.
Not used to process pathological, cytotoxic, or radioactive waste

46. LAND DISPOSAL-DEEP BURIAL
Wastes belonging to category 1,3,6 collected in yellow containers are disposed by this method.

47. LAND DISPOSAL-LAND FILLING
 Land filling means disposal of residual solid wastes on land in a facility designed with protective measures against pollution of ground water, surface water, air and ground.
 Sanitary landfills are specially constructed for disposal of nonbiodegradable infectious hospital wastes.
 It should have an impermeable clay and pebble base.
 Stored earth for covering at the end of each disposal operation.
 Frequent spray of insecticide is done.

48. MICROWAVING Highly efficient 30-40% weight reduction.
Minimal environmental pollution and occupational risk.
Cost effective. 40

49. WASTE SHARP symbol and appropriate wording.
 They are needles, syringes, scalpels, blades, broken glass capable of causing injuries or introducing infection.
 Their segregation reduces the chances of injury.
 Final disposal is done by mutilation.
 Must be collected at the point of generation, in a leak- proof and puncture-resistant container.
 Containers must bear the international biohazard
symbol and appropriate wording.
 Containers should never be completely filled, nor filled
above the full line indicated on box.

50. PLASTIC WASTE
 Plastics being non- biodegradable remain in the soil for more than 1000 yrs contaminating the soil and surrounding water bodies.  Collection and reuse of disposable plastics without adequate treatment will result in spread of infections.  Improper burning leads to release of toxic gases like Sulphur dioxides, hydrochlorides etc which are potent carcinogens.

51. PLASTIC WASTE Continued…  Use of plastic should be minimized.
 Plastics should be properly disinfected.
 They are better managed by non burning technologies.
 Microwaves, autoclaves, chemical disinfection are most suited.

52. BIO-SPILL KIT Place in a labeled bag or bucket and keep in areas where
Container of undiluted household bleach
Several pairs of gloves
Safety glasses
Absorbent material
Bio hazardous waste (autoclave) bags
Dust pan & scoop or tongs for broken glass
Place in a labeled bag or bucket and keep in areas where
biohazards are handled.

53. Bio-hazard symbols

54. THANK YOU