HOSPITAL WASTE MANAGEMENT SYSTEM-

(BIO-MEDICAL WASTE MANAGEMENT)

Bio-medical waste means “any waste which is generated
during
– the diagnosis,
– treatment or
– immunization of human beings or animals or
– in research activities or
– in production or testing of biological or pathogenic agents

Biomedical waste poses hazard due to two principal reasons

– infectivity and
– toxicity.
Bio Medical waste consists of
• Human anatomical waste like tissues, organs and body
parts
• Animal wastes generated during research from veterinary
hospitals
• Microbiology and biotechnology wastes
• Waste sharps like hypodermic needles, syringes, scalpels
and broken glass
• Discarded medicines and cytotoxic drugs
• Soiled waste such as dressing, bandages, plaster casts,
material contaminated with blood, tubes and catheters
• Liquid waste from any of the infected areas
• Incineration ash and other chemical wastes
Health Hazards of Healthcare Waste
• It contains:
– Infectious agents
– Toxic chemicals
– Sharps
– Genotoxic material
– Radio-active material
• Hazard from infectious waste and sharps
– HIV
– Hepatitis B
– Hepatitis C
– Antibiotic resistant bacteria
• Chemical and pharmaceutical waste
– Corrosive
– Burns
– Explosives
Main groups at risk are:
– Doctors, nurses and paramedical workers
– Patients in health-care establishments
– Visitors to health-care establishments
– Workers in allied services e.g. laundry, waste handling and
transportation and
– Workers in waste disposal facilities (including rag pickers)e.g.
landfills and incinerators
• Public sensitivity: – Public is very sensitive to the visual
impact of health care waste – Especially anatomical waste
Need of biomedical waste management in hospitals :
The reasons due to which there is great need of management of hospitals
waste such as:
• Injuries from sharps leading to infection to all categories of hospital
personnel and waste handlers
• nosocomial infections in patients from poor infection control practices
and poor waste management.
• Risk of infection outside the hospital for waste handlers and scavengers
and sometimes general public living in the vicinity of hospitals.
• Risk associated with hazardous chemicals, drugs to persons handling
wastes
• “Disposable” being repacked and sold by unscrupulous elements without
even being washed.
• Drugs which have been disposed of, being repacked and sold off to
unsuspecting buyers.
• Risk of air, water and soil pollution directly due to waste, or due to
defective incineration emissions and ash.
Biomedical Waste Management Process :
Categories of Bio-medical Waste in India :

Categorized as per the “Bio-medical waste (Management and

Handling) Rules, 1988 into 10 categories
• The rules are prescribed by the ‘Ministry of Environment and
Forests, G.O.I’ in a following table)
– The containers should be clearly marked with
• the bio-hazard symbol and

• Cytotoxic hazard symbol

• The symbols should be prominent and NON-Washable

 WASTE TREATMENT AND DISPOSAL
CATEGORY TYPES OF WASTES OPTIONS
Category No. Human Anatomical Waste Incineration@/ deep burial
1 (Human tissues, organs, body parts)
Category No. Animal Waste
2 (Animal tissues, organs, body parts, carcasses, bleeding parts,
fluid, blood and experimental used in research, waste Incineration@/ deep burial
generated by veterinary hospitals and colleges, discharge from
hospitals, animal houses)

Category No. Microbiology And Biotechnology Waste

3 (Wastes from laboratory cultures, stocks or specimen of live
micro-organisms or attenuated vaccines, human and animal Local autoclaving/ microwaving/
cell cultures used in research and infectious agents from incineration@
research and industrial laboratories, wastes from production
of biologicals, toxins and devices used for transfer of cultures)

Category No. Waste Sharps Disinfecting (chemical treatment

4 (Needles, syringes, scalpels, blades, glass, etc. that may cause @@/ autoclaving/ microwaving
puncture and cuts. This includes both used and unused sharps) and mutilation/ shredding##

Category No. Discarded Medicines and Cytotoxic Drugs Incineration@/ destruction and
5 (Wastes comprising of outdated, contaminated and discarded drugs disposal in secured
medicines) landfills

Category No. Solid Waste

6 (Items contaminated with body fluids including cotton, Incineration@/ autoclaving/
dressings, soiled plaster casts, lines, bedding and other microwaving
materials contaminated with blood)
Bio-medical Waste Colour coding :
Bio-medical Waste Garbage bin Colour coding :
Segregation :

• Segregation refers to the basic separation of different categories of waste

generated at source.

• Segregation is the most crucial step in bio-medical waste management.

• Effective segregation alone can ensure effective bio-medical waste

management.

• The BMWs must be segregated in accordance to guidelines laid down

under schedule 1 of BMW Rules, 1998 (i.e. categories 1 – 10).
How does segregation help :

•Segregation reduces the amount of waste needs special handling and

treatment
•Effective segregation process prevents the mixture of medical waste like
sharps with the general municipal waste.
• Prevents illegally reuse of certain components of medical waste like used
syringes, needles and other plastics.
•Provides an opportunity for recycling certain components of medical waste
like plastics after proper and thorough disinfection.
•Recycled plastic material can be used for non-food grade applications.
•Reduces the cost of treatment and disposal (80 per cent of a hospital’s
waste is general waste, which does not require special treatment, provided
it is not contaminated with other infectious waste)
•The bins and bags should carry the biohazard symbol indicating the nature
of waste to the patients and public.
Collection :

•The collection of biomedical waste involves use of different types of

container from various sources of biomedical wastes like Operation
Theatre, laboratory, wards, kitchen, corridor etc.
•The containers/ bins should be placed in such a way that 100% collection is
achieved. Sharps must always be kept in puncture-proof containers to avoid
injuries and infection to the workers handling them. Storage
• Once collection occurs then biomedical waste is stored in a proper place.
Segregated wastes of different categories need to be collected in
identifiable containers.
•The duration of storage should not exceed for 8-10 hrs in big hospitals
(more than 250 bedded) and 24 hrs in nursing homes.
•Each container may be clearly labelled to show the ward or room where it
is kept. The reason for this labelling is that it may be necessary to trace the
waste back to its source.
•Besides this, storage area should be marked with a caution sign
Transportation :

•The waste should be transported for treatment either in trolleys or in

covered wheelbarrow.
•Manual loading should be avoided as far as for as possible.
•The bags / Container containing BMWs should be tied/ lidded before
transportation.
•Before transporting the bag containing BMWs, it should be accompanied
with a signed document by Nurse/ Doctor mentioning date, shift, quantity
and destination.
•Special vehicles must be used so as to prevent access to, and direct
contact with, the waste by the transportation operators, the scavengers
and the public.
•The effects of traffic accidents should be considered in the design, and the
driver must be trained in the procedures he must follow in case of an
accidental spillage
Personnel safety devices :
•The use of protective gears should be made mandatory for all the
personnel handling waste.
• Gloves: Heavy-duty rubber gloves should be used for waste handling by
the waste retrievers.
– This should be bright yellow in colour.
– After handling the waste, the gloves should be washed twice with carbolic
soap and a disinfectant.
– The size should fit the operator.
• Aprons, gowns, suits or other apparels: Apparel is worn to prevent
contamination of clothing and protect skin.
– It could be made of cloth or impermeable material such as plastic.
– People working in incinerator chambers should have gowns or suits made
of non-inflammable material.
• Masks: Various types of masks, goggles, and face shields
• Boots: Leg coverings, boots or shoe-covers provide greater protection to
the skin when splashes or large quantities of infected waste have to be
handled.
– The boots should be rubber-soled and anti-skid type.
– They should cover the leg up to the ankle.
Treatment and Disposal Technologies for BMW :
• Incineration
– Double chamber pyrolytic incinerator
– Rotatory kilns
•Chemical disinfection
• Wet and dry thermal treatment
– High pressure steam
– Non-burn, dry thermal disinfection
• Microwave irradiation
• Land disposal
– Not to be dumped in open dumps
– Sanitary landfills should be used
• Inertization
– Mixing with cement and other substances before disposal
– Reduces the risk of migration into surface or ground water
Disposal Methods:
Common Biomedical Wastes Treatment Facility [CBWTFs] :

•The Common Biomedical wastes treatment facility, cast the responsibilities

on municipal bodies to collect biomedical wastes/treated biomedical
wastes and also provide sites for setting up of incinerator.
• One of India’s major achievements has been to change the attitudes of
the operators of health care facilities to incorporate good HCW
management and to purchase on-site waste management services from the
private sector.
• Several medical facilities can use these Common Biomedical Waste
Treatment Facility
Treatment schemes:STP in MBBR process
PRIMARY TREATMENT: -
SCREEN CHAMBER: - Large Debris entering in to the system will be protected with a Screen
installed before the Collection sump.
COLLECTION SUMP: - The sewage collected from the Screen Chamber is let in to the collection
sump and it is aerated for even mixing of the sewage.

SECONDARY TREATMENT: - 
MOVING BED BIO-FILM REACTORS: - The Moving Bed Bio-film Reactors (MBBR) is filled with
high quality self supporting cylindrical shaped Poly Propylene Material. Bacterial Growth shall
be generated by providing compressed air in Bio-Reactor (MBBR) and get attached to the PP
media to form fixed film. Here the BOD, COD, Organic Pollutants get digested easily.
CLARIFIER: - Treated Water and Sludge will be separated and it will be taken to Clarified Water
Tank.
TERTIARY TREATMENT: -
 
DISINFECTION: - Hypo is used as disinfectant.
PRESSURE SAND FILTER: - It is used as final polishing unit for the removal of suspended solids.
ACTIVATED CARBON FILTER: - It is used as final polishing unit for the removal of color and
odor.
TREATED WATER TANK: - The filtrate water from Pressure Sand Filter and Activated Carbon
Filter is collected in the treated water tank.
ADVANTAGES OF MOVING BED BIOLOGICAL REACTOR (MBBR):-

1. Less Area is required

2. Less sludge generation than any other system
3. Easy Operation & No Recirculation of sludge is required
4. Stable operation without frequent supervision
5. Lower expansion and retrofit costs due to modular construction and reduced
excavation
6. Short wastewater retention time allows for a smaller footprint
7. Reduced life cycle costs as compared to suspended growth systems
8. Simple operation, less lab testing for process control
9. Operator friendly, easily modified for upgrades, retrofits and multiple applications
10. Less Amount of sludge is generated than any other system
11. Minimum Civil works
12. Capable of Handling Shock Loads
13. Since the system is fully automatic, no round the clock monitoring is required.
14. The system enables to reuse the water which is very well within Pollution
Control Board Norms.
MOVING BED BIOLOGICAL REACTOR (MBBR):-
MOVING BED BIOLOGICAL REACTOR (MBBR):-
THANK YOU