Health Care Waste Management

Health care waste
management
Dr Anshuli Trivedi
IInd Year Resident in PSM
NSCB Medical College Jabalpur
“Health care waste’’
“Any waste, which is generated during the
diagnosis, treatment or immunization of human
beings or animals or in research activities
pertaining to in the production or testing of
biological substances”. That are included in
Schedule-I.
Usual pattern of kind of waste
( WHO, 1999)
 75 to 90 % : ‘non –risk’ or general health care waste
and
 10 to 25 % is hazardous.
Categorization of waste produced:
 General health care waste: 80%
 Pathological & infectious waste: 15 %
 Chemical & pharmaceutical waste: 3%
 Sharp waste : 1%
 RA/Cytotoxic/Pressurized containers, thermometers,
batteries: less than 1%
Sources of health care waste:
Institutions involved in generation of biomedical waste
are:
 Govt & Pvt. Hospitals
 Nursing homes
 Blood banks
 Laboratories & research centers
 Biotechnology institutions
 Animal & slaughter houses.
 In a survey done in New Delhi, 2003: solid waste
generated in hospitals & nursing homes varies 30-800
grams per bed per day, with average of 260 gm per bed
per day.
 It is estimated that an average hospital stream contains
atleaset10 per cent materials that could be considered as
potentially infectious agents. Ex-Formaldehyde,Hg,Cl.
Policy on Hospital Waste Management &
Handling in India
Policy Statement states-to provide a system for
management of all potentially infectious and
hazardous waste according with Biomedical
waste rules-1998.
 As per the rules by Ministry of Environment &
Forest came into force by bill introduced on
27th July 1998.
 This is formulated under the act of 1986 under
Article 6,8 & 25.
Hospital waste management is a
process which consists of:
 Color coding: Yellow, Blue and Black
 Segregation at source
 Collection
 Transportation
 Storage
 Disposal
 Recycling regular waste
Categories of Bio Medical Waste: Schedule-I.
S. Category of Type of container Method of

No. waste used for management
collection/storage
I Human Yellow Incineration/Deep

Anatomical container/plastic burial
waste bags
II Animal waste Yellow Incineration/Deep
container/plastic burial
bags
III Microbiology Yellow Local autoclaving
&biotechnology waste container/plastic bags /microwaving
/incineration
IV Waste sharps Blue Puncture proof Disinfection by
container chemical treatment
autoclaving/micro
waving/mutilations
/shredding
V Discarded medicines Black plastic bag Incineration/Deep
& cyto toxic drugs burial
VI Soiled wastes Blue container/plastic autoclaving/micro

bags waving
/incineration
VII Solid disposable Yellow Puncture proof Disinfection by
waste container chemical treatment
autoclaving/micro
waving/mutilations
/shredding
VIII Liquid Not required Disinfection by
waste chemical treatment
discharge into drains.
XI Incinerator Black plastic bag Disposal in landfill

ash
XII Chemical Black plastic bag Disinfection by
waste chemical treatment
,discharge into drains
for liquids & secured
landfill for solids.
•Chemical treatment-1%Sod Hypochlorite solution with 5 % chlorine

• OR10 grams of bleaching powder in 1 liter of water for 30 minutes.
( WHO guidelines)
Sharps
Non sharps
Segregation of waste:
 Segregation should be done at the source of generation of bio-medical
waste i.e. all patient care activity areas: OTs ,LRs, Lab ,Wards etc. Certain
infectious waste may be removed only after disinfection..Ex-blood soiled
solids.
 Responsibility of segregation: Doctors, nurses & technicians.
 Different color containers are available for segregation.
 Location of containers- All color coded containers should be located at the

point of generation of waste i.e. OT, LR etc Labeling: must done
procedure.
 Bags: Waste bags are filled up to only 3/4th capacity, tie and removed
securely must be kept in safe place. No untreated bio-medical waste shall
be stored beyond a period of 48 hours.
Dr. U. V. N. Rao, Resident Medical Officer, Apollo Hospital, Hyderabad says

that by implementing good segregation programs, it is possible to reduce
this waste stream to less than 8 %. The estimated amount of unregulated
infectious waste per day per bed varies between 8000 grams and 11000
grams, which if regulated, would vary between 50 gms and 1500 gms.
Safety measures
 Personal protection: Gloves, masks,
protective glasses, plastic aprons, special
footwear eg. gum boots for waste handlers
 Immunization: Hep B & Tetanus
 Reporting accidents and spillage: apply
Universal Precautions.
Transportation of waste:
Transportation within the hospital:
 separate routes, if not possible
 separate time
 separate containers and trolleys
 Transportation outside the hospital : should be
done in vehicles specified under Motor vehicle
act, 1988.
 Vehicle should be leakproof.
Treatment methods of hospital waste:
General waste: by sanitary landfill & composting
etc.
Infectious waste:
 Incineration
 Deep burial
 Autoclave & microwave
 Secured landfill
Landfill
It should be 2m deep. Filled up to half the depth &
filled up to 50cm by lime. Covered with mesh.
It should be leak proof, temper proof, & made
under authorized supervision on an erosion free
land.
It should be away from surface water or sanitary
well.
Maintain record of site & maintenance of landfills.
Incineration
 Double-chamber pyrolytic: Incinerators specially
designed to burn infectious health-care waste
Training, Management &Administration
 To make aware the staff about safe hospital waste
management practices, each hospital must have well
planned training programs for all categories of
workers.
 More emphasis should be given in training modules
as per category of personnel.
 Do not sell/reuse hospital waste without autoclaving
/microwaving.
 Regular waste audit. Waste management committee
under superintendent. Regular meeting to review the
performance of waste disposal.
 Do not burn waste in premises.In case of accident
inform Pollution Control Board.
Recommendations
 A judicial use of equipments & instruments in use.

 Reuse & recycle the waste as much as possible.
 Treat waste by safe & environmentally sound methods.
 Keeping strict watch on its disposal.
 Coordination b/w hospitals & municipal corporation
 Coordination b/w hospitals & NGOs/Pvt Sector.
 Greater participation of Govt .in dealing with situation.
THANKS
Have a nice
Day.

Health Care Waste Management

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Health care waste

S. Category of Type of container Method of

I Human Yellow Incineration/Deep

VI Soiled wastes Blue container/plastic autoclaving/micro

XI Incinerator Black plastic bag Disposal in landfill

•Chemical treatment-1%Sod Hypochlorite solution with 5 % chlorine

 Responsibility of segregation: Doctors, nurses & technicians.

 Different color containers are available for segregation.

 Location of containers- All color coded containers should be located at the

Dr. U. V. N. Rao, Resident Medical Officer, Apollo Hospital, Hyderabad says

 A judicial use of equipments & instruments in use.

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