Table of contents
- Definitions Hopsital waste • Biomedical waste
- Health Hazards of BMW
- Modes of disposal
- Overview of new guidelines
- Old guidelines • old Categories
- New guidlines 2016
- Major changes
- Symbols used in BMW management
- Video wrap
Question asked
- Define ‘biomedical waste’. Briefly categorize them. Enumerate their health hazards.List4 important methods for disposal of biomedical wastes.(08/1)10
- Define biomedicalwaste. Describe its hazards. Outline modes of disposal of biomedical waste generated in a hospital setting.(12/1,Oct17)2+3+5
- Hospital Waste Management (06)10
Definition / What is Biomedical waste?
Definitions related to BMW according to Ministry of Environment and Forests are.
What is Hospital waste?
This refers to all waste, biological or non‐ biological that is discarded and not intended for further use.
What is Bio-medical waste?
Any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, and including categories mentioned in Schedule I, of the BMW rules, 2016.
Health hazards of Biomedical Waste
- Harmful microorganisms from BMW can infect hospital patients, health workers, and the general public.
- Passage of drug-resistant microorganisms from health facilities into the environment.
- Toxic exposure to pharmacy products, like antibiotics, cytotoxic drugs released into the environment.
- The radioactive substance used in treatment can cause radiation injuries
Chemical burns and thermal injuries arising from biomedical waste management itself. - Sharps from BMW can inflict injuries.
- Similar hazards to animals and birds causing a change in human-environments balance.
Modes of Disposal of BMW
1. Autoclaving
- Involves steam sterilization.
- Introduces very hot steam for a determined amount of time.
- Costs much less than other methods.
- No personal health risks.
2. Incineration
- It is quick, easy, and simple.
- Removes the waste entirely and effectively.
- Emissions during burning can be dangerous.
3. Chemicals disinfection
- Useful for liquid waste.
- Chlorine is commonly used.
- Introduced to the liquid waste to kill microorganisms and pathogens. In the case of solid waste, they are grinded first.
- Once decontaminated, the liquid is disposed into the sewer system.
4. Microwaving
- Waste is shredded first, mixed with water, and then heated to kill microorganisms.
- Shredding lowers the volume of biomedical waste, Which is a plus of this method.
- Can’t be used for all biomedical wastes.
5. Plasma pyrolysis
- Uses extremely high temperatures in an oxygen-deprived environment to completely dissociate waste.
- Uses heat generated by graphite electrode-based plasma arc system.
Overview of New Guidelines
The hospital waste management guidelines in India has been updated recently in 2016.
There are many changes in rules for segregation, packaging, transport, storage, and disposal of biomedical waste. They are more simplified now.
There can be important questions based on these highlights in DNB theory exams, OSCE, and even for clinical viva.
It is imperative to know older guidelines so as to realize and memorize the differences.
What are the old guidelines?
Old categories
According to the old guidelines (1998 and 2011 update), the following categories of hospital waste management were recognized.
| Categories | Inclusion |
| Cat- 1 | Human Anatomical Wastes (human body parts, tissues, and organs) |
| Cat- 2 | Animal Anatomical Wastes (Animal tissues, organs, body parts, waste generated by veterinary hospitals, animal houses) |
| Cat- 3 | Microbiology and Biotechnology (specimens of micro-organisms live or attenuated vaccines etc) |
| Cat- 4 | Waste Sharps (needles, syringes, scalpels, blades, glass, etc) |
| Cat- 5 | Discarded medicines and Cytotoxic drugs (outdated, contaminated, and discarded medicines) |
| Cat- 6 | Soiled wastes (items contaminated with blood, body fluids such as cotton, dressings, linen, beddings etc) |
| Cat- 7 | Solid wastes (waste generated from disposable items other than sharps such as tubing, catheters, IV sets) |
| Cat- 8 | Liquid wastes ( washing, cleaning ) |
| Cat- 9 | Incineration ash |
| Cat- 10 | Chemical wastes ( disinfectants, insecticides ) |
Old type of container for BMW
The old classification for the type of container used for medical waste segregation was as follows.
| Color code | Container | Category | Treatment |
| Yellow | Plastic Bag | 1,2,3,6 | Incineration/ Deep burial |
| Red | Disinfected container/ Plastic bag | 3,6,7 | Autoclaving / Microwaving / Chemical treatment |
| Blue / White | Puncture proof | 4,7 | Autoclaving / Microwaving / Chemical treatment & Destruction / Shredding |
| Black | Plastic Bag | 5,9,10 (solid) | Disposal in secured landfill |
New Guidelines for Biomedical Waste management 2016
As Per the New guidelines on hospital waste management the Bio-medical waste is now classified into just 4 categories. This is way less confusing than the 10 categories in previous guidelines.
The 2011 update brought down the number to eight categories of biomedical waste from ten categories in the 1998 notification. The 2016 notification further brings down the number of categories to four.
The categories and disposal options in the 2016 guidelines are
| Category | Type of container | Type of waste | Treatment |
| Yellow | Non-chlorinated plastic bags | - Human Anatomical Waste Animal - Anatomical Waste - Soiled Waste - Expired Medicines - Chemical Waste - Chemical Liquid Waste - Discarded linen, mattresses, beddings contaminated with blood or body fluid. - Microbiology, Biotechnology and clinical laboratory waste | Incineration or Plasma Pyrolysis or deep burial |
| Red | Non-chlorinated plastic bags or containers | Contaminated Waste (Tubing, bottles, Intravenous tubes and sets, catheters, urine bags, syringes (without needles and fixed needle syringes) and vacutainers with their needles cut) and gloves ) | Autoclaving or micro waving/ hydroclaving and then recycling ( no land fill here) |
| White | Puncture proof, Leak proof, tamper proof containers | Waste sharps including Metals (Needles, syringes with fixed needles, needles from needle tip cutter or burner, scalpels, blades, or any other contaminated sharp) | Autoclaving or Dry Heat Sterilization followed by shredding, mutilation or encapsulation. |
| Blue | Cardboard boxes with blue colored marking | Glassware (Broken or discarded and contaminated glass including medicine vials and ampoules except those contaminated with cytotoxic wastes) | Disinfection/ autoclaving/ microwaving/ hydroclaving and then sent for recycling |
What are the Major changes in Biomedical waste management 2016 guidelines from that in 1998?
Highlights of changes are
- Authorization mandatory for all no matter how small is the HCF (Health care facility)
- Formal annual report
- Schedule and forms changed
- Chemical pretreatment with 10% hypochlorite instead of 1%
- New methods of disposal like pyrolysis, hydrolysis, encapsulation, and inertization
- More emphasis on recycling now
Major changes in Biomedical waste management 2016 from 1998 guidelines
Image source: Reference 2
What are the various symbols used for biomedical waste segregation and management?
This is of particular importance in Image-based OSCE questions in exams.
Biomedical Hazard Label
Cytotoxic hazard symbol
DP Video wraps
Best of video's on related topics with the best ingredients
Watch this video with best overview on recent guidelines. (AIIMS NICU)