Everything about new Biomedical waste management

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

  1. Define ‘biomedical waste’. Briefly categorize them. Enumerate their health hazards.List4 important methods for disposal of biomedical wastes.(08/1)10
  2. Define biomedicalwaste. Describe its hazards. Outline modes of disposal of biomedical waste generated in a hospital setting.(12/1,Oct17)2+3+5
  3. 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

  1. Harmful microorganisms from BMW can infect hospital patients, health workers, and the general public.
  2. Passage of drug-resistant microorganisms from health facilities into the environment.
  3. Toxic exposure to pharmacy products, like antibiotics, cytotoxic drugs released into the environment.
  4. The radioactive substance used in treatment can cause radiation injuries
    Chemical burns and thermal injuries arising from biomedical waste management itself.
  5. Sharps from BMW can inflict injuries.
  6. Similar hazards to animals and birds causing a change in human-environments balance.

Modes of Disposal of BMW

1. Autoclaving

  1. Involves steam sterilization.
  2. Introduces very hot steam for a determined amount of time.
  3. Costs much less than other methods.
  4. No personal health risks.

2. Incineration

  1. It is quick, easy, and simple.
  2. Removes the waste entirely and effectively.
  3. Emissions during burning can be dangerous.

3. Chemicals disinfection

  1. Useful for liquid waste.
  2. Chlorine is commonly used.
  3. Introduced to the liquid waste to kill microorganisms and pathogens. In the case of solid waste, they are grinded first.
  4. Once decontaminated, the liquid is disposed into the sewer system.

4. Microwaving

  1. Waste is shredded first, mixed with water, and then heated to kill microorganisms.
  2. Shredding lowers the volume of biomedical waste, Which is a plus of this method.
  3. Can’t be used for all biomedical wastes.

5. Plasma pyrolysis

  1. Uses extremely high temperatures in an oxygen-deprived environment to completely dissociate waste.
  2. 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.

Table Showing Old categories of Biomedical waste
CategoriesInclusion
Cat- 1Human Anatomical Wastes (human body parts, tissues, and organs)
Cat- 2Animal Anatomical Wastes (Animal tissues, organs, body parts, waste generated by veterinary hospitals, animal houses)
Cat- 3Microbiology and Biotechnology (specimens of micro-organisms live or attenuated vaccines etc)
Cat- 4Waste Sharps (needles, syringes, scalpels, blades, glass, etc)
Cat- 5Discarded medicines and Cytotoxic drugs (outdated, contaminated, and discarded medicines)
Cat- 6Soiled wastes (items contaminated with blood, body fluids such as cotton, dressings, linen, beddings etc)
Cat- 7Solid wastes (waste generated from disposable items other than sharps such as tubing, catheters, IV sets)
Cat- 8Liquid wastes ( washing, cleaning )
Cat- 9Incineration ash
Cat- 10Chemical 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.

Table Showing Old classification for Biomedical waste categories
Color codeContainerCategoryTreatment
Yellow Plastic Bag1,2,3,6Incineration/ Deep burial
RedDisinfected container/
Plastic bag
3,6,7Autoclaving / Microwaving /
Chemical treatment
Blue / WhitePuncture proof4,7Autoclaving / Microwaving /
Chemical treatment & Destruction / Shredding
BlackPlastic Bag5,9,10 (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

Table 3 - Updated Biomedical waste management categories and waste disposal methods 2016.Source -Reference 1
CategoryType of containerType of wasteTreatment
YellowNon-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
RedNon-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)
WhitePuncture 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.
BlueCardboard 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

  1. Authorization mandatory for all no matter how small is the HCF (Health care facility)
  2. Formal annual report
  3. Schedule and forms changed
  4. Chemical pretreatment with 10% hypochlorite instead of 1%
  5. New methods of disposal like pyrolysis, hydrolysis, encapsulation, and inertization
  6. 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

symbol for biomedical waste
Fig.2 - Symbol for Biomedical Hazard

Cytotoxic hazard symbol

symbol for cytotoxic waste
Fig.3 - Symbol for Cytotoxic hazard

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)

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auhtor

About Author

Ajay Agade | DNB(Pediatrics), FNB(Pediatric Intensive Care), Fellowship in Pediatric pulmonology

Ajay is a Paediatric Intensivist, currently working in Pediatric Respirology & LTV at Great Ormond Street Hospital NHS, London