BIOMEDICAL WASTE MANAGEMENT REGULATORY COMPLAINCE

1
BIOMEDICAL WASTE MANAGEMENT- REGULATORY
COMPLAINCE MANAGEMENT OF BMW FACILITIES

• Dr LAKSHMI RAGHUPATHY
• Former Director, MoEF
• Adviser, Environment Managment

2
FAQ BIOMEDICAL WASTES

• What is biomedical waste?
• Is bio-medical was infectious?
• Need for mgt of bio-medical wastes
• Why segregate?
• What does the color code signify?
• Why use separate containers?
• What is the safe method for Sharps disposal?
• What is the maximum storage time for BMW?
• What is Treatment Disposal facility?
• What are the advantages of Common facility?
• How and where to locate facility ?
• How to transport BMW to common facility?
• How to reduce BMW?

3
WHAT IS BIOMEDICAL WASTE?

• BIOMEDICAL WASTES are wastes, which are 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 1
• Bio-medical wastes are infectious and hazardous
  - need to be managed carefully

4
BIOMEDICAL WASTESREGULATIONS

• BIOMEDICAL WASTES (MH) RULES 1998 - E(P) ACT
  1986 as amended in 2000, 2003
• MOEF- NODAL AGENCY
• PRESCRIBED AUTHORITY-IMPLEMENTATION
• These rules provide a system for regulating
  handling BMW which includes collection,
  segregation at source, norms for packaging
  labeling and options for treatment and disposal
  along with the standard for treatment
  technologies.
• For proper management Handling of Bio-Medical
  Waste.
• Applicable to all persons who generate, collect,
  receive, store, transport, treat, dispose or
  handle bio-medical waste in any form.

5
BIOMEDICAL WASTE HANDLING(CRADLE TO GRAVE)

• CHARACTERIZATION
• QUANTIFICATION
• SEGREGATION
• STORAGE
• TRANSPORTATION
• TREATMENT
• DISPOSAL

6
BIOMEDICAL WASTE CATEGORIES

• 10 WASTE CATEGORIES
• CAT1 HUMAN ANATOMICAL
• CAT2 ANIMAL
• CAT3 MICROBIOLOGY BIOTECHNOLOGY
• CAT4 WASTE SHARPS
• CAT5 CYTOTOXICDRUGS DISCARDED MEDICINES
• CAT6 SOILDWASTE
• CAT7 SOLID WASTE
• CAT8 LIQUID WASTE
• CAT9 INCINERATIONASH
• CAT10 CHEMICAL

7
SEGREGATION , PACKAGING TREATMENT DISPOSAL

• CATEGORY WASTE TYPE CONTAINER TREATMENT
  DISPOSAL
• 1. HUMAN ANATOMICAL (Y P)
  INCINERATION/DEEP BURIAL
• 2. ANIMAL WASTE (Y,P) INCINEARTION/DEEP
  BURIAL
• MICROBIOLOGY (Y,R) AUTOCLAVING/MICROWAVING
• BIOTECH
  /INCINERATION
• 4. WASTE SHARPS B,W DISINFECTION(CHEM)
  /AUTOCL/MICRO/SHREDDING
• DISCARDED MED INCINERATION/DESTRUCTION
• CYTO-Drugs BLUE /SECURED LANDFILL
• 6. SOILED (YELLOW) INCINERATION/AUTOCL
  /MICROWAVING
• SOLID R,B,W CHEM.DISINFEC/AUTOCL/MICROWAV/
• (DISPOSABLES) SHREDDING
• 8. LIQUID CHEM DISINFEC DISCHARGE
  INTO DRAINS
• 9. INCINERATION ASH Bl MUNICIPAL LAND
  FILLS
• 10. CHEMICAL Bl CHEM TREATMENT DRAINS/
  LANDFILL

8
BIOMEDICAL WASTESREGULATIONS

• WASTE CAT 1,2,3 6 - YELLOW - PLASTIC BAGS
  INCINERATION BURIEL
• WASTE CAT 3,6 7 - RED-DISINFEC CONT
  PLASTIC BAGS
• - CHEMICAL DIS.
  AUTOCL, MICRO.
• CAT4 7 - BLUE /WHITE/TRANS-PLASTIC BAGS- - -
  CHEMCIAL ,SHREDDING, AUTOCL, MICRO,
• CAT5,9 10 - BLACK-PLASTIC BAG
• - SECURED LANDFILL

9
COMPLIANCE STATUS

• Comprehensive Rules but poor compliance there
  are many aspects in the rules that required to be
  complied with
• Authorisation not completed in many states
• Storage provisions have not provided in most of
  the heath care institutions
• Dedicated vehicles for transportation of
  biomedical wastes are not provided in many states
  
• Treatment disposal facilities have been set up
  but not achieving prescribed Standards

10
BIO-MEDICAL WASTE MANAGEMENT

• Steps taken by the States/UTs
• Inventorization of all bio-medical waste
  generators - hospitals, nursing homes, clinics
  etc.
• Ensure that hospitals seek authorisation.
• Action against violation of the rules
• Facilitate Creation of Common Treatment and
  Disposal Facilities for Biomedical Waste.

11
Bio-Medical Waste (Management Handling)
Rules,1998

• As per Rule 8 , Every Occupier of an institution
  generating, collecting, receiving, storing,
  transporting, treating, disposing and /or
  handling bio-medical waste in any other manner,
  except such occupier of clinics, dispensaries,
  pathological laboratories, blood banks providing
  treatment / service to less than 1000 (one
  thousand) patients per month, shall make an
  application in Form I to the prescribed authority
  (DPCC) for grant of authorization.

12
DEADLINES FOR SETTING UP BIOMEDICAL WASTE
TREATMENT FACILITIES

• According to BMW Rules 1998 deadline for setting
  up of treatment facilities
• Metros with population gt30 lakhs -30.06.2000
• Cities with population lt 30 lakhs
• Hospitals and Nursing Homes gt500 beds
  -30.06.2000
• Hospitals and Nursing Homes 200-500 beds
  -31.12.2000
• Hospitals and Nursing Homes 50-200 beds
  -31.12.2001
• Hospitals and Nursing Homes lt50 beds
  -31.12.2002
• All others
  -31.12.2002

13
Operators of Common BMW Treatment Facilities in
Delhi (CBMWTF)

• DPCC has authorized 2 Operators to create Common
  BMW Treatment Facilities in Delhi
• 1. M/s Metro Bio- Care Waste Management Pvt.
  Ltd., 55, Railway Road, Samaipur Industrial Area,
  Delhi -42.
• 2. M/s Synergy Waste Management Pvt. Ltd, Near
  Okhla STP, Sukhdev Vihar, Okhla, Delhi -20.
• Both the Operators have been authorized for
  collection of BMW from the Health Care Units in
  Delhi, for transportation of collected waste to
  the Common treatment site for the treatment as
  per BMW Rules.

14
COMMON BMW FACILITIES

• Facilties Total - 157- Operation- 149

15
OPTIMIZATION OF BIO-MEDICAL WASTE MANAGEMENT

• Large health care units to have a treatment
  disposal facility of their own
• Large units with spare capacity in their to be
  shared with smaller units
• Treatment facilities to accept waste form small
  waste generators .
• Common Treatment Disposal Facilities under PPP.
• Local medical association to assist in
  cooperative ventures.
• State Govts. municipal bodies to join hands
• Sites allotted for common incineration facilities
  
• Treated bio-medical wastes to be picked up by
  municipal bodies.

16
NEWER APPROACHES FOR BMW MANAGEMENT

• Effective collection system to be put in place
  within and outside health care units
• Ensure proper segregation and packaging
• Pollution prevention thru EST
• Waste reduction
• Use of safe substitutes for hazardous subs in use

17
NEWER TECHNOLOGIES

• NEWER TECHNOLOGIES TO BE ADOPTED FOR BMW
• NON INCINERATION TECHNOLOGY
• AUTOCLAVING HYDROCLAVING MICROWAVING
• USE OF REUSABLES WHERE POSSIBLE INSTEAD OF
  DISPOSABLES
• SAFE SUBSTITUTES FOR MERCURY
• MODERNIZATION OF THE OPERATING PLANTS

18
REQUIEMENTS FOR BIOMEDICAL WASTES MGT

• Facilitating the process of BMW Mgt
• Precautionary principles preventive approach
• Training awareness programmes
• Appropriate qualification training
• Allocation of responsibilities
• Providing infrastructure and equipments
• Budget allocation
• Co-ordination and cooperation with other
  institutions

19
ISSUES ON BIOMEDICAL WASTES MANAGEMENT

• ISSUES
• Adequate attention not given
• Indiscriminate Disposal
• Segregation Lacking
• Unscruplus Recycling
• No Treatment Disposal Facility
• No Training Awareness
• Monitoring Mechanisms Lacking
• Lack of infrastructure in hospitals to tackle the
  problem of bio-medical wastes.
• Inadequate/NIL allocation of funds.
• Lack of training for nurses and other
  para-medical staff.
• Absence of personal protective gears like gloves
  etc., while segregating and transporting wastes.

20
ACTION POINTS

• SOLUTIONS
• Follow regulations
• Use re-usables
• Prescribe safe recycling
• Waste minimization
• Integral part of hospital management system
• Awareness education
• Management monitoring mechanisms
• Penalty punishments
• Utilisation of spare capacity of existing
  incinerators and other facilities in the
  hospitals by small units. Also utilisation of
  incinerators in the private sector industries for
  treatment of Hospitals Wastes..
• Inclusion of Biomedical waste management as a
  part of medical curriculum

21
Thank You