Bio Medical Waste

Management
Guidelines

Dr. Anjalatchi Muthukumaran

Vice Principal and Nursing
Superintendent
Era College of Nursing and ELMCH
Era University , Lucknow 226003
 Content of the BMWM
• Introduction • Transportation of BMW from
• Definition/meaning segregation point to Disposal
area/storage area
• Goal/aim/objectives
• Treatment of Disposal method
• Component of BMWM
• Recycle of BMWM
• Need of BMWM • Forms /format to use daily
• Sources of BMWM records purpose
• Category of BMWM • Symbol /sign of BMWM
• Color code for BMWM • Indicators to follow in BMWM
• Segregation point at BMWM • Checklist
• Packing of BMWM • Summary
• Cleaning /Disinfection of • Conclusion
BMW bin/Polythene/trolley • Question related topic ?
• PPE for BMW handler • References
 Biomedical Waste
• Biomedical or Hospital Waste is any kind of waste containing
infectious materials.
• It may also include waste associated with the generation of
biomedical waste that visually appears to be medical.
• Broadly, Biomedical Waste refers to any waste which is
generated during the diagnosis, treatment or immunization of
human beings or animals or in research activities pertaining
thereto or in production or testing of biological products including
categories mentioned in Schedule 1, of the BMW Rules 2016.
INTRODUCTION
Definition of waste
WHO AT RISK?
QUANTITY OF WASTE GENERATED
PER BED /PER DAY SEGREGATION
 Aim
/objectives/purpose
TYPE OF BMW WASTE
CLASSIFICATION OF BMWM
PHC segregation point
Component of BMWM
The Biomedical Wastes consist of:
• 1. Human anatomical waste like tissues, organs and
body parts
• 2. Animal wastes generated during research from
veterinary hospitals
• 3. Microbiology and biotechnology wastes
• 4. Waste sharps like hypodermic needles, syringes,
scalpels and broken glass
• 5. Discarded medicines and cytotoxic drugs
• 6. Soiled waste such as dressing, bandages, plaster
casts, material contaminated with blood, tubes and
catheters
• 7. Liquid waste from any of the infected areas
• 8. Incineration ash and other chemical wastes
BMW waste exposure hazards
STEPS IN MANAGEMENT
BMWM
Category of BMWM
SEGREGATION OF
WASTE
EXAMPLE OF WASTE
CONTINUED
 MANGEMENT OF HEALTH CARE
WASTE
• Patient right and
responsibilities
• Patient safety act
• Consumer protection
act 1986
• Environmental
protection act
• Central pollution board
control act
• BMWM guidelines2016
 Color Coding of Biomedical Waste in India

As per Bio-medical Waste Management Rules,

2016
• Bio-medical waste is required to be segregated in
following color coded waste categories –
• Red Bag – Syringes (without needles), soiled
gloves, catheters, IV tubes etc. should be all
disposed of in a red coloured bag, which will later
be incinerated.
• Yellow Bag – All dressings, bandages and cotton
swabs with body fluids, blood bags, human
anatomical waste, body parts are to be discarded
in yellow bags.
COLOR CODES OF BMWM
 Concerns with
Biomedical Waste
• Land Pollution – If not treated and dumped into
landfills then there is a high chance for heavy
metals like cadmium, lead, mercury, etc. get
released. Further, there is a chance these metals
get absorbed by plants and can then enter the
food chain also.
• Air Pollution – Pathogens present in the waste
can enter and remain in the air for a long period
in the form of spores or pathogens. As Covid-19
spreads through the air, improper treating/not
treating it might lead to a new wave of
respiratory syndromes.
 Continued
• Radioactive Pollution – Hospitals are
increasingly using radioactive isotopes for
diagnostic and therapeutic applications. The main
radioisotopes used in hospitals are technetium-
99m (Tc-99m), Iodine-131(I-131), etc. These have
carcinogenic properties.
• Epidemic – According to the WHO study,
improper waste management is one of the major
causes of an increase in infectious diseases
globally. This is why the Covid-19 pandemic
wastes require proper treatment
 Continued
• Operational Health Hazards – Improper handling
of biomedical waste might lead to Injuries from
sharps and exposure to harmful radioactive wastes.
This will create issues for nurses, emergency
medical personnel, and sanitary workers.
• Increased Antimicrobial Resistance (AMR) –
Biomedical wastes aggravate the problem of AMR.
Ever since the pandemic, the use of biocides
(sanitizers, disinfectants, and antibiotics) increased
manifold. If there is no proper treatment of biocides
then the AMR will increase rapidly.
 BMWM
Autoclaving
• Autoclaving - The process of autoclaving involves
steam sterilization. Instead of incineration, which
can be expensive, autoclaving simply introduces
very hot steam for a determined amount of time.
 Color code with
treatment method
YELLOW BIN
RED BIN
BLUE CONTAINER
WHITE BOX
cycle
Disposal process of
BMWM
methods
Disposal of BMWM
 Incineration
• Incineration – The major benefits of incineration
are that it is quick, easy, and simple. It effectively
removes the waste entirely and safely removes
any microorganisms.
Incinerator
Chemical disinfection
• Chemical disinfection – When it comes to liquid
waste, a common biomedical waste disposal
method can be chemical disinfection.
• Chlorine is a regular choice for this process, and
is introduced to the liquid waste in order to kill
microorganisms and pathogens
HYDROCLAVE
 Microwaving
• Microwaving – Microwave technology can also
disinfect wastes. Wastes are first placed into a
shredder. This wastes are mixed with water and
internally heated that neutralizes present biologicals.
 Irradiation
• Irradiation – This method involves waste
sterilization by exposing waste to cobalt sources.
Cobalt emits gamma rays that kill all the
microbes in wastes.
Deep burial method
Sharp pit method
 Shredding
• Shredding – It is a process by which waste are de-shaped
or cut into smaller pieces so as to make the wastes
unrecognizable.
• It helps in prevention of reuse of bio-medical waste and
also acts as an identifier that the wastes have been
disinfected and are safe to dispose-off.
Needle Stick Injury
protocol
Treatment guidelines
for PEP
 Legal legislation /Authorities related to BMWM
• Authorities Dealing with Biomedical Waste in India Central Pollution
Control Board – The CPCB has been following up with all SPCBs/PCCs to
ensure effective management of biomedical waste in States/UTs.
• National Green Tribunal (NGT) – The NGT has been stringent on the
application of the BMW 2016.
• Common Bio-Medical Waste Treatment and Disposal Facilities (CBWTDF) –
There are now over 200 licensed CBWTDF or Common Treatment Facilities
(CTF) in India.
Legislation with
penalty
 Features of BMW,
2016
• Compulsory pre-treatment – The method of
sterilization/disinfection should be in accordance with
National AIDS Control Organization (NACO) or WHO.
• Phasing out plastic use – The use of chlorinated plastic
bags, gloves, blood bags, etc. should be gradually
stopped and this phasing out should be within 2 years
from the date of notification of these rules.
• Safe disposal of Liquid waste – They need to be
separated at source by pre-treatment before mixing
with other liquid waste.
• Incineration guidelines – The existing incinerator should
be upgraded/modified to achieve the new standard
within 2 years from the date of this notification.
HANDLING INFECTIOUS
WASTE
observed
Segregation of BMWM
SEGREGATION POINT
HOW POLYTHENE TO
BE PURCHASED
How to select the label
of BMW bag
Label/polythene bag
PACKING OF BMW
BINS
Packing and disposal
method
transportation and
storage
Bio medical waste management preparation

chart
TRANSPORTATION
Safe transportation
Continued
Storage guidelines
Personal protective
measure( PPE)
Continued
Standard precausions
Safety training
program
Standard precautions
Frequently answer
questions
 Challenges in India
• Increase in waste– In a highly populous country
like India, there is a rise in residential biomedical
waste and its collection without adhering to
safety protocols could also trigger a surge in
caseload.
• Poor Compliance of BMW rules – States are not
following the CPCB guidelines.
• Non-segregation – In some states, improper
segregation of waste has been reported.
• Improper disposal – The non-segregation of
waste results in the incineration of contaminated
plastics producing toxic gases and adding to air
pollution.
• Lack of infrastructure – Currently, in India, there
are only 198 CBMWTF in operation and 28 are
under construction.
• No alternative to incineration – During
incineration and postcombustion cooling, waste
components dissociate and recombine forming
new particles.
BIO MEDICAL WASTE MANAGEMENT
POSTER CHART
EXAMPLE OF SOME ORGANIZATION
BMWM CHART
Example –chart
BMWM chart in one
language
DENTAL CLINIC -BMWM
CHART
Health education
activities -bmwm
BMWM signage
BMW activities
 Conclusion
• Safe and effective management of biomedical waste is not
only a lawful obligation but also a civil duty.
• The current BMWM 2016 rules are an improvement over
earlier rules in terms of improved segregation, transportation,
and disposal methods, to decrease environmental pollution
and ensure the safety of the staff, patients, and public
TRANSPORTATION IS CORRECT OR

WRONG?

STORAGE OF WASTE ?
 References
• 1. Hari Singh. (2018). Essentials of management for
healthcare professionals. Crc Press, Taylor & Francis Group.
• 2. WHO. Review of Health Impacts from Microbiological
Hazards in Health-Care Wastes. Geneva: World Health
Organization;
• 3. R Radhakrishnan, Dr. (2006). Bio Medical waste
management. Sumit Enterprises.
• 4. K Sasikumar, & Sanoop Gopi Krishna. (2009). Solid waste
management. Phi Learning.
• 5.Ministry of health and family welfare guidelines
• 6. national health mission guidelines
• 7. central pollution board guidelines
• 8. state health guidelines
• 9.Environment safety guidelines
 Take your home
message
• Your responsible for your health
• Your responsible for health care services if your health
care professionals
• Take plenty of water every day
• Eat balanced diet
• Eat seasonal fruits, vegetables , and other
• Avoid junks foods and fast food
• be happy ,your responsible for your health
• Make the environment healthy, happy and ready to do
work with smile manner
• Get vaccination as per policy
• Lead your life as healthy way, not wealthy way…….
THANK YOU SO
MUCH