‫بسم الله‬

‫الرحمن الرحيم‬
Health Care Waste Managem
 LEARNING OBJECTIVES
After going through this ppt, the students will be able to :
Define the health care-waste
Classify health care- waste
Describe the sources of health care waste
Describe risks associated with health care waste
Describe the handling, storage and transportation of
health care waste
Describe the treatment and disposal technologies of
health care waste
 Biomedical Waste
Definition:
“Bio medical or health care waste” is any waste, which
is generated during the diagnosis, treatment or
immunization of human beings or animals in health-
care establishments, research facilities, and
laboratories. etc.”

.
HEALTHCARE WASTE CHARACTERIZATION

03/05/25 5
 Hospital waste

Pharmaceutical 75-90%
Non Clinical Waste

Pathological 10-25%
Clinical Waste Genotoxic

Infectious
Pressurized containers
Needles

Waste with heavy Chemical

Metal content

Radioactive waste
 Healthcare General Waste
Healthcare General Waste (HCGW)
– Paper packaging
– Plastic packaging
– Food preparation
– And other items that have not been
contaminated
 Healthcare Risk Waste

Healthcare Risk Waste (HCRW)

Infectious waste
Hazardous waste
Harmful to humans and environment
 Categories of health care waste
No Waste category Description and example
1 Infectious waste Waste suspected to be in contact with
pathogens. Eg. Lab culture, tissues,
material or equipment
2 Pathological Human tissues or fluid
waste e.g body parts, blood, body fluids
3 Sharps Sharp waste
Eg. Needles, infusion sets, scalpels,
knives, broken glass.
4 Pharmaceutical Waste containing pharmaceuticals
waste Eg. pharmaceuticals (Expired).
5 Highly infectious Consists of microbial culture and stock
waste of highly infectious agents from
medical analysis laboratories. Eg.
Body fluids
6 Genotoxic waste Waste containing substances
with genotoxic properties
e.g waste containing cytotoxic drugs,
genotoxic chemicals

7 Chemical waste Waste containing chemical

substances
e.g. reagents, desinfectant, solvents

8 Waste with high Batteries, broken thermometer,

content of heavy blood pressure gauges
metals
9 Pressurized Gas cylinders, gas cartridge,
containers aerosol cans

10 Radioactive Waste containing radioactive

waste substance
e.g unused liquids from radiotherapy
Waste Sharps eg: Needles Discarded medicines
Pharmaceutical Waste

Human anatomical waste Solid waste eg: cotton swabs

Pathological
waste

12
 Pathological Waste

Blood bags found in the municipal waste stream in violation

of rules for such waste. 13
Pharmaceutical Waste

Sharp Waste
 Genotoxic Cytotoxic drugs
waste

Chemical
waste
15
Lab
Waste with high content
of heavy metals

Worn out batteries

Blood pressure guages 16

Aerosol cans

PRESSURISE
D
CONTAINER
S
Gas cartridges

Gas cylinders

17
 WHO ARE AT RISK?

Doctors
Nursing staff
Ward staff
Housekeepers
Patients & visitors
Community
Environment
 CATEGORIES OF PERSONS
EXPOSED TO RISK OF INFECTION

03/05/25 19
 ROUTES OF TRANSMISSION

03/05/25 20
 Hazards of chemical and
pharmaceutical waste
Toxic
Genotoxic
Corrosive
Flammable
Reactive
Explosive
They may cause :
Intoxications
Acute or chronic exposure
Injuries
Burn
 Hazards from genotoxic waste

Cancer, genetic mutations

Exposure occurs through contact with the
body fluids and secretions of patients
undergoing chemotherapy

Genotoxic waste
Hazards from radioactive waste

Cancers, genetic mutations

Radioactive waste

25
 WHAT IS NEEDED?
All Biomedical Waste has to be
Minimized.
Segregated.
Disinfected.
Transported and
Disposed off in a environmental friendly manner.

Biomedical waste should not be mixed with other

wastes.
Steps of Waste Management

Generation
Segregation / separation (color coding)
Collection
Storage (designated room, not accessible
to un authorized personnel)
Treatment
Transportation (enclosed vehicles with
labelling of waste)
Final disposal
 Segregate Hazards at the Source

Separate sharps and infectious waste

where they are used
– This prevents injuries that can occur when
people sort the trash after it is disposed
Janitors can reinforce separation of sharps
waste disposal by reporting sharps in
garbage to Hospital Infection Control
Committee members

Slide 29
 WASTE DISPOSAL

PAPER

WRAPPERS

KITCHEN WASTE/FOOD BLACK BIN

General waste
Paper, plastics
Wrappers
Cardboards
Outer packaging
Kitchen waste
Unsoiled plaster cast
 WASTE DISPOSAL Pathology waste

soiled linen,
contaminated
A BS gowns,
S W
drapes
Swab stick-

centa ical
decontaminated

wast n anatom
e-pla
a
Hum
Dressing

Bandages

YELLOW BIN
Human/Animal tissue organs or body parts
Animal carcasses
Any non plastic soiled waste( contaminated
with blood/ body fluids )
Cotton dressings, bandages
Linen beddings
Soiled plaster casts, Soiled paper
Used/ removed sutures
 WASTE DISPOSAL

All infectious, non

sharp plastic waste Urine bag

Plastic culture
plates & tubes

I/V sets
Drains RED BIN
Infectious plastic and rubber waste such as

Gloves
IV tubings and I. V sets
Catheters
Urine bags, Blood bags
Syringes
Suction tips
Infected plastic containers
Rubber base materials
Retraction cords
Blue/White puncture proof container
Sharp edged or pointed metallic sharps
Needles
Scalpel blades
Suture needle
Intracath
LP needle
Bone screws ( sharps), Arch bars, Burs
Lancets
Glass sharps such as broken ampoules,injection vials
Glass slides, coverslip
Injection vials
Segregated incinerable wastes kept in Yellow
bag
 Containers – Colour

General Waste

Sharps
Cytotoxic
Lab plastics Carcas
s,
anato
mical
 Containers Type
Container type
Must be appropriate to contents and regulations
Bags – No sharps, medicines or liquids
Sharps bins – sharps ONLY
Other Rigid Bins – various e.g.
High liquid-content Clinical
Combustible Radioactive
Special and Clinical (e.g. Cytotoxic)
Waste medicines
COLOUR CODING AND TYPE OF CONTAINER FOR
DISPOSAL OF BIOMEDICAL WASTE

Color Type of Waste Treatment

Coding Container Categor options
y
Yellow Plastic bag Cat.1, 2,3,6 Incineration/deep burial

Red Disinfected Cat 3,6,7 Autoclave/Microwave/

container/Plastic Chemical Treatment
bag
Blue/White Puncture proof Cat.4,7 Autoclave/Microwave/
translucent container Chemical Treatment &
destruction/shredding
Black Plastic bag Cat 5,9,10 Disposal in secured
landfill
 Classification and Management
Category Waste Type Treatment and Disposal Method
Human Wastes (Tissues,
Category 1 Incineration / deep burial
organs, body parts
Category 2 Animal Waste Incineration / deep burial
Microbiology and
Category 3 Autoclave/microwave/incineration
Biotechnology waste
Disinfection (chemical
Category 4 Sharps treatment)+/autoclaving/microwaving
and mutilation shredding

Discarded Medicines and Incineration/ destruction and drugs

Category 5
Cytotoxic Drugs disposal in secured landfills
 Contd…
Category Waste Type Treatment and Disposal Method

Category 6 Contaminated solid waste Incineration/autoclaving / microwaving

Disinfection by chemical treatment+

Solid waste (disposable
Category 7 microwaving/autoclaving & mutilation
items other than sharps)
shredding
Liquid waste (generated
from laboratory washing, Disinfection by chemical treatment+
Category 8
cleaning, housekeeping and discharge into the drains
and disinfecting activity)

Category 9 Incineration ash Disposal in municipal landfill

Chemical Treatment + and discharge in

Category10 Chemical Wastes to drain for liquids and secured landfill
for solids
Disposal Of Wastes
 Disposal Procedure – Carcass
Carcass or anatomical material
Small / medium carcasses or obvious body
parts
Render safe first
Yellow bags or containers
Freeze prior to collection or keep refrigerated
 Disposal Procedure – Blood
Blood or body fluids
Render safe first
Including heavily soaked materials (e.g.
swabs, dressings)
Yellow containers or heavy gauge yellow
bags (only if doubled and NOT leaking)
Freeze prior to collection
 Disposal Procedure – Sharps
Sharps
Including needles, scalpel blades and small
pieces of glass
ALWAYS USE a Sharps bin
DO NOT overfill or shake
(If contaminated) autoclave when bin is full
 Disposal Procedure – Plastics
Laboratory plastics
Render safe first
If non-identifiable following autoclave then
non-clinical disposal [Black Bag and label
“Safe for Disposal”]
If identifiable still then possibly “offensive” -
Orange Bag and label as for Clinical Waste

Slide #47
#47
 Disposal Procedure – Glass

Glassware
Render safe first
Designated boxes – clearly labelled
“Broken Glassware – Safe for Disposal”

Except if contains hazardous chemicals

– special disposal route via Chemistry
Disposal Procedure – Medicines

Medicines
Designated medicine bins only (usually
Blue Rigid container)
Do not use containers intended for other
uses (e.g. sharps bins)
Do not pour down the drain
Some medicines are considered to be
Special Waste
 Disposal Procedure – Special
Cytotoxic Waste
– Special Waste, therefore
Packaging and labelling requirements
Holding locations – separate
containment
Extra charges
– Notify Waste Manager
 Disposal Procedure – Special
Infectious Waste
– Wherever possible, should be rendered safe /
inactivated BEFORE leaving the lab
– If not possible then special conditions apply:
Packaging and labelling
Holding locations – separate containment
Extra paperwork
Extra charges
– Notify Waste Manager immediately
Dr. Rehab Abdelhai
Dr. Rehab Abdelhai
The treatment and disposal technologies
for health care waste

1. Incineration
2. Chemical disinfection
3. Wet and dry thermal treatment
4. Microwave irradiation
5. Land disposal
6. Inertization
 Incineration
Burning of waste
material in the
presence of oxygen.
Waste volume
reduction, destroying
some harmful
constituents.
Works at temperature
(~ 400–700°C).

Drawback
toxic products like furanes and dioxins - can cause air pollution
 TREATMENT AND DISPOSAL
PROCEDURES MAIN FUNCTION
Incineration burn trash and other types of waste
until it is reduced to ash.

Autoclaving and Shredding It uses a combination of heat, steam

and pressure.

Chemical treatment Using sodium hypochlorite

solution, bleaching powder, savlon
and then discharged into
drains/sewers
Irradiation technique Involve the expose to UV radiation
and ionizing radiation
 Treatment and Disposal
Methods of Hospital Waste

57
TREATMENT/ ADVANTAGES DISADVANTAGES
DISPOSAL
METHOD
Rotary kiln Adequate –all High investment
infective waste and operating costs
Most Chemical
waste
Pharmaceutical
waste
Pyrolytic Adequate –all Incomplete
incineration infective waste destruction of
Most cytotoxics
pharmaceutical Relative high
waste investment
Chemical waste 58
ROTARY KILN PYROLYTIC
INCINERATOR
59
Single- Good disinfection efficiency Significant
chamber Drastic reduction of weight emissions of
incinerator and volume of waste atmospheric
pollutants
Residues disposed in
landfills Need for periodic
removal of slag
No need of high trained
and soot
operators
Inefficient in
Low investment/operating
destroying
cost
thermally resistant
chemicals /drugs

Drum/ brick Drastic reduction of weight Massive emission

incinerator and volume of waste of black smoke,
Very low investment and ash toxic flue gas
operation

60
SINGLE CHAMBER DRUM/BRICK
INCINERATOR INCINERATION

61
Chemical Highly efficient Requires highly
disinfection disinfection under good qualified
operating conditions technicians for
Chemical disinfectantsoperating of the
are relatively process
inexpensive Uses hazardous
substances that
requires
comprehensive
safety measures
Wet Environmentally sound Shredders are
thermal Relatively low subject to
treatment investment/operating frequent
costs breakdowns
Poor functioning
62
 Operating requires
qualified technicians
Inadequate for
anatomical,
pharmaceutical,chemic
al waste ,waste that is
not steam permeable
Micro- Good disinfection High investment and
wave efficiency under operating costs
irradiation
appropriate Potential operation
conditions Maintenance
Drastic reduction in problems
waste volume
Environmentally
63
sound
Encapsulation Simple Not recommended for
Low cost non sharp infectious
Safe waste

Safe burying Low cost Safe only if access to

Relatively safe site is limited and
if access to site certain precautions are
is restricted taken

inertisation Relatively Not applicable to

inexpensive infectious waste

64
CHEMICAL DISINFECTION

65
 WET THERMAL TREATMENT

Off-site wet thermal (or "steam autoclave") treatment facility

66
MICROWAVE
IRRADIATION

67
ENCAPSULATION
68
Inertisation, Immobilisation

69
 Conclusion
If we want to protect our
environment and health
of community we must
sensitize ourselves to this
important issue not only
in the interest of health
managers but also in the
interest of community.
73