Biomedical Waste

BIOMEDICAL WASTE
1)Introduction:
Biomedical waste, also known as infectious waste or medical waste, is defined as solid waste generated during the diagnosis, testing, treatment, research or production of biological products for humans or animals. Biomedical waste includes syringes, live vaccines, laboratory samples, body parts, bodily fluids and waste, sharp needles, cultures and lancets.
Biomedical waste consists of solids, liquids, sharps, and laboratory waste that are potentially infectious or dangerous. It must be properly managed to protect the general public, specifically healthcare and sanitation workers who are regularly exposed to biomedical waste as an occupational hazard.
Biomedical waste differs from other types of hazardous waste, such as industrial waste, in that it comes from biological sources or is used in the diagnosis, prevention, or treatment of diseases. Common producers of biomedical waste include hospitals, health clinics, nursing homes, medical research laboratories, offices of physicians, dentists, and veterinarians, home health care, and funeral homes.
2) common sources of Bio-medical waste:
Biomedical waste is generated in hospitals, nursing homes, clinics, medical laboratories, blood banks, animal houses etc. Such a waste can also be generated at home if health care is being provided there to a patient (e.g. injection, dressing material etc.) Because biomedical waste can be detrimental to human health, the law requires such facilities to follow procedures that protect the public from coming into contact with it. Agencies that regulate different aspects of biomedical waste include Occupational Safety and Health Administration (OSHA), Food and Drug Administration (FDA) and Nuclear Regulatory Commission.
3) Management and disposal of Bio-medical waste:
The Biomedical Waste Management & Handling Rules 1998 require all Hospitals, Nursing homes, Municipal
Corporations, Clinics, Pathological Labs, Blood Banks animal houses, research institutes etc who generate, collect , receive, store, transport, treat, dispose or handle bio-medical waste in any form that It shall be the duty of every occupier of an institution generating bio-medical waste to ensure that such waste is handled without any adverse effect to human health and environment.
While urban solid waste has attracted the attention of town planners, environmental activists and civic administrators, there is yet lack of concern for some special sources of waste and its management.
Handling, segregation, mutilation, disinfection, storage, transportation and final disposal are vital steps for safe and scientific management of biomedial waste in any establishment [3]. The key to minimisation and effective management of biomedical waste is segregation
(separation) and identification of the waste. The most appropriate way of identifying the categories of biomedical waste is by sorting the waste into colour coded plastic bags or containers. Biomedical waste incineration, autoclave, hydroclave or microwave.

The waste disposal methods vary in their capabilities, cost, availability to generation and impacts on the environment. The various disposal methods include incineration, autoclaving, chemical methods, thermal methods (low and high), ionizing radiation process, deep burial and microwaving incineration and autoclaving are considered traditional methods. Chitnis et al have devised a solar heating system for disinfecting infectious waste in economically less developed countries. They obtained a considerable reduction in the amount of viable bacteria by this method. However, 'considerable reduction in viable number of bacteria' seems to be misleading term. The medical waste should be completely free of pathogenic bacteria before disposal . This would ensure maximum public hygiene quality.
Untreated medical waste can be disposed off in sanitary landfills. Disposal without treatment is not recommended for human tissues, sharps and culture from clinical laboratories.
The cost of construction, operation and maintenance of system for managing waste represents a significant part of overall budget of a hospital if the BMW handling rules have to be implemented in their true spirit. Self-contained on-site treatment methods may be desirable and feasible for large health care facilities. They will not be practical or economical for smaller institutes. An acceptable common system should be in place which will provide regular supply of color coded bags, daily collection of infectious waste, safe transportation of waste to off site treatment facility and final disposal with suitable technology.
4) segregation into various categories:
Segregation is the essence of waste management and should be done at the source of generation of Bio-medical waste e.g. all patient care activity areas, diagnostic services areas, operation theaters, labour rooms, treatment rooms etc. The responsibility of segregation should be with the generator of biomedical waste i.e. doctors, nurses, technicians etc. (medical and paramedical personnel). The biomedical waste should be segregated as per categories mentioned in the rules that are as follows :
(1) Bio-medical waste shall not be mixed with other wastes.
(2) Bio-medical waste shall be segregated into containers/bags at the point of generation in accordance with Schedule II prior to its storage, transportation, treatment and disposal. The containers shall be labeled according to Schedule III. segregation consists of placing different kinds of wastes in different containers or coded bags at the point of generation [Table - 1]. It helps to reduce the bulk of infectious waste as well as treatment costs. Segregation also helps to contain the spread of infection and reduces the chances of infecting other health care workers.

5) various types of treatment facilities:
The term 'treatment' refers to the process that modifies the waste in some way before it is taken to its final resting place. Treatment is mainly required to disinfect or decontaminate the waste, right at source so that it is no longer the source of pathogenic organisms. After such treatment, the residue can be handled safely, transported and stored.

Needles and syringe nozzle - shredded in needle destroyer and syringe cutters
Scalpel blades/ Lancet/ Broken glass should be put in separate containers with bleach, transferred to plastic/ cardboard boxes; sealed to prevent spillage and transported to incubators
9Glassware should be disinfected, cleaned and sterilized
Culture plates with viable culture should be autoclaved; media are placed in appropriate bags and disposed off. The plates can be reused after sterilization
Gloves should be shredded / cut / mutilated before disposal.
Swabs should be chemically disinfected followed by incineration. If they contain only a small amount of blood that does not drip, they can be placed in the garbage.
Disposable items are often recycled and have the risk of being used illegally. Dipping in freshly prepared 1% sodium hypochlorite for 30 min. - one hour, followed by mutilation before disposal should be the policy adopted for such items.
Under no circumstances, should heat be used for disposal of amalgam. The heat will cause mercury to volatize and be released to the environment. So teeth with amalgam restoration should be treated by immersion in high-level disinfectant (e.g. Gluteraldehyde) for 30 min. Treated teeth can then be rinsed.
Liquid waste generated by the laboratory is either pathological or chemical in nature. Non-infectious waste should be neutralized with reagents.
Liquid infectious waste should be treated with a chemical disinfectant for contamination and then neutralized.
Institutions generating Bio-Medical Waste has a major constraint for space. Another factor affecting individual or on-site treatment and disposal facilities is the cost. Advantages of a centralized facility are reduction in pollution and energy consumption, stream lined collection and proper treatment of waste economically.

6) Harmful effects on Environment:
Improperly contained contaminated sharps pose greatest infectious risk associated with hospital waste. There is also theoretical health risk to medical waste handlers from pathogens that may be aerosolized during the compacting, grinding or shredding process that is associated with certain medical waste management or treatment practices. Physical (injury) and health hazards are also associated with the high operating temperatures of incinerators and steam sterilizers and with toxic gases vented into the atmosphere after waste treatment. Public impacts are confined to esthetic degradation of the environment from careless disposal and the environmental impact of improperly operated incinerators or other medical waste treatment equipment.
Biomedical waste includes anatomical waste, syringes, gauze, absorbents, glass. Serious health problems are caused by such disposals. Rotting of it in front of clinics, street corners is not uncommon due to which rag pickers, mostly children are attacked by the hepatitis virus or jaundice-causing virus. The dumping of solid wastes spoils the beauty of cities and towns, causing health problems.
The Garbage becomes breeding grounds for disease-carrying vectors such as flies, mosquitoes, rats and cockroaches. Reports say that about 8,00,000 flies is produced in one cubic meter of garbage, which carry pathogenic organisms, causing dysentery, diarrhea, etc. Rats, carriers of insects and bio-organisms, cause plague.
7) Laws laid by the Government:
LEGAL SANCTIONS FOR 810- MEDICAL WASTES
MANAGEMENT:
3. In the past there were different provisions under various
Laws to meet the environmental issues, but they were some
How remained to be ineffective for all practical purposes. The
Following table provides the comparison of laws enacted in
Different countries for control of environmental issues pertaining
To Bio-Medical wastes:
4. Country Nature of pollution related Legislation on Waste
Management including bio-Medical Wastes Management.
India-
a) The persons Act, 1919
b) The Drugs and Cosmetics Act, 1940
c) The Prevention of Food Adulteration Act, 1976
d) The Industries (Development and Regulation) Act. 1951
e) The insecticides Act; 1968
f) The destructive Insects and Pests Act, 1914

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7) Date of submission:-9/11/2009]
Article -
BMC PLANS TO OPEN BIO-WASTE PLANT IN MALAD FOR REFUSE GENERATED IN WESTERN SUBURBS
Pressure will ease on Deonar dumpyard
The public resistance against pollution created by a biomedical waste treatment waste facility at the Deonar dumping ground is paying off. The BMC has decided to take steps to curb pollution by reducing the burden of bio waste being treated at the facility.
Civic authorities are now planning to reduce the pollution load by diverting a part of the bio-medical waste to another treatment facility. A senior civic official said that plans were being worked out to set up another biomedical treatment plant at Malad. Waste generated from hospitals in western suburbs (over three tonne) could then be diverted there.
The BMC has already held a meeting with the state pollution control board, which oversees biomedical waste disposal, requesting the board authorities to gauge the feasibility of such a plant at Malad.
More than 10 tonnes of biomedical waste is generated in 1,200 healthcare centers in the city. The waste, including surgical dressings, disposable syringes, rubber gloves, operations gowns, dissected organs and blood, is currently disposed of at the Deonar treatment facility, where an incinerator has been set up to handle this waste.
Local residents,who have already filed a petition in the high court demanding the closure of the dumping facility, have been complaining of a rise in pollution levels owing to the bio-medical waste facility, which was recently initiated at the site. Even members of a committee, appointed by the high court to look into the grievances aired by the local residents, have observed that the biomedical incinerator facility was discharging carcinogenic pollutants. The official added that the municipal corporation was also interested in switching to an environmentally-sound technology to treat bio-medical waste. The civic body is keen the explore the potential of a globally used technique called plasma pyrolysis or gasification, where medical waste is treated at intense temperature
(1,200C) to curb pollutant discharge.
The senior official added that the pollution control norms will have to be changed if the "green" technology were to be adopted. The BMC has requested
MPCB to work on the feasibility of employing the new technology.
MPCB authorities said they were yet to study BMC's proposal in detail. Switching over to the green technology will however come for a cost. Plasma pyrolysis is expensive.
So, the hospitals generating the medical waste will have to bear higher disposal charges, if it were to be employed.