Biomedical waste management- an
overview
Rabindran 1
1Dr. Rabindran, Consultant Neonatologist, Billroth Hospital, Chennai
Address for
Correspondence: Dr Rabindran, E mail:
rabindranindia@yahoo.co.in
Abstract
Biomedical waste management system is poor in most of the hospital.
There is urgent need to increase awareness related with this issue in
all the hospital staff.
Keywords:
Biomedical waste, Colour-coding, Segregation
Biomedical waste is any kind of waste either solid or liquid containing
infectious/ potentially infectious materials of medical, laboratory or
research origin from activities such as diagnosis, prevention &
treatment of diseases [1]. It consists of human anatomical
waste, animal waste, microbiology & biotechnology waste, waste
sharps, discarded medicines & cytotoxic drugs, soiled waste,
liquid waste, incineration ash & chemical wastes.
Common generators of biomedical waste include hospitals,
clinics, medical & veterinary colleges, blood banks,
mortuaries, autopsy centers, biotechnology institutions, research
laboratories, home health care & funeral homes. Hazardous
chemicals & radioactive waste though non-infectious require
proper disposal. World Health Organization states that 10% of
hospital waste are infectious & 5% are non-infectious but
hazardous waste [2].
Biomedical waste has an exposure risk to general public &
occupational hazard to healthcare & sanitation workers.
Management includes waste generation, segregation, collection,
reception, transportation, storage, treatment (on-site/ off-site)
& final disposal [3]. Generation includes collection in strong
leak-proof containers marked with red biohazard symbol. Discarded
sharps are collected in needle boxes. Cleaning devices include brooms,
dustpans, mops & vacuum cleaners. Segregation refers to basic
separation of different categories of waste generated at source thereby
reducing risks & cost of handling & disposal. Handling
involves manually moving waste with standard precautions from point of
generation, accumulation & storage locations. Waste should be
transported for treatment either in trolleys, or covered wheelbarrow.
Storage should not exceed 8-10 hour in big hospitals & 24 hour
in nursing homes. Personnel safety devices like bright yellow
heavy-duty rubber gloves, aprons, gowns, suits made of
impermeable material like plastic, masks, goggles, face shields, leg
coverings, rubber-soled & anti-skid type boots &
shoe-covers provide protection.
Biomedical waste treatment reduces hazards & renders it for
subsequent handling & disposal. Incineration, autoclaving,
bleach, sodium hydroxide, hypochlorite, alkaline digesters, heat
& microwave are used to sterilize waste. Incineration
uses high temperature to convert waste into inert material [4]. Types
of incinerators used include multiple hearth type, rotary kiln
& controlled air types. Non-incineration technology includes
thermal, chemical, irradiative & biological methods.
Autoclaving uses steam & pressure & is of 3 types
namely gravity type, pre-vacuum type & retort type [5].
Microwave Irradiation uses high frequency waves which generate heat to
kill pathogens. Plasma Pyrolysis is a process converting organic waste
into commercially useful byproducts using plasma-arc.
WHO has classified medical waste into 8 categories which include
general, pathological, radioactive, chemical, infectious, sharps,
pharmaceuticals & pressurized wastes. In India, Biomedical
waste (Management & Handling) Rules 1998 along with further
amendments regulate biomedical waste management. It consists
of 6 schedules - I: Category of Biomedical waste,
II: Colour coding & type of container, III: Label for
Biomedical waste containers/ bags which should be
non-washable & prominently visible, IV: Label for transport
of Biomedical waste containers/ bags, V: Standard for
treatment & disposal, VI: Schedule for waste treatment
facilities like Incinerator/ Autoclave/ Microwave System. Operating
Standards like combustion efficiency & Emission Standards are
defined.
Schedule -I classifies waste into 10 categories. I- Human anatomical
waste- disposed by incineration / deep burial; II- Animal waste-
disposed by incineration / deep burial; III- Microbiology &
Biotechnology waste - disposed by autoclaving/ microwaving /
incineration; IV- Waste sharps- disinfected by chemical treatment /
autoclaving / microwaving followed by mutilation / shredding; V-
Discarded medicine & cytotoxic drugs - disposed by incineration
followed by disposal in secured landfill; VI- Soiled waste - disposed
by incineration / autoclaving / microwaving; VII- Solid waste -
disinfected by chemical treatment / autoclaving / microwaving followed
by mutilation / shredding; VIII- Liquid waste- disinfected by chemical
treatment & discharge into drains; IX- Incineration ash-
disposed in municipal landfill; X- Chemical waste - discharge into
drains for liquids & secured landfill for solids.
Schedule -II defines colour coding & type of containers; Yellow
is a plastic bag used for category 1,2, 3 & 6 waste &
treated by incineration/ deep burial. Red is a disinfected container/
plastic bag for category 3,6 & 7 waste & treated by
autoclaving/microwaving/ chemical treatment. Blue/white translucent is
a plastic bag/ puncture proof for category 4 &7 waste &
treated by autoclaving/microwaving/ chemical treatment and destructed
by shredding. Black / Green is a plastic bag for category 5,9
&10 & disposed in secured landfill.
Improper Biomedical waste management leads to environmental pollution,
multiplication of vectors like insects, rodents &
worms leading to transmission of diseases like typhoid, cholera,
plague, hepatitis & AIDS. Recycling of disposable syringes,
needles, intravenous sets, and glass bottles without proper
sterilization leads to hepatitis, tetanus, HIV & viral
diseases. Benefits of biomedical waste management include healthy
surroundings, reduction in hospital acquired infections & cost
of infection control, reduction in reuse of infectious disposables
& prevention of occupational health hazards. Awareness about
hazards of biomedical waste & its proper disposal is required
for a safe & healthy future.
Verma V et al published his study related with awareness and practice
of biomedical waste in one of the tertiary care teaching hospital. They
observed that still it has lacunae in actions to dispose of its waste
and uphold its statutory responsibilities. A policy/ system needs to be
formulated/developed based on ‘training, educating, creating
awareness, reduce, recover, reuse and dispose. [6]
Funding:
Nil, Conflict of
interest: None initiated.
Permission from IRB:
Yes
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How to cite this article?
Rabindran. Biomedical waste management- an overview. Int J Med Res Rev
2016;4(10):1921-1922.doi:10.17511/ijmrr. 2016.i10.01.