2. WHAT IS BMW ?
It is defined as “any waste, which is generated during the
diagnosis, treatment or immunization of human beings or
animals or research activities pertaining thereto or in the
production or testing of biological or in health camps,
including the categories mentioned in Schedule I appended
to BMW rules 2016”
“Any solid and/or liquid waste including its container and
any intermediate product, which is generated during the
diagnosis, treatment or immunization of human beings or
animals”.
2
BiomedicalWaste(BMW)Management
3. Bio-Medical Waste generated by
Hospitals
Nursing Homes
Clinics
Dispensaries
Veterinary Institutes/Animal Houses
Pathological Laboratories
Blood Banks/Blood Donation Camps
Ayush Hospitals
Clinical Establishment
Research/Educational Institute/Research Labs
Health Camps
Medical or Surgical Camps
Vaccination Camps
Blood Donation Camps
First Aid Rooms of Schools
Forensic Laboratories
3
WHO GENERATES BMW ?
BiomedicalWaste(BMW)Management
7. Risk of HIV &
HBV
Nosociomial
infections
Others..
7
HEALTH HAZARDS
BiomedicalWaste(BMW)Management
8. By ingestion
(contaminated
unwashed hands,
contaminated food
stuffs, water etc)
Intact or
non intact
skin,
mucous
membranes
Inhalation of
dust
particles
containing
germs
8
ROUTES OF TRANSMISSION
BiomedicalWaste(BMW)Management
10. Medical, Paramedical & Sanitation
staff should be
vaccinated against Hepatitis B
Using heavy duty gloves especially while
dealing with infectious wastes
Recapping needles should be
discouraged. In case, if unavoidable
single handed method should be used
Segregation of Biomedical Waste & Safe
disposal.
All necessary compliance in accordance with
BMW (Management) Rules 2016 to avoid
unwanted occurrence.
10
PRECAUTIONS
BiomedicalWaste(BMW)Management
11. The Air (Prevention and Control of Pollution) Act, 1981
The Water (Prevention and Control of Pollution) Act, 1974
The Environment (Protection) Act, 1986
The Hazardous Waste (Management & Handling) Rules, 2016
The National Environmental Tribunal Act, 1995
The Biomedical Waste (Management) Rules, 2016
The Municipal Solid Waste (Management & Handling) Rules, 2000
The E-Waste (Management) Rules, 2016 11
ENVIRONMENT LEGISLATION
BiomedicalWaste(BMW)Management
12. 12
KEY FEATURES OF BMW (M) RULES, 2016
The ambit of the rules has been expanded to include vaccination camps,
blood donation camps, surgical camps or any other healthcare activity.
Occupier shall take all necessary steps to ensure that bio-medical
waste is handled without any adverse effect to human health and
the environment and in accordance with these rules.
Make a provision within the premises for a safe, ventilated and
secured location for storage of segregated biomedical waste in
colored bags or containers in the manner as specified.
Phase-out the use of chlorinated plastic bags, gloves and blood bags
within two years.
Pretreatment of the laboratory waste, microbiological waste, blood
samples and blood bags through disinfection or sterilization onsite
in the manner as prescribed by WHO or NACO.
Do not give treated bio-medical waste with municipal solid waste
Conduct health check up at the time of induction, provide training
to all its health care workers and immunize all health workers at
the time of induction and thereafter at least once every year.
Report major accidents.
Cont……
BiomedicalWaste(BMW)Management
13. 13
The details of training programmes conducted, number of
personnel trained and number of personnel not undergone any
training shall be provided in the Annual Report.
Ensure occupational safety of all its health care workers and others
involved in handling of biomedical waste by providing appropriate
and adequate personal protective equipments.
Establish a Bar Code System for bags or containers containing
biomedical waste for disposal.
Untreated human anatomical waste, animal anatomical waste,
soiled waste and, biotechnology waste shall not be stored beyond a
period of forty – eight hours:
Existing incinerators to achieve the standards for retention time in
secondary chamber and Dioxin and Furans within two years.
Ensure segregation of liquid chemical waste at source and ensure
pre- treatment or neutralization prior to mixing with other effluent
generated from health care facilities.
Biomedical waste has been classified in to 4 categories instead 10 to
improve the segregation of waste at source.
Cont……
BiomedicalWaste(BMW)Management
KEY FEATURES OF BMW (M) RULES, 2016
14. 14
Procedure to get authorization simplified. Automatic authorization
for bedded hospitals. The validity of authorization synchronized
with validity of consent orders for Bedded HCFs. One time
Authorization for Non-bedded HCFs;
Operator of a common biomedical waste treatment and disposal facility
to ensure the timely collection of biomedical waste from the HCFs and
assist the HCFs in conduct of training.
Maintain and update on day to day basis the bio-medical waste
management register and display the monthly record on its website
according to the bio-medical waste generated in terms of category and
colour coding as specified.
Establish a system to review and monitor the activities related to bio-
medical waste management by forming a committee & maintain the
record.
Every occupier or operator of common bio-medical waste treatment
facility shall submit an annual report to the prescribed authority in
Form-IV, on or before the 30th June of every year.
Occupier shall make available the annual report on its web-site and
all the health care facilities shall make own website within two
years.
BiomedicalWaste(BMW)Management
KEY FEATURES OF BMW (M) RULES, 2016
15. 15
COLOR
CODE
TYPE OF BAG/
CONTAINER
TYPE OF WASTE TREATMENT OPTIONS
Yellow
Yellow coloured
non-chlorinated
plastic bags
(a) Human Anatomical Waste Incineration or Plasma Pyrolysis
or
deep burial
(b)Animal Anatomical Waste
(c) Soiled Waste:
(d) Expired or Discarded
Medicines:
Returned back to the
manufacturer or supplier for
incineration
(e) Chemical Waste
Disposed of by incineration or
Plasma
Pyrolysis or Encapsulation
Separate
collection
system leading
to effluent
treatment system
(f) Chemical Liquid Waste
Chemical
liquid waste shall be pre-treated
before
mixing with other wastewater
Non-chlorinated
yellow plastic
bags or suitable
packing material
(g) Discarded linen,
mattresses, beddings
contaminated with
blood or body fluid.
Non- chlorinated chemical
disinfection
followed by incineration or
Plazma
Pyrolysis or for energy recovery
Autoclave safe
plastic bags or
containers
(h) Microbiology,
Biotechnology and
other clinical
laboratory waste:
Pre-treat to sterilize with
nonchlorinated
chemicals on-site
CATEGORIES OF BMW
BiomedicalWaste(BMW)Management
16. 16
CATEGORIES OF BMW
COLOR
CODE
TYPE OF BAG/
CONTAINER
TYPE OF WASTE TREATMENT OPTIONS
Red
Red coloured
non-chlorinated
plastic bags or
containers
Contaminated Waste
(Recyclable)
Autoclaving or micro-waving/
hydroclaving followed by shredding
or
mutilation or combination of
sterilization and shredding.
Treated
waste to be sent to registered or
authorized recyclers
White
(Translucent)
Puncture proof,
Leak proof,
tamper proof
containers
Waste sharps
including Metals:
Autoclaving or Dry Heat
Sterilization
followed by shredding
Blue
Cardboard boxes
with blue
colored marking
(a) Glassware
Disinfection and then
sent for recycling.(b) Metallic Body
Implants
BiomedicalWaste(BMW)Management
18. 18
WASTE SURVEY
Waste survey is an important component of
the waste management scheme. A survey
helps in evaluation both the type and
quantity of waste generated in hospitals.
Aims:
• Differentiate the types of waste
• Quantify the waste generated
• Determine the points of generation &
type of waste generated at each point
• Determine the level of generation &
disinfection within the hospital
• To find out the type of disposal carried
out
BiomedicalWaste(BMW)Management
19. 19
Segregation refers to the basic separation of different categories of waste
generated at source and thereby reducing the risks as well as cost of
handling and disposal.
Segregation is the most crucial step in bio-medical waste management.
Effective segregation alone can ensure effective bio-medical waste
management.
The BMWs must be segregated in accordance to guidelines laid down under
schedule 1 of BMW Rules, 2016.
SEGREGATION
BiomedicalWaste(BMW)Management
20. 20
•The collection of biomedical waste involves use of different types of container .
• The containers/ bins should be placed in such a way that 100 % collection is
achieved.
• Sharps must always be kept in puncture-proof containers to avoid injuries
and infection to the workers handling them.
COLLECTION
BiomedicalWaste(BMW)Management
21. 21
Once collection occurs then biomedical waste is stored in a proper place.
Segregated wastes of different categories need to be collected in identifiable
containers. The duration of storage should not exceed for 8-10 hrs in big
hospitals (more than 250 bedded) and 24 hrs in nursing homes. Each
container may be clearly labelled to show the ward or room where it is kept.
The reason for this labelling is that it may be necessary to trace the waste
back to its source. Besides this, storage area should be marked with a
caution sign.
STORAGE
BiomedicalWaste(BMW)Management
22. 22
TRANSPORT
Final Transport of BMW must be to CBMWTSDF only in authorized
vehicle with appropriate documentation for further record.
BiomedicalWaste(BMW)Management
23. 23
BiomedicalWaste(BMW)Management
RECORD KEEPING
MPCB Consent & Authorization.
Formation of Committee to Establish a system to review and monitor the
activities related to bio-medical waste management & maintain the record.
Documents of Tie-up with CBMWTSDF to safe dispose of BMW.
Record of Pretreatment of BMW & Trade Effluent.
Records of Training, Health Check up.
Record of BMW generation & disposal through CBMWTSDF.
Annual Report.
LABEL FOR BIO_MEDICAL WASTE CONTAINERS or BAGS
25. 25
BiomedicalWaste(BMW)Management
DUTIES OF HCF’S / COMPLIANCE
To obtain MPCB Consent & Authorization for it’s activity.
To take all necessary steps to ensure the appropriate handling of BMW as
per the guidelines of BMW (M) Rules, 2016.
To make all the provisions of safe segregation, pre-treatment, storage &
transport to CBMWTSDF.
Pre-treatment of BMW.
Phase out the chlorinated bags, gloves & blood bags.
Not to give any BMW to Municipal solid waste unless the solid waste other
than BMW.
Provide the training to all health care workers, staff at the time of Induction
& thereafter once in year & maintain the record of the same.
Immunize all its health care workers and others time to time & maintain the record.
Establish a Bar- Code System for bags or containers containing bio-medical waste
Cont….
It shall be the duty of every Occupier………
26. 26
BiomedicalWaste(BMW)Management
DUTIES OF HCF’S / COMPLIANCE
Ensure segregation of liquid chemical waste at source and ensure pre-treatment or
neutralization.
Ensure treatment and disposal of liquid waste before mixing with sewage water.
Ensure complete treatment of sewage waste water & chlorination before discharge
to drain.
Ensure occupational safety of all its staff & monitor the same time to time.
Conduct health check up at the time of induction and at least once in a year for all its
health care workers and maintain the records.
Maintain and update on day to day basis the bio-medical waste management
register and display the monthly record on its website.
Report major accidents.
Prepare the Annual report for the Period of January to December & submit the same
till 30th June.
Make available the annual report on its web-site.
Form a committee to establish a system to review and monitor the activities
related to bio-medical waste management & maintain the record.
It shall be the duty of every Occupier………
27. 27
BiomedicalWaste(BMW)Management
OUR HELPING HAND
Consultancy services to obtain MPCB Consent & Authorization.
Preparation & Submission of Annual Report.
Plant installation for pre-treatment/treatment of waste water (ETP), full-
fledge treatment of sewage waste water (STP).
Consultancy services/Annual Contract to
Pre-treatment of BMW
Formation of committee & BMW management
Implementation of Bar code system.
Systematic procedure for Segregation, storage & final disposal of BMW.
Training to Health work
Record keeping of Training, Health check up, Immunization of Health
Care workers & staff, BMW generation & disposal, occupational safety.
Report major accidents.
Services offer by us………
28. Concluding….
It is just not the law abide compliance but
the SOCIAL RESPONSIBILITY of every
Health Care Establishment to say…
NO TO HAZARD OF BIOMEDICAL WASTE
It will only take..
Proper planning.
Spread Awareness.
Involvement everyone.
Segregation, Pre-treatment at first stage.
Appropriate Storage
Timely Disposal.
All Records…
And………………………….. ALL CLEAN. 28
BiomedicalWaste(BMW)Management
The collection of biomedical waste involves use of different types of container from various sources of biomedical wastes like Operation Theatre, laboratory, wards, kitchen, corridor etc. The containers/ bins should be placed in such a way that 100 % collection is achieved. Sharps must always be kept in puncture-proof containers to avoid injuries and infection to the workers handling them.
Once collection occurs then biomedical waste is stored in a proper place. Segregated wastes of different categories need to be collected in identifiable containers. The duration of storage should not exceed for 8-10 hrs in big hospitals (more than 250 bedded) and 24 hrs in nursing homes. Each container may be clearly labelled to show the ward or room where it is kept. The reason for this labelling is that it may be necessary to trace the waste back to its source. Besides this, storage area should be marked with a caution sign.
The waste should be transported for treatment either in trolleys or in covered wheelbarrow. Manual loading should be avoided as far as for as possible. The bags / Container containing BMWs should be tied/ lidded before transportation. Before transporting the bag containing BMWs, it should be accompanied with a signed document by Nurse/ Doctor mentioning date, shift, quantity and destination.
Special vehicles must be used so as to prevent access to, and direct contact with, the waste by the transportation operators, the scavengers and the public. The transport containers should be properly enclosed. The effects of traffic accidents should be considered in the design, and the driver must be trained in the procedures he must follow in case of an accidental spillage. It should also be possible to wash the interior of the containers thoroughly.
We need innovative and radical measures to clean up the distressing picture of lack of civic concern on the part of hospitals and slackness in government implementation of bare minimum of rules, as waste generation particularly biomedical waste imposes increasing direct and indirect costs on society. The challenge before us, therefore, is to scientifically manage growing quantities of biomedical waste that go beyond past practices. If we want to protect our environment and health of community we must sensitize our selves to this important issue not only in the interest of health managers but also in the interest of community.
Hopefully as these environmental health hazards are exposed, changes will be made to protect the future of our 'Earth' and the living beings that inhabit it!