| Last Updated:: 02/11/2016

Bio-Medical Waste


Definition. According to Biomedical Waste (Management and Handling) Rules, 1998 of India “Any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals.

BIO-MEDICAL WASTE (BMW)


Bio-medical waste is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals. It include wastes like human anatomical waste, animal waste, microbiology & biotechnology waste, waste sharps, discarded medicines& cytotoxic drugs, soiled waste, solid waste, liquid waste, incineration ash, chemical wastes. These wastes are potentially hazardous because of the potentially infectious in nature as it may pose a serious threat to human health, if its management is indiscriminate and unscientific. Earlier, bio-medical waste management was not an integral part of the health care programme. The negligence on the part of health care waste management programme, in the past, was reflected in various articles in the newspapers and public litigations in various Courts including in the Hon’ble Supreme Court and this is also evident from the sporadic epidemics experienced in different parts of the Country.


Bio-Medical waste consists of

Human anatomical waste like tissues, organs and body parts
Animal wastes generated during research from veterinary hospitals
Microbiology and biotechnology wastes from laboratory, culture stocks or specimens of micro-organisms, live or attenuated vaccines, human and animal cell culture used in research
Waste sharps like hypodermic needles, syringes, scalpels and broken glass
Discarded medicines and cytotoxic drugs comprising of outdated, contaminated and discarded medicines
Soiled waste such as cotton balls used while blood collection or used as absorbent material for accidental blood and body fluid spillage
Solid waste such as dressing, bandages, plaster casts, material contaminated with blood, tubes and catheters
Liquid waste from any of the infected areas
Incineration ash from incineration of any bio-medical waste
Chemical wastes generated while testing and analysis


SEGREGATION AT SOURCE AND CATEGORIES OF BIO-MEDICAL WASTE


BMW Rules emphasis segregation of bio-medical waste at source of generation. Segregation of wastes at source of generation helps:

I. to minimize mixing of bio-medical waste with that of the municipal solid waste generated within the HCFs ;
II. to reduce volume of waste to be handled/treated;
III. to minimize cost of treatment ;
IV. to minimize toxic emissions ; and
V. to facilitate effective recovery of useful plastics etc.


Bio- Medical waste is divided into 10 waste categories:

1.Human and Anatomical Waste
2.Animal Waste
3.Microbiology and Bio-technology Waste
4.Waste Sharps
5.Discarded Medicines and Outdated Drugs
6.Soiled Waste
7.Solid Waste
8.Liquid Waste
9.Incineration ash
10.Chemical Waste



1. Human and Anatomical Waste

2. Animal Waste
 
3. Microbiology and Bio-technology Waste
 
4. Waste Sharps
 
5. Discarded Medicines and Outdated Drugs
 
6. Soiled Waste
 
7. Solid Waste
 
8. Liquid Waste
 
9. Incineration ash
 
10. Chemical Waste

CATEGORIES OF BIO-MEDICAL WASTE AND THE TREATMENT & DISPOSAL OPTIONS


The category-wise bio-medical waste treatment and disposal option is given below:


Waste Category Waste Class and Description Treatment and Disposal [Option]
No. 1 Human  Anatomical Wastes,
(Human tissues, organs, waste body parts)
Incineration @/ deep burial*
No. 2 Animal Wastes
(Wastes consisting of animal tissue, organs, body parts, carcasses, body fluid, blood and blood products, items contaminated with blood and fluids, wastes from surgery treatment and autopsy and wastes of experimental animals used in research, waste generated by veterinary hospitals, colleges, animal houses and livestock farms)
Incineration @/ deep burial*
No. 3 Microbiology & Biotechnology Waste
(Wastes from laboratory, culture stocks or specimens of micro-organisms, live or attenuated vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, wastes from production of biological dishes and devices used for transfer of cultures)
Local Autoclaving / microwaving/incineration @
No. 4 Waste Sharps
(Needles, syringes, scalpels, blades, glass, etc that are capable of causing puncture and cuts. This includes both used and unused sharps)
Disinfection using chemical treatment/autoclaving/microwaving and mutilation. shredding and disposal in landfill / recycling (for PVC, plastics and glass wares)
No. 5 Discarded  Medicines
(Wastes comprising of outdated, contaminated and discarded medicines)
Incineration @ or destruction and  disposal in landfills
No. 6 Soiled Wastes
(Wastes generated from soiled cotton, dressings, plaster casts, linens, beddings, material contaminated with blood including the packaging materials)
Incineration @  autoclaving/microwaving
No. 7 Solid Waste
(Wastes generated from disposable items other than the waste sharps such as tubings, catheters, intravenous sets etc.)
Disinfection by chemical treatment @@ autoclaving/microwaving and mutilation/shredding ##
No. 8 Liquid Waste
(waste generated from  laboratory and washing, cleaning, house-keeping and disinfecting activities)
Disinfection by chemical treatment@@ and discharge into drains.
No. 9 Incineration Ash
(ash from incineration of any bio-medical waste)
Disposal in municipal landfill
No. 10 Chemical Waste
(chemicals used in production of biologicals, chemicals used in disinfection, as insecticides, etc.)
Chemical treatment@@    and discharge into drains for liquids and secured landfill for solids

@@ Chemical treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfection.
## Mutilation/shredding must be such so as to prevent unauthorised reuse.
@ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated.
* Deep burial shall be an option available only in town with population less than five lakhs and in rural areas.

COLOR CODING & TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTE


Colour coding
Type of container
Waste category
Treatment options
Yellow
Yellow coloured non-chlorinated plastic bags Human anatomical wastes, Animal anatomical wastes,
Soiled wastes
Incineration or Plasma pyrolysis or deep burial*
Expired or discarded medicines Return back to manufacturer or supplier for incineration at >1200°C
Chemical wastes Incineration or Plasma pyrolysis or Encapsulation in hazardous waste treatment, storage, and disposal facility (TSDF)
Separate collection system leading to effluent treatment system Chemical liquid wastes After resource recovery, the chemical liquid waste shall be pre-treated before mixing with other wastewater.
Non-chlorinated yellow plastic bags or suitable packing material Discarded linens, Mattresses, Beddings contaminated with blood or body fluids Non-chlorinated chemical disinfection followed by Incineration or Plasma pyrolysis or for Energy recovery
Autoclave safe plastic bags or containers Microbiology, biotechnology, and other clinical laboratory waste Pre-treat to sterilize with non-chlorinated chemicals onsite as per National AIDS Control Organization or WHO guidelines thereafter for Incineration
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 should be sent to registered recyclers for energy recovery. Plastic waste should not be sent to landfill sites.
White (Translucent)
Puncture proof, leak proof, tamper proof containers Waste sharps including metals Autoclaving or Dry Heat Sterilization
Blue
Glassware Cardboard boxes with blue coloured marking Disinfection or through autoclaving or microwaving or hydroclaving and then sent for recycling.
Metallic body implants

* Disposal by deep burial is permitted only in rural or remote areas where there is no access to common bio-medical waste treatment facility. This will be carried out with prior approval from the prescribed authority as per the Standards. The deep burial facility shall be located as per the provisions and guidelines issued by CPCB from time to time.

LABEL FOR BIO-MEDICAL WASTE CONTAINERS/BAGS


Different labels for Bio-medical waste containers and bags shall be required for identification and safe handling of this waste. These labels for storage/transportation of Biomedical waste are as under:

 


NEW TECHNOLOGIES FOR TREATMENT OF BIO-MEDICAL WASTE


As per Schedule-I of the Bio-medical Waste (Management & Handling) Rules, 1998 & as amended, any Health Care Facility (HCF) or Common Bio-medical Waste Treatment Facility (CBWTF) Operator wishing to use other Stat-of-the-art-technologies other than stipulated under Schedule-I of the said rules, shall approach the Central Pollution Control Board (CPCB) to get the standards laid down to enable the prescribed authority to consider grant of authorization. For the purpose of evaluation of new technologies for treatment of bio-medical waste and to suggest suitable standards for any such technologies, an Expert Committee was reconstituted by CPCB.


CPCB have granted conditional or provisional approval to new Technologies (other than notified under BMW Rules) for treatment of bio-medical waste, under the BMW Rules as under:

(1) Plasma Pyrolysis;
(2) Waste Sharps Dry heat sterilization and encapsulation
(3) Shredding cum Chemical disinfection (Static/Mobile)


Plasma Pyrolysis Technology

'Plasma Pyrolysis' treatment technology can be adopted for treatment and disposal of bio-medical waste wherein destruction of bio-medical waste similar to the incineration can be achieved. In case of plasma pyrolysis, bio-medical waste is treated at high temperature under controlled condition to form gases like methane, hydrogen and carbon monoxide which are subjected to combustion (oxidation) in secondary chamber. In the plasma pyrolysis process waste is converted into small clinker which can be disposed in secured landfills.


CPCB granted provisional approval to the ‘Plasma Pyrolysis Technology’ as an additional option for treatment of Bio-medical waste categories 1, 2, 5 & 6 of the BMW Rules.


A Pilot Scale Plasma Pyrolysis System

Waste Sharps Dry Heat Sterilization & Encapsulation

‘Waste Sharp Dry Heat Sterilization & Encapsulation’ technology is based on 'dry heat sterilization' especially for treatment of waste category no. 04 (i.e. waste sharps) as listed under Schedule-I of the BMW Rules, 1998. Approval to this technology is accorded by CPCB under the Bio-medical Waste (Management & Handling) Rules, 1998 as amended subject to the conditions. Dry Heat Sterilization & Encapsulation of Waste Sharps treatment equipment and the canister before used for collection of waste sharps and the canister after treatment.


Dry Heat Sterilisation System


Canister before and after Treatment of Waste Sharps by Dry Heat Sterilization & Encapsulation

Shredding cum Chemical Disinfection of Bio-medical Waste (Static/Mobile)

This technology is based on ‘shredding followed by chemical disinfection’ of biomedical waste. Provisional approval to this technology is accorded by CPCB for treatment of bio-medical waste on trial basis for evaluation / efficacy of the technology. This is a non-burn technology, in which bio-medical waste is shredded beyond recognition and sterilized so as to make it suitable for disposal along with municipal solid waste.


CPCB granted provisional approval to the ‘Plasma Pyrolysis Technology’ as an additional option for treatment of Bio-medical waste categories 1, 2, 5 & 6 of the BMW Rules.


Shredding cum Chemical Disinfection of Bio-medical Waste Treatment Technology – Static Unit

Shredding cum Chemical Disinfection of Bio-medical Waste Treatment Technology – Mobile Unit

BIO-MEDICAL WASTE (MANAGEMENT AND HANDLING) RULES, 2016


Bio-medical Waste (Management & Handling) Rules, 1998 were notified by the Ministry of Environment & Forests (MoEF) under the Environment (Protection) Act, 1986. In exercise of the powers conferred by Section 6, 8 and 25 of the Environment (Protection) Act, 1986 (29 of 1986), and in supersession of the Bio-Medical Waste (Management and Handling) Rules, 1998 and further amendments made thereof, the Central Government vide G.S.R. 343(E) dated 28 th March, 2016 published the Bio-medical Waste Management Rules, 2016. These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form including hospitals, nursing homes, clinics, dispensaries, veterinary institutions, animal houses, pathological laboratories, blood banks, ayush hospitals, clinical establishments, research or educational institutions, health camps, medical or surgical camps, vaccination camps, blood donation camps, first aid rooms of schools, forensic laboratories and research labs.


The ‘prescribed authority’ for enforcement of the provisions of these rules in respect of all the health care facilities located in any State/Union Territory is the respective State Pollution Control Board (SPCB)/ Pollution Control Committee (PCC) and in case of health care establishments of the Armed Forces under the Ministry of Defence shall be the Director General, Armed Forces Medical Services (DGAFMS). These rules stipulate duties of the Occupier or Operator of a Common Bio-medical Waste Treatment Facility as well as the identified authorities. According to these rules, every occupier or operator handling bio-medical waste, irrespective of the quantity is required to obtain authorisation from the respective prescribed authority i.e. State Pollution Control Board and Pollution Control Committee, as the case may be. These rules consist of four schedules and five forms.


Bio-medical Waste Management Rules, 2016


Bio-medical Waste (Management and Handling) Rules, 1998


OTHER INFORMATIONS


Persons at the risk of the hazards of medical procedures are as follows:


Procedure
Person at risk
Mode of Transmission
Collection of blood samples
Patient Health worker
Contaminated needle, gloves, Skin puncture by needle or container, Contamination of hands by blood
Transfer of specimens (within laboratory)
Laboratory personnel
Contamination of exterior of specimen container, Broken container, Splash of specimen
HIV serology and virology
Laboratory personnel
Skin puncture, splash of specimen, Broken specimen container, Perforated gloves
Cleaning and Maintenance
Laboratory Personnel Supporting staff
Skin puncture or contamination, Splashes, Contaminated work surface
Waste Disposal
Laboratory Personnel Support Staff Transport worker
Contact with contaminated waste Puncture wounds and cuts
Shipment of specimens
Transport worker Postal worker
Broken or leaking specimen, containers and packages


For more information on Bio-Medical Waste you can access CPCB ENVIS Newsletter Bio-Medical Waste - An Overview