Presentation on

 Bio-Medical Waste Management

 

 

 

 

Presented by

Avaneesh Kumar Yadav

(M.Tech.-2014EN06)Civil Engineering Department

Motilal Nehru National Institute of Technology Allahabad, Allahabad

Bio-Medical Waste (BMW)Definition: As per Bio-Medical Waste (Management and Handling)

Rules, 1998 , “Bio-medical waste is any type of waste generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining to the production of drugs in pharmaceutical companies, animal waste generated in the veterinary hospitals and also in the slaughter houses, etc.”

Need for BMW Management: If BMW is not segregated at source & allowed to be mixed

with MSW, it may cause dreadful and infectious diseases like HIV, hepatitis B & C, tuberculosis and other skin and respiratory ailments.

Unscientific technology like open burning for disposal of BMW may lead to dangerous levels of emission of gases like dioxins and furans in the environment, which contain cancer causing agents.

Residual ash, if not disposed off in secured landfills, can also pollute the underground water and contaminate the soil.

The liquid waste generated when let into sewers can also lead to surface water pollution if not treated properly.

Injuries from sharps and exposure to harmful chemical waste and radioactive waste also cause health hazards to employees involved in collection and disposal of BMW. 

Plastic waste can choke animals, which scavenge on openly dumped waste.

Radioactive waste and heavy metals in liquid form can come from chemical or biological research and may affect the reproductive system adversly.

Sources Generating Bio-Medical Waste: Major Sources:• Govt. hospitals/private hospitals/nursing homes/

dispensaries• Primary health centers• Medical colleges and research centers/ paramedic

services• Veterinary colleges and animal research centers• Blood banks/mortuaries/autopsy centers• Biotechnology institutions• Production units

Minor Sources:• Physicians/ dentists’ clinics• Animal houses/slaughter houses• Blood donation camps• Vaccination centers• Acupuncturists/psychiatric clinics/cosmetic piercing• Funeral services

Amount and Composition of hospital waste generated:

Quantity of BMW: Country Quantity (kg/bed/day) U. K. 2.5 U.S.A. 4.5 France 2.5 Spain 3.0 India 1.5

Composition of BMW: Hazardous 15% a) Hazardous but non-infective 5% b) Hazardous and infective 10% Non-hazardous 85% Composition by weight: Combustible 80% (a) Plastic 14% (b) Dry cellublostic solid 48% (c)Wet cellublostic solid 18% Non-combustible 20%

Collection of BMW:

Segregated collection of waste at source is a single most important step in bio-medical waste management and this practice results in- 

Waste minimization Effective waste management Decrease in expenses incurred in managing waste Reduce the risk of infection ensuring better healthcare

Bio-Medical Waste Management Rules 1998 gives the colourcoding that should be used for the various categories of waste-

Storage of BMW: Immediate treatment and disposal are ideal procedures to be

followed for disposal of bio medical waste. Untreated bio medical waste however, can be stored for not

more than 48 hrs. If for some reason it becomes necessary to store the waste

beyond such period, permission from the local state authority must be taken and it must be ensured that it does not adversely affect human health and the environment.

Treatment of BMW at Source: Incineration Chemical Disinfection Autoclaving Shredding Microwave Irradiation Plasma Pyrolysis

Emission Standards for Incineration:

  Standards & Requirements for Incineration: Minimum height of the stack should be 30 meters above the

ground. Above emission limits should be achieved. Waste to be incinerated not to be disinfected with chlorine

substance. Chlorinated plastics should not be incinerated

Parameters Conc (mg/N m3 at 12% CO2 correction )

Particulate matter 150

Nitrogen oxides 450

HCL 50

Toxic metals in incineration ash should be limited to within regulatory quantities.

Only low sulphur fuels like LDO/LSHS to be used as fuel.

Chemical Disinfection: High level disinfectants like chlorine releasing compounds are

used for disinfecting materials contaminated with blood and blood products. The recommended dilutions for these compounds are given as follows:

Name of Disinfectant Available chlorine

Required chlorine

Required chlorine Contact period

Amount of disinfectant to be dissolved in 1 ltr of water

Sodium hypochlorite       5%        0.5%        30 min               100 ml

Calcium hypochlorite       70%        0.5%        30 min                 7.0 g

NaOCl powder         -        0.5%        30 min                 8.5 g

Chloramine        25%        0.5%        30 min                 20 g

Microwave Irradiation• The microwave is based on the principle of generation of high

frequency waves.• These waves cause the particles within the waste material to

vibrate, generating heat.• This heat generated from within kills allpa thogens.

Plasma Pyrolysis It is a state-of-the-art technology for safe disposal of

medical waste. It is an environment-friendly technology, which converts

organic waste into commercially useful byproducts.

The intense heat generated by the plasma enables it to dispose all types of waste including municipal solid waste, biomedical waste and hazardous waste in a safe and reliable manner.

Medical waste is pyrolysed into CO, H2, and hydrocarbons when it comes in contact with the plasma-arc.

These gases are burned and produce a high temperature (around 1200oC).

Transportation of BMW Properly designed carts, trolleys and other wheeled containers

should be used for the transportation of waste inside the facilities both within the health facility and from the facility to the final disposal location.

Wheeled containers should be so designed that they have no sharp edges. Waste handlers must be provided with uniform, apron, boots,

gloves and masks, and these should be worn when transporting the waste.

Case Study of Bio-Medical Waste of a Rural Hospital in Chhattisgarh:

• The survey of a medical hospital with 550 beds, 42 wards and 20 OPDs, attached to a medical college was carried

out during the time period between August-2010 to October-2010.

• The data collected is tabulated as follows: (All Units are in Kg/day)

TABLE 2 : Segregation of bio-medical waste of ground floor

TABLE 1: Segregation of bio-medical waste of ground floor

TABLE 3: Segregation of bio-medical waste of ground floor

TABLE 4: Segregation of bio-medical waste of first floor

TABLE 5: Segregation of bio-medical waste of second floor

TABLE 6: Incineration Ash Generated in August 2010

TABLE 7: Incineration Ash Generated in August 2010

Average ash generation is normally between 4-5% of theweight of the waste; as against that we have the ash generationas 13% which is on higher side.For Preliminary Planning for waste managementestimation is done on following basis-

• 80%- General health care waste.• 15%-Pathological & infectious waste.• 1%-sharp waste.• 3%-Chemical & Pharmacological waste.• 1%-special waste (Cardio active, cytotoxic, Pressurized

container)TABLE 8 : Actual waste generated at the hospital

Sr.No.

Type ofwaste

Actual wastefrom study in%

Waste inKg

1. General        77.48        687

2. Pathological & Infectious        12.06        107

3. Sharp        2.02        18

4. Chemical pharmacological        5.63        50

5. Special Waste        2.81        25

                Total        100       887

Summary The hospital under study generated 0.58 kg/day. Over all capacity of hospital is 550 beds and it generates

around 687 kg per day. Over all waste generation of health care center is 887 kg per

day, out of which 200 kg (Refer: Table-8 ) need to be take care of and need extra precaution for disposal.

Out of these 200 kg of waste, 71.6 kg went for incineration as it is highly infectious. Remaining 128.4 kg is disposed through sanitary landfill disposal method.

As daily solid waste of hospital generated was in range between 190 to 230 kg out of which 70 to 115 kg went for the incineration and rest was put in to their own near-by sanitary land fill site.

The domestic waste generated is managed by municipal disposal system.

Disposal System Practiced by the Rural Medical Hospital:

• The waste from color-coded containers is transported to the appropriate disposal points.

• No Infectious waste is stored beyond 24 hours.• Properly designed carts, trolleys and other wheeled containers

are used for the transportation of waste inside the facilities.• Treatment of sharps is done, i.e. by treating with 1%

hypochlorite solution or any other equivalent chemical reagent. Shredder is used for disposal of sharp content.

• “Incinex incinerator” (Double chamber pyrolytic incinerator established in 1981) with capacity of 35 Kg/hr is used by rural health care institution.

• Fuel: LDO(Diesel) is used whose consumption is around 25 to 27 liters per day.

• Sanitary Land Filling is done at their own land fill site.

Suggestions for Advancement:• In case of failure of current instruments and infrastructure of

waste disposal, the hospital must have alternate plan for safe transportation of infectious waste to disposal.

• Instead of Incineration, it is suggested to use “Plasma Pyrolysis” which is new & widely used economical and environment friendly method.

• Plasma Pyrolysis is smoke free technology for safe disposal of chlorinated waste.

• It is so compact that it can be installed in a small premises.• Neither chimney nor foul odour removal system is required in

it.• Also, it has no dependency on air & moisture unlike

incineration process because it uses plasma torch for heating.

CONCLUSION

• The study reveals that the hospital under study incinerates infectious waste only.

• Considering comparison and applicability of plasma pyrolysis with incineration, it can be concluded that all wastes i.e. pathogenic, sharps and infectious except general waste can go for Plasma Pyrolysis where residue left over would be negligible with almost no additional cost of treatment and at the same time it would safeguard the environment.

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