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By Dr Neil Biomedical Waste Management Rules in Hospitals 2014 1

Biomedical Waste Management Rules in Hospitals 2014 PDF or PPT

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Download Dr Neil’s biomedical waste management rules in hospitals 2014 presentation in PPT or PDF format. Researched way of deposing biohazardous waste. #Medical #Waste #Hospitals www.biomedicalwastesolutions.com/biomedical-waste-management-rules-hospitals/

Text of Biomedical Waste Management Rules in Hospitals 2014 PDF or PPT

  • By Dr Neil Biomedical Waste Management Rules in Hospitals 2014 1
  • BIOMEDICAL WASTE SOLUTIONS Hospital Waste Management Biomedical Waste Solutions (BMWS) Hospital Waste Management discusses how to effectively manage waste disposal in hospitals, healthcare facilities, medical facilities, infirmary, or any organizations or establishments that deals with medicines. As we all know, the waste materials from these establishments need to be disposed properly because it puts us at a great risk not only for our health but for the environment as well. The wastes from hospitals as we all know are mostly non-biodegradable which will really destroy our environment if not disposed of properly. Most also may have the possibility of containing transmittable diseases that may affect our health especially those waste that involves needles. 2www.BioMedicalWasteSolutions.com
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  • This will basically tell us why we need to manage wastes coming from hospitals properly, and the process of how to effectively perform such task. The hospital waste management problem is not only happening in selected places but all nations have this problem; thus, the need to address this growing problem and start to analyze and plan on how to effectively manage the waste disposal of these establishments. The government authority of a certain locality where hospitals are present should deal with this first-hand and make sure that the heads of these hospitals or medical facilities know their responsibilities on properly managing their waste. Communication is necessary to achieve success in endeavors to properly a age a o u itys aste espe ially those o the healthcare department. Without some sort of agreement among public, private and government sectors, there is always the possibility of failure on whatever system a community is adapting to properly dispose their wastes. Hopefully, with good communication and with vigilance and strict compliance to rules and regulations for waste disposal, we would not have the fear of destroying our environment as well as our health. 4www.BioMedicalWasteSolutions.com
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  • The necessity for scheduling Formulation of goals and setting up for their fulfilment are priceless for boosting medical trash management at the general, regional, and local level. Planning needs the definition of a plan that will facilitate very careful carrying out of the important procedures and the proper appropriation of supplies relating to the known main concerns. This is noteworthy for the motivation of authority, healthcare-care workers, and the community, and for defining even more activities that may be recommended. Research on the production of waste will be the basis for distinguishing options and establishing goals for waste minimization, reuse and recycling, and price lowering. A nationwide program of sound health-care waste management is attainable through an action plan. 7www.BioMedicalWasteSolutions.com
  • Global Guidelines for Garbage Management The United Nations Conference on the Environment and Development (UNCED) in 1992 led to the use of Agenda 21, which offers a fix of measures for trash handling. The instructions may be summarized as follows: Prevent and lower trash output. Reuse or recycle the garbage to the magnitude possible. Handle trash by safe and eco-friendly sound methods. Dispose of the finalized elements by garbage dump in confined and correctly made sites. 8www.BioMedicalWasteSolutions.com
  • Agenda 21 also highlights that any waste product producer is liable for the remedies and complete disposal of its own rubbish; where possible, every neighborhood should get rid of its waste within its own borders. The European Union has developed a common European Community Technique on trash Management; other regional groupings of countries may put together related policies in the outlook. 9www.BioMedicalWasteSolutions.com
  • National Projects For Medical-Care Waste Administration Objective of a national control management A national administration plan will enable health-care garbage management possibilities to be optimized on a national measure. A national survey of healthcare garbage will offer the appropriate institution with grounds for pinpointing approaches on a district, regional, and national basis, taking into account conditions, demands, and methods at each level. An excellent, safe and secure, and affordable method will be concerned principally with remedies, reusing, transport, and disposal picks. 10www.BioMedicalWasteSolutions.com
  • Action plan for the development of a national program A national program of sound health-care waste management can be put together with a seven-step action program. The seven steps, their suggested time frame are defined in Figure 1 and in more facts in the implementing words. 11www.BioMedicalWasteSolutions.com
  • Step 1. Create policy devotion and accountability for wellness-care trash control Before an action plan is implemented there must be desire to the advancement of a national policy, and accountability must be assigned to the appropriate government council. The ministry of health or the ministry of environment will commonly assist as the main authority, and should function accurately with other appropriate ministries. The specific authority will collaborate with other ministries, the private sector, nongovernmental agencies (NGOs), and professional organizations, as required, to assure implementation of the action plan. Policy desire should be declined in recommended budgetary allocations at distinctive government levels. Guidance from central government should turn to max efficiency in the use of readily available resources from health-care places. 12www.BioMedicalWasteSolutions.com
  • Step 2. Make a national review of health-care waste techniques The national institution liable for the disposal of health-care waste should be completely careful of present levels of waste production and of national waste management procedures. A detailed research is ideal for planning an amazing waste management method. It is suggested that a wide-ranging questionnaire be finalized for all health-care establishments in order to produce the following: number of hospital beds and bed occupancy rate for every single health-care establishment; kinds and volumes of garbage produced; employees i ol ed i the a age e t of health-care waste; current health-care waste disposal procedures, including sequestration, collection, transportation, storage, and disposal strategies. The review should also comprise site observations and interviews with health or support staff (waste workers, cleaners, etc.) at a variety of levels. The facts built-up will incorporate a basis for forming approach for district, regional, and national levels. 13
  • Step 3. Cultivate national guidelines The foundation for a national program for health-care waste management is the technical guidelines plus the appropriate platform that assists them. Step 3 thus consists of the formulation of a national policy document and technical guidelines based on the results of the national survey; the two may be brought with each other in one thorough document. Their content, should offer the technical foundation on which health-care establishments can create their unique management programs. 14www.BioMedicalWasteSolutions.com
  • Step 4. Develop a policy on regional and collaborative methods of health-care waste treatment The selected government organization should understand resources that will guarantee a national network of disposal features for health-care waste, accessible by clinics and other health-care facilities. The national (or regional) policy should also offer technical requirements for the processes and gears involved in appropriate treatment selection. There are three practical picks for managing the treatment of health-care waste: Option 1: an on location treatment service in each health-care institution. Option 2: regional or collaborative health-care waste treatment facilities, supplemented by in depth facilities for outlying medical facilities. 15www.BioMedicalWasteSolutions.com
  • Option 3: treatment of health-care waste in existing industrial or municipal treatment features (e.g. municipal incinerators), where these can be found. Each option has characteristics and down sides. The national or regional planning policy will count on local conditions such as the administrative mechanisms for activating proper waste management procedures, the number, place, dimensions, and enter of health-care places, high of road network, and financial and technical resources. 16www.BioMedicalWasteSolutions.com
  • On-site health-care waste treatment service The good points of providing each health-care organization with on-site treatment amenities include the following: benefits; minimization of issues to public health and the environment by confinement of deadly wastes to the health-care premise. On-site treatment facilities are especially ideal in areas where hospitals are established far from each other and the street system is weak. They must be handled by the medical facilities where they are found and may accept health-care waste gathered from distributed little sources in the environment areas. 17www.BioMedicalWasteSolutions.com
  • The negatives of on-site disposal include the following: Costs may be substantial if there are many clinics. General, a lot more technical personnel may be involved to operate and keep the facilities. It may be overwhelming for the pertinent authorities to monitor the show of many small facilities; this may cause in poor compliance with operating standards, depending on the enter of facilities, and increased environmental pollution. 18
  • State-wide and combined treatment centers On location waste disposal techniques, which may be desired for giant healthcare places, may not be feasible or economical for smaller institutions, for which regional or cooperative disposal may be the better way to go. Such systems are in use in varied international locations, running on either a voluntary or a statutory basis. For example, a group of medical facilities may work together to set up a regional health-care waste treatment facility (e.g. a high-capacity incinerator) at one healthcare facility which will then receive waste items from others within the team. In other instances, the local authority or a private waste disposal company may create a centered plant to accept waste from health-care centers inside its region. 19www.BioMedicalWasteSolutions.com
  • Figure 1. Action plan for the development of a national program of good healthcare and waste management 20www.BioMedicalWasteSolutions.com
  • Survey questionnaire for hospital waste management QUESTIONNAIRE Hospital (name, location): _______ ______________________________ _____________ _ Type of hospital (tick one): Specialist General University (training/provincial) Regional District Sub-district No. of inpatients: /day No. of outpatients: /day No. of beds (total): /day including ______________________________ _ ________ in _______________ ward (no.) (type of ward ) ________ in _______________ ward (no.) (type of ward ) ________ in _______________ ward (no.) (type of ward ) ________ in _______________ ward (no.) (type of ward ) 21www.BioMedicalWasteSolutions.com
  • Survey questionnaire for hospital waste management (continued ) Safe management of wastes from health-care activities 22
  • Survey questionnaire for hospital waste management (continued ) Waste segregation, collection, storage, and handling Describe riey hat happe s et ee segregatio if a y a d fi al disposal of: Sharps _______________________________________________________________ Pathological waste _____________________________________________________ Infectious waste ________________________________________________________ Radioactive waste ______________________________________________________ Chemical waste ________________________________________________________ Pharmaceutical waste ___________________________________________________ Pressurized containers __________________________________________________ 23www.BioMedicalWasteSolutions.com
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  • Survey questionnaire for hospital waste management (continued ) Personnel involved in the management of hospital solid waste 1. (a) Designation of person(s) responsible for organization and management of waste collection, handling, storage, and disposal at the hospital administration level. _____________________________________________________________________________________ (b) General qualification and level of education of designated person. _____________________________________________________________________________________ (c) Has he/she received any training on hospital waste management? Yes No If yes, what type of training and of what duration? _____________________________________________________________________________________ 2. Indicate the number of persons involved in the collection, handling, and storage of hospital waste, their designation, their training in solid waste handling and management, and the number of years of experience of this type of work. Number Designation Training Experience 3. Do the waste management staff have job descriptions detailing their tasks? Yes No 4. Are instructions/training given to newly hired waste management staff? Yes No Hospital waste management policy 1. Are you aware of any legislation application to hospital waste management? Yes No If yes, please list the legislative Acts: 25www.BioMedicalWasteSolutions.com
  • 2. Are you aware of a document outlining the hospital waste management policy? Yes No If yes, give title of document (and attach a copy if possible): ____________________________________________________________________________________ 3. Is there a manual or guideline document on management of hospital wastes available: (a) In the Ministry of Health? Yes No If yes, give title of document: ____________________________________________________________________________________ (b) In your hospital? Yes No If yes, give title of document: ____________________________________________________________________________________ 4. (a) Does your hospital have a Waste Management Plan? Yes No If yes, please attach a copy. (b) Does your hospital have a Waste Management Team (or Teams)? Yes No If yes, please list the members by designation 26www.BioMedicalWasteSolutions.com
  • Designation No. Team leader _________________________________ ________________ Team members: _________________________________ ________________ Waste handling staff: _________________________________________________ 5. Are there clearly defined procedures for collection and handling of wastes from specified units in the hospital? Yes No 6. Are there waste management responsibilities included in the job descriptions of hospital supervisory staff (Head of Hospital, Department Heads, Matron/Senior Nursing Officer, Hospital Engineer, Infection Control Officer, Pharmacist, Laboratory Supervisor, etc.)? Yes No If yes, provide sample copies. 7. How are the present waste collection, handling, and disposal responsibilities defined in the job descriptions of the staff involved? (Cite appropriate statement or provide copies.) 27www.BioMedicalWasteSolutions.com
  • Centralized regional features could create the following strengths: improved cost-effectiveness for larger sized units, through economies of scale; spare capacity can be offered more cheaply; potential changes or expansions (relating to flue-gas cleaning systems of incinerators, for example) are probably to be more economical; where privatization of services is observed as a desired option, this can be realized more perfectly on a regional basis than for multiple tiny units; in addition, it will be smoother for the important government agencies to oversee and supervise the facilities; excellent operation can be more easily guaranteed in one centralized facility than in several plants where skilful staff may not be easily available; air pollution may be more effortlessly kept to a minimum at a centralized plant (costs of monitoring and surveillance and of flue-gas cleaning, for example, will be limited); hospitals will not have to spend time and workers to managing their personal installations. The location of regional facilities for the treatment of health-care waste should be meticulously selected. 28www.BioMedicalWasteSolutions.com
  • Catchment areas should be recognized on the basis of approximated waste production by the health-care facilities involved, and the site of the treatment plant within each catchment area should then be based on the following considerations: availability for the hospitals and health-care facilities to be served (road conditions, distances, and transportation times); quantities of health-care garbage expected from some places within the distinguished catchment region; whether or not transfer channels are required (daily transfer of waste direct from clinics to the regional facility, with no need for transfer stations, would be excellent, keeping away from double control of waste); probably modifications in the capacity or characteristic of each hospital and hence in the amount or nature of its waste; preliminary environmental thoughts, based on a complete environmental and health impact appraisal (the assessed impact may be lower if the facility is located inside an industrial "park" manufactured exclusively for hazardous companies); adequacy of the land area for the facility at a recommended place; public attitude towards the treatment system. Minimizing overall times for transportation of health-care wastes to the regional facility should be an worthwhile advantage in the options of place and in knowing recommended transportation channels. Allotting complete numbers of collection motor vehicles to the many routes in the region will make sure day to day collection of waste and give to in general cost-effectiveness. 29www.BioMedicalWasteSolutions.com
  • Step 5. Rules: limitations and guidelines for health-care waste management Once developed, the policy and guidelines should be secured by legislation that controls their application. This law is customarily based on international legal agreements and underlying principles of sound trash management. Step 6. Start a national training system In order to achieve appropriate procedures in health-care waste management and compliance with requirements, it is vital for all managers and other workers engaged to receive proper instruction. To this end, the central government should help in groundwork of "train the trainer" techniques, and professional institutions or centers for the trainers' program should be identified. 30
  • Step 7. Review the national health-care waste management program upon execution The national program for management of health-care garbage should be considered as an on-going process with regular monitoring and appraisal by the liable national government agency. In addition, the instructions on treatment techniques should be consistently current to keep pace with new improvements. The national agency will base its analysis basically on reports from the health- care establishments on their triumph in following waste management programs. It should compare yearly reports presented by the heads of the establishments and make occasional visits to carry out reviews of the waste management systems. Any sort of inadequacies in the waste management system should be pointed out to the head of the establishment in writing, together with instructions for remedial ways. The time limit for carrying out of restorative ways should be chosen and the head of the establishment should be knowledgeable of the re-examination date. In the case of off-site waste treatment centers, incinerator workers, road haulage providers, and landfill workers should also be checked. Regular analysis of waste management ways by both the national government agency and the health-care establishments should result both in top-quality protection of work-related and public health and in increased cost- effectiveness of waste disposal. 31
  • Appraisal of waste release In order to establish a waste management plan, the waste management team ought to make an analysis of all waste produced in the healthcare facility. The WMO should be trusted for organizing such a review and for scrutinizing the outcome. The garbage should be grouped with respect to the category system specified in the national guidelines (or as described in this handbook if no such guidelines are available). The research should determine the average daily amount of trash in each category generated by each medical facility department. Special care should be utilized to analyze the possibility of highest production and the periodic generation of fantastic amounts of waste products. For example, the effect of epidemics and other issues that affects the volumes of waste generated should be projected. Account should also be taken of interested slack intervals or other strange conditions that may factor extensive variations in garbage amounts. Survey results should incorporate a test of any future modifications in hospital status, departmental progress, or the establishment of new departments. 32www.BioMedicalWasteSolutions.com
  • Development of a trash management plan During formation of the waste management plan, any member of the waste management group (WMT) should carry out a review of present trash management arrangements in his or her area of obligation. Established methods should then be evaluated in the light of the national guidelines and instructions made to the WMO on how the guidelines can be executed in each spot. On the basis of the waste production survey and these guidelines, the WMO should prepare a draft discussion document for the WMT. This discussion document should incorporate points of the new waste management system. It should be divided up into portions covering the following challenges: present situation (waste management procedures, employees and equipment involved) levels of waste produced possibilities for trash minimization, reuse, and recycling waste segregation 33www.BioMedicalWasteSolutions.com
  • on-site handling, transport, and storing tactics recognition and evaluation of waste cures and disposal types (on- and off-site) recognition and analysis of the possibilities, and linked expenses record-keeping training evaluation of expenses relating to trash management (exact state and suggested options) strategy for execution of the plan. 34www.BioMedicalWasteSolutions.com
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  • The draft discussion record should be prepared in consultation with all members of the WMT and their staff. Officials from the local authority and from the national government agency liable for the disposal of health-care wastes should be asked to aid in the development of the garbage management plan (WMP). The WMP should be based on the discussion document and should be delivered to a meeting of the WMT for approval. The WMO should amend the draft discussion document in the light of comments made by the WMT. When full agreement has been attained, the document should be specific as the medical institution WMP. The WMO should now complete the WMP with a diagram that describes the line management framework and the liaison paths, and a list of names and telephone numbers of liable personnel to be alerted in the occasion of a disaster. 36www.BioMedicalWasteSolutions.com
  • Advice for inclusion in the trash management plan Location and organization of collection and storage facilities 1. Pictures of the business demonstrating selected bag-holder sites for each and every ward and department in the hospital; each bag site shall be appropriately designated for health-care waste or other waste. 2. Drawings exhibiting the central storage site for health-care waste and the isolate site for other garbage. Details of the type of containers, security merchandise, and arrangements for washing and decontaminating waste-collection trolleys (or other transport devices) should be determined. The document should also address eventual wants for refrigerated storage facilities. 3. Blueprints detailing the paths of waste-collection trolleys through the hospital, with definitely noticeable individual collection routes. 4. A collection schedule for each trolley route, the method of waste to be collected, the range of wards and departments to be checked out on one round. The central storage point in the establishment for that particular waste should be identified. 37www.BioMedicalWasteSolutions.com
  • Design criteria 5. Blueprints showing the kinds of bag holder to be used in the wards and departments. 6. Drawings exhibiting the type of trolley or wheeled bin to be used for bag collection. 7. Images of sharps bins, with their requirements. Need material and human resources 8. An approximation of the amounts and cost of bag holders and collection trolleys. 9. An approximation of the amount of sharps containers and health- care garbage barrel bins forced annually, classified into countless options if suitable. 10. An estimate of the total and fee of yellow and black plastic bags to be used yearly. 11. An estimate of the host of personnel forced for trash collection. 38www.BioMedicalWasteSolutions.com
  • Responsibilities 12. Definitions of commitments, duties, and norms of practice for each of the a variety of kinds of workers of the hospital who, through their regular work, will establish trash and be involved in the segregation, storage, and control of the waste products. 13. A definition of the obligations of hospital attendants and additional personnel in collecting and maneuvering wastes, for each ward and department; where special practices are required, e.g. for radioactive waste or hazardous chemical waste, the stage at which attendants or ancillary staff become involved in waste handling shall be clearly defined. Procedures and practices 14. Basic drawing (flow chart) demonstrating procedure for waste segregation. 15. The procedures for segregation, storage, and handling of wastes needing unique preparations, such as autoclaving. 39www.BioMedicalWasteSolutions.com
  • 16. Define of checking techniques for waste areas and their resort. 17. Backup tactics, formulated with manual on storage or evacuation of healthcare garbage in case of malfunction of the treatment unit or during closure down for scheduled maintenance. 18. Emergency procedures. Training 19. Training instruction and programs. 40www.BioMedicalWasteSolutions.com
  • Implementation of the waste management plan Implementation of the WMP is the duty of the Head of Hospital. It involves the following steps: 1. Interim ways, to be introduced as a predecessor to full execution of the new trash management system, should be designed by the WMO, in partnership with the WMT, and be appended to the plan. A bar chart should also be included, detailing dates of application of each part of the new system. 2. Provision for upcoming expansion of the hospital or of waste storage facilities should be done. 3. The Head of Hospital installs personnel to the posts with accountability for garbage management. Notices of these appointments should be frequently distributed and changes should be released when changes happen. 4. The Infection Control Officer should sort out and supervise coaching programs for all staff, in collaboration with the WMO and other members of the WMT. Initial training sessions should be attended by key staff members, including medical staff, who should be advised to be aware in checking the overall performance of waste disposal duties by non-medical staff. The Infection Control Officer should buy the speakers for training lessons and determine the content and type of training given to each group of staff. 41www.BioMedicalWasteSolutions.com
  • 5. As soon as the actions in 1-4 have been achieved and required equipment for garbage management is around, the operations defined in the WMP can be put into practice. 6. The WMT should look at the WMP yearly and start alterations important to upgrade the system. Temporary modifications may also be made as and when essential. 7. The Head of Hospital should prepare an annual report to the national government agency reliable for the disposal of health-care waste products, providing reports on waste generation and disposal, workers and equipment criteria, and fees. Downfalls in the waste maneuvering, segregation, storage, transport, or disposal system, or garbage management reports that result in injury should be reported as soon as feasible to the Infection Control Officer. 42www.BioMedicalWasteSolutions.com
  • Management of health-care trash from spread out little sources Basic principles Improvement in health-care waste management should start in giant healthcare facilities, then extend to smaller health-care places, and lastly to the diverse sources of small volumes of waste. The heads of health-care establishments are responsible for health protection and safety at the work environment and take legal responsibility for the safe disposal of health-care waste produced in their facilities. They should therefore take all sensible strategies to: prevent health-care garbage from initiating environmental contamination or unfavorable effects on human health; ensure that health-care waste is sufficiently segregated and safely packed, especially in the case of sharps which should be loaded in puncture- proof containers; ensure that bags or containers of health-care waste are handled only by those technically licensed to transport and/or dispose of such waste; 43www.BioMedicalWasteSolutions.com
  • guarantee that a transfer note describing the waste is handed to the recipient when waste is transferred; check that the driver of the collection vehicle is conscious of the rules governing transport of deadly products. The solutions for safe collection and disposal of health- care waste from small sources, which do commonly not treat their own waste, include the following: the local authority or an licensed private contractor collects the waste for treatment at a local hospital incinerator or other building; an licensed private contractor collects and treats the waste at the o tra tors treat e t fa ility; the local authority or an licensed private contractor collects the waste for treatment at a municipal waste incinerator or for treatment by another disinfection or confinement plan. 44www.BioMedicalWasteSolutions.com
  • All waste should be clearly marked with self-adhesive or tie-on labels signifying point of production (hospital and department), content, and in the case of transport off-site and certain additional facts. Any agreement for collection by a private authorized health-care waste provider should identify the disposal or treatment facility to be used. The carrier should, whenever possible, use specific vehicles for the collection of transmittable trash. Collection of health-care wastes from their source should be average and frequent. Any storage of garbage before destruction or collection for off-site disposal should be in a protected area designated for the reason. Private professionals, health-care research establishments, haemodialysis centers, veterinary practices, and nursing homes should create infection control policies. All workforces should be able to comprehend the policy, which should include things of the procedures to follow in case of a needle-stick harm or exposure to contaminated blood. 45www.BioMedicalWasteSolutions.com
  • Research activities Waste material produced in research areas can extend from small items such as culture dishes to large animal carcasses, and may also consist of soiled beddings and sharps. The trash is often contagious or even highly infectious. Heads of research units are trusted for the training of personnel and for guaranteeing ideal segregation of garbage. Because of the nature of the waste generated in research facilities, the following precautions should be taken: Extremely infectious garbage should be autoclaved or incinerated on site whenever possible and should be handled only by trained and authorized staff. If on-site treatment is hard or wasteful, cooled storage facilities should be offered and there should be a frequent collection by a contractor who has appropriate incineration facilities. Animal carcasses that cannot be destroyed as soon as possible after experimentation should be retained at a temperature below -20C. Any contractual plan for analysis by personnel outside the institution should include right provisions for the safe handling and disposal of any waste. Biotechnology laboratories may generate waste that presents special dangers (such as genetically modified material) and that should in no concerns be released into the environment. Management of such trash needs additional precautions that are beyond the scope of this handbook. 46www.BioMedicalWasteSolutions.com
  • References and suggested further reading Christen J (1996). Dar es Salaam Urban Health Project. Health-care waste management in district health facilities: situational analysis and system de- velopment. St Gallen, Switzerland, Swiss Centre for Development Coopera- tion in Technology and Management (SKAT). WHO (1995). Survey of hospital wastes management in South-East Asia Region. New Delhi, World Health Organization Regional Office for South-East Asia (document SEA/EH/493). WHO (1997). Action plan for the development of national programme for sound management of hospital wastes. An outcome of the Regional Consultation on Sound Management of Hospital Waste, Chiang Mai, Thailand, 28-29 Novem- ber 1996. New Delhi, World Health Organization Regional Office for South- East Asia. WHO/CEPIS (1994). Gua para el manejo interno de residuos slidos hospitalarios. [Guide to the internal management of solid hospital waste.] Lima, World Health Organization/Pan American Sanitary Engineering and Environmental Sciences Center. 47www.BioMedicalWasteSolutions.com
  • By Dr Neil Biomedical Waste Management Rules in Hospitals 2014 48