Biomedical waste Management

Biomedical Waste Management 
Definition-

  • "Waste generated during the diagnosis, testing, treatment, research or production of biological products for humans or animals (WHO)"
  • "Biomedical waste means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production or testing of biological". -According to Biomedical waste (Management and handling) rules,1998 of India.

World Health Organization Śtates                                               

  • 85% of hospital wastes are actually non-hazardous,
  • Whereas 10% are infectious
  • 5% are non-infectious but they are included in hazardous wastes. 

Classification of Bio-Medical Waste-

The World Health Organization (WHO) has classified medical waste into eight categories-

  1. General Waste
  2. Pathological
  3. Radioactive
  4. Chemical
  5. Infectious to potentially infectious waste
  6. Sharps
  7. Pharmaceuticals
  8. Pressurized containers

Sourcesof Bio-Medical Waste-

Major Sources Minor sources
Hospitals Clinics
Labs Dental clinics
Research centers Home care
Animal research Cosmetic clinics
Blood banks Paramedics
Nursing homes Funeral services
Mortuaries Institutions
Autopsy centers  


Hazardous Health Care Waste can Result In-

  1. Infection
  2. Genotoxicity and Cytotoxicity
  3. Chemical toxicity
  4. Radioactivity hazards.
  5. Physical injuries
  6. Public sensitivity.

Need of biomedical waste management in hospitals-

The  reasons due to which there is great need of management of hospitals waste such as-

  • Injuries from sharps leading to infection to all categories of hospital personnel and waste handler.
  • Nosocomial infections in patients from poor infection control practices and poor waste management.
  • Risk of infection outside hospital for waste handlers and scavengers and at time general public living in the vicinity of hospitals.
  • Risk associated with hazardous chemicals, drugs to persons handling wastes at all levels.
  • “Disposable” being repacked and sold by unscrupulous elements without even being washed.
  • Drugs which have been disposed of, being repacked and sold off to unsuspecting buyers.
  • Risk of air, water and soil pollution directly due to waste, or due to defective incineration emissions and ash.

Biomedical Waste Management Process

The hospital waste like body parts, organs, tissues, blood and body fluids along with soiled linen, cotton, bandage and plaster casts from infected and contaminated areas are very essential to be properly collected, segregated, stored, transported, treated and disposed of in safe manner to prevent nosocomial or hospital acquired infection.

  1. Waste collection
  2. Segregation
  3. Transportation and storage
  4. Treatment & Disposal
  5. Transport to final Disposal site
  6. Final Disposal

 

Health Care Waste Management Hierarchy

Biomedical Waste Treatment and Disposal

A. Incineration Technology

  • This is a high temperature thermal process employing combustion of the waste under controlled condition for converting them into inert material and gases. Incinerators can be oil fired or electrically powered or a combination there of.
  • Broadly, three types of incinerators are used for hospital waste.
  • Multiple hearth type, rotary kiln and controlled air types.

B. Non-IncinerationTechnology-

Non-incineration treatment includes four basic processes: thermal, chemical, irradiative, and biological. The majority of non-incineration technologies employ the thermal and chemical processes. The main purpose of the treatment technology is to decontaminate waste by destroying pathogens. 

C. Autoclaving

The process involves using steam at high temperatures.

  • These are also of three types- Gravity type, Pre- vacuum type and Autoclave treatment has been recommended for microbiology and biotechnology waste, waste sharps, soiled and solid wastes.
  • This technology renders certain categories (mentioned in the rules) of bio-medical waste innocuous and unrecognizable so that the treated residue can be land filled.

D. 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 all pathogens.


 E. Chemical Methods -

1 % hypochlorite solution can be used for chemical disinfection

F. Plasma Pyrolysis

  • Plasma pyrolysis 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 by products.
  • 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. 

Personnel Safety Devices

  • Gloves
  • Aprons, gowns, suits or other apparels
  • Masks
  • Boots

The use of protective gears should be made mandatory for all the personnel handling waste.

A. Gloves-

  • Heavy-duty rubber gloves
  • This should be bright yellow in colour. After handling the waste, the gloves should be washed twice.
  • The gloves should be washed after every use with carbolic soap and a disinfectant.
  • The size should fit the operator.

 B. Aprons, gowns, suits or other apparels-

 Apparel is worn to prevent contamination of clothing and protect skin.

C. Masks-

 Various types of masks, goggles, and face shields are worn alone or in combination, to provide a protective barrier. It is mandatory for personnel working in the incinerator chamber to wear a mask covering both nose and mouth, preferably a gas mask with filters.

D. Boots-

Leg coverings, boots or shoe-covers provide greater protection to the skin when splashes or large quantities of infected waste have to be handled. The boots should be rubber-soled and anti-skid type. They should cover the leg up to the ankle. 

Benefits of Biomedical Waste Management

  • Cleaner and healthier surroundings.
  • Reduction in the incidence of hospital acquired and general infections.
  • Reduction in the cost of infection control within the hospital.
  • Reduction in the possibility of disease and death due to reuse and repackaging of infectious disposables.
  • Low incidence of community and occupational health hazards.
  • Reduction in the cost of waste management and generation of revenue through appropriate treatment and disposal of waste.
  • Improved image of the healthcare establishment and increase the quality of life. 

NURSES' RESPONSIBILITY IN BIOMEDICAL WASTE MANAGEMENT

  • All nurses should have proper knowledge about biomedical waste management.
  • Proper segregation of waste should be done at the point of generation.
  • All the sharps should be disposed properly in puncture resistant containers. 
  • Disinfect the surface with 1% sodium hypochlorite for 30 minutes.
  • Ensure the use of personal protective equipment while handling biomedical waste.
  • Do not recap needles.
  • Never overload bins used for biomedical waste.
  • Ensure proper disposal of waste in appropriate color coded bags.
  • Monitor and supervise the staff for proper disposal of waste.
  • Change the chemical solutions frequently.
  • Ensure proper disinfection of infectious waste before disposal.

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