An exclusive project report on Bio-Medical Waste (BMW). This project report will help you to learn about: 1. Introduction to Bio-Medical Waste 2. Definition of Bio-Medical Waste 3. Classification 4. Sources 5. Categories 6. Legal Aspect 7. Treatment 8. Collection and Storage 9. Health Hazards.
Contents:
- Project Report on Introduction to Bio-Medical Waste
- Project Report on the Definition of Bio-Medical Waste
- Project Report on the Classification of Bio-Medical Waste
- Project Report on the Sources of Biomedical Waste
- Project Report on the Categories of Bio-Medical Waste
- Project Report on the Legal Aspect of Bio-Medical Waste
- Project Report on the Treatment of Bio-Medical Waste
- Project Report on the Collection and Storage of Bio-Medical Waste
- Project Report on the Health Hazards of Bio-Medical Waste
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Project Report # 1. Introduction to Bio-Medical Waste (BMW):
All human activities produce waste. We all know that such waste may be dangerous and needs safe disposal. Industrial waste, sewage and agricultural waste, polluted water, soil and air. It can also be dangerous to human beings and environment.
Similarly, hospitals and other health care facilities generate lot of waste which can transmit infections, particularly HIV, Hepatitis B & C and Tetanus, to the people who handle it or come in contact with it.
Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, nursing home authorities but also to the environment. The proper management of biomedical waste has become a worldwide humanitarian topic today.
Although hazards of poor management of biomedical waste have aroused the concern world over, especially in the light of its far-reaching effects on human health and the environment. Hospital waste is a potential health hazard to the health care workers, the public and flora and fauna of the area.
The problems of the waste disposal in the hospitals and other health-care institutions have become issues of increasing concern. Most countries of the world\ especially the developing nations, are facing the grim situation arising out of environmental pollution due to pathological waste arising from increasing population and the consequent rapid growth in the number of health care centres.
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India is no exception to this and it is estimated that there are more than 15,000 small and private hospitals and nursing homes in the country. This is apart from clinics and pathological labs, which also generate sizeable amounts of medical waste.
India generates around three million tonnes of medical waste every year and the amount is expected to grow at eight per cent annually. Creating large dumping grounds and incinerators is the first step and some progressive states such as Maharashtra, Karnataka and Tamil Nadu are making efforts despite opposition.
Barring a few large private hospitals in metros, none of the other smaller hospitals and nursing homes have any effective system to safely dispose off their wastes. With no care or caution, these health establishments have been dumping waste in local municipal bins or even worse, out in the open. Such irresponsible dumping has been promoting unauthorized reuse of medical waste by the rag pickers for some years back.
Surveys carried out by various agencies show that the health care establishments in India are not giving due attention to their waste management. After the notification of the Bio-medical Waste (Handling and Management) Rules, 1998, these establishments are slowly streamlining the process of waste segregation, collection, treatment, and disposal. Many of the larger hospitals have either installed the treatment facilities or are in the process of doing so.
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Who generates BMW? A “generator” of BMW is any person who owns or operates a facility that produces BMW in any quantity. This includes, but is not limited to, the following: hospitals, skilled nursing facilities, laboratories, physicians, offices, veterinarians, dental offices, funeral homes, industry, etc.
In the case where more than one generator of BMW is located in the same building, each individual business entity is considered a separate generator. Note: waste generated by an individual at home is specifically not regulated as BMW.
Project Report # 2. Definition of Bio-Medical Waste:
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 biological.
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The Government of India specifies that Hospital Waste Management is a part of hospital hygiene and maintenance activities. This involves management of range of activities, which are mainly engineering functions, such as collection, transportation, operation or treatment of processing systems, and disposal of wastes.
World Health Organization states that 85% of hospital wastes are actually non-hazardous, whereas 10% are’ infectious and 5% are non-infectious but they are included in hazardous wastes. About 15% to 35% of Hospital waste is regulated as infectious waste.
Bio-Medical Waste consists of:
i. Human anatomical waste like tissues, organs and body parts
ii. Animal wastes generated during research from veterinary hospitals
iii. Microbiology and biotechnology wastes
iv. Waste sharps like hypodermic needles, syringes, scalpels and broken glass
v. Discarded medicines and cytotoxic drugs
vi. Soiled waste such as dressing, bandages, plaster casts, material contaminated with blood, tubes and catheters
vii. Liquid waste from any of the infected areas and
viii. Incineration ash and other chemical wastes.
Project Report # 3. Classification of Bio-Medical Waste:
The World Health Organization (WHO) has classified medical waste into eight categories:
i. General Waste
ii. Pathological
iii. Radioactive
iv. Chemical
v. Infectious to potentially infectious waste
vi. Sharps
vii. Pharmaceuticals and
viii. Pressurized containers.
Project Report # 4. Sources of Biomedical Waste:
Hospitals produce waste, which is increasing over the years in its amount and type. The hospital waste, in addition to the risk for patients and personnel who handle them also poses a threat to public health and environment.
Major Sources:
i. Govt. hospitals/private hospitals/nursing homes/ dispensaries.
ii. Primary health centres.
iii. Medical colleges and research centres/ paramedical services.
iv. Veterinary colleges and animal research centres.
v. Blood banks/mortuaries/autopsy centres.
vi. Biotechnology institutions.
vii. Production units.
Minor Sources:
i. Physicians/ dentists’ clinics.
ii. Animal houses/slaughter houses.
iii. Blood donation camps.
iv. Vaccination centres.
v. Acupuncturists/psychiatric clinics/cosmetic piercing.
vi. Funeral services.
vii. Institutions for disabled persons.
Project Report # 5. Categories of Bio-Medical Waste:
Chemicals treatment is using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfections.
The most essential part of hospital waste management is the segregation of Bio-medical waste. The segregation of the waste should be performed within the premises of the hospital/nursing homes.
The colour coding, type of container to be used for different waste categories and suggested treatment options are listed below:
Project Report # 6. Legal Aspect of Bio-Medical Waste:
The Central Government, to perform its functions effectively as contemplated under sections 6, 8, and 25 of the Environment Protection Act, 1986, has made various Rules, Notifications and Orders including the Bio-medical wastes (Management & Handling) Rules, 1998.
A brief summary of the provisions in Bio-medical wastes (Management & Handling) Rules, 1998 is given below:
i. Section 3 establishes the authority of the government to undertake various steps for protection and improvement of the environment.
ii. Section 5 provides; for issuance of directions in writing.
iii. Section 6 empowers the government to make rules.
iv. Section 8 permits the education of individuals dealing with hazardous wastes regarding various safety measures.
v. Section 10 bestows authority to enter the premises and inspect.
vi. Section 15 allows the government to take punitive steps against defaulters. This involves imprisonment up to five years or penalty upto rupees one lakh or both. In case the default continues, it would then attract a penalty of rupees five thousand per day up to one year and thereafter imprisonment up to seven years.
vii. Section 17 provides for punishment in case of violations by government departments.
Even after the June, 2000 deadline most of the large hospitals have not complied with these Rules, as there is no specified authority to monitor the implementation of these Rules.
Project Report # 7. Treatment of Bio-Medical Waste:
i. Chemical Processes:
These processes use chemicals that act as disinfectants. Sodium hypochlorits, dissolved chlorine dioxide, per-acetic acid, hydrogen peroxide, dry inorganic chemicals and ozone are examples of such chemicals. Most chemical processes are water-intensive and require neutralising agents.
ii. Thermal Processes:
These processes utilise heat to disinfect. Depending on the temperature they operate it has been grouped into two categories, which are Low-heat systems and High-heat systems Low-heat systems (operate between 93-177°C) use steam, hot water, or electromagnetic radiation to heat and decontaminate the waste.
Autoclaving is a low heat thermal process and it uses steam for disinfection of waste. Autoclaves are of two types depending on the method they use for removal of air pockets are gravity flow autoclave and vacuum autoclave.
Microwaving is a process which disinfects the waste by moist heat and steam generated by microwave. High-heat systems (operate between 540-8,300°c) employ combustion and high temperature plasma to decontaminate and destroy the waste.
Incinerator & Hydroclaving are high heat systems. Hydroclaving – is steam treatment with fragmentation and drying of waste.
iii. Mechanical Processes:
These processes are used to change the physical form or characteristics of the waste either to facilitate waste handling or to process the waste in conjunction with other treatment steps. The two primary mechanical processes are
Compaction:
Used to reduce the volume of the waste
Shredding:
Used to destroy plastic and paper waste to prevent their reuse. Only the disinfected waste can be used in a shredder.
iv. Irradiation Processes:
Expose wastes to ultraviolet or ionizing radiation in an enclosed chamber. These systems require post shredding to render the waste unrecognizable.
v. Biological Processes:
Using biological enzymes for treating medical waste. It is claimed that biological reactions will not only decontaminate the waste but will also cause the destruction of all the organic constituents so that only plastics, glass, and other inert will remain in the residues.
Points to ponder in processing the waste.
a. Incineration:
i. Incinerators should be suitably designed to achieve the emission limits.
ii. Wastes to be incinerated shall not be chemically treated with any chlorinated disinfectant.
iii. Toxic metals in the incineration ash shall be limited within the regulatory quantities
iv. Only low sulphur fuel like Diesel shall be used as fuel in the incinerator.
b. Autoclaving:
The autoclave should be dedicated for the purpose of disinfecting and treating biomedical waste.
A. When operating a gravity flow autoclave, medical waste shall be subjected to:
i. A temperature of not less than 121°C and pressure of about 15 pounds per square inch (psi) for an autoclave residence time of not less than 60 minutes; or
ii. A temperature of not less than 135°C and a pressure of 31 psi for an autoclave residence time of not less than 45 minutes; or
iii. A temperature of not Less than 149°C and a pressure of 52 psi for an autoclave residence time of not less than 30 minutes.
B. When operating a vacuum autoclave, medical waste shall be subjected to a minimum of one per vacuum pulse to purge the autoclave of all air. The waste shall be subjected to the following:
i. A temperature of not less than 121°C and a pressure of 15 psi per an autoclave residence time of not less than 45 minutes; or
ii. Temperature of not less than 135°C and a pressure of 31 psi for an autoclave residence time of not less than 30 minutes; or Medical waste shall not be considered properly treated unless the time, temperature and pressure indicate stipulated limits. If for any reason, these were not reached, the entire load of medical waste must be autoclaved again until the proper temperature, pressure and residence time are achieved.
c. Microwaving:
i. Microwave treatment shall not be used for cytotoxic, hazardous or radioactive wastes, contaminated animal carcasses, body parts and large metal items.
ii. The microwave system shall comply with the efficacy tests/routine tests
iii. The microwave should completely and consistently kill bacteria and other pathogenic organisms that is ensured by the approved biological indicator at the maximum design capacity of each microwave unit.
d. Deep Burial:
i. A pit or trench should be dug about 2 m deep. It should be half filled with waste, and then covered with lime within 50 cm of the surface, before filling the rest of the pit with soil.
ii. It must be ensured that animals do not have access to burial sites.
iii. Covers of galvanised iron/wire meshes may be used.
iv. On each occasion, when wastes are added to the pit, a layer of 10cm of soil must be added to cover the wastes.
v. Burial must be performed under close and dedicated supervision.
vi. The site should be relatively impermeable and no shallow well should be close to the site.
vii. The pits should be distant from habitation, and sited so as to ensure that no contamination of any surface water or ground water occurs.
viii. The area should not be prone to flooding or erosion.
ix. The location of the site must be authorized by the prescribed authority.
x. The institution shall maintain a record of all pits for deep burial.
e. Disposal of Sharps:
Sharps are discarded needles and lancets that have been used in animal or human patient care/treatment or in medical, research or industrial laboratories. Sharps include items such as hypodermic needles, syringes, dental carpules, and scalpel blades. Please note that certain exemptions apply to farmers.
i. Blades and needles waste after disinfection should be disposed in circular or rectangular pits.
ii. Such pits can be dug and lined with brick, masonry, or concrete rings.
iii. The pit should be covered with a heavy concrete slab, which is penetrated by a galvanized Steel pipe projecting about 1.5 m above the slab, within internal diameter of upto 20 mm.
iv. When the pipe is full it can be sealed completely after another has been prepared.
f. Radioactive Waste from Medical Establishments:
i. It may be stored under carefully controlled conditions until the level of radioactivity is so low that they may be treated as other waste.
ii. Special care is needed when old equipment containing radioactive source is being discarded.
iii. Expert advice should be taken into account.
g. Mercury Control:
Wastes containing Mercury due to breakage of thermometer and other measuring equipment need to be given
i. Proper attention should be given to the collection of the spilt mercury, its storage and sending of the same back to the manufacturers
ii. Must take all measures to ensure that the spilt mercury does not become part of biomedical wastes and
iii. Waste containing equal to or more than 50 ppm of mercury is a hazardous waste and the concerned generators of the wastes including the health care units are required to dispose the waste as per the norms.
h. Standard for Liquid Waste:
The effluent generated from the hospitals must conform to the following:
i. Waste minimization:
Waste minimization is an important first step in managing wastes safely, responsibly and in a cost effective manner. This management step makes use of reducing, reusing and recycling principles. There are many possible routes to minimize the amount of both general waste and biomedical waste within the health care or related facility.
Alternate technologies for biomedical waste minimization (e.g., microwave treatment; hammer mill) have been investigated and are not considered to be practical. Some of the principles of waste minimization are listed below and will be developed further in the long-term strategy.
Project Report # 8. Collection and Storage of Bio-Medical Waste:
The collection of biomedical waste involves use of different types of containers from various sources of biomedical wastes like Operation Theatres, laboratory’s, wards, kitchens, corridors 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.
Storage:
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 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.
Project Report # 9. Health Hazards of Bio-Medical Waste:
According to the WHO, the global life expectancy is increasing year after year. However, deaths due to infectious diseases are increasing. A study conducted by the WHO reveals that more than 50,000 people die every day from infectious diseases.
One of the causes for the increase in infectious diseases is improper waste management. Blood, body fluids and body secretions which -are constituents of bio-medical waste harbour most of the viruses, bacteria and parasites that cause infection.
This passes via a number of human contacts, all of whom are potential ‘recipients’ of the infection. Human Immunodeficiency Virus (HIV) and hepatitis virus spearhead an extensive list of infections and diseases documented to have spread through bio-medical waste. Tuberculosis, pneumonia, diarrhoea diseases, tetanus, whooping cough etc., are other common diseases which spread due to improper waste management.
A. Occupational Health Hazards:
The health hazards due to improper waste management can affect
i. The occupants in institutions and spread in the vicinity of the institutions
ii. People who happen to be in contact with the institution like laundry workers, nurses, emergency medical personnel, and refuse workers.
iii. Risk of infection outside hospital for waste handlers, scavengers and (eventually) the general public
iv. Risks associated with hazardous chemicals, drugs, being handled by persons handling waste at all levels and
v. Injuries from sharps and exposure to harmful chemical waste and radioactive waste also cause health hazards to employees.
B. Hazards to the General Public:
The general public’s health can also be adversely affected by bio-medical waste.
i. Improper practices such as dumping of bio-medical waste in municipal dustbins, open spaces, water bodies etc., leads to the spread of diseases.
ii. Emissions from incinerators and open burning also lead to exposure to harmful gases which can cause cancer and respiratory diseases.
iii. Exposure to radioactive waste in the waste stream can also cause serious health hazards.
iv. An often-ignored area is the increase of in-home healthcare activities. An increase in the number of diabetics who inject themselves with insulin, home nurses taking care of terminally ill patients etc., all generate bio-medical waste, which can cause health hazards.
