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Keshav Swarnkar Bio medical waste means any waste that 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. Bio medical waste rule 1998, India. Slide 5: GENERATION OF BIOMEDICAL WASTE. TYPES Solid wastes Liquid wastes. SOLID WASTES : SOLID WASTES Dry garbage – ordinary floor refuse, papers, flowers, trash Wet garbage – waste from kitchen(fruit peels, leftover food ) Wet tissues and bones – wastes from operation theatres, labour theatres, mortuary and laboratories Plaster cast – from the plaster rooms Packing materials – cardboard cartons, paper packets Surgical waste – dressings, cotton pads Metal waste – tin cans, bottle caps, needles Glass – broken bottles, syringes Disposable plastic items – from all areas of the hospital LIQUID WASTES : LIQUID WASTES Sullage and sewage – from bathrooms, lavatories, toilets, kitchen, pantries, operation rooms, dressing room, laboratory and laundry Chemical developer and fixer solutions – from the radiology department Radioactive waste – from the radiotherapy and nuclear medicine SOURCES OF HOSPITAL WASTE. : SOURCES OF HOSPITAL WASTE. Hospital and health care centres. Clinics or offices Medical research centres and laboratories Animal’s institutions Blood banks and collection centres and donation camps Biotechnological institutes and production units Slide 9: VOLUME HAZARDS OF BIOMEDICAL WASTE AIR POLLUTION WATER POLLUTION LAND POLLUTION HAZARDOUS WASTES : HAZARDOUS WASTES Infectious waste Chemical waste Cytotoxic waste Injurious waste DISPOSAL OF HOSPITAL WASTE AND LAW. : DISPOSAL OF HOSPITAL WASTE AND LAW. Environment (protection) Act in 1998 Biomedical waste (management and handling) Rules 1998. These tow rules are applied to all individuals who generate, collect, receive, store, transport, treat, dispose off or handle biomedical waste in any form. Schedule I: - categories of biomedical waste in India Schedule II: - colour coding and type of container Schedule I: - categories of biomedical waste in India : Schedule I: - categories of biomedical waste in India COLOUR CODING AND TYPE OF CONTAINER : COLOUR CODING AND TYPE OF CONTAINER WHO HEALTH CARE WASTE POLICY – 2005 : WHO HEALTH CARE WASTE POLICY – 2005 Unsafe health care waste management leads to death and disability Health care waste management may also represent a risk to health Balancing risks to make sound policy decisions in health care waste management Guiding policy principles Prompt sound waste management policies Support global efforts to reduce the amount of noxious emissions Increasing the use of incinerators Slide 17: STRATEGY Short term Production of syringes with the same plastic globally to make recycling easier Selection of PVC free medical devices Development of recycling options Research promotion Slide 18: Medium term Efforts to reduce unnecessary injections Research Risk assessment Long term Reduce unsafe management of health care wastes Support countries to promote safe management of health care wastes Support to countries for developing policies and plans Promote environmentally sound management of health care wastes SAFE DISPOSAL METHODS OF BIOMEDICAL WASTE : SAFE DISPOSAL METHODS OF BIOMEDICAL WASTE Collection and segregation Transportation and storage Disposal techniques COLLECTION AND SEGREGATION : COLLECTION AND SEGREGATION Points to be remembered Bins and bags should have a symbol of biomedical hazard Do not mix the contents of different coloured bins Needles should be destroyed by a needle cutter Sharps should be kept in a puncture proof container Disposable items should be cut before discarding Waste should not spill outside TRANSPORTATION AND STORAGE : TRANSPORTATION AND STORAGE Points to be remembered Before taking the bags it should be tied and labelled The waste handlers should not touch any other articles A covered cart with a symbol of biomedical waste hazard shall be used to carry the waste to the central area of collection Do not throw the bags at any point Unauthorized persons should not enter the storage area It should be transported to the final site of disposal in a covered vehicle DISPOSAL TECHNIQUES : DISPOSAL TECHNIQUES Chemical disinfection Thermal measure Incineration Microwave irradiation Landfill. Inertization Chemical disinfection : Chemical disinfection Plastic, Rubber materials IV sets Blood bags Gloves Catheters Urobags Syringe Needles Blood, urine, stools or hospital sewage Slide 24: Thermal measure (wet and dry) Autoclave (wet):- it is effective for microbiology and biotechnology waste. Hydroclave (dry):- shredded infectious waste is exposed to high temperature, high pressure steam autoclaving. Microwave irradiation: - this is also useful in sterilizing the infected disposable waste. Slide 25: Wastes to be incinerated Human materials Animal waste Laboratory waste Dressing materials Wastes not to be incinerated Pressurised gas containers Reactive chemical waste Radiographic waste Plastics Ampoules Comparison between electrical oil incinerators : Comparison between electrical oil incinerators Slide 27: Inertization: - here the waste is mixed with cement and other substance before disposal and it becomes inert and do not contaminate the water. Landfill. - Landfill is another preferred method like incineration for the final disposal of biomedical waste. A sanitary landfill can be acceptable choice for disposal of hospital waste in developing countries like India. Point to be remembered : Point to be remembered A place with authoritative permission The site should be away from the residential areas/ water sources Appropriate engineering preparation Easy transportation facilities Constant supervision CHARACTERISTICS OF A GOOD WASTE DISPOSAL SYSTEM : CHARACTERISTICS OF A GOOD WASTE DISPOSAL SYSTEM Good appearance Safety Pest control Odour control Public health safety Sanitary Economical Convenient Approach routs for the transportation of the infected waste. The poor bio-medical waste management include:- : The poor bio-medical waste management include:- Improper packing Improper segregation Improper on-site waste handling and movement Improper on-site storage Improper off-site transportation Improper treatment and disposal Poor monitoring of the management HOSPITAL WASTE: SAFETY MEASURES FOR NURSES : HOSPITAL WASTE: SAFETY MEASURES FOR NURSES Personal protective devices General protective measures In case of injury caused by infected sharps Other measures of safety GENERAL WASTE MANAGEMENT : GENERAL WASTE MANAGEMENT Waste or refuse is the unwanted leftover substances that have been discarded or thrown away. Waste, litter, garbage etc are the other names of refuse TYPES Solid waste Wet wastes SOURCES OF WASTES : SOURCES OF WASTES Domestic sources Market and street wastes Industrial sources Stable litter Why the wastes become a health hazard? : Why the wastes become a health hazard? It decomposes and favours fly breeding It attracts rodents and vermin The pathogens present in the wastes may be conveyed back to humans’ food by flies and dust Possibility of water pollution It presents an unsightly appearance and bad odour. DISPOSAL OF WASTE : DISPOSAL OF WASTE 1). Collection and transportation Push carts or trolleys Bullock carts Tractor trolleys Dumpers 2). Actual disposal Methods of waste disposal : Methods of waste disposal 1. Small scale methods Burning Manure pits Burial Feeding the animals Large scale methods : Large scale methods Incineration Dumping Controlled tipping Composting Anaerobic Aerobic The Five Step Waste Management Cycle : The Five Step Waste Management Cycle LEGAL MEASURE : LEGAL MEASURE To control the recycling of the polythene bags and the refuses, since 2001 the central government has banned the use of polythene bags of less than 20 microns thickness The hospitals should get a certificate from the pollution control board The hospitals should have incinerators for disposing the biomedical wastes The government of India enacted an Environment (protection) Act in 1998 and then notified the Biomedical waste (management and handling) Rules 1998. Slide 40: PUBLIC EDUCATION ECONOMICS AND FINANCE INTERNATIONAL COOPERATION BIBLIOGRAPHY : BIBLIOGRAPHY B.M. Sakharkear. Principles of Hospital Administration and Planning. India: Jaypee Brothers BT Basavanthappa. Community Health Nursing. 2nd edition. Bengaluru (India): Jaypee publications; 2008 K. Park. Preventive and Social Medicine. 18th edition. Jabalpur (India): M/s Banarsidas Bhanot;2005 Keshav Swarnkar. Community Health Nursing. 2nd Edition. India: NR Brothers; 2007 Wikipedia. (2009). Waste management. Retrieved June 24, 2009 from http://en.wikipedia.org/wiki/Waste_management Journal review : Journal review Lt Col SKM Rao, Cdr RK Ranyal, Lt Col SS Bhatia and Lt Col VR Sharma. Biomedical waste management: An Infrastructural Survey of Hospitals. MJAFI, Vol. 60, No. 4, 2004 Gupta S, Boojh R, Mishra A and Chandra H. (2009). Hospital waste management system – a case study of a south Indian city. Retrieved July 30, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/19470535 Hanumantha Rao P. (2009). Hospital waste management system in a south Indian city. Retrieved July 19, 2009 from http://www.ncbi.nlm.nih.gov/sites/entrez Sharholy M, Ahmad K, Mahmood G and Trivedi RC. (2007). Municipal solid waste management in Indian cities. Retrieved June 24, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/16766176 Narayana T. (2009). Municipal solid waste management in India: from waste disposal to recovery of resources? Retrieved June 24, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/18829290 You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.