SOLID WASTE MANAGEMENT IN HOSPITALS Presented by Nous

SOLID WASTE MANAGEMENT IN HOSPITALS Presented by Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS “ Medical care is vital for our life and health, but the waste generated from medical activities represents a real problem of living nature and human world. Improper management of waste generated in health care facilities causes a direct health impact on the community, the health care workers and on the environment The Government of India (notification, 1998) 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. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS According to Biomedical Waste 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 biologicals. ” Major Sources q Govt. hospitals/private hospitals/nursing homes. q Primary health centers. q Veterinary colleges and animal research centers. q Blood banks / mortuaries / autopsy centers. q Biotechnology institutions. 85% of hospital wastes is nonhazardous 10% are infectious 5% are noninfectious but they are included in hazardous wastes. Minor Sources q Physicians/ dentists’ clinics q Animal houses/slaughter houses. q Blood donation camps. q Vaccination centers. q Acupuncturists/psychiatric clinics/cosmetic piercing. q Funeral services. q Production units. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS "Biomedical waste" means solid waste of the following types: "Liquid human body fluids" means waste that includes waste liquid emanating or derived from humans including but not limited to human blood and blood products, serum and plasma, sputum, drainage secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid and amniotic fluid that exceeds fifty milliliters per container, storage vessel, or plastic bag. "Pathological waste, " which includes waste human source biopsy materials, tissues, and anatomical parts that emanate from surgery, obstetrical procedures, autopsy, and laboratory procedures. "Pathological waste" does not include teeth or formaldehyde or other preservative agents, human corpses, remains, and anatomical parts that are intended for interment or cremation. "Cultures and stocks" means waste that includes waste cultures and stocks of microbiological agents infectious to humans, discarded live and attenuated vaccines infectious to humans, human blood specimens, and laboratory wastes that are contaminated with these agents or specimens. "Biosafety level 4 disease waste, " which includes wastes contaminated with blood, excretions, exudates, or secretions from humans or animals who are isolated to protect others from highly communicable infectious diseases that are identified as viruses assigned to Biosafety Level 4 by the Centers for Disease Control, National Institute of Health, Biosafety "Animal waste, " which includes waste animal carcasses, body parts, and bedding of animals that were known to have been deliberately infected or inoculated with human pathogenic microorganisms during research. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS CATEGORY OF BIO-MEDICAL WASTE CAT NO 1 • Human Anatomical Waste (human tissues, organs, body parts) CAT NO 2 • Animal Waste Animal tissues, organs, Body parts carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals / colleges, discharge from hospitals, animal houses) CAT NO 3 • Microbiology & Biotechnology waste (wastes from laboratory cultures, stocks or specimens of micro-organisms live or attenuated vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, wastes from production of biological, toxins, dishes and devices used for transfer of cultures) CAT NO 4 • Waste Sharps (needles, syringes, scalpels blades, glass etc. that may cause puncture and cuts. This includes both used & unused sharps) CAT NO 5 • Discarded Medicines and Cytotoxic drugs (wastes comprising of outdated, contaminated and discarded medicines) Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS CATEGORY OF WASTE – CONT. CAT NO 6 • Solid Waste (Items contaminated with blood and body fluids including cotton, dressings, soiled plaster casts, line beddings, other material contaminated with blood) CAT NO 7 • Solid Waste (waste generated from disposable items other than the waste sharps such as tubing, catheters, intravenous sets etc. ) CAT NO 8 • Liquid Waste (waste generated from laboratory & washing, cleaning , housekeeping and disinfecting activities) CAT NO 9 • Incineration Ash (ash from incineration of any bio-medical waste) CAT NO 10 • Chemical Waste (chemicals used in production of biological, chemicals, used in disinfect ion, as insecticides, etc) Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS 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. WASTE COLLECTIO N SEGREGATI ON TRANSPORT ATION AND STORAGE TREATMENT & DISPOSAL TRANSPORT TO FINAL DISPOSAL SITE FINAL DISPOSAL Example of vehicle used for transportation of biomedical waste. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS PLANNING & DESIGNING FOR SOLID WASTE IN HOSPITALS A. SEGGREGATION OF WASTE AT THE POINT OF GENERATION § The waste is collected in three or four color coded containers and the sharps are collected separately in the sharp container B. TRANSPORT OF COLLECTED WASTED TO CENTRAL POINT OF DISPOSAL AND TREATEMENT • The waste shall be transported in covered trolleys, separate for each category C. TREATEMENT AT CENTRAL POINT • The segregated and collected waste shall be suitably treated as per DPCC norms by one autoclaving two disinfection three chemical sterilization • The waste shall be compacted either by pulverization and compaction or by simple compaction. D. FINAL DISPOSAL • Either the waste is handed over to a third party waste handling agency or by deploying waste handling technology like IGMET waste can be pulverized disinfected and compacted whereby the volume is reduced by 90% and then resultant compacted waste is disposed off to third party or municipal waste handlers. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS WASTE SEGREGATION AND PACKAGING COLOR CODING YELLOW (CAT 1, 2, 3, 6) TYPES OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS Plastic bag Human anatomical waste, Animal waste Incineration RED (CAT 3, 6, 7) Disinfected container/ plastic bag Microbiology and Biotechnology waste, Soiled waste, Solid Waste Autoclaving/Microwaving / Chemical Treatment BLUE / WHITE TRANS. (CAT 4, 7) Plastic bag/ puncture proof Container Waste Sharps, Solid Waste Autoclaving/ Microwaving/ Chemical Treatment and destruction/ shredding Plastic bag Discarded medicines and cytotoxic drugs, Incineration ash, Chemical waste Disposable in secured Landfill BLACK (CAT 5, 9, 10) Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS BIOMEDICAL WASTE TREATMENT & DISPOSAL 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 thereof. Broadly, three types of incinerators are used for hospital waste: multiple hearth type, rotary kiln and controlled air types. All the types can have primary and secondary combustion chambers to ensure optimal combustion. These are refractory lined. Non-Incineration. Technology Non-incineration treatment includes four basic processes: thermal, chemical, irradiative, and biological. The majority of non-incineration technologies employ thermal and chemical processes. The main purpose of the treatment technology is to decontaminate waste by destroying pathogens. Facilities should make certain that the technology could meet state criteria for disinfection. Autoclaving Chemical Methods Microwave Irradiation Plasma Pyrolysis Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS NOUS WILL PROVIDE REQUIREMENT FOR q Area and Space distributed throughout the hospital. q Will establish corridors for movement both horizontal and vertical q Recommend suitable equipment for collection transport and initial treatment of solid waste. q Recommend suitable equipment for compaction, disinfection and pulverization. q Design waste handling yard for safe storage of solid waste till it is disposed off. REFERENCES q Nous has done this specific planning and designing for the following hospitals Ø Indraprastha Apollo Hospital, Delhi Ø INHS, Ashvni, Mumbai Ø ILBS, Vasant Kunj, Delhi Ø M. M. Medical College, Mulana, Ambala Ø PGIMER, Chandigarh Batra Medical College, Jammu We do this for all the hospital that we plan and design in a limited way. “Nous Will Provide the SOP for Bio-Medical Nous Waste handling for. Ltd. Hospital Consultants Pvt. implementation as part of Hospital Operations. ”

SOLID WASTE MANAGEMENT IN HOSPITALS NEED OF BIOMEDICAL WASTE MANAGEMENT IN HOSPITALS The reasons due to which there is great need of management of hospitals waste such as: Ø Injuries from sharps leading to infection to all categories of hospital personnel and waste handler. Ø Infections in patients from poor infection control practices and poor waste management. Ø Risk of infection outside hospital for waste handlers and scavengers and at time general public living in the vicinity of hospitals. Ø Risk associated with hazardous chemicals, drugs to persons handling wastes at all levels. Ø “Disposable” being repacked and sold by unscrupulous elements without even being washed. Ø Drugs which have been disposed of, being repacked and sold off to unsuspecting buyers. Ø Risk of air, water and soil pollution directly due to waste, or due to defective incineration emissions and ash 3. Nous Hospital Consultants Pvt. Ltd.

SOLID WASTE MANAGEMENT IN HOSPITALS KEY BENEFITS ü Reduction in the incidence of hospital acquired and general infections. ü Reduction in the cost of infection control within the hospital. ü Reduction in the possibility of disease and death due to reuse and repackaging of infectious disposables. ü Low incidence of community and occupational health hazards. ü Reduction in the cost of waste management and generation of revenue through appropriate ü treatment and disposal of waste. Improved image of the healthcare establishment and increase the quality of life. ü Cleaner and healthier surroundings. Nous Hospital Consultants Pvt. Ltd.

THANK YOU Nous Hospital Consultants Pvt. Ltd. 31, Shopping Complex, Gulmohar Park, New Delhi – 110049 , India P: 011 26858107 F: 011 26858017 Email: nousdoc@gmail. com Website: http: //www. nousdoc. com