Waste Minimization Segregation Labeling UNITII Waste Minimization Process

Waste Minimization, Segregation & Labeling (UNIT-II)

Waste Minimization • Process & policy of reducing amount of waste produced by a person or society • Need/role – 15% hazard mixed with 85% non-hazard waste – Duty of hospital authority to identify & quantify by controlling demand/inventory, consumables items & breakages – Recycling of certain waste (paper, glassware, plastic etc) – Encourage purchase of reusable items made of glass, metal & non PVC (polyvinyl chloride) – Apart from protecting people & environment, save hospitals in great deal of money in long run – Meticulous segregation is key to minimize the quantity of waste to be treated.

Advantages Waste Minimization • Reduces potential exposure of hazards associated with waste • Reduced volume & toxicity of unavoidable waste • Improved storage, transportation, treatment & disposal • Proper containment of hazardous material • Prompt removal from workplace • Long-term economic benefit.

How to do? 1. Source reduction • Through product substitution, technological change, good operating practices. • Methods can be adopted: prevent waste of product in nursing & cleaning activities, prefer physical over chemical cleaning, select supplies that are less wasteful or hazardous, centralize the purchasing of chemicals over hospital level. 2. Resource recovery & recycling • Majority of waste is same as office waste (paper, cardboard, plastic wrappings, metal containers, glass) • Recycling not practiced by healthcare (silver in x-ray flim)– method of disposal, recycled product bought & used. Generate revenues. • Consideration given to segregate material to be recycled. 3. Educating the staff (nursing, housekeeping staff, about diff categories of waste 4. Composting organic waste – recycling, waste mixed with nitrogen source, provided with air & water. (used in lawns, garden, farm to add nutrients & texture to soil)

Example-waste minimization procedures • Minimizing chemotherapy & antineoplastic chemicals (optimize the size during purchase, employ effective spill clean up, reduce volume used, segregate waste, return outdated to manufacturer) • Formaldehyde (minimize concentration, minimize waste when used in dialysis m/c RO unit, capture the waste & reuse in pathology, autopsy labs etc) • Photographic chemical (keep developer & fixer cans covered to prevent evaporation) • Waste anesthetic gases (minimize waste thru leakage by proper maintenance)

Reuse • Equipments designed for the purpose of reuse & withstand in sterilization process. • Scalpels, hypodermic needle & syringes, glass bottles etc. • Thermal sterilization – Dry heat sterilization (exposure to 160⁰ C for 120 min or 170⁰ C for 60 min in a “Hot air oven”) – Steam sterilization (121⁰ C for 30 min in an “autoclave”) • Cold sterilization / chemical sterilization – Ethylene oxide (highly hazard, 50 -60⁰ C for 3 -8 hours in “reactor tank” use gas sterilizer, carried by highly trained & adequately protected personnel, ) – Glutaraldehyde (safer for operator, but microbiologically less efficient, exposure to 30 min, plastic syringes should not be reused) • Pins, needles, seeds of long-half life radionuclide's may be reused after sterilization

Waste Segregation • Separation of different types of waste by sorting into designated categories • Most vital step in effective HC waste management. • Green purchasing, waste minimization considered before drafting segregation plan. • Need • If not SEGREGATED, – mixing municipal & biomedical waste, human & animal lives in danger, hamper the entire process of BMW • Backbone of WM, meticulous collection, transportation, treatment & disposal.

How does segregation help? / Advantages of segregation • Prevents illegal reuse of HC waste i. e. syringes, needles, other plastics. • Provide opportunity for recycling & generate revenues. • Biodegradable waste can be composted within hospital premises & used for gardening. • Reduces waste level, cost of treatment & disposal. • Prevent cross-contamination of various waste thus improve infection control • Reduce occupational health hazards to healthcare workers.

How to do Segregation • Should be done under the supervision of waste producer close to the point of generation (in ward, in bedside, in theater, in delivery room, in lab etc), this avoids dangerous secondary sorting. • Correct & efficient segregation requires dedicated rigorous training & education of employees, supervisor, manager. • SOP for segregation should be common & uniformly practiced throughout the country. • Segregated waste of diff categories collected in identifiable containers at each collection point. • Preferred system of labeling, color-coded bags or containers should be used. These bags are sealed & removed when it less than 3 quarters full by clinical & sanitary personnel. • Regularly monitored to ensure procedures are being practiced accurately. • Ensure correct disposal route & personnel safety.

Essential properties of container/bag • Should not leak • Should have a cover • Capacity to contain a designated volume & bear the weight without any demage. • 3/4 th full, then securely sealed & appropriated label has to be attached. • Adequate symbol must be displayed for each type of BMW according to their code.

Advantages of color-coded container • • Easy for the staff to properly segregate Contents of the bin easily identifiable Potential hazards can be easily identifiable Various treatment & disposal requirement can be readily selected.

Cautions • Never compact biomedical waste at point of origin • BMW should be removed from its container or origin only by a licensed BMW disposal firm. • Never mix BMW with radioactive or hazardous chemical waste. • If Hazardous & Non-hazardous wastes are accidently mixed should be treated as Hazardous substance. • Staff should never attempt to correct the error in segregation, e. g. removing bags after disposal, putting one bag into other.

Person responsible for segregation • Person who produce/generate waste – Well aware about material used & their purpose – Know the items used on infectious patients & lab experiments – Ware the proper PPEs – Trained & expertise in waste disposal

Procedure for segregation • Done in accordance with schedule II of BMW rule. • Radioactive waste are segregated based on some conditions imposed in radiation level. • General waste should be categorized as – To landfill – For composting – To recycling