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NATIONAL GUIDELINES ON HOSPITAL WASTE

l\1ANAGEMENT HASED UPON THE BlIO~MEmCAL W ASl'E (MANAGEMENT & R..rnDLING) RULES, 1998

The Bio-Medicel Waste (Management & Handling) Rules, 1998 were notified under the Environment Protection Act, 1986 (29 of 198,6) by the Ministry of Environment and Forest, Govt. of India on 20l1! July 1998.. The guidelines have been prepared to enable each hospital to implement the said Rules, by developing comprehensive phn for hospital waste management, in terms of segregation, collection, treatment, transportation and disposal. of the hospital waste.

1. POLICY ON HOSPITAL WASTE lYlANAGEMENT

The policy statement aims "to provide for a system for management of all potentially infectious and hazardous waste in accordance with the Bio-Medical Waate (Management & Handling) Rules, 1998 (BMW, 1998)

2. DEFINITIONOFBIO~MEDICAL WASTE

Bio-Medical waste means any waste" which is generated during the diagnosis, treatment or immunization of human beings or animals 0.1' in research activities pertairiing thereto or in the production or testing of biologicals, including categories meatioaed in the Schedule I of the Bio-Medical Waste (Management & Handling) Rules., 1998.

3. CATEGORIES OF :Bm-MEDICAL WASTE

Hazardous, toxic and Bio-medical waste has been separated into following categories for the purpose of its safe transportation to a specific site for specific treatment. Certain categories of infectious waste require specific treatment (disinfection/decontamination) before transportation for disposal. These' categories of bio-medical waste are, mentioned as below.-

Categl!lry No.1 - Human AllIatomical Waste

This includes human tissues, organs" and body parts.

Category N ill. 2 - Animal Waste .

This includes animal tissues, organs, body parts, carcasses, bleeding parts, fluid, btood and experimental animalsu.sed in research; waste generated by veterinary hospitals andcolleges; discharge from hospitals and animal houses,

Category No .. 3 -Micrllbiology & B~otedmology Waste

This includes wastes from laboratory cultures, stocks or specimens of microorganisms 11 ve or attenuated vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, wastes from production of

biologicals; toxins. dishes and devices used for transfer of cultures, .

Category No.4 ~ Waste sharps

This comprises of needles, syringes, scalpels, blades, glass, ere. that may cause puncture and cuts. This inchsdes both used and unusable sharps.

Category No.5 - Discarded Medicines and Cyto,toxic drugs

TIlls includes wastes comprising of outdated, contaminated and discarded. medicines.

Category No.6 - Soiled Waste

It comprises of items contaminated with blood, and body fluidainclading coaea, dressings, soiled plaster casts, linens, beddings, other material contaminated with blood.

Category No.7 - Solid Waste

This includes wastes generated from disposable items, other the waste sharps, such as tubings, catheters, intravenous sets, etc.

Category No .. 8 - Liquid Waste

This Includes waste generated from laboratory and washing, cleaning, housekeeping

and disinfecting activities. .

Categ.ory No, 9 - Incineration Ash

This consists of ash from incineration of any bio-medical waste.

c.atego.ry No. 10 - Chemical Waste

This contains chemicals used in production of biologicals and chemicals used in disinfection, insecticides, etc.

4. SEGREGATION OF WASTE

4.1 It should be done at the site of generation of'bio-medieal waste, e.g., all patient care activity areas, diagnostic services' areas, operation theatres, labor rooms, treatment rooms, etc.

4.2 The responsibility of segregation should be with the generator of bio-medical waste, i.e, Doctors, Nurses, Technician, etc.

4.3 The Bio-medical waste should be segregated as per categories applicable.

5.. COLLECTION OF BIO~MEmcAL WASTE :

Collection of Bio-medical waste should be done as per Bio-Medical Waste (Management & HandJing) Rules, 1998 (Rule 6 ~ Schedule II). The collection bags and the containers should be labeled as per guidelines of Schedule m, i.e, symbols for biohazard and cytotoxic. A separate container shall be placed at every point of generation for general waste to be disposed of through Municipal Authority.

The trolleys, which are used to collect hospital waste, should be designed in such a way that. there should be no leakage or spillage of bio-medical waste while transporting to designated site.

T

fC

d

II f

fB'

dl 1

'lY_lI_e 0 on tamer an_ co our or eo ec Ion 0 lome lea waste:
No. Category Type of container Colour Coding
I Human anatomical Waste Plastic hal! Yellow
"2 Animal Waste Plastic bag Yellow
3 Microbiology & Bio- Plastic bag YellowlRed
Technology Waste
4 Waste sharp Plastic hag, Puncture BluelWhite/
proof container trans lucent
5 Discarded Medicines & Plastic bag -Black
Cytotoxic Waste
6 Solid waste (Soiled) Plastic bag Yellow! Red
7 "'Solid Waste (!'lastic) Plastic b<lg_ Blue I White
8 I Liquid waste -- -- , I'i(l,

9

T~ pla5Iic&~oo ~s 1~'Ilid like blood; uri:ne, pu.s:, 'ele. .• should be; put in:]~.re4 ool,OIW:' lJagt9:r mW;fOwa¥mg aiIld ay.~:Vin~ M.el, oth~ items g~oU!1d b~ pm into blue O~ ..... hite bag aft~l' C"Mmilc«ll.tte~t and 1III111.ti18tiOcn / S:b;r.eddWg,

:5.2. .AJl diG lT$II18: sern to ,lnc..rD.e!:atQridil'il[p burIal {catl,2.,3,e)s.hould he llla~d. i~ Yll::UOW G!!lJ.grod bags,

5.3 ;I; . ll tIi~l::ho"li'iMi.ilal '!';',;:f1;te to be S'e!ltt for }.fjcro'wilvefA1.rtocltl::~'e, trea.t;me:tlt SllOUlii be pllaced in R~,·co1o:mI .. ba,gs. (;:@t. 3.6 & 7}

J.4 Any l!l3flt~ wlli.chi~ ~'l: to ,silredoier :eDLerA,ulDcJ;avlllilg. I Mic:~viligiOh~~al ~atmmi [s to be:pack.e1J in Bluel'\V:hif.e .trat1J~l1i>e.;rnt I~ag.

5.;5Loe~dillm o(fr,wmtainen % Aill oo.l!i.tDI.eIsb.aJiiing differern.t ,oolo:red p,lam:i.c ~, i!!MuWbs loc;ilte{I at 'the fI'Oillt .of ge11erw(fon of ""-SiSk', i.,e." Ilsar d,T" tables, ilUeacio.fl mfml).'i. td.i~_()\S5.c,. ~MC~ ~; dresq,troR:i'eys,inject1clllitlo1i.eytl, e[1l).

5".(1 ,La:b,di!ng. ~ AU '~{l~~el'Sm:ni'llt ID.~ la.~16d bi.() .. h~<:d i:\r: ,cytotox:f,e witll. 'Symb6Js at\ll!IIain.g to. tltei'lll~ (SchetluIe m ,cr Bto"rtI'ooh:ml Wasle RuJes, 199'~

5.7 Bag: It $Wz!!Uld Ibe~-.sun:d I:l!mt .... asi:.e:b~:gs :;IN filled up to' ~,ft.W'filiI ca..pacity. ~fedl ~~y OO"IQ re.ilW'\i'I!d :from. t11e~!te of me g,erlemtion to !;be sJto:.a.~ areI\. regIW}I:l'~t and! runoty_

's.S Tfw ea~6go:ries~if 'WaSte (Ou, 4.~7"g & ](I) wru:tiru- .r:C:tq'lllire pre,tl1catmtlnt {:decO"J'i~tlollltlis~) ,"rue si.te .. 'Of~N3ItU(JII sLlc:n a~ pl~sti~ ruld ~aIiP materi;Us,.~lC;" rumulfi! be~\led fr.om. 'IM st~~ of gc.nlMi!litu~ GI1!!Y .umer ]l!~e-treatmCfit.

5.9' ''The'q:tlalltiity o:f ,oollectioo sb.,ruldile G.ocum.enredirt a Iegi:st!:l\ The; Q010Ulr 'p~as.ti.cb~gs sh0'Wd tre :!iep.I~d omd. ·tl.'Iecgarbagc bin milultl. 00. dea:ne:d! wiat

dtj)i1lf~(;taot IO~]J. -

6. Srun:g~ • Waste,

Sro.ra:ge 1erern to the h'Qidingof Bip',mrokal was~ fm a ce~~n .Fe!!OO 0;1' time 8ilth~ sit,e .(l.f~n~~tiWI flU its: trn:ru;itfu[·~.tm;t'mt andfiIi'al dlsPQsal

Wl:I 1fnttTea~~b~@·m__edielll w.:u;te ,sbaJ~~e kept ~,l\ed, beyQ,r{d a pcriot! of 4\8 b;cJlItS;;

ThIS aiLll.b.lrlr.i~, p~0f:l must ~.G' fiJe p-ermimo[l of tIt::! ll~c.njbed ail.ltboicllY if far <IDy~~~ h!:lecom.es ~ru;y t(j!·:nl)reiJrie w~~he.yo!l1d 4'3 .hrmr~,.

The ~thp:Fiu,ill; ~I."SOII. slio"l'W'! ~ mUSUkiS m·ms.~ deloit .~~ was~· a'iX:~. nQ't, iid:"e.t'~~y affe~ liumw:"i bealth. an.a the e:n~~t,or.rme~t.., inc c:as.~ it is. k~Jl1lleyo;J;Ld the ~cdbe(11i.t:J:lli]t..

'1,1.1 Wiiliin !he hospital, ~ I,oute.S t!;aIJ1S'~ be de ign!O\reC. 10 a .... Clta Ifi€ p~, of...w.site ~ugh 'pat~e:nt care areas, as fur as p!Js!iib!,~,

7, 1~2 Sepat1l,te time schedules ee p!:'eparccJ furtmJWipOR!ltio~ ofBi(l-medIcal loWllr>W ,0!Ill.d ~~;riil mm:. It will l'e1ll!,l!;)(i; ~,ees ofrne~r. mix; up.

7.1.3 IDediiJi!lttd vmee.led ~ai!lel.'\';J 1'l'OL1eys or ~MS with proper 1:abel (85 ~r Schdlille IV of Rule 6) shOiild. be.ased Wi) 'tr.riJlJPPitlh.e wmm: from the ~i~ of :stma:gelo the 'S,ite of trMtm€:J1t.

7.1.4 TroUeys or ems :s"h.().uld be thOirotl,ghl:y L'ileans·OO! and dismfected in lihe: event of My ~illage.

',.1.5 Tjjol!~~ m carts 1>hould be thor'Ol]~bl)' cleruu:.ed IlJld distnf~d in the evem of ~ :spillage.

7.2,1 N~rtL$l'anaiiilg Wl~g conrain.oo in the: motor V<!:hlde~ .At." 19'.8:8 ol"ml"g ther~tlfider, Bio-medical waste shall be tmDiJportod! only in such vehicles as, IDay he au'lhori~d f,or thepuqJoEJe by me cornpitent

111.1thor:i,ty. -

7.2.2, The cantairLers:fu. ~spott:a,tioli must be labeled!l5 'givc'n in ScheduJe man4IY0fBwfW.1998,

8;, TREA;n~ m' HOSPllTAl.. WM'FE (PLEASE SEE RULE '~J S'CHEDlILE V &V1)

8,1 Gm1~~1 waste~ (NOfi·~8JI'.d!.O~. ool1-toxic,nfJJil..irJfiii!c[~OtlS). The saKe, disposal of this waste shQuld. be erwJreel by the occupier tli:ro g,h local MUIlidpal. Aut1:K!lrity.

8,2 BiI>·Medical wE5ie

Moni:t"o:lin~u'i tllcini}fator f autpclawimicrovn.v"'e :liliaH be 1c.a.!ITied nut once in!t month to check the 'pmmm:m.~ of the equipment One should e..:nsl:lre:

b. The ]ll"ilper Qpet:<rticm ,& Maint:ml.rulo(';: of t'he mcinernlQ:!]f' ,fl.1i4IDC"law,el microwave,

u, ;:,\.ll;U:nnil.Cl1t &tpre:s'Cribed t'e:J:llpe-r.atmes 1[1 bOoth the chambers ,Of

u!'lcmm'L'l.tol' while iacin~rating the wa:;1iit,.

m., Not to iltoinemte P'VCplastLC materials.

iv, QlLly skiil1ooflecs(l!3"S operate the:'iiquipment

v, P.mpEiT t, QOni book shall "be: mainfaiIJed-for the m~~IWMru:sl autoclave! mi.cro'Wa'Vel sJm~dcleL Such r.coord 'hook s.h;;ll tJa;ve the e.llitrie.s of pe~()d of operation, i.l:::IDPe.m:twet pre56Ulll !!IlItmlltCl whi1e treating the Wl!-51:e, quantity oiwi'L5t.c wat"..d e;t;c.

vi, The ,:;;Cil,l"Cf.Ig¢Ci $..~ !Kit be allowed to sort out!'ha wMte.

vii. Prope(!' hyg.lene slhl111 be nWntm;nerl at, both, 'w ''laste'tre:atmen! pltIDt site I1!S weJlO'lll, the waste stOrage area.

...tii.

Cilllt¢g)jci~. 4,.7,~ ~ .Ws.1iotdd b~ 1:Jrn.atoo ""itli. clrie-m.ioal dlsimoew_nt lliike 1% hypoehlQrH:e $€1lmion o:r .any lother. eQu:h'aI~llt cll_emii~al :O:llE~nt I:Q ~t cfisin1le:!l:tio!ll.

8.2..6

fudrutr.atilMl.; T~ j:l1d~!l' '.!lhould! ~ lrl~$I~ll~ "El:!J1d made (,tIF~ati6nal 85ll.tr s:lPc.meauall.S =<1£11': tfie BMW .rn~es; l'S9:8 (Sch.edlule .V) .and 1111 !ilUt'hof£izatiQI:! .:>ha11 'be !Men fr{Yrnili~ 1{..fe,sctiO;luil .authori~ fu.:I'~he :t'MIlaif~~ment ~ ~clli.!lJg ofbLo"llleilii£ai '!'J<lS~e: incl;rulillg msta!1aU'O]] iill.d Op!!I3D.qlil.DHl":Mt!:Ilen!l :l'a:dlity M. ~r Ru!.e B· OiISjo,o,l\lleill.cal W~ne ~ &; HanDlling) RWC!l, 1998;. Spe;~ific lC'[':quircmmu,ts rt8~n~ 1!h'~ in~in~;gti;)i' Wld iLQ!lt'Jl:5 {'£ ~ni~:m:,,~iO:Il effi.¢,l~l1-C~mld ~issjo.l1 levels e~. ~v~ b~[l, 4'~[~d in. ;~@ Bi ~"1'A~ili~:!lL W2l~e j){ar!a.g-e<ooelll .& HgrJiicl.li[lgJ Rrul~, m9'8;, lr.L tUifii~ or l!:rIifd]l<im-pitals, jQillt facmtL!:l:S foil' :irn:rnetatiol'l tan. be Oeve.lo.ped depe.tld.i.ng .lJipoil 1Ire; loca] lX)lld'eI] oftEle H-os,p~w a:rul ft.3s.iuilil;y, Th~, pr __ baga mM/Z pf chl.~;pif:iSfi~ ;S]roti!d not bG ill.cillsr:atf.!J1,

p~ bWfiid: s.~"'d rot ril'eqJ< bur.ial. ~abQilillluA;iW!lcd in 1M B.i.e· mediiM wasm (MMage:m.mt& Handlmgc} Rl!!I!.es 199:g (lSchoollle:V), The ()t'J:':s:~n.g JESS tfian 5 l.ak:bIJ'O'Pul~i[iol1 can opt ['Ox cdeep burii1l for w~t!l'S!1n'l;!er'e~s 1 &2.

A'lLwc1a~.'!I SiliId MWI~w.a.Vll1ur.eatment: SbmJb:ffls{or • Olu,t~cI~"img ani! Micri~})MI"viIlg are lliro ~ntioned! .ill tbe Bi().Medi~ 1i'tfl.cS![.~ (M~'emeElit &; h:andl:ing) .Ruk:s 199~ (3o.h€auJ.e V). AU eqllipme:tn imltailll~dls:OOred. ~>!lluld meet t.\e5e specm~ti,Oifis. The WMte ~ categ:o:l:Y 3A~6 Sind "1 can. be· tlDealled by ~, tec.~~~~

Shn:ddin:g: 'I.he 1!~tics <rVbQ~ll~, IV'sen, '\YriiJ]g~s. tarhftil1lrs, ,0'1:£=;), ~ (needi.e~, bl~~ .. glass; etcj shO;1.dd: h~ shr,e:cided IlUr~"' tl.rhly alk::r ~c<d ~~IltJ"hifjcrnlWav:iD(gi AI:It:oclaVing. 'EmSi,l~jf:lgc dismfectiOlll, Ntmdle lillestr~ers<CIm. be wed for d.iqJO'S:ai IJif~le;, direcU" 'Wi1ih~Uit

~\;aI.~ent. .

S~'tlXil:,J: .l3ndfiU ~ t:he ~c,i~~ MI., discarcl.\:d Jl:ledl.~in~, cy1o~o~i~ s"taMe5 atid.soUd ~heillli1=-aI ~ s"tiwi:lld I;>e we~~d b;y tIilllGplion (Gat,5, 9 &IOJ

[i m~ be oo~¢d thG.fI;!I.I'l'l muJ.!ivle O'Ptionr.a.vuabh: fQr a:i~sal. fu·f t.ertailil cat~lQlj' of waliire, ThotintBividual hospibl eJ!!'! PhO~se !he, ks'f QPtW\I;!· d~nding upon U'eilJtm.e.rut faoortics avai]abIJe~ Rad!ioacti\'eW~;;n.e m~~m.ent, Oil" thcrad1oa.cti'!ffl waste sbo~d be; }IIld~I1 .. as ])~r,th~·.~t.ieLifiesCil:E BJ\RC.

l, Chem:il'i"~ Wasre .& Ugj1.!Illd. Wailt~ ffllm L~bl)rI1itl(l!ty, Sruj'tijbLe B,ll.tmenil'., dilution 'pr 1% )Jyp~hlorite: S:Q,lllillQ:il as ~Ili:l'ed ~. be g1}'en herore ~i.sp£i'1l~l.

ii, "l'be effiW!l.ts geOOl'a.Wtl 'fl'b.lJJ1. m~ b:ospi~. sooilld C0mO[:lllJ. to ]imib as laid clevm. ]11 1he EI&orMedica1 W~I~ CMw.Iil~e.n! &; H.an.m1::ia.g) IW[.e~\ 1 §I98 CSchedu!le V)

iIDi. fhe 1]-41.11£1 a:ncl: 'M.wmcal wastte:ili.ouid not be used fur .:my·lltiLfiir ~o:s~,

'Iv. For' dischillg.~ into public S~\i'ieIS with. telUlmw faeili.ti~(!; .~~ p~nbed ~tmd8i[d. ]i:rID!$ Sfl91;L!d be~M!.I!!'~,

i 1.2 The, Heads f;}f ,~c:h nosp'ital wiU h.il:ve: to take autll,orization for generation"."f waste from ~~all'i: anthorhies well in time, a-s notified by the eoneemed StlIke I U.T. G(j.,.:~mm.e.I~!t: and get it renewed as peT time sehednle laid! In the rni.es. The,il!p'p'lioat~i()¥! i~ rc 00 made as per format gil,!~ iII form. 1 far ~rmt of

at!lilho~twn.. (Pi.eas~ ~~ pag~ 131 of IIDH.fied BMW RuLes) .

11 ,3 Th~ annealreports, aeeLdellt-reportmg. as required ~ B~ rules 3h.mlld be s-uboottedio"ilie eonceraed author'ihes ago per BMW ruies OOrmii:t (Forron Oll'id FO,ml m 1'l1;Spectl:v.eI.y) cPh~as,e seepages 19 & 29 (If BMW .R.lI~.,~),

11.1 Mt!.Itid,Pai ,:;Iu[:hQrines:; As: qu:iJt~, a lrur,£e pen::en,ta,ge of waste (upttJ SiQ"lJlJ) g,elDer;ateG. in .indian h(!spi~ bcloogsfO perfil cate~(lIry (:nan't'Oxlc and non.hazardous),. the hoopitit aruilioritle5 s11;O'uld have ICOinstmlt lMetacUm:l! with munici4llai aut:ho.ri.t.ies 50 ih!at!:h.is .cat'egory of waste is ~'eg!!lla:rl.y tahn Ot'll of th~ hb~:iU!l! ]It(miigeg for furtiu dis:p:o'Saf.

11,:2COOilidlnated! effu.m should ~~ :made by health amhooti1esmil mlllllicipal artl1:ihorides HI inw£ve private seoCW!l"INGO'.s fur creation of com!mo:n f~ilitull:£

fur treatmient .

I.]),] Hea:l:th. i9,mtlroriries in oom-dinatioll wHlIl mWlicjpal acullioiirLes should facilitate opti:m.liI trt.ilizatiQ:n.of~treatn:lent facili~>" in the aJ:ea.

]2:.4 COOrrunatThOE mth N'GO's::m.d .Bl1virorune.ntru GWIllPS. for puolicawareness & 'eiit:a.e 8,ma,]"!.

[lSi Sharing offaci1ity: Hospital whic.h we: .!lot 011 a possession oft.hei:r awn facility fo,r tta~t 'ITI,a)' get ~r ~treMed in; iii sharedfucllity,.'Thoe hQ~tals havIng .addmoI!IflJ oopaciJtym.:ay ext:t;n.dJ their :fuciHty to IleaIDy smrul.l.er Hlo:>pitail. or he1dth.cooe u:mt5.

12,16 There shi:luI.d hecooMin:ated~eooies to mh, care: of e~.ige.ll.'C~esfdisfUptiol:l of ~e treatmelH equipment in alllllit,