Frequently Asked Questions

1) Define Bio-medical Waste?

  • The term ‘Bio-medical Waste’ includes any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or research activities pertaining thereto, or in the production or testing of biologicals or in health camps, including the categories mentioned in Schedule 1 of the Bio-medical Waste Management Rules, 2016.
    In addition, biomedical waste includes similar kind of waste that are generated at household level, due to health care offered at household level eg dialysis at home, self administration of insulin injections and restorative care.

2) What is the importance of managing Bio-medical Waste?

  • Healthcare services which aim at aim of health care services is to reduce potential risks to health and reduce health problems in humans. Activities undertaken to achieve this aim generate biomedical waste that in itself is hazardous to health and has a potential to cause injuries and spread infections. Therefore to minimize risks to human and environmental health it is important that safe methods of handling, disposal and treatment are instituted.

3) What are the different types of Bio-medical Waste ?

  • A : Yellow

  • • Human anatomical waste
  • • Animal anatomical waste
  • • Soiled waste
  • • Expired or discarded medicines
  • • Chemical waste
  • • Chemical liquid waste
  • • Discarded linen, mattresses, beddings contaminated with blood or body fluid
  • • Microbiology, biotechnology and other clinical laboratory waste
  • B : Red

  • • Contaminated waste (recyclable)- Plastic and Rubber
  • C : White

  • • Waste sharps- (metallic sharps)
  • D: Blue

  • • Glassware
  • • Metallic body implants

4) What is containment?

  • Containment is the method of treatment where segregated waste is contained in appropriate colour coded containers till its final disposal so that it does not cause any harm to human or environment.

5) How many coloured bins do I need to maintain?

  • Four colours - Yellow, Red, White and Blue

    • • Human and animal Anatomical Waste
    • • Soiled Waste
    • • Expired or Discarded Medicines including cytotoxic drug
    • • Chemical Waste
    • • Chemical Liquid Waste
    • • Discarded linen, mattresses, beddings contaminated with blood or body fluid
    • • Microbiology, Biotechnology and other clinical laboratory waste
    • • Contaminated Waste (Recyclable plastic & rubber waste)
    • • Waste sharps
    • • Glasswares & metallic body implants

6) What type of container should I use for sharps?

  • White (Translucent) Puncture proof, Leak proof, Tamper proof containers.

7) Do I need to disinfect Sharps at the HCF?

  • Under the 2016 rules, chemical disinfection has not been mentioned at the level of HCF. However, at HCF, a disinfectant can be added to ensure safety before sending to CBWTF. But at CBWTF, autoclaving followed by shredding and mutilation is done before sending for encapsulation with cement concrete. As a good practice, it would be better to chemically treat with hypochlorite waste before sending to CBWTF.

8) Should Microbiology, biotechnology and other clinical laboratory waste be pre-treated?

  • Yes. Microbiology, biotechnology and other clinical laboratory waste needs to be pre-treated at HCF either by Autoclave/ Microwave/ Hydroclave and then sent for Incineration.

9) What precautions are to be taken while using sodium hypochlorite solution?

  • • Personal protective equipment (PPE) – heavy duty rubber gloves, masks, goggles, apron and gum boots.
  • • In case of accidental splash to the eyes they have to be washed abundantly with water.

10) How do I store Sodium hypochlorite solution?

  • • Sodium hypochlorite has to be stored in a cool and dry place away from sunlight.
  • • It is corrosive to metals and has to be stored in closed plastic containers.

11) Do we need to wash the surface before disinfection?

  • • Presence of dirt and organic matter decreases the efficiency of chlorine-based disinfectants for disinfection of surfaces and floors, dirt needs to be cleaned before disinfection is undertaken.

12) Can chlorine-based disinfectant be mixed any other cleaning agent?

  • • Chlorine-based disinfectant should not be mixed with other cleaning agents. Presence of ammonia in the cleaning agents can react with sodium hypochlorite causing the release of chloramines and inhaling these can be harmful.

13) What is the recommended disinfection agents as per amended BMWM Rules, 2016?

  • • 1% Sodium hypochlorite solution

14) Who provides the waste transport facility from the hospital to the Common bio-medical waste treatment facility (CBWTF)?

  • The operator of CBWTF generally provides the vehicle for the transport of bio-medical waste from the healthcare facility.

15) Who collects the non-biomedical waste from the hospitals?

  • The municipal body of the area picks up and transports segregated general solid waste generated in hospitals and nursing homes.

16) Is training required for waste transporters?

  • Yes. The waste transporters need to be trained on the following:
  • • Relevant legal regulations
  • • Hazards of bio-medical waste
  • • Waste classifications
  • • Coding and documentation
  • • Spillage procedures
  • • Use of appropriate PPE

17) What are the personal protective measures to be worn by the bio-medical waste transporter?

  • Cap, mask, face shield, gown, gumboots and heavy duty gloves

18) How should bio-medical waste be stored?

  • Bio-medical waste must be stored so that it avoids being mixed with other general waste. The access to it must be limited to personnel authorized to handle it. The areas used for storage must be constructed of materials that are impermeable and can be easily maintained in a sanitary condition.

19) How long can the bio-medical waste be stored?

  • Immediate treatment and disposal are ideal procedures to be followed for disposal of bio- medical waste. Storage of infectious waste should not exceed 48 hours.

20) Is it necessary to have temporary storage area?

  • Yes, as per BMWM rules 2016, it is the duty of the occupier to ensure provision of temporary storage room area within the hospital premises.

21) Can mercury be disposed of along with bio-medical waste?

  • No. Mercury is considered as hazardous waste and should not be disposed of with bio-medical waste even if contaminated by bio-medical waste. It must be stored in a separate container half filled with water in a storage area in the health facility and must be handed over to a hazardous waste treatment facility.

22) Can anyone in the facility clean-up a mercury spill?

  • No. As soon as there is a mercury spill, evacuate the area and call trained personnel in the health care facility to help clean-up the spill so as to ensure proper use of PPE and steps in cleaning up.

23) Who should handle the spill?

  • Only those trained and authorised to handle the spill must be involved in cleaning the spill.

24) Is it necessary to wear PPE to clean up a spill?

  • Definitely, yes. To prevent any infection to the health care worker, all PPE must be worn while handling any spill.

25) What are the precautions before letting down waste water into the drain?

  • Precautions for pouring bio-medical liquid waste down the drainage system are:
  • • The worker should wear personal protective equipment which include an apron, gloves, safety glasses to protect from spillage and aerosols generated during the disposal process
  • • The liquid waste should not be poured where people wash their hands and should be poured close to the surface of water so as to avoid splashing. The waste basin should be rinsed and the container disinfected after pouring of the liquid waste.

26) How to disinfect infectious liquid waste not connected to ETP?

  • Infectious liquid waste needs to be chemically treated with 1% to 2% Sodium Hypochlorite for a contact period of 20 mins and then let to general sewer

27) What methods of treatment technologies are available at the Primary Health Centre level to manage bio-medical waste?

  • a. Autoclaves
  • b. Microwave
  • c. Chemical treatment
  • d. Deep Burial
  • e. Sharps pit

28) What are the variables to keep in mind when selecting a treatment technology?

  • a. Waste characteristics
  • b. Technology capabilities and requirements
  • c. Environmental and safety factors
  • d. Cost considerations

29) Are health care workers protected from blood, body fluids and other potentially infectious materials when they wear any type of fluid-resistant garment?

  • Different sorts of gowns and coveralls have distinctive measures for opposing the infiltration of body liquids and infections. It is important to choose the garment that meets the recommended specifications based on the patient’s clinical status and activities being performed. While a garment may be labeled as “fluid-resistant” that does not mean it will provide resistance to blood, body fluids or viruses. Regardless of specification, protective garments must be used correctly in order to ensure intended protection.

30) When should a health care worker use an apron as part of the PPE ensemble? Should the apron or other PPE be disinfected or changed in the patient room if it becomes soiled with body fluids from the patient?

  • CDC recommends that a health care worker wear an apron over their gown or coveralls any time a patient is vomiting or has diarrhoea. An apron is recommended in those circumstances to minimize the soiling of underlying PPE and provide an easily discarded layer if the apron becomes soiled. An apron should also be used routinely if the facility is using a coverall that has an exposed, unprotected zipper in the front. If there is significant soiling of the PPE, the health care worker should leave the patient care area and take off the PPE in the doffing area under the observation of a trained observer. Proceeding to work in equipment that is soiled creates added risks for contamination.

31) Does the employer have to provide personal protective equipment?

  • As per BMW rules, it is the duty of the employer to ensure that he/she supplies the necessary PPEs and also ensure that the waste handlers use it whenever indicated.

32) Which bin should glass slides with infected body fluid be disposed off?

  • Since slides are made of glass they should be put in the cardboard box with blue marking which will finally be sent for autoclaving and recycling.

33) What is the two bin strategy used in emergency?

  • Two bin strategy is used in emergences in the initial phase. The strategy is to contain and segregate sharps form the other types of waste.

34) What is the first step in the management of healthcare waste in emergencies?

  • Rapid assessment is the first step in the waste management in emergencies. Information regarding available resources, quantum and types of waste generated can be gathered by rapid assessment.

35) What are the responsibilities of the personnel in-charge of bio-medical waste?

  • • To carry the required color coded bins to the camp.
  • • To display the segregation chart at the health camp.
  • • To transport the bio-medical waste back to the hospital.

36) What are the two types of monitoring mechanism that needs to be established for sustainability of safe and sound bio-medical waste management system?

  • • Day-to-day monitoring.
  • • Periodic monitoring.

37) Who will do it?

  • • Senior staff nurse.
  • • Departmental heads.
  • • Waste management officer.

38) How should monitoring is done?

  • • From the point of generation viz. Quantity, segregation, labelling, collection, handling, use of personal protective equipment by waste handlers, transportation, storage etc. of bio-medical waste.
  • • Management of spills like blood, body fluids, chemicals, mercury etc. by concerned staff.
  • • Inventory management of the equipment, bags, bins, liners, etc. necessary for waste management.
  • • Records like waste management register, injury register etc.
  • • Use of appropriate PPEs during handling of waste.

39) How to monitor?

  • • Use of a monitoring check list of the above activities (Prototype given in Annexure 3 & 4).

40) How is the authorisation given to a hospital?

  • Every occupier or operator handling bio-medical waste, irrespective of the quantity shall make an application in Form II to the prescribed authority i.e. State Pollution Control Board and Pollution Control Committee for grant of authorisation.

41) Why is documentation important in bio-medical waste management?

  • It helps in providing the documentary evidence required for managerial decision making and detection of problems, loopholes in the system.

42) How long the documents related to BMWM need to be maintained by the HCFs?

  • All the concerned documents and reports related to BMWM should be maintained for five years.

43) What are the reports that need to be submitted as per laws of the country?

  • • An annual report to be submitted in Form IV to the State Pollution Control Board by 31st Jan every year, to include the categories of waste and their quantification.
  • • The Air and Water Consent forms should also be filed.
  • • Accident reporting in Form I (in an event of any major accidents).
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