this upload on bio-medical waste treatment and disposal overview is improved version of my previous upload on the subject. The presentation highlights the bio-medical treatment status at Allahabad, India. The content is the result of my experience gained from routine inspections of various health care facilities located in Allahabad region.

1. Overview
of
Bio-Medical Waste
Treatment & Disposal
Manoj Chaurasia
Assistant Environment Engineer
U P POLLUTION CONTROL BOARD
Think before you throw!

2. Water Pollution Air Pollution
Hazardous waste
Municipal solid waste
Noise Pollution
Bio-medical waste
E-Waste
ENVIRONMENT and POLLUTION
Rivers, ground water Ambient air quality
Open dumps in cities
Infectious waste
D.G. sets, Crackers
Toxic chemicals, Contamination
Discarded TV, Comp. parts

3.  Ministry of Environment and Forest (MoEF),
Government of India
 Establishes environmental policies, sets goals and
facilitate the implementation of such policies.
 Central Pollution Control Board (CPCB)
 To set environmental standards for all parts of the
country.
 State Pollution Control Boards (SPCBs) and
Pollution Control Committees (PCCs)
 Regulatory bodies set up for the implementation of the
norms to bring pollution under control in the
respective states and union territories.
Governing Bodies in India

4.  Water (Prevention & Control of Pollution) Act, 1974
 Air (Prevention & Control of Pollution) Act, 1981
 Environment (Protection) Act, 1986
 …………
 ...........
 Bio-Medical Waste (Management & Handling) Rules, 1998
 …………..
 …….
Functions and responsibilities of CPCB, SPCBs &
PCCs are assigned under these Acts and Rules.
Environmental Acts and Rules

5.  “Anything which is not intended for further use is termed as
waste”.
 All our daily activities can give rise to a variety of wastes
arising from different sources. e.g., household rubbish,
sewage sludge, wastes from manufacturing activities,
packaging items, discarded cars, old televisions, garden
waste, old paint containers and many more.
 Nature finds its way of managing waste by natural recycling
processes (e.g. leaves in a forest decomposing into soil).
Other wastes may become problematic.
 Almost all manufactured products are destined to become
waste at some point in time.
Improper disposal of this waste leads to spread of
communicable diseases, causes obnoxious conditions and spoils
biosphere as a whole.
Waste : Introduction

6.  Hospital waste or Health care waste includes garbage, refuse,
rubbish and Bio-medical waste.
80% - Non-Hazardous(Gen. waste)
 Hospital waste 15% - Infectious BMW
5% - Non -infectious
but hazardous
Bio-Medical Waste: during diagnosis, treatment or immunization
of human beings or animal or in research activities pertaining
there to or in the production or testing of biologicals.
Hazardous: any waste which is due to toxic, flammable,
explosive or corrosive characteristics causes danger or likely to
cause danger to health or environment .
Bio-Medical Waste : Introduction

7.  Health care establishments are located within the municipal area.
 Hospital waste naturally has close linkage with the
municipal waste generated in the area.
 About 80% of the total hospital waste is not hazardous/infected.
 Waste generated at the hospital kitchen or garden, the
office or packaging material from the store, etc. can be
disposed as same as municipal solid waste.
Cost of treatment of BMW (Bio-medical waste)
is much higher than the treatment expenses of
MSW (Municipal solid waste).
Linkage with Municipal Solid Waste

8.  Various communicable diseases, which spread through
contaminated cotton, bandage, syringes, blood, body fluids &
contaminated organs, are important to be prevented.
 Bio-medical waste scattered in and around the hospitals
invites flies, insects, rodents, cats and dogs that are
responsible for the spread of communicable disease like
plague and rabies.
 Rag pickers in the hospital, sorting out the garbage are at a
risk of getting tetanus and HIV infections.
 Recycling of disposable syringes, needles & other article like
glass bottles without proper sterilization may be responsible
for Hepatitis, HIV, and other viral diseases.
Need to dispose infected & hazardous waste in most safe &
eco-friendly manner.
Need for bio-medical waste treatment

9.  Out patient department(OPD): emergency unit.
 Investigative facility area: OT, x-ray, ultra sound,
ECG, pathology, etc.
 In-patient department: wards.
 Utility areas: office, kitchen, store, laundry,
chemist’s counter, etc.
Emergency unit, investigative area & the wards are the
main generators of infected & hazardous waste in the
hospitals
Health Care Establishments : Introduction

10. Hospital Waste
20% 80%
Infectious Non Infectious
(Kitchen waste, card Board Boxes)
0.5%
Sharps Non Sharps
(Glass + Metal)
80% 15% 5%
Plastic Non Plastic Laboratory Waste
Sharp Plastic Cotton Specimen
Needles PVC Gauge Body fluid
Scalpel PE Linen Tissue (Path)
Blades PET Animal Carcass
Blood Bags
IV Catheter
Respiratory Equipment
PPC RED BAGS YELLOW
COMMON FACILITY

11. Waste Category No. Waste Category Type Treatment and Disposal Option+
Category No. I
Human Anatomical Waste
(human tissues, organs, body parts)
incineration@/deep burial*
Category 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)
incineration@/deep burial*
Category 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
biologicals, toxins, dishes and devices used
for transfer of cultures)
local autoclaving/micro-
waving/incineration@
Category No 4
Waste sharps
(needles, syringes, scalpels, blades, glass,
etc. that may cause puncture and cuts. This
includes both used and unused sharps)
disinfection (chemical
treatment@/auto claving/micro-waving
and mutilation/shredding
Category No 5
Discarded Medicines and Cytotoxic drugs
(wastes comprising of outdated,
contaminated and discarded medicines)
incineration@/destruction and drugs
disposal in secured landfills

12. Category No 6
Soiled Waste
(Items contaminated with blood, and
body fluids including cotton, dressings,
soiled plaster casts, lines, beddings,
other material contaminated with blood)
incineration@autoclaving/microwaving
Category No. 7
Solid Waste
(wastes generated from disposable items
other than the waste sharps such as
tubings, catheters, intravenous sets etc).
disinfection by chemical treatment@@
autoclaving/microwaving and
mutilation/shredding##
Category No. 8
Liquid Waste
(waste generated from laboratory and
washing, cleaning, house-keeping and
disinfecting activities)
disinfection by chemical treatment@@
and discharge into drains.
Category No. 9
Incineration Ash
(ash from incineration of any bio-medical
waste)
disposal in municipal landfill
Category No. 10
Chemical Waste
(chemicals used in production of
biologicals, chemicals used in
disinfection, as insecticides, etc.)
chemical treatment@@ and discharge
into drains for liquids and secured
landfill for solids
+ Options given above are based on available technologies. Occupier/operator wishing to use other State-of-the-art technologies shall approach
the Central Pollution Control Board to get the standards laid down to enable the prescribed authority to consider grant of authorisation
@@ Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical
treatment ensures disinfection.
## Mutilation/shredding must be such so as to prevent unauthorised reuse.
@ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated.
* Deep burial shall be an option available only in towns with population less than five lakhs and in rural areas.

13. Category wise BMW collection in bins

14. Category wise BMW collection in bins

15. Category wise BMW collection in bins

16. Category Wise
Bio-Medical Waste
Treatment Options

17. Category 1( Human Anatomical Waste)

18. Category 2 (Animal Waste)

19. Category 3( Microbiology & Biotechnological Waste)

20. Category 4 ( Waste Sharps)

21. Category 5 (Discarded drugs & Medicines)

22. Category 6 (Soiled Waste)

23. Category 7 (Solid Waste)

24. Category 9 (Incineration Ash)

25. BMW Treatment: Available technologies
 Incineration
 Autoclave Treatment
 Hydroclave Treatment
 Microwave Treatment
 Chemical Disinfection
 Sanitary & Secured Landfilling

26. Bio-Medical Waste Treatment Technologies
INCINERATION
 Incinerators can be oil fired or electrically powered or both.
 Solid phase combustion( primary chamber) & Gas phase
combustion( secondary chamber).
 Volatiles are liberated in the first chamber whereas they are
destroyed in the second one.
 Primary chamber operates with temperature range of about
800 (+/-) 50 deg. C while secondary chamber operates under
excess air conditions at about 1050 (+/-) 50 deg. C.
 APCD & chimney is attached with the incinerators to
control the flue gases.
 Incinerators: multiple hearth type, rotary kiln, controlled air
type.
Incineration has been recommended for human anatomical
waste, animal waste & soiled waste.

27. Bio-Medical Waste Treatment Technologies
Charging in Primary Chamber
Primary & Secondary Chamber
Incinerators

29. Bio-Medical Waste Treatment Technologies
AUTOCLAVE TREATMENT
 Low heat process where steam is brought into direct
contact with the waste material for sufficient duration to
disinfect the waste.
 System operates in the temp. range 101-150 deg. C for 30-
90 minutes duration.
 Disinfected waste is finally landfilled.
 Three types: Gravity type, Pre-vacuum type & Retort type.
Recommended for microbiology & biotechnology waste,
waste sharps, soiled & solid wastes

30. Autoclaves
Bio-Medical Waste Treatment Technologies

31. Bio-Medical Waste Treatment Technologies
HYDROCLAVE TREATMENT
 Steam sterilisation process, having double walled container in
which the steam is injected into the outer jacket & waste is
inside.
 Moisture contained in the waste evapourates & builds up the
requisite steam pressure (35-36 psi).
 Total time for cycle is about 50 minutes, which includes start-up,
heat-up, sterilisation, venting, depressurisation & dehydration.
 Certain benefits, such as absence of liquid discharges, no air
emissions, no requirement of chemicals, reduced volume &
weight of waste.
Recommended for the same categories of waste as the
autoclave.

32. Bio-Medical Waste Treatment Technologies
MICROWAVE TREATMENT
 Disinfection technology, which heat the waste material from
inside out, provides a high level of disinfection.
 Shredded material is moistened with high temp. steam prior to
put through series of microwave generators.
 Microwave generators heat the material to 95-100 deg. C. and
disinfect the waste during min. residence time of 30 minutes.
 Process is computerised & automatic hoisting arrangement for
smooth & effective control.
Category nos. 3, 4, 6, 7 wastes are permitted to be
microwaved.

33. Bio-Medical Waste Treatment Technologies
CHEMICAL DISINFECTION
 Mainly use of at least 1% hypochlorite solution with minimum
contact period of 30 minutes.
 Equivalent chemical reagents are phenolic compounds, iodine,
formaldehyde-alcohol or iodine-alcohol combination.
 Treated solid waste material is landfilled & treated liquid waste is
drained.
Recommended for waste sharps, solid & liquid wastes as
well as chemical wastes.

34. Bio-Medical Waste Treatment Technologies
SANITARY & SECURED LANDFILLING
 Secured deep burial when facility of incineration is not available
(for towns having < 5 lakh population & rural areas) - Human
anatomical waste.
 Secured landfill – Animal waste.
 Sanitary landfill – Autoclaved/hydroclaved/microwaved waste.
 Sanitary landfill – Incineration ash.
 Concrete lined pit of abt. 1 m (l*b*d) covered with a heavy
concrete slab having 1-1.5 m high steel pipe of 50 mm dia. –
Waste sharps.
Disposal of bio-medical waste in secured landfill till proper
treatment & disposal facility is in place.

35. Overview
of
Common Bio-medical Waste Treatment
Facility (CBWTF)

36. General Facilities at CBWTF
 Incinerator
 Autoclave
 Chemical treatment
 Shredder
 Needle destroyer and disposal pit
 Effluent treatment plant
 Temporary Ash storage area
 Vehicles for collection of BMW

37. CBWTF
Storage area
Incinerator chambers

38. Incineration Operation
 Having a PLC(programmable logic control) based
control system to prevent
• Waste charging until the required temperatures are attained.
• Waste charging in case of unsafe conditions such as very
high temperature in the chambers, failure of the combustion
air fan, ID fan, high temp. at the outlet of apcd.
 Computer recording device which can continuously
monitor no. of batch, temperature, CO, CO2 and O2 in
gaseous emission.

39. CBMWTF
Venturi scrubber
Incinerator Attachments

40. Air pollution control system

41. Air Pollution Control System (A.P.C.S.)
 Duct – interconnecting pipes
 Air pollution control device – to separate the
PM from the gas stream
 Fan – provides sufficient energy for the gas
stream
 Stack – to disperse the gas stream &
provides samples for continuous monitoring

42. Air Pollution Control Device (A.P.C.D.)
 Venturi scrubber offers high performance collection of
fine particles usually smaller than 2 to 3 microns.
 Venturi scrubber is followed by centrifugal type
droplet separator to remove liquid droplets from flue
gas.
 Lime solution is used to control the acid gases too.
 Waste water generated is neutralised before
discharging.

43. CBMWTF
INCINERATOR THERMOCLAVE (HI-TECH AUTOCLAVE)

44. Shredding
CBWTF

45. CBWTF
Different units

46. Incineration Ash Disposal
 Disposed in sanitary landfill.
 VOC’s in the ash shall not be
more than 0.01 %.
 Toxic metals in incineration ash
shall be limited within the
regulatory quantities as defined
under the hazardous waste (mgt.
& hnd.) rules, 1989. Temporary ash storage
area at CBWTF

47. Status of BMW in Allahabad
 Total Health Care Facility – 267 Nos.
 Quantity of BMW Generated – 993 Kg/D
 Quantity of BMW Treated – 900 Kg/D
 A Common Bio-medical treatment & disposal
facility is established by M/s FERRO Build
Hard (I) Pvt. Ltd at Naini
(Ref: July 2013, UPPCB report)

48. Present Scenario !
 Problems in segregation.

49. Present Scenario !
 Frequency of waste collection from small hospitals.

50. Present Scenario !
 BMW is dumped with general health care
waste.

51. Knowledge Gaps in
Bio-Medical Waste Treatment
 Training & Motivation in Health Care Establishments.
 At Hospital Administration & Management Staff Level.
 Para-Medical Personnel Level, e.g., Nurses, Ward Boys
etc.
 Shredded followed by autoclaved plastic waste have problems
in reuse.(Category 07 waste)
 Adoption of non-burnt technologies in place of conventional
bio-medical Incinerators.
 Treatment of Mercury waste?
 Lack of awareness among masses.
Need to Find Solution

52. Appointment of “Waste Management Officer”
(help to organize, supervise the bio-medical waste
disposal policy in hospital.)
Need of future
Thank You

53. DEEP BURIAL FOR RURAL AREA
BLACK
PLASTICFILM
100mm (4”) Mud & Lime Film
Medical waste