Bio-medical Waste Management rules 2016 with amend 2018

1. Bio Medical Waste Management
Rules 2016 &
(Amendment) Rules, 2018
State Quality Assurance Medical Officer
State Quality Improvement Unit
Commissionerate of Health
Gandhinagar

2. Greek physician
Hippocrates
"First do no harm"

3. Definition of Biomedical Waste
Biomedical waste has been defined as “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
biological or in health camps, including the categories mentioned in
ScheduleI appendedtotheseRules”as perBiomedicalWasteRules2016.

4. Why BMW Management is Important ?
• 80% non infectious (kitchen waste, paper)
• 15% is infectious (dressings, anatomical wastes, blood bags)
• 5% is non infectious but hazardous,(chemicals, drugs and
mercury)
• When this 20% of the hospital infectious material is mixed
with 80% Then all the 100% waste becomes hazardous and
infectious, hence segregation should be at source.

5. Biomedical waste rules 2016
• Gazetted on 28th March 2016
• Replaces Biomedical Waste (Management & handling) Rules 1998
• Major Changes –
Scope – also includes Ayush Health Facilities, Vaccination Camps, medical or
surgical camp, First-Aid Rooms of Schools, Forensic Labs, etc.

6. SALIENT FEATURES
• The ambit of the rules has been expanded to include vaccination camps, blood
donation camps, surgical camps or any other healthcare activity
• Phase-out the use of chlorinated plastic bags, gloves and blood bags within two years
• Pre-treatment of the laboratory waste, microbiological waste, blood samples and
blood bags through disinfection or sterilization on-site in the manner as prescribed
by WHO or NACO
• Provide training to all its health care workers and immunize all health workers
regularly (Hepatitis B and TT)

7. SALIENT FEATURES
• Establish a Bar-Code System for bags or containers containing bio-medical
waste for disposal
• Report major accidents
• Bio-medical waste has been classified in to 4 categories instead 10 to improve
the segregation of waste at source
• Procedure to get authorization simplified. Automatic authorization for
bedded hospitals. The validity of authorization synchronized with validity of
consent orders for Bedded HCFs. One time Authorization for Non-bedded
HCFs
• Dispose off the waste with in 48 hrs.
• No healthcare facility shall setup onsite BMW treatment facilities if a
CBMWTF exists within 75 kms of distance, to setup if no such facility.

8. Steps for Waste Management
Segregation
Collection & Storage
Transportation
Disposal

9. Segregation
GENERAL REQUIREMENTS
• Segregation as per the colour coding provided in the BMW Rules, 2016
(Revision 2018).
• Segregation at the point of generation only.
• It is the responsibility of the waste generator only.
• Do not mix general waste generated with the bio medical waste.
• The work instructions (colour coding) are displayed at appropriate areas
of the hospital.
16-03-2019 QI-NHSRC

10. Collection and Storage
GENERAL REQUIREMENTS
• All the bags used for waste collection is need to be sealed once they are full
to the 3/4th of the capacity and transported to the central waste storage
area or interim storage areas
• Collection in the closed covered containers
• Collection time needs to be fixed for daily pick.
• General waste must not be collected at the same time or in the same
trolley
• Appropriate PPE i.e. Gum boots, Heavy duty gloves, face masks and eye
wear.
• All the bags needs to be labelled with biohazard or cytotoxic hazard symbol.
16-03-2019 QI-NHSRC

12. Transportation
• In covered wheel barrow based sturdy trolleys through a route which has low traffic flow
of patients and visitors.
• All the trolleys used for the transportation of the waste must be labelled with bio hazard
logo.
• After every transportation cycle, ensure trolley is washed & dried up.
• Route of transportation preferably be planned in such a way that ensures:
• Does not include transportation through high risk areas
• Supplies and waste are transported through separate routes.
• Waste is not transported through areas having high traffic of patients and visitors
• Central Waste collection area can be easy accessed through this route
• Provide safe transportation of waste to avoiding spillage and scattering of waste
16-03-2019 QI-NHSRC

13. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options
No Colour
Category of
Waste
Colour
1 Yellow
2 Red
3 White
4 Blue

14. 16-03-2019 QI-NHSRC
S. No.
Category Type of waste Colour & Type of Container
1. Yellow
Category
 Human Anatomical
Waste
 Soiled Waste
 Discarded or Expired
Medicine
 Chemical Liquid
Waste
 Chemical Laboratory
Waste
Yellow colour Non Chlorinated Plastic Bags or
containers
2. Red Category Contaminated Waste
(Recyclable)
Red Colour Non Chlorinated Plastic Bags and
Containers
3. White Category Waste Sharps including
metals
White Colour puncture proof, leak proof,
Temper Proof containers
4. Blue Category  Glassware
 Metallic Body
Implants
Cardboard boxes with blue colour marking or
blue colour puncture proof, temper proof
containers

15. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

16. SCHEDULE1-CATEGORIESAND THEIRSEGREGATION,COLLECTION, TREATMENT,PROCESSINGAND
DISPOSALOPTIONS
Glassware:
Broken or discarded and
contaminated glass including
medicine vials and ampoules except
those contaminated with cytotoxic
wastes & Metallic Body Implants

17. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

18. SHARP CONTAINERS
Puncture proof, Tamper proof, Leak proof containers!!

19. SCHEDULE 1- WHITE
Waste sharps Including
Metals:
Needles, syringes with fixed needles,
needles from needle tip cutter or burner,
scalpels, blades,
This includes both used, discarded and
contaminated metal sharps
Autoclaving or Dry Heat Sterilization
followed by shredding or mutilation

20. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

21. SCHEDULE1-REDCATEGORY:PLASTICS
RECYCLEBLEWASTE
(a) Wastes generated from tubing,
bottles, intravenous tubes and sets,
catheters, urine bags, syringes (without
needles and fixed needle syringes) and
gloves
Red coloured non-
chlorinated plastic
bags or containers
Autoclaving or micro-waving/hydroclaving followed by
shredding or mutilation
catheters, urine bags, syringes (without
needles and fixed needle syringes) and
gloves

22. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

23. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

24. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

25. SCHEDULE I : YELLOW CATEGORY: SOILED WASTE
(a)Human Anatomical Waste: Human tissues, organs, body parts and
fetus
(b)Animal Anatomical Waste :
(c)Soiled Waste: Items contaminated with blood, body fluids like
dressings, plaster casts, cotton swabs and bags containing residual or
discarded blood
Incineration or Plasma Pyrolysis or deep burial

26. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

27. DRUGS
(d) Expired or Discarded
Medicines including antibiotics
Common bio-medical waste treatment
facility: Incineration
(d) CYTOTOXIC DRUGS: including all
items contaminated with cytotoxic drugs
along
with glass or plastic ampoules,
vials etc.

28. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

29. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

30. CHEMICAL & LIQUID WASTES
(g) Chemical Waste: Discarded
disinfectants
Yellow coloured
containers or non-
chlorinated plastic
bags
Disposed of by incineration or
Plasma Pyrolysis or Encapsulation in
hazardous waste treatment, storage and
disposal facility.
(h) Chemical Liquid Waste
:discarded Formalin, liquid from
laboratories and floor washings,
cleaning, etc.
Separate Collection
system leading to effluent
treatment system

32. Liquid disinfection unit

33. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

34. Biomedical wastes categories and their segregation,
collection, treatment, processing and
disposal options

35. Microbiology, Biotechnology and other
clinical laboratory waste: Laboratory
cultures, stocks or specimens of
microorganisms
Pre-treat to sterilize with
nonchlorinated chemicals on-site as
per NACO or World Health
Organization
LINEN: linen, mattresses,
contaminated with blood or body
fluid.
LABORATORY WASTES & LINEN

36. MONITORING OF IMPLEMENTATION OF THE RULES: ANNUAL REPORT
Every occupier shall submit an annual report to the prescribed authority by 30th of June every year
The prescribed authority shall compile, review, analyze and report to the CPCB by 31st July every year
The CPCB shall submit a report on the same to the MoEFCC by 31st August every year
The Annual reports shall be available on the websites of the occupier, SPCB and the CPCB

37. 2016 Rules Bio Medical Waste Management
(Amendment) Rules, 2018
phase out use of chlorinated plastic bags, gloves and
blood bags within two years from the date of
notification of these rules
phase out use of chlorinated plastic bags (excluding blood
bags) and gloves by the 27th March, 2019
establish a Bar- Code System for bags or containers
containing bio-medical waste to be sent out of the
premises or place for any purpose within one year
from the date of the notification of these rules;
establish a Bar- Code System for bags or containers
containing bio-medical waste to be sent out of the premises
or place for the further treatment and disposal in
accordance with the guidelines issued by the Central
Pollution Control Board by 27th March, 2019
make available the annual report on its web-site and
all the health care facilities shall make own website
within two years from the date of notification of
these rules
all the health care facilities (any number of beds) shall make
available the annual report on its web-site within a period of
two years from the date of publication of Bio-Medical
Waste Management (Amendment) Rules, 2018

38. 2016 Rules Bio Medical Waste Management
(Amendment) Rules, 2018
Annual Report- The prescribed authority shall compile,
review and analyse the information received and send
this information to the Central Pollution Control Board
on or before the 31st July of every year.
Annual Report- The prescribed authority shall compile,
review and analyse the information received and send this
information to Central Pollution Control Board in Form
IVA before the 31st July of every year.
Yellow waste list Addition of :
Routine mask and gown in list
Glassware/Metallic Body Implants- Cardboard boxes
with blue colored marking
Puncture proof and leak proof boxes or containers with
blue colored marking
Chemical treatment using at least 10% Sodium
Hypochlorite
Chemical treatment using 1% to 2% shall be substituted

39. Transportation

40. Waste handler with PPE

41. Bio Medical waste storage facility