Types of Biomedical Waste Management and Its Sources

In Biomedical waste management health care waste is divided into two main categories hazardous and non-hazardous. If the waste is not segregated correctly, hazardous waste can contaminate non-hazardous waste. This can make the collection, transportation, treatment and disposal of waste difficult and dangerous. Furthermore, treating non-hazardous waste as if it results in wasted resources and effort is dangerous.

Categories and Sources of Waste

Category-1 Hazardous Waste

Examples of infectious waste

Used sharp waste or unused sharp items examples are tools (such as scalpels and blades), needles, syringes, and broken glass or ampoules. Pathological waste (bodily waste) for example human tissue or fluid (such as blood and body fluids), organs (body parts), plaques and fetuses and unused blood products. Other infectious waste examples are dirty gloves, gauze or bandages that are contaminated with blood, body fluids, viruses, or parasites.

Examples of toxic waste

Pharmaceutical waste is used, expired or no longer required pharmaceutical products (such as vaccines and drugs)

Chemical waste examples are chemical substances (such as laboratory reagents or film developers), disinfectants, solvents, and wastes with high heavy metal content (such as batteries, broken thermometers, and blood pressure gauges).

Genotoxic (harmful to human genes) and cytotoxic (harmful to human cells) example are medicines used in cancer treatment, exposure to patients' body fluids chemotherapy or cytotoxic drugs and other materials contaminated by these agents.

Radioactive waste examples are radioactive materials (such as unused fluids from radiotherapy or laboratory research), glassware, packages, or radioactive materials, paper contaminated with urine and feces that contain radio nuclides and seal sources (containers that contain radioactive materials). Contaminated with or tested are stored and sealed).

Category-2 Non Hazardous Waste

Non-hazardous waste can be disposed of as municipal waste. Municipal waste is general waste generated primarily by households and commercial activities, and is collected by municipalities, ideally for disposal. Municipal waste should not contain untreated medical waste. Examples are paper, boxes, bottles, plastic containers, and personal protective equipment (PPE) that have not been contaminated with bodily fluids or used in an isolation area.
Waste Processing and Minimizing

Steps of the process:

Types of Biomedical Waste Management and Its Sources

Minimizing waste

Where possible, reducing the amount of waste produced by a health care facility is a good waste management practice. Waste minimization is most commonly applied at the generation point, but it can also occur before the entry of items into a healthcare facility.

Some examples of good waste reduction practice include: Select the material with minimum packaging. Choosing devices that can be reprocessed locally that is, properly cleaned, disinfected and / or sterilized for reuse. Replacing (or replacing) products For example, using steam sterilization in place of a toxic chemical disinfectant (ie, glutaraldehyde).

Segregating Waste

Waste segregation can substantially reduce the amount of healthcare waste that needs special treatment. Health cares facilities must separate waste when and where it is generated, such as before going to a patient's room, examination room, operating theater, or laboratory. Depending on the potential danger of waste and methods of treatment and eventual disposal, employees should discard the waste in appropriate containers. Separate the waste by working on a three-bin system. Use clearly labeled waste containers.

Recommended separation plan of WHO

General waste

Put general health care waste, such as food scraps and office waste, in a container lined with a plain plastic bag. Do not store such waste in containers or bags with biohazard symbols.

Hazardous Sharp West

Disposal of hazardous sharp waste such as syringes, scalpels, suture needles, and glass in a puncture resistant sharp container to prevent needlesticks, cuts and puncture injury. Sharp containers must be labeled with a biohazard symbol and designated "sharp". The sharp container must be located within arm's reach where the sharp is used. Avoid overfilling sharp containers and discard them when three quarters are full to prevent excessive injury. Sharp containers must be single-use

Hazardous Non-Sharp Waste

Other hazardous wastes, such as pathological and infectious wastes, should go in a separate container which is: Leak proof and puncture resistant, Covered with a lid, properly labeled with a bio hazard symbol and color coded, Lined and closed with a plastic bag and three quarters of the bag is closed and loaded to enable safe transport

Other hazardous waste

Other hazardous wastes such as chemical, pharmaceutical and radioactive wastes should be packed and labeled with the appropriate hazard symbol. Ensure that packaging materials do not react with hazardous components of waste.

Waste Collection, Transportation, and Storage

After separating waste, designate staff to collect and transport each ward or unit for disposal or transport to a dedicated storage area for disposal.

Collection

To deal with hazardous or infectious waste, always wear PPE which should include: Utility gloves (not nitrile gloves), a heavy duty apron and the shoes

Transport

The equipment in the healthcare facility that holds and transports waste should not be used for any other purpose. If available, use separate equipment, such as a cart or wheelbarrow, to transport hazardous and non-hazardous waste separately. The dedicated team should be:

Easy to load and unload
It has no sharp edges that can tear bags or damage containers.
Easy to clean
Clearly labeled

Storage

Store waste until it can be treated or transported offsite. Health care facilities should have an operational plan for waste so that the need to store waste is minimized. When making an operating plan, consider the amount of waste produced daily, the needs of waste management staff, the size of storage areas, and the final disposal method. Waste storage areas may be located within a health care facility or in a designated area in the field.

Whether kept indoors or outdoors, waste must be protected from people and animals, and protected from rain. Ensure that the waste storage area is easily accessible by the staff in charge of handling waste. If waste is moved offsite, consider placing a storage area where waste-collection vehicles have easy access the waste storage area should be of appropriate size for the amount of waste generated by the health care facility.

Infectious waste should not exceed the following periods: Temperature: 72 hours in winter / 48 hours in summer and 48 hours in cold weather / 24 hours during hot weather. If a refrigerated storage room is available, the infectious waste can be cooled to temperatures from 3 ° C to 8 ° C for more than a week.

Waste Treatment and Disposal

After collection, health care waste is treated and / or disposed according to its type. The WHO recommends the treatment of hazardous waste prior to disposal to reduce risk and hazard. The disposal method depends on how it has been treated, as well as the type and quantity of waste, the space available on site, and access to disposal options.

Thermal methods

Heat methods, which destroy microorganisms in the waste through heat, include low- and high-temperature technologies. Non-combustion (low-heat) processes, like autoclave and steam based treatment systems, operate at 100–180 ° C (212–356 ° F). Combustion (high-temperature) processes range from about 200 ° C (392 ° F) to over 1,000 ° C (1,800 ° F).

Chemical methods

With chemical methods, the waste is exposed to a chemical agent that kills microorganisms such as chlorine dioxide, sodium hypochlorite, lime solution or calcium oxide powder. Chemical disinfection is best suited for the treatment of liquid waste such as blood, urine, feces, or hospital sewage. Manual chemical disinfection of solid wastes is not recommended.

Radiation method

Radiation methods use ultraviolet radiation or microwaves to destroy microorganisms. They complement other settlement methods and are not easily accessible in low and middle income countries.

Biological methods

Biological methods, including manure and burial, depend on the natural decomposition of organic materials. These procedures are recommended for the placenta.

Mechanical methods

Mechanical methods include shredding, grinding, mixing, and compacting techniques that reduce waste volumes but do not destroy microorganisms. They usually complement other treatment methods. These procedures can be used to destroy needles and syringes. Use them after dissolution of waste, or as part of a closed system.

Infectious Waste Treatment and Disposal

Pathological / Anatomical Wastes

Waste in these categories is traditionally buried or cremated in incinerators. Treatment and disposal of pathological and anatomical wastes may be bound by social and religious norms. For example, placenta waste can be buried in pits or taken home.

Liquid infectious waste

This type of waste includes liquid culture media, blood, body fluids, human excreta, and fluids from operating theaters. Autoclaves and incineration techniques typically available in low-resource settings are not effective for large quantities of liquids. Liquid infectious wastes can be disposed of directly in closed sewer systems (such as a utility sink drain or flushable toilet) or in dispatch septic tank systems by employees wearing PPE and taking precautions to avoid spraying.

Other Hazardous Waste Treatment and Disposal

Chemical, pharmaceutical and radioactive wastes should be included in the National Strategy for Hazardous Wastes, and treated according to international and local regulations. Ashes from ash are considered dangerous as they may contain heavy metals and other toxins. Ash must be disposed of properly at hazardous waste sites (such as engineered landfills), encapsulated and buried, or disposed of in concrete-lined ash pits.
Avoid direct contact and inhalation, and wear appropriate PPE (such as utility gloves, plastic aprons, goggles, and masks or N95 respirators).

Other Treatment and Disposal Options

If healthcare facilities do not have the ability to treat waste or return it to the manufacturer, encapsulation or inactivation may be used to dispose of small amounts of sharps, chemicals, or pharmaceutical wastes. These methods can reduce the risk of injury to people and reduce the risk of toxins migrating to the surface or ground water.

These methods are rarely used. Encapsulation is a process that seals waste containers with an immobilizing material such as a container. After hardening, the containers can be safely disposed of in a landfill. Insurization involves mixing of waste (such as pharmaceutical and high metal-content ash) with water, lime, and cement before disposal to reduce the risk of toxic substances in surface and groundwater. Pharmaceuticals must be removed from their packaging and ground before being mixed.

Disposal Sites

In the previous section, we mentioned different types of settlement sites. Now we will learn more about these sites.

Landfills

If done properly, disposing of healthcare waste, both treated and untreated, in landfills can protect staff, the community and the environment. Landfills are specifically designed and engineered for the safe disposal of waste on land.

Properly constructed sanitary landfills:

Restrict access to prevent sweep Prevent infiltration of water. They are lined with a low permeability material (such as clay) Ideally, at the end of each work day, the waste should be spread out in thin layers, compacted and covered with soil. Gases should not be allowed to build up as they become dangerous.

Placenta pits

In many cultures, burying placentas is an important custom. In low-resource settings, a placental well is an effective option for safe removal. The site for a placental well should minimize public accessibility the size will depend on the number of daily deliveries in the facility. On average, a placenta and its associated fluids will require 5 liters (1.5 gallons) of well capacity. The well must be designed to prevent debris from contaminating the surrounding groundwater. A distance of at least 1.5 meters (approximately 5 feet) from the bottom of the well to the ground water level is recommended. Placental wells are not recommended for sites where the water table is close to the surface or in areas prone to flooding.

Sharp holes

Even after decontamination, the waste from sharp objects could present physical risks. There could also be a risk of reuse. Decontaminated sharps debris can be disposed of in concrete lined sharps pits on the facility premises or can be encapsulated by mixing the debris with immobilizing material, such as cement, before disposal. These procedures are recommended only in cases where waste is handled manually and landfill for general waste is not insured.

Ash pits

Incineration ash is conventionally considered hazardous by virtue of its likely heavy metal content and the dioxins and furans it may contain. It should preferably be disposed of in sites designed for hazardous waste, eg. cells designated in engineering fillings, encapsulated and placed in specialized monofill sites or placed on the ground in an ash pit. The ash pit must be lined with concrete, not accessible to the public and at least 1.5 meters above the water table.

Small burial sites for waste disposal

In health care facilities with limited resources, the only option available for waste disposal is the safe short-term burial of waste in or near the facility. Safe burial at the site is practical only for limited periods of time (1–2 years) and for relatively small amounts of waste. Burial can be used as a method of waste disposal only when the water table is more than 4 meters (12 feet) below the surface. During this time, the health care center should continue to search for better and more permanent methods of waste disposal.

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