Disposal of Waste

Health facilities needs to streamline and standardise the entire activities required to manage waste right from its inception to its final disposal. This includes collection, transport, treatment and disposal of waste together with monitoring and regulation. It also encompasses the legal and regulatory framework that relates to waste management.

Implementation of BMW Rules

BMW management rules were revised through a gazette notification by the Central Government in 2016 & 2018 (Amendment) and it has become mandatory for health facilities to manage bio medical waste generated from the health facilities as per the new rules.

The bio medical waste as defined by the BMW Rules, 2016 is any waste which is generated during the activities of diagnosis, treatment and immunisation of human beings or any research activities pertaining thereto or in the production or testing of biological or in the health camps.

For implementation of the BMW Rules, 2016 & 2018 (Amendment) the health facilities need to be aware of the key changes that are incorporated in the BMW Rules vis-a-vis BMW Rules, 1998. The health facilities need to ensure that it has a copy of new BMW Rules for ready reference and as a guiding document for BMW management.

For implementation of the BMW Rules 2016 & 2018 (Amendment) the health facilities needs to ensure the following:

• Bio medical waste generated from the health facilities is segregated as per the new colour coding scheme specified in the BMW Rules, 2016 & 2018 (Amendment)
• All the health facilities which are situated within 75 km radius of Common Bio Medical Waste Treatment Facility (CBMWTF), need to have a formal agreement with the CBMWTF for final treatment and disposal of the bio medical waste
• Health facilities which do not lie within 75 km radius of CBMWTF need to have approval for deep burial pit, used for disposal of waste from the Pollution Control Board office
• Health facilities also need to ensure that the pre-treat the waste at the health facilities as per BMW Rules before handing over the same to CBMWTF or before the final disposal
• Each health facility also needs to ensure that only non-chlorinated bags ( excluding blood bags) are used by the hospital for collection of waste in the hospital
• Health facilities also need to ensure that they monitor the activities of BMW management through a committee formed at the facility. This committee should meet at least once in six months and all the records related to the same need to be maintained by the health facility.

Segregation, Collection & Transportation of BMW

The key activities that a hospital performs for the management of BMW include segregation of the waste at the point of generation, timely collection of waste and transportation of the waste from the interim storage areas of the hospital to the central storage area and transportation of the waste from the central storage area to the deep burial pits (in case of facilities not having agreement with CBMWTF).

General Requirements

• It is imperative for healthcare organisations to segregate the waste generated from the facilities at the point of generation only
• Segregation of the waste is the responsibility of the waste generator only
• The waste generated from different areas of the hospital needs to be segregated as per the colour coding provided in the BMW Rules, 2016 & 2018 (Amendment).
• The general waste generated should not to be mixed with the bio medical waste.
• The work instructions are displayed at appropriate areas of the hospital for proper segregation of the waste as per the colour coding.

Segregation of BMW Waste as per BMW Rules, 2016 & 2018 (Amendment)

Waste water must also be disposed effectively since it can serve as a breeding ground for mosquitoes. People may also slip and fall in muddy puddles, and children may play in them and risk waterborne illness.

The area should be kept clean and planting of trees and plants should be encouraged.

Burning of plastic wastes is hazardous to human health and must not be practiced.Plastic bags must be segregated and recycled. If plastic is coming out of the patient care area, it needs to be disinfected by Chlorine Solution, and mutilated to prevent its re-circulation by unscrupulous element.

Sources:

1. Guidelines For Implementation Of "KAYAKALP" Initiative
2. Swachhta Abhiyaan Guidelines for Public Health Facilities

Related Resources

1. Bio-Medical Waste (Management and Handling) Rules, 2016
2. Bio-Medical Waste (Management and Handling) Rules, 2018
3. Guidelines for Management of Healthcare Waste as per Biomedical Waste Management Rules, 2016