Spotters in "Hospital Waste Management" for CFM & MPH students

 As per “Bio-medical Waste Management Rules, 2016” 

1. Yellow Bin/ Bag:

Type of Bag/ Container used: 

Non-chlorinated plastic bags

Type of Waste: 

1. Human Anatomical Waste

A. Tissues, organs, body parts

B. Foetus, Umbilical stump, placenta

2. Animal Anatomical Waste: Tissues, Organs, body parts

3. Soiled Waste: items contaminated with blood and body fluids

A. Dressings, sponges, gauze

B. Plaster casts

C. Cotton swabs

D. Blood bags

E. Infected gowns, mask, shoe covers, cap

4.  Expired or Discarded Medicines: including antibiotics (except cytotoxic)

5. Chemical Waste:

A. Discarded disinfectants, Cleaning agents

B. X-ray film developing liquid, Infected secretions

C. Aspirated body fluids, Liquid from laboratories

6. Microbiology, Biotechnology, and other clinical lab waste

7. Chemical Liquid Waste

Yellow bin/ bag with the cytotoxic label:

1. Used, discarded, and expired cytotoxic drugs whether in plastic vaccutainers, syringes, glass vials, ampoules, glass bottles. The container is not the determining factor in the case of the segregation of cytotoxic wastes.

2. All items used during preparation and administration of cytotoxic drugs (eg: glass and plastic bottles, ampoules, vials, iv sets, gloves, syringes without needle, dressing, cotton swabs, etc.)

Treatment/Disposal options:

Incineration or Plasma pyrolysis or deep burial*

2. Red Bin/ Bag:

Type of Bag/ Container used: 

non-chlorinated plastic bags or containers

Type of Waste: 

Contaminated Waste (Recyclable) or All infected plastic recyclable waste:

A. Waste generated from tubings,

B. Plastic i/v bottles, (normal saline,

DNS, Ringer lactate, etc)

C. IV tubes /BT sets, central line, PICC line

D. Gloves

E. Urine bags, Catheters

F. Drains

G. Syringes without needles

H. Vaccutainers without needles

I. Et/tt tubes, Ng tubes

J. Transparent dressing sheet (eg: Tegaderm)

K. Ventilator/ nebulizer tubing’s

L. Ostomy bags

M. Tracheal tubes

N. Suction/ oxygen tubing’s

O. Diagnostic kits

P. All plastic and rubber infected waste

generated from laboratories*

Treatment/Disposal options:

Autoclaving/microwaving /hydroclaving and then sent for recycling not be sent to landfill

3. Blue Bin/ Cardboard Box:

Type of Bag/ Container used: 

Cardboard boxes with blue colored marking / blue colored non-chlorinated plastic bags or containers

Type of Waste: 

Glassware:

1. Broken, discarded, and contaminated glassware including slides, vials, and ampoules (except cytotoxic waste)

2. Metallic body implants

3. Disposable laparoscopic instruments

4. All glassware generated from, laboratories *

*All laboratory waste is first treated on-site by microwaving before final disposal

Treatment/Disposal options:

Disinfection or autoclaving, microwaving, hydroclaving

and then sent for recycling

4. White Bin/ Translucent Box:

Type of Bag/ Container used: 

(Translucent) Puncture, Leak & tamper-proof containers

Type of Waste: 

Waste Metal sharps:

A. Needles without a cap

B. Pre-filled glass syringe with fixed needles

C. Scalpel, blades

D. Biopsy needles

E. Guide wires

F. Suture needles

G. Cannula and biopsy needle stilette

H. All sharps generated from laboratories*

Treatment/Disposal options:

Auto or Dry Heat Sterilization followed by shredding or

mutilation or encapsulation

5. Black Bin/ Bag:

Type of Bag/ Container used: 

Non-chlorinated plastic bags or containers.

Type of Waste: 

1. General waste including food, paper waste, etc

2. Uninfected plastic wastes such a mineral water bottles

3. Uninfected disposable towel

4. Uninfected gowns, shoe covers, cap, masks

5. Covers of sterile items such as syringes etc

6. Sterillium used bottle

7. Bacillol or any other uninfected used bottle.

Treatment/Disposal options:

Incineration or Plasma pyrolysis or deep burial or recycling depending on the material.

Bio-Medical Waste rules 2016 doesn’t apply to 

• Radioactive wastes
• Hazardous chemicals
• Lead-acid batteries
• Hazardous wastes
• E-Waste
• Municipal Solid Wastes
• Hazardous microorganisms, genetically engineered microorganisms, and cells

6. Hub cutter:

Important points:

• A hub cutter/ manual syringe and needle destroyer is used to destroy the disposable or auto-disable syringes after use.
• It destroys the syringe hub & needle in a single action.
• Stops reuse of needles & syringes and save healthcare professionals from needlestick injuries.
• Used to improve injection safety or to minimize needlestick injuries to prevent transmission of blood-borne infections such as Hepatitis B and HIV. 
• Parts: One or two insertion holes for the syringe, One or two handles (attached to the blades which cut the syringe hub), One plastic container (into which the cutoff parts of the syringes and the needles are retained).
• How to use: The needle and the hub of the syringe are inserted into the hole of the hub cutter. The syringe is held with one hand and the other hand is used to clamp the handles until the hub is completely cut and the needle falls into the container.
  
• Disinfected: By autoclaving, boiling in water for at least 10 minutes or, chemical treatment for 30 minutes (using at least 1% solution of sodium hypochlorite or freshly prepared bleach solution).
  
• The hub cutters should be washed with at least 1% solution of sodium hypochlorite or freshly prepared bleach solution before reuse.
• Disposal: The needles buried in a safety pit & syringes sent for recycling.
  The needles and broken vials buried in a safety pit

References:

1. Park, K. (2019). Park's textbook of preventive and social medicine. 25th. Jabalpur, India: M/S Banarsidas Bhanot.
2. Kadri AM. (2019). IAPSM's Textbook of Community Medicine. 1st. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd.
3. https://www.aiims.edu/en/departments-and-centers/central-facilities/265-biomedical/7346-bio-medical-waste-management.html
4. https://www.exportersindia.com/hospitokart-continental-pvt-ltd/needle-cum-hub-cutter-3798977.htm photo credit
5. https://www.indiamart.com/proddetail/laboware-needle-syringe-hub-cutter-16574798233.html photo credit
6. https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf