FAQs – November Issue 2023
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Q1. What are the recent rules and guidelines for biomedical waste management in India? How do we access the guidelines?
The Biomedical waste management rules revised in 2016 with two key amendments made in 2018 and 2019 by the Ministry of Environment, Forest & Climate Change is the key legislation on BMWM in India. (can be accessed via https://cpcb.nic.in/rules-3/) These rules are supported by various guidelines, which can be accessed on the Central Pollution Control Board website. The website link is as follows: https://cpcb.nic.in/technical-guidelines-2
Q2. Where do we discard blood bags?
The blood bags should be pretreated at the hospital/laboratory/blood bank using a dedicated BMW autoclave. Thereafter it should be discarded in yellow bags to be sent to the common biomedical waste treatment facility (CBWTF)
Q3. Where do we discard vacutainers with blood?
The vacutainers with blood should be pretreated at the source (hospital/laboratory) using a dedicated BMW autoclave. These should then be placed in regular red bags in the laboratory to handed over to the CBWTF.
Q4. What is the rationale for discarding blood bags in yellow but urobags in red?
As the blood bags are highly infectious & and a source of organism multiplication, they need to be pretreated before being sent to the CBWTF. It could be that blood may have an unknown pathogen which is not easily destroyed with only autoclaving (e.g. prions) Hence it is best considered incinerated (even though blood bags are made up of chlorinated plastic). Urobags on the other hand have predictable organisms mostly bacteria or other pathogens that can be easily destroyed by sterilization alone. Hence, they are discarded in the red bag.
Q5. What is the colour coding used to discard ECG leads?
There is no mention of ECG leads in particular in the CPCB BMW guidelines. Based on the material seen in the ECG lead, most of the material belongs to the yellow category. Hence yellow may be chosen to discard ECG leads. But some follow blue owing to the metal component & and even some follow red. If you have a reason specific to any other colour coding (Eg: Red, Blue), you can add it to your hospital policy document it and communicate it to your CBWTF (third party).
Q6. Where do we discard expired medicine?
The expired medicine should be discarded in yellow-coloured bags separately.
Q7. Is it mandatory to cut the needles before discarding them in the white transparent puncture-proof container?
It is not mandatory to cut the needles using a needle cutter/destroyer. The needles can be discarded separately in the white puncture-proof container and the syringes are to be discarded in red-coloured bags. If you practice cutting the needle, then needle should be discarded in white and the remaining hub should be discarded in red.
Q8. Is it necessary to treat the biohazard wastes (Eg: HIV reactive) separately?
No need, all wastes should be considered as hazardous and should be treated with utmost precautions.
Q9. How do we discard empty lignocaine gel tubing?
If the tubing is made of plastic, discard it into red coloured bag and if it is of metal, then discard it into blue coloured container.
Q10. How to discard guide wires?
It should be discarded in a blue puncture-proof container of an appropriate size.
Q11. What is the exact method to discard chemotherapy wastes? Does all the consumables (Eg: Mask, gloves) go into yellow with C symbol?
As per the BMW rules 2016 and the available evidence, all the wastes generated during the preparation or mixing of chemotherapy agents should go into yellow with C symbol irrespective of the material type. (Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582558/)
Q12. Where do we discard the liver biopsy needle, and trucut biopsy needles with lengthy sharps?
It should be discarded in a white translucent puncture-proof container of an appropriate size.
Q13. How long can we store biomedical waste in a hospital setting? Is it for all the colour-coded categories of waste?
In the previous BMW Rules 1998, it was mentioned that “no untreated bio-medical waste shall be kept stored beyond a period of 48 hours”. But in the 2016 Rules, the clause was changed and only a few categories were put under this clause. BMW Rules 2016 says that “untreated human anatomical waste, animal anatomical waste, soiled waste and biotechnology wastes (Yellow Bags wastes) shall not be stored beyond a period of forty –eight hours”. Hence the sharps waste, and metal wastes can be discarded once the containers are ¾ filled. Thus, effectively the 48-hour clause is only for yellow bag waste. But efforts should be made to remove and treat waste as early as possible.
Q14. Is it mandatory that the mercury should be phased out?
Yes, it is mandatory that the mercury should be phased out. It is a hazardous waste (Reference: 2016/H/16/3, New Delhi Lr dated 29.06.2016). All the devices (Eg: BP apparatus, thermometer) that use mercury should be phased out and replaced with non-mercury alternatives.
Q15. Where do we discard blood sugar strips and other rapid test strips?
All strips made of plastic should be discarded in red-colour bags
Q16. How do we discard chemical wastes generated in the laboratory (Eg: Formalin, Glutaraldehyde)
These chemicals need to be neutralized with appropriate neutralizers and then disposed in the drains connected to hospitals effluent treatment plant (ETP).
Q17. How to dispose of ethylene oxide (EO) cartridges?
EO cartridge discarding can be discarded safely in red bag as it is a nonincinerated waste. Do not puncture or incinerate unused cartridges. Aerate empty cartridges according to instructions in the equipment manual. After aeration offer for recycling or disposal of as non-incinerated waste (Red colour).
Q18. How do we discard cautery cable?
Cautery cable is discarded in red-colour bags.
Q19. Who is responsible for the barcoding? Is it the occupier or the common treatment facility centre?
It is the occupier who is responsible for the barcoding of the waste bags. However, the barcoded bags can be procured from the CBWTF based on the MOU drawn between the hospital and the third party. In some states, the barcoding is done by the state pollution control board. Hence discuss with your local SPCB and CBWTF.
Q20. What is the policy for disposal of battery wastes?
The battery wastes should be collected separately and should be auctioned or should be given back to the manufacturer/vendor Battery waste comes under the Battery Waste Management Rules 2022.
The link is given below
https://cpcb.nic.in/uploads/hwmd/Battery-WasteManagementRules-2022.pdf
It is the duty of the consumer to discard Waste Battery separately from other waste streams and to ensure that they are given to an entity engaged in collection refurbishment or recycling.
Q21. Is it mandatory to weigh in each ward/ICU or can we weigh the BMW wastes for the entire hospital together?
There is no defined rule for where the weighing should take place. The bags can be pasted with a label that has specifics like the area where the waste originated from. Then the hospital staff posted in temporary storage area can weigh and keep a note of ward-wise data. As weighing is helpful to trace back the overutilization of consumables, ward-wise weighing will help to do an analysis of the BMW waste exceeds the general norm of per bed generation.
Q22. What is the colour coding for e-waste?
E- waste is covered under the E-waste Management Rules 2022. Bulk consumers of electrical and electronic equipment listed in Schedule I shall ensure that e-waste generated by them shall be handed over only to the registered producer, refurbisher or recycler of this waste. (can be accessed via https://cpcb.nic.in/uploads/Projects/EWaste/e-waste_rules_2022.pdf )
Q23. How long can we store the diluted (1%) Sodium hypochlorite solution?
The diluted and freshly prepared 1% sodium hypochlorite can be used for a maximum of 24 hours. Alternatively, chlorine (NaDCC) tablets can be used.
