Monday, September 29, 2014

biomedical waste


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Health Care Establishments (HCEs) produce a number of different types of waste and following are the Acts / Rules pertaining to pollution control & applicable to HCEs :


  • The Bio-Medical Waste (Management and Handling) Rules,1998, as amended to date ( for Bio-Medical Waste generated from the HCEs).Click Here for Rules 1998


  • The Municipal Solid Waste (Management and Handling) Rules,2000,as amended to date( for Municipal Solid Waste(General Waste) generated from the HCEs).Click Here for Rules 2000


  • The Water(Prevention and Control of Pollution) Act,1974, as amended to date and Rules made thereunder ( for Waste Water /Liquid Waste generated from the HCEs, liquid waste also covered under the said BMW Rules).Click Here for Act 1974


  • The Air (Prevention and Control of Pollution)Act,1981 as amended to date and Rules made thereunder (for Air Emissions from Boilers , DG Set(s), Incinerators etc. generated from the HCEs)Click Here for Act 1981


  • The Environment (Protection) Act, 1986, as amended to date and Rules made thereunder Click Here for Act 1986


  • The E-Waste (Management and Handling)Rules,2011(to be effective from 01.05.2012) for Electronic Wastes generated from the HCEs ).Click Here for Rules 2011


  • The Batteries (Management and Handling) Rules,2001,as amended to date (for Lead Acid Batteries wastes generated from the HCEs ).Click Here for Rules 2001


  • The Water(Prevention and Control of Pollution)Cess Act , 1977, as amended to date and Rules made thereunder ( for paying the water cess to DPCC for the quantity of water used by HCEs).Click Here for Act 1977


  • The Hazardous Waste (Management, Handling and Transboundary Movement )Rules, 2008, as amended to date. (for Hazardous Waste generated from the HCEs ). Click Here


  • The Plastics Manufacture, Sale and Usage Rules, 1999, as amended to date ( for regulating the use of plastic ).Click Here for Rules 1999


  • The Delhi Degradable Plastic Bag ( Manufacture, Sale and Usage ) and Garbage (Control) (Amendment) Act,2008 (Delhi Act9 of 2008) Click Here


  • The Noise Pollution (Regulation and Control) Rules, 2000 ,as amended to Date ( to control noise pollution e.g. from DG Sets etc ).Click Here for Rules


  • The Ozone Depleting Substances (Regulation and Control) Rules, 2000, as amended to date.Click Here for Rules

Note : Radioactive Wastes are covered under the provisions of the Atomic Energy Act, 1962 and Rules made thereunder and the enforcement agency for the said Rules is Atomic Energy Regulatory Commission (AERC) .

Bio- Medical Waste Management Cell :

For the proper management of the Bio Medical Waste and implementation of the Bio-Medical Waste (Management and Handling) Rules,1998, as amended to date , Bio- Medical Waste Management Cell has been created in Delhi Pollution Control Committee. The Cell carries out all the activities pertaining to this cell for the implementation of the Bio-Medical Waste (Management and Handling) Rules and other duties assigned to the cell. Following are the Engineers deputed in Bio Medical Waste Management Cell:

  1. Ms. Ajeeta Dayal Agarwal, Senior Environmental Engineer � Incharge

  2. Sh. Sanjay Vatts, Env. Engineer

  3. Sh. Shayam Sunder, Env. Engineer
The biomedical units generating bio-medical waste have been categorized on the basis of bed strength, and three committees have been constituted to deal with units and decide Authorization under the said BMW Rules and Consent under the Air & Water Acts, as given below;

Committees for Bio-Medical Waste in DPCC




S.No.MEMBER OF THE COMMITTEECATEGORY
1.BMW Committee No.1
  1. Chairman, DPCC
  2. Member Secretary, DPCC
  3. Dr. T.K. Joshi, COEH.
  4. Medical Superintendent, GB Pant Hosptial
  5. Addl. Director,DPCC
  6. Concerned Sr. Env. Engineer.
  7. Concerned Env. Engineer
  8. Dr. Chetna Harzai, Scientiest. (Deptt. of Env.)
Hospital Nursing Homes etc. having bed strength of 100 and above and transporters and operators of Common Bio-Medical Waste Treatement Facilities.
2.BMW Committee No.2
  1. Member Secretary, DPCC
  2. Dr. T.K. Joshi, COEH.
  3. Medical Superintendent, Aruna Asaf Ali Hospital
  4. Addl. Director,DPCC
  5. Concerned Sr. Env. Engineer.
  6. Concerned Env. Engineer
Hospital/ Nursing Homes/Health Care Establishments etc.,having bed strength between 10 to 99

For Health Care Establishments/Nursing Homes having bed strength upto 9 beds authorization etc. under BMW Rules will be granted at the level of Sr. Env. Engineer with the approval of Addl. Director.

No. of Health Care Establishments in Delhi : About 1900 ( based on the applications for authorization received in DPCC).
Quantum of Bio-Medical Waste Generation & Treatment in Delhi: 10.125 Tons /day(based on the annual report for the year 2010).
There are 10 Incinerators (including 3 CBWTFs), 21 autoclaves(including 3CBWTFs) and 3microwaves operating in Delhi.
As per the said BMW Rules of 1998, Bio-medical waste shall be treated and disposed off in accordance with Schedule I and in compliance with the standards prescribed in Schedule Vand every occupier (a person who has control over the institution generating bio-medical waste ) , where required, shall set up in accordance with time schedule in Schedule VI, requisite bio-medical waste treatment facilities like incinerator, autoclave, microwave system for the treatment of waste. Later on after the amendments vide notification dated 02.06.2000 Health Care Establishments can get the requisite treatment of waste at a common waste treatment (Common Bio-Medical Waste Treatment Facility (CBWTF)) or any other waste treatment facility.

Common Bio-Medical Waste Treatment Facilities (CBWTFs) in Delhi :
There are three operators of CBWTFs in Delhi :
  1. M/s Synergy Waste Management (P)Ltd.,Near Composite Plant, Okhla Tank, New Delhi-20 Phone (O) : 011- 26933371, 26933372, Fax-26933373

  2. M/s Biotic Waste Solutions Pvt.Ltd., 46 , SSI Industrial Area,G.T.Karnal Road, Delhi-33 Phone (O) : 011 � 47528106, 47528107 .

  3. M/s SMS Water Grace BMW Pvt. Ltd , Nilothi Sewage Treatment Plant Complex of DJB, Nilothi, Delhi-41 Phone No. 011-28363691 ,28363692,28363693,28363079. Fax No: 011-28363690 Mob: 09560521112,09871222338.

NOTE:- The Bio-Medical Waste generated from Health Care Establishments includes plastic waste also and these 3 CBWTSs have the facility of autoclave & shredding for treatment of infected plastic so these are the approved agencies for plastic waste also in context in of Health Care Establishments of Delhi.

These CBWTFs are having Treatment Equipments i.e. Incinerator, Autoclave, Shredder etc for the treatment and Disposal of the Bio Medical Waste collected from the Health Care Establishments in Delhi. They are also having Effluent Treatment Plant for the treatment of the waste water generated from their facilities.

Programmable Logic Control (PLC) have been installed by the operators of CBWTFs for better operation / performance of Incinerators.

These operators collect and treat the biomedical waste from their about 3500 member units (this includes no. of health care units which are attending less than 1000 patients per month and are not required to apply for Authorization.).

DPCC has issued several public notices in the recent years for the proper management of Bio- Medical Waste (for Segregation , Sharp Waste Management , installation of ETP etc.)

A Public Notice was issued in Times of India on (Click here for the Public Notice)27.06.2010 and in Nav Bharat Times on 28.06.2010 for the awareness of Hospitals/Health Care Facilities, mentioning the main provisions of the Bio Medical Waste (Management and Handling) Rules , for proper segregation of Bio Medical Waste, sharp waste management, proper storage etc.

A Public Notice was also issued on (Click here for the Public Notice)24.07.2011seeking application from the Health Care Establishments for renewal of Authorization under the Bio Medical Waste (Management and Handling) Rules,1998.

In the past letters were issued to 
  1. Pr. Secy. (Health), GNCT of Delhi
  2. Addl. Commissioner (Health), MCD
  3. Jt. Secy, Min. of Health, Government of India for issuance of suitable directions to the Directors/Medical Superintendents of Delhi Government Hospitals for curtailing the use of Mercury based thermometers/ B.P. Apparatus to reduce the mercury pollution.

A Public Notice was issued on (Click here for the Public Notice)02.05.08 for providing Template for the commitment to minimize mercury waste by Hospitals.

Hospitals having 50 beds or more have been asked to phase out Mercury Based Equipments (Thermometers & B.P.Apparatus) and 70 hospitals have informed regarding phasing out of Mercury based equipments in their Hospitals.

Following two agencies have been identified by DPCC for collection of the mercury from the Hospital/Health Care Establishments in Delhi.
  1. Shri Rohit Talwar , M/s Supreme Surgico , 262 / 425 , Lane No. 8, Friends Colony Industrial Area, Shadara, Delhi. (Mobile No. 9958527527)

  2. Shri Sandeep Kalra, M/s Anita Industries, 29, Bhagat Singh Market, New Delhi. (Mobile No. 9810240250)
These agencies are engaged in manufacture of Thermometers / B.P. measuring Apparatus etc. and the collected mercury from hospitals which is almost in elemental form is used in their manufacturing process.

Bio-Medical Waste (Management & Handling) Rules, 1998

(Click here to see the Rules 1998 2003)

Purpose: 
  1. For proper management & handling of Bio-Medical Waste.
  2. Applicable to all persons who generate, collect, receive, store, transport, treat, dispose or handle Bio-Medical Waste in any form.

Bio Medical Waste : 
�Bio-Medical Waste� means any waste which is generated during the diagnosis, treatment or immunisation of human beings or animals, or in research activities pertaining thereto, or in the production or testing of biologicals and including categories mentioned in Schedule-I of the Bio Medical Waste (Management and Handling) Rules 1998.

Occupier : 
�Occupier � in relation to any institution generating Bio medical waste means a person who has control over that institution and /or its premises.

Salient Provisions of the BMW Rules : 
  • As per Rule 5 of the said BMW Rules , Bio-medical waste shall be treated and disposed off in accordance with Schedule I (Click here to see the Schedule I),and in compliance with the standards prescribed in Schedule V (Click here to see the Schedule V).

  • Every Health Care Establishment shall either have its own Bio medical waste treatment facilities (like incinerator, autoclave, microwave system )for the treatment of the waste or ensure requisite treatment of waste through Common Bio-Medical Waste Treatment Facility (CBWTF) (by having an Agreement with the operator of the CBWTF ). It is also the duty of the Occupier of the Health Care Establishment to take all steps to ensure that Bio Medical Waste is handled without any adverse effect to human health and the environment.

  • As per Rule 7 of the said BMW Rules, State Pollution Control Boards in respect of States and the Pollution Control Committees in respect of Union Territories are the Prescribed Authorities ( Delhi Pollution Control Committee in case of Delhi ).

  • As per Rule 8 of The Bio -Medical Waste ( Management and Handling) Rules, 1998, as amended to date,every occupier of an institution generating, collecting, receiving, storing, transporting, treating, disposing and/or handling bio-medical waste in any other manner, except such occupier of clinics, dispensaries, pathological laboratories, blood banks providing treatment / service to less than 1000 (one thousand) patients per month, shall make an application in Form I(Click here to see Form I). to the prescribed authority (Delhi Pollution Control Committee in case of Delhi) for grant of authorization.

CATEGORIES OF BIO MEDICAL WASTE (BMW)

(Please refer Schedule I , Click here to see the Schedule I)
Category No. 1      Human Anatomical Waste
Category No. 2      Animal Waste
Category No. 3      Microbiology & Biotechnology Waste
Category No. 4      Waste sharps
Category No. 5      Discarded Medicines and Cytotoxic drugs
Category No. 6      Soiled Waste
Category No. 7      Solid Waste
Category No. 8      Liquid Waste
Category No. 9       Incineration Ash
Category No. 10    Chemical Waste

Segregation & Colour Coding

Yellow: Human Anotomical Waste(Human Tissues, organs,body parts),Animal Waste (Tissues, organs, body parts, Carcasses etc.), Microbiology and Bio- technology Waste,Soiled Waste( Waste Category 1,2 and 3 & 6)

Red: Microbiology and Biotechnology Waste((Waste Category 3), Soiled Waste(Waste Category 6) , Solid Waste ( Waste Category 7)

Blue/White: Waste Sharps(Waste Category 4)& Solid Waste (waste Category 7)

Black: Discarded medicines & Cytotoxic Drugs((Waste Category 5), Incineration Ash((Waste Category 9) and Chemical Waste [ Waste Category 10(solid) ]

BMW Containers/Bags /Storage Facility must have proper Labels( Bio- Hazard/ Cyto Toxic Hazard Symbol) as prescribed in Schedule III of the Rules.

Treatment Of Bio Medical Waste 

Category No.1    Incineration /deep burial

Category No.2    Incineration /deep burial

Category No.3    Autoclaving/microwaving/incineration

Category No.4    Disinfection(chemical treatment)/autoclaving/microwaving and
                            mutilation/shredding.

Category No.5    Incineration/destruction/ and drugs disposal in secured landfills

Category No. 6    Incineration/autoclaving/microwaving

Category No.7    Disinfection by chemical treatment/autoclaving/ microwaving and
                           mutilation/ shredding

Category No.8    Disinfection by chemical treatment & discharge into drains

Category No.9    Disposal in municipal land fill

Category No.10    Chemical treatment and discharge into drains for liquids and secured
                              landfill for solids.

Suggested Treatment 

Yellow -Incineration/deep burial

Red - Autoclaving/ Microwaving /Chemical Treatment

Blue/White- Autoclaving/Microwaving/Chemical Treatment and destruction / shredding

Black - Disposal in Secured landfill


Schedule V (Standards for Treatment and Disposal of Bio Medical Waste)

Click here to see the Schedule V

Standards for Incinerators

A. Operating Standards

  1. Combustion Efficiency (CE ) shall be at least 99 %
  2. The Combustion Efficiency is computed as follows :
    C.E. = [(%Co2) / (% CO2 + % CO)] *100

  3. The Secondary Chamber gas residence time shall be at least 1 (one second) at 1050 � 50 Co , with minimum 3 % Oxygen in the stack gas).

B. Emission Standards




S.No.PARAMETERSCONCENTRATION in mg/Nm3 at(12 % CO2 correction)
1.Particulate Matter150
2.Nitrogen Oxides450
3.HCL50
4.Minimum stack height shall be 30 meters above ground.-
5.Volatile Organic Compounds in ash shall not be more than 0.01%-

Standards For Waste Autoclaving ( Please refer Schedule V )

For Validation Test/ Spore testing 

Biological indicator shall be Bacillus stearothermophilus spores or strips at least 1x104spores per ml. Should completely and consistently kill the approved biological indicator.

Routine Test 

A chemical indicator strip/tape changes colour when certain temperature is reached

For Microwave 

Microwave treatment shall not be done for cytotoxic, hazardous or radioactive wastes

Standards for Liquid Waste





PARAMETERSPERMISSIBLE LIMITS
pH6.5-9.0
Suspended Solids100 mg/L
Oil & Grease10 mg/L
BOD30 mg/L
COD250 mg/L
Bio-assay Test90% survival of fish after 96 hours in 100% effluent

These limits are applicable to those hospitals which are either connected with sewers without terminal Sewage Treatment Plant or not connected to public sewers.

For discharge into public sewers with terminal facilities , the General Standards as notified under the Environment (Protection ) Act, 1986, shall be applicable . Click here to see the General Standards(Schedule VI) 

Main parameters are given below:




PARAMETERSPERMISSIBLE LIMITS
pH5.5-9.0
Suspended Solids600 mg/L
Oil & Grease10 mg/L
BOD350mg/L
Bio-assay Test90% survival of fish after 96 hours in 100% effluent

DPCC has taken decision that Hospital having 50 beds or more shall install Effluent Treatment Plant (ETP) for the treatment of waste water generated and for recycling of treated effluent for use in horticulture, air conditioning/ cooling plants and flushing of toilet etc.



How to Apply for Authorization under the Bio-Medical Waste (Management And Handling) Rules,1998.

Following are required to be submitted

  1. An Application Form in prescribed Form-I, duly filled up. (Click here for the Form I).

  2. An affidavit on Rs.10/- non-judicial stamp paper having declaration in the prescribed format, duly attested by a Notary Public. (Click here for the language of Affidavit).

  3. Prescribed Fee for three years[minimum for 3 years, if there is late / delay in submission of the application for renewal then extra fee is required for the whole no of year(s)(gap period)]for authorization under Bio-Medical Waste (Management & Handling)Rules,1998, through Demand Draft in favour of Delhi Pollution Control Committee. (Click here for the Fee structure).



  4. Fee Structure for Authorization for Private Health Care Establishments / Units
    1. Clinics, Path Labs and Blood Banks Rs. 1000/-per annum.

    2. Vet.Instt., Dispensaries & Animal Houses Rs. 1000/- per annum.

    3. Hospitals,Nursing Homes &Health Care Establishments upto 4 beds Rs. 1000/- per annum and additional Rs. 100 per bed per annum from fifth bed onwards.

    4. Operator of the facility of Bio Medical Waste(excluding transportation), Rs.10,000/-per annum.

    5. Transporter of Bio Medical Waste Rs .7500/-per annum

    Fee for Authorization for Health Care Establishments / Units run by Govt. / Govt. Body/ Non Profit Organization is Rs. 100 /- per year .

    Separate Demand Draft of Rs.100/- in favour of Delhi Pollution Control Committee is required to be submitted alongwith the application, if the form is downloaded from the web site of DPCC.

  5. Copy of Valid Agreement, with operator of Common Bio Medical Waste Treatment Facility(CBWTF), authorized by DPCC ( If treatment and disposal of the Bio Medical Waste is through the CBWTF). Click here for the list of Authorized CBWTFs in Delhi.

    The Application for Authorization alongwith the enclosures / required documents can be submitted at the Enquiry Counter of Delhi Pollution Control Committee at 4th Floor, ISBT Building, Kashmere Gate, Delhi - 06. between 10.00 A.M. to 4.00 P.M. on any working day.

    In case of difficulty concerned Engineers of Bio Medical Waste Management Cell may be contacted .

Requirement of Consent to Establish / Operate under the the Air and Water Acts 

Health Care Establishments (HCE) are also required to apply for Consent to Establish under the Air (Prevention and Control of Pollution) Act, 1981 as amended to date and Water (Prevention and Control of Pollution) Act, 1974 as amended to date (Health Care Establishments existing prior to 19.11.2008 and having less than 50 beds have been exempted from applying for Consent to Establish under the Air & Water Acts, as per the policy decision taken and communicated vide letter dated 19.11.2008) in the prescribed Form alongwith required Consent Fee & Documents / Enclosures (Please click here to see the prescribed) Form Consent Fee

However Health Care Establishments having oil fired boiler are not exempted & are required to apply for Consent to Establish under the Air & Water Acts. The HCEs having 10 beds or more which have been established on 19.11.2008 or thereafter and New / Proposed / upcoming HCEs having 10 beds or more are also required to apply for Consent to Establish under the Air & Water Acts.

Health Care Establishments are also required to apply for Consent to Operate under the Air (Prevention and Control of Pollution) Act, 1981 as amended to date, and Water (Prevention and Control of Pollution) Act,1974 as amended to date.

Fee for Consent to Establish / Operate under the Air & Water Acts, for Health Care Establishments / Units run by Govt. / Govt. Body/ Non Profit Organization is Rs. 100 /- per year .

For Fee Structure for Consent to Establish / Operate under the Air & Water Acts, for Private Health Care Establishments /Units 
please click here.

Noise Monitoring report for D.G.Set(s), Stack Monitoring report for Incinerator / Boiler and Effluent Analysis report for Effluent Treatment Plant ( monitoring / analysis report older than 6 months is not accepted)from any of the Empanelled Laboratories of Delhi Pollution Control Committee are required to be submitted alongwith the application besides other documents / enclosures mentioned in the application form. (Click here for the Empanelled Laboratories).

Incinerators are covered under the Bio-Medical Waste (Management & Handling) Rules.

For DG Set(s) provide Acoustic Enclosure or treat the Room Acoustically to meet the norms prescribed by Ministry of Environment and Forest Govt. of India (MOEF) vide Notifications No. G.S.R. 371(E) dated 17.05.2002 and G.S.R. 448(E) dated 12.07.2004 and Ambient Air Quality standard in respect of Noise as mentioned in Schedule III of the Environment Protection Rules ,1986 and also provide adequate stack height for DG Sets as given below : The minimum height (H) of stack to be provided with each generator set is as given below

H = h + 0.2 *(square root of capacity of DGSet in KVA)
H = Total Height of Stack in meter
h = Height of the building in meters where the Generator Set is installed
KVA = Total Generator capacity of the set in KVA.


As per decision taken by DPCC, Hospitals having 50 beds or more are required to install Effluent Treatment Plant for the treatment of waste water generated from the Hospital for recycling of treated effluent and for use in Horticulture, air conditioning/ cooling plants and for flushing of toilets etc.

Hospitals having 50 beds or more are also required to install Solar Water Heating System, Rain Water Harvesting System, Replace ordinary bulbs with CFL and do plantation on the periphery / boundary of the Hospital.

Health Care Establishments are required to comply with the standards prescribed in the Environment (Protection)Rules, 1986, as amended to date and prescribed in the Bio-Medical Waste (Management & Handling) Rules.



Advisory Committee 
Advisory Committee for Bio Medical Waste , headed by Secretary (Health), Govt. of NCT of Delhi and having member from the various organisations and having experts , has been constituted as per the provisions of the Bio-Medical Waste (Management and Handling) Rules, for its effective implementation.

Maintenance of Records , Accident Reporting and Submission of Annual Report 

Every authorized person is required to maintain records related to generation, collection, reception, storage , transportation, treatment and disposal and / or any form of handling of Bio Medical Waste in accordance with the Rules and Guidelines issued (Records should be maintained on daily basis).

Authorized person is also required to report accident (in Form III) , if any, occurred during the handling / transportation of the Bio Medical Waste to the Prescribed Authority ( DPCC ).

It is mandatory for Every Occupier of Health Care Establishment / Operator of CBWTF to submit an annual report to the prescribed authority ( DPCC) in Form II by 31st January, every year, to include information about the categories and quantities of Bio Medical Waste handled during the preceding year. Please click here to see Form II.

Appeal 

Financial Commissioner, Govt. of NCT of Delhi is the Appellate Authority under the Bio-Medical Waste (Management and Handling) Rules . Appeal, if any, is to be filed with in 30 days from the date of receipt of the Aggrieved Order . No fee prescribed for filing Appeal

Any violation of the provisions of the said Rules attracts action under the Environment (Protection) Act,1986, as amended to date, wherein there is provision for punishment of imprisonment for a term which may extend to five years with fine upto one lakh rupees, or with both.

Note : The Bio Medical Waste (Management and Handling) Rules, 1998, were notified by Ministry of Environment and Forest , Govt. of India vide notification dated 20.07.1998 and further amendments were done in the said Rules from time to time. Now Draft of the Bio -Medical Waste (Management and Handling) Rules, 2011 has been notified by the said Ministry vide notification dated 24.08.2011 seeking objections / suggestions . For details these Rules can be referred at the website of Ministry of Environment and Forest , Govt. of India(www.moef.nic.in) and for other related information website of Central Pollution Control Board ( www.cpcb.nic.in ) may be referred.

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