Hospital Bio-Waste Management

Pilot/ demonstration scheme for Bio-medical Waste Management in Selected Government Hospital for Hospital Waste Management:

In pursuance to the notification of Bio-Medical Waste (management & Handling) Rules, 1998, the Ministry of Health & Family Welfare had constituted a National Hospital Waste Management Committee (NHWMC) to coordinate and guide on the various aspects including policies, programme and issues on hospital waste management in the country. In a meeting of NHWMC held on 9 th November, 1999, it was decided that a scheme be formulated to provide assistance to State Govts / UT administrations for procurement of equipment, providing training etc. for Pilot projects / Demonstration projects under Hospital Waste Management.

In order to extend financial assistance for Pilot projects / Demonstration projects to selected Government hospitals for hospital waste management, guidelines have been prepared. These guidelines had been approved by the competent authority by way of Standing Finance Committee Memo and issued on 11 th January, 2000.

As per the aforesaid guidelines, it has been proposed to provide financial assistance for identified hospitals, institutions for purchase of equipments such as

  • Incinerator / Microwave Rs.35.0 lakh
  • Autoclave(1015 lit) Rs.30.0 lakh
  • Shredder (100 to 360 Kg/hr) Rs.10.0 lakh
  • Waste Transportation Trolley Upto Rs.50,000.00
  • Civil & Electrical Work Rs.2.50 lakh
  • Literature/IEC/ Training Rs.2.0 lakh
  • Procurement of Protective Gear, Rs.5.0 lakh

equipment needle shredder

& plastic bags(colour coded) ___________

Rs.85.0 lakh

The financial assistance under the scheme is limited to Rs.85.0 lakh per hospital or Rs.1.5 crore maximum per State / UT. The State / UT will have the option to choose any equipment from the list above to cover as many hospitals as possible. Under the scheme, funds are directly released to the concerned hospital.

 

The scheme has been transferred to this Ministry during 2005-06 in October, 2005 with a budget allocation of Rs. 1.00 Crore only. Due to non-availability of appropriate proposal funds could not be released.

Rs. 1.00 Crore has been provided under the scheme for the year 2006-07.

The guidelines for the scheme is as under:

Guidelines for the Project providing financial support to the selected Government hospitals for Hospital Waste Management.

***********

The Ministry of Environment & Forests notified the “Bio-Medical Waste (Management & Handling) Rules, 1998” in July, 1998.

In accordance with the rules (Rule 4), it is the duty of every “Occupier”, i.e. a person who has the control over the institution and/or its premises, to take all steps to ensure that the waste generated is handled without any adverse effect to human health and environment. The Rules further state that every Occupier, where required, shall set up requisite bio-medical waste treatment facilities like incinerator, autoclave, microwave system for the treatment of waste, or ensure requisite treatment of waste at a common treatment facility or any other treatment facility. No untreated bio-medical waste shall be kept stored beyond a period of 48 hours (Rules 5 & 6).

The hospitals, nursing homes, clinic, dispensary, animal house, pathological lab, etc. are, therefore, required to set in place the biological waste treatment facilities. It is, however, not incumbent that every institution has to have its own waste treatment facilities. The rules also envisage that common facility or any other facilities can be used for waste treatment. However, it is incumbent on the occupier to ensure that the waste is treated within a period of 48 hours. Schedule VI of the rules also provides the time limits by which the waste treatment facilities are required to be in place.

In connection with the implementation of the Rules, it has been decided to take up pilot projects in selected Government hospitals – Central and State.

 

AIM: The aim of the scheme is to implement pilot projects to have a demonstration effect by providing financial assistance to identified hospitals / institutions under Central / State Governments for:

1. Purchase of equipments such as:

      • Incinerator
      • Microwave
      • Autoclave
      • Shredder

2. Other equipments including colour coded bags and puncture proof containers, protective gears, etc.

3. Civil and electrical works to house and operate the waste treatment facilities

4. Training

5. I.E.C. activities

Hospital Waste Management System must be established in accordance with the Bio-Medical Waste (Management & Handling) Rules, 1998.

Segregation must be done at the source of generation of waste. As 80-85% of waste generated in hospitals is non-hazardous or general waste, segregation will reduce the quantum of waste that needs special treatment to only 15-20% of the total waste. The categories for segregation of waste and colour coding and type of container, should be as in Schedule 1 and 2 of the Bio-Medical Waste (Management & Handling) Rules, 1998.

The various options for treatment of waste can be selected according to feasibility and type of waste as given in the Schedule – 1. The correct colour bag should be used for the particular treatment option.

The various options are:

  1. Incineration: The incinerator installed must meet the specification and emission standards as given in the Bio-Medical Waste (Management & Handling) Rules, 1998 and must meet the guidelines developed by Central Pollution Control Board for design and construction of bio-medical waste incinerator (circulated to all States/UTs vide letter No.Z-28015/50/2003-H dated 18.11.2003) – a certificate may be taken from the State Pollution Control Board. Waste category, 1, 2, 3, 5 & 6 as stated in the Schedule – I of the Bio-Medical Waste (Management & Handling) Rules, 1998. Wherever common facilities for treatment and disposal of bio-medical waste are available, installation of incinerators by individual hospitals may not be encouraged and such waste should be transported to be common facility for proper treatment.
  1. Autoclaving/Microwaving: Standards for autoclaving and microwaving are provided in the Bio-Medical Waste (Management & Handling) Rules, 1998. The equipment for autoclaving or microwaving waste should conform to these standards. These options can be selected for waste categories 3, 4, 6, 7 of Schedule – I of the Bio-Medical Waste (Management & Handling) Rules, 1998.
  1. Shredder: Shredding will cause a reduction in the volume of waste and will also effectively prevent its re-use. It is required for waste category 4 and 7 of the Schedule – I of the Bio-Medical Waste (Management & Handling) Rules, 1998. It should be ensured that waste is disinfected by chemicals / microwaving / autoclaving before shredding.
  1. Needle and syringe destroyer: These units can be used for needles and syringes at the point of use. These will destroy the used needles reducing it to ashes and cut the syringe effectively preventing the re-use.
  1. Transportation of waste: Within the hospital in dedicated wheeled containers, trolleys or carts should be used to transport the bins or plastic bags to the site of storage / treatment. The wheeled container should be designed so that waste can be easily loaded, remain secure during transportation, does not have sharp edges and is easy to clean and disinfect.

The assistance will be given direct to the hospital / institute for purchase of equipments for waste treatment facilities / installation of equipment and civil / electrical works to house the waste treatment facilities, training, I.E.C. activities including preparation and publication of literature, posters, pamphlets, etc. The financial assistance will be limited to Rs.85 lakhs per hospital or Rs.1.50 crore per State/U.T. The estimated costs are as under:

1.

Incinerator or Microwave

=

Rs.35.00 lakhs

2.

Shredder (Approx. 100 kg. to 360 kg/hour)

=

Rs.10.00 lakhs

3.

Autoclave (Approx. Cap. Vol. 1015 ltrs)

=

Rs.30.00 lakhs

4.

Waste transportation: Onsite-wheel barrow/wheeled container or similar carriage

=

Upto max. of Rs.50,000.00

5.

Civil and Electrical works

=

Rs.2.50 lakhs

6.

Literature/IEC/Training of staff

=

Rs.2.00 lakhs

7.

Procurement of equipments like needle shredder, puncture proof containers for sharps, colour coded bags, trolleys, protective gears for staff etc. for disposal of hospital wastes

=

Rs.5.00 lakhs

The following eligibility conditions have to be fulfilled for availing of financial assistance:

  • The application for financial assistance should be forwarded to this Ministry through the State Government / UT Administration concerned.
  • The State Government / UT Administration should ensure that the existing facilities are inspected by a responsible officer and deficiencies pointed out. The proposal for additionalities, if any, in the form of equipment should be, as far as possible, by way of complementary equipments supported by estimates of concerned authorities.
  • The cost of equipments to be purchased should be indicated. The equipments will be purchased as per prescribed procedure. These will be entered into an Assets Register to be maintained by the hospital.
  • The grant will be subject to the condition that the State Government / UT Administration will give an undertaking that adequate arrangements for running the equipments and their maintenance for disposal of hospital waste shall be made.
  • The grant will be subject to the condition that the State Government / UT Administration / Hospital will give an undertaking that they will provide the required trained manpower for running of the equipments and their maintenance for proper treatment and disposal of the bio-medical waste.
  • The funds sanctioned will be utilized for the purpose for which it is sanctioned.
  • The accounts of the hospital about purchase of equipment / maintenance of equipments / transportation of the waste / expenditure incurred on civil / electrical works will be audited by the Accountant General of the State Government / UT Administration and its utilization certificate will be forwarded to the Ministry of Health & Family Welfare within a period of six months after the expiry of the financial year during which the grants is sanctioned.

The financial assistance will be limited to Rs.85 lakhs per hospital or Rs.1.5 crore per State / U.T. The State/U.Ts will have the option to choose any equipment(s) from the list above to cover as many hospitals as possible. However, the financial assistance per State will be provided up to a maximum amount of Rs.1.5 crore.

Scrutiny of applications:

The applications received from the State Government / UT Administrations for setting up of facilities for disposal of hospital waste in the hospitals under their administrative control will be considered in the Ministry in a Committee headed by Additional Secretary and proposals cleared for giving financial assistance. The proposals then will be processed for sanction of financial assistance to the Government Hospitals / Institutes. In the case of Central Government Hospitals / Institutions, the Head of the Institutions may send their proposal through Dte. GHS.

The Joint Secretary (Hospital), DDG level Officer in the De. GHS concerned with hospitals matters will be the Nodal Officer for implementation of the scheme. The proposals will be examined through a Committee consisting of Additional Secretary, Chairman, the Joint Secretary dealing with hospital matters, Joint Secretary (FA) or his representative, DDG level Officer dealing with hospitals in Dte. GHS and one representative of Central Pollution Control Board/Ministry of Environment & Forests as Members. The Member Secretary of the Committee will be Director / Deputy Secretary dealing with hospital matters. The funds for setting up facilities for disposal of hospital waste will be sanctioned to the State Government / UT Administration / Occupier and it will be implemented by the concerned Government and to the concerned Head of the Hospital in case of Central Government Hospitals / Institutions.
 

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