INFECTION MANAGEMENT AND ENVIRONMENT PLAN

GUIDELINES FOR HEALTHCARE WORKERS

FOR WASTE MANAGEMENT AND INFECTION CONTROL
IN PRIMARY HEALTH CENTRES

Ministry of Health & Family Welfare

Government of India
This Document has been designed by Arvinder Chawla and Kamal Kumar, illustrated by Vivek Kaushik and printed by Colorcom Advertising

2 2007, Printing of the IMEP guidelines for Government of India is supported by DFID, India.
Preface
Biomedical waste refers to all wastes generated from healthcare and health research
facilities and associated laboratories. While most of this is communal waste, a small
percentage can be deemed infectious and/or hazardous. These include infected sharps
and wastes with infectious, hazardous, radioactive, or genotoxic characteristics, which
if inadequately treated and managed can have adverse impact on the environment and
on public health through air, land and water pollution. Therefore institutionalizing effective
waste management systems in all healthcare facilities is a key prerequisite to improving
efficiency and effectiveness of healthcare.

The regulatory framework for environmental management in the health sector in India is
provided by the Bio-Medical Rules (prepared in 1998; amended in 2000 and 2003), which
apply to all persons/institutions generating and/or handling healthcare waste in any
form. The Rules define bio-medical waste as “any waste which is generated during
diagnosis, treatment or immunization of human beings or animals, or in research activities
or in the production or testing of biologicals and including categories mentioned in
schedule-I of the rules”. The Rules, besides identifying the various waste categories, also
recommend treatment and disposal methods and the standards to be laid down for the
same.

The Ministry of Health & Family Welfare commissioned the development of a National
Policy document to address the issues relating to infection control and waste management
and define a framework for implementation of an Infection Management and Environment
Plan (IMEP) in healthcare facilities. This policy document was commissioned under the
Reproductive and Child Health Programme Phase - II, with technical and financial support
from DFIDI and the World Bank.

3
 The final IMEP document comprises of 2 volumes:
™ A Policy Framework document which gives a broad overview and contains generic
guidance to central and state level institutions on the type of systems and processes
to be established for infection control and biomedical waste management.
™ A set of Operational Guidelines which are designed as instruction manuals for healthcare
workers at primary level healthcare facilities, i.e. Community Health Centres, Pri-
mary Health Centres and Sub Centres. These guidelines are in the form of simple
pictorial presentations of the various steps needed to manage infectious waste in a
hygienic, safe and environmentally sound manner.
The IMEP Guidelines will be implemented and monitored under the auspices of the National
Rural Health Mission (NRHM) and will go a long way to internalise state–of–the art, best
practices in managing health and environment risks in the healthcare institutions of our
country.

Date: 1st April, 2007 (Naresh Dayal)

Secretary (Health and Family Welfare)
Ministry of Health and Family Welfare
Government of India

4
Acknowledgement
The Infection Management and Environment Plan document is an important component
of the support to primary level healthcare being provided under the auspices of the
National Rural Health Mission (NRHM) and Reproductive and Child Health Programme
Phase - II. The Policy Framework document and the Operational Guidelines are intended
to facilitate and enhance implementation of the Bio-Medical Waste Management Rules of
the Government of India.
The vision and constant encouragement provided by Shri P.K. Hota, former Secretary,
Health and Family Welfare enabled us to bring out these guidelines. I express my sincere
thanks to Shri Naresh Dayal, Secretary, Health & Family Welfare under whose leadership
these guidelines have been finalized.
Special thanks are also due to Ms. Ruma Tavorath, Environment Specialist, The World
Bank, for her technical contribution and continued guidance to bring the document to its
current shape. We are particularly thankful to Dr. Sean Doolan, Environment Adviser,
DFIDI who conceptualized this document and to Mr. Stephen Young, Senior Infrastructure
and Urban Development Adviser, DFIDI for the continued support. Ms. Ellora Guhathakurta,
Programme officer, DFIDI deserves special mention for her meticulous and sustained
follow-up and coordination throughout the administrative process.
I recognize the excellent contributions of Mr. S. Vaideeswaran, Consultant, The World
Bank and Dr. Megha Rathi, Consultant, DFIDI in successfully translating the concepts of
the Policy Framework and Operational Guidelines into reality. Sincere appreciation is due
to Shri S.S. Brar, Joint Secretary (RCH) and Shri A.P. Singh, Director (DC) for their
leadership, encouragement and guidance.
I acknowledge the contributions of Dr. V.K. Manchanda, erstwhile Deputy Commissioner
(MCH), Dr. Narika Namshum, Deputy Commissioner (Child Health and Training),
5
 Dr. I.P. Kaur, Deputy Commissioner (Maternal Health) and Dr. Himanshu Bhushan, Assistant
Commissioner (Maternal Health).
I would like to make a special mention of Dr. Manisha Malhotra, Assistant Commissioner,
Maternal Health Division, for her unstinting support and unwavering commitment to
finalizing, disseminating and enhancing the importance of this activity within the NRHM
agenda.
The cooperation and technical inputs provided to this activity by the members of the
“Working Group” deserves special mention. So does the contribution of the secretarial
staff from the various organizations who have facilitated us in this important activity.

Date: 1st April, 2007 (S. Jalaja)

Additional Secretary
Mission Director, NRHM
Ministry of Health & Family Welfare
Government of India

6
Contents
Waste Management in Primary Health Centers 10

A. WASTE MANAGEMENT 15
1. Steps of waste management 17
1.1 Segregation 18
1.2 Collection and Storage 20
1.3 Transportation 22
1.4 Treatment and Disposal 24

2. Management of different waste streams 26

2.1 Sharps 26
2.1.1 Sharps and its kind 26
2.1.2 Different kinds of needles and syringes 27
2.1.3 Broken glasses 34
2.1.4 Metal sharps 36

7
 2.2. Anatomical waste 38
2.3 Sputum cups and slides 40
2.4 Plastic waste 42
2.5 Liquid waste 44
2.5.1 Liquid waste spills 44
2.5.2 Disposal of disinfectants 46
2.6 Mercury spills 48

B. INFECTION CONTROL 51
1. Hand washing 52
2. Personal Protective Equipments 53
3. Use of Disinfectants 54
4. Soiled linen management 56
5. Cleaning floors 57
6. Sterilization of reusable equipments 58
7. Storing medicines and chemicals 60

8
C. ANNEXURE 63
1. Schedule 1 63
2. Schedule 2 65
3. Standards for Deep Burial Pit 66
4. Form III (Accident Reporting) 67

9
 Waste Management in Primary Health Centers
A Primary Health Centre (PHC) caters to a population of around 30 000 and undertakes various activities
that generate different kinds of waste that need to be managed as per the Bio-medical Waste
(Management and Handling) Rules, 1998. These rules make it mandatory for all health care facilities to
have a sound health care waste management system. The present guidelines are intended to help the
health care workers manage their waste and safeguard themselves and the community from the ill-
effects of contaminated waste. This operational guide will help in establishing a sound Health care
Waste Management system within the PHCs.
A PHC generates
different kinds and
quantity of waste
based on the activities
undertaken by it. The
following table
explains in brief the
different areas and
types of waste
generated in a PHC.

Always keep your surroundings clean

10
Table: Areas of waste generation and kinds of waste generated in the Primary Health Centres
S.No. Areas of Activities performed Types of Consumables used
Waste generation Waste generated* for Managing Waste

1. Operation Theatre Family planning procedures, Blood and body fluids, soiled waste, Coloured bags, bins, hub
cataract surgeries. swabs, cotton, syringes and needles, cutter/destroyer, 1% bleaching
Minor Surgical Procedures blades, gloves and masks powder solution, Puncture
Proof Container.

2. Labour Room Child birth (Deliveries) Placenta, blood and body fluids, soiled waste, - do-
cotton, swabs, syringes and needles, blades,
tubings and IV sets masks and gloves

3. Laboratory Malarial smears, TB testing Blood and body fluids, syringes and - do-
and other essential laboratory needles, gloves, slides, sputum and
services sputum cups, chemical waste and liquid
waste

4. Injection Room Immunization and curative Syringes and needles, ampoules, vials, - do-
injections broken glasses, gloves and vaccine waste

5. Ward In-patient services Blood and body fluids, syringe and needle,
slides, ampoules, vials, chemical waste, - do-
liquid waste, broken thermometer and
soiled waste
11
 S.No. Areas of Activities performed Types of Consumables used
Waste generation Waste generated* for Managing Waste

6. OPD Out-patient services, routine Blood and body fluids, syringes and Coloured bags, bins, hub
examination of patients needles, slides, ampoules, vials, broken cutter/destroyer, 1% bleaching
thermometer, plaster cast chemical waste powder solution, Puncture
and liquid waste, Proof Container.

7. Store Store Discarded medicine Green bag and bin

* General or non-biomedical waste is generated at all the points of waste generation in the health care facility

12
While managing the waste
generated from PHC a waste
management system that is
simple, safe for health care
workers and the community,
easy to operate and
economically viable. For the
easy understanding and
implementation of waste
management in PHCs the
various steps for waste
management have been
depicted in the form of
illustrations. These
illustrations are self-
explanatory and are aimed at
helping the health care
workers to manage the
waste as per the Bio-medical
Waste (Management and
Handling), Rules 1998.
Health care waste is a risk to all, it affects us in different ways

13
WASTE MANAGEMENT

15
1. Steps For Waste Management

Step 1

SEGREGATION

Step 2

COLLECTION AND STORAGE

Step 3

TRANSPORTATION

Step 4

TREATMENT AND DISPOSAL

17
 1.1 Segregation

Do’s
1. Always segregate waste into infectious and non-infectious waste at source of
generation as per the colour coding in the health care facility like CHC/PHC/Sub-
centre

2. Infectious waste includes

a. Sharps: Needles, blades, broken glass which are to be disposed in
white/ blue puncture proof container
b. Non-Sharps (soiled waste): Infected plastics, syringes, dressings, gloves,
masks, blood bags, urine bags are to be disposed in red plastic bins/bags
c. Anatomical waste: Placenta, body parts to be disposed in yellow plastic
bins/bags

3. Non-infectious (General) waste includes waste similar to household waste like

packaging material, cartons, fruit and vegetable peels, syringe and needle wrappers,
medicine covers to be disposed in green/black plastic bins or bags

Don’ts
Never mix infectious and non-infectious waste either at source of generation, during waste
collection, waste storage, waste transportation or during final disposal of waste

18
Segregation

(SOILED WASTE)
Always segregate waste at the source of generation 19
 1.2 Collection and Storage

Do’s
1. Always collect the waste in covered bins

2. Fill the bins upto the 3/4th level

3. Clean the bins regularly with soap and water/disinfect the bins regularly

Don’ts
1. Never overfill the bins

2. Never mix infectious and non-infectious waste in the same bin

3. Never store waste beyond 48 hrs

20
Collection and Storage

Bad: Don’t overfill the bins Good: Always fill only 3/4th bin
21
 1.3 Transportation

Do’s
1. Always carry/transport the waste in closed containers

2. Use dedicated waste collection bins/trolleys/wheel barrows for transporting waste

3. Transport waste through a pre-defined route within the health care facility

Don’ts
1. Never transport the waste in open containers or bags, it may spill and lead to spread of
infections

2. Never transport waste through crowded areas

22
Transportation

Bad - Don’t carry waste in open bags, and never Good - Always carry the waste in secure
carry it through crowded areas sealed containers/ bags

23
 1.4 Treatment and Disposal

Do’s
1. Always remember to disinfect and mutilate the waste before its final disposal

2. Remember the following while treating the waste streams

a. Anatomical waste to be deep buried
b. Syringes to be cut (with hub cutters) and chemically disinfected with 1%
bleaching powder solution at source of generation before final disposal into
sharps pit
c. Infected plastics to be chemically disinfected or autoclaved, shredded and
recycled and sent for final disposal into municipal dumps
d. General waste without any treatment to be sent to waste dumps for final
disposal

Don’ts
Never throw infectious waste into general waste without any pre-treatment and mutilation

24
Treatment and Disposal

Disinfection & Mutilation

Ensure disinfection
and mutilation of
waste before final
disposal 25
 2. Management of Different Waste Streams

2.1 Sharps

2.1.1 Sharps and its Kind

Sharps are such objects that are capable of causing injuries by piercing the skin. Sharps
include metal sharps like needles and blades and glass sharps like broken ampoules, vials
and slides

26
2.1.2 Different Kinds of Needles and Syringes
In the following pages the waste management of
a) Disposable syringes, b) Auto-disable syringes and c) Glass syringes has been illustrated

Bad - Mixing of waste Good - Sharps in puncture proof container

27
 a) Disposable Syringes

Do’s
1. Always wear protective gears like gloves while handling needles and syringes
2. Always collect needles and syringes in puncture proof containers
3. Always mutilate/cut the tip of the syringe and the needle with a needle and hub
cutter before disinfecting them
4. Remember to detach the barrel and the plunger before disinfecting the syringe
5. Disinfect the mutilated needles and the syringes with 1% bleaching powder solution at
least for one hour
6. After disinfection and mutilation of needles and syringes collect them in puncture proof
container
7. Final disposal of disinfected and mutilated syringes in general waste stream/recycling

Don’ts
1. Never mix sharps with other waste streams
2. Never throw the needles and the syringes without
mutilation and disinfection into the waste bin
3. Never recap or bend needles
4. Never discard the sharps in polybags
5. Never burn the syringes
6. Never dispose the sharps in open areas accessible
to scavengers

28
Disposable Syringes

Detach the
Barrel and
plunger

Disinfected and mutilated syringes General waste stream 29

 b) Auto-Disable Syringes
Do’s
1. Always wear protective gears like gloves while handling needles and syringes
2. Always collect the auto-disable syringes in puncture proof containers
3. Always mutilate/cut the tip of the syringe and the needle before disinfecting them
with a needle and hub cutter
4. Disinfect the mutilated needles and the syringes with 1% bleaching powder solution for
at least 1 hour
5. After disinfection and mutilation of needles and syringes always collect them in
puncture proof containers
6. Final disposal of disinfected and mutilated
syringes in general waste stream/recycling

Don’ts
1. Never mix sharps with other
waste streams
2. Never recap or bend the needles
3. Never throw the needles and
the syringes without mutilation
and disinfection into the waste bin
4. Never burn the syringes

30
NEVER BURN SYRINGES
Auto-Disable Syringes

Disinfected and mutilated General waste stream 31

auto-disable syringes
 c) Glass Syringes
Do’s
1. Always wear personal protective gearslike gloves
while handling needles and syringes

2. After using the glass syringes remove

the needles by forcipes and mutilate the needles Used syringes

3. Collect the glass syringes in a box

4. Remove the barrel and plunger of the glass

syringe and sterilize them in a sterilizer or a
cooker for at least 20 minutes

5. Remove the sterilized syringes with sterile Washing

used syringes
forcipes and store them in sterile containers only with
water

Don’ts
1. Never reuse the glass syringes without
proper sterilization. Ensure proper
sterilization of the syringes

2. Never reuse the needles

Always single use the needles

Reusing syringes
32
Glass Syringes

Boiled for 20 minutes

Sterile syringes in sterile

containers for reuse

33
 2.1.3 Broken Glasses

Do’s
1. Always safely cut and discard the ampoules and vials in sharps container

2. Finally dispose the broken glasses in sharps pit

Don’ts
1. Never cut the ampoules in such a way that they can hurt others

2. Never break glass sharps manually

34
Broken Glasses

35
 2.1.4 Metal Sharps
Do’s
1. Discard the metal sharps like blades, lancets and scalples in puncture proof
container with disinfectant solution
2. Finally dispose the metal sharps in sharps pit

Don’ts
1. Never dispose sharps in nonsecure area
2. Never discard the metal sharps in non-puncture proof containers

Nonsecure disposal of sharps Never collect sharps in plastic bags

36
Metal Sharps

37
 2.2 Anatomical Waste
Do’s
1. Always segregate anatomical parts from other waste streams at the source of generation
in yellow bags/containers
2. Collect anatomical waste like placenta in closed bags/covered bins at the source of
generation
3. Transport the placenta from source of generation to final disposal site in covered bins/bags
4. Dispose the placenta along with disinfectant in secure deep burial pit

Don’ts
1. Never mix the waste at source of generation or later during collection and transportation
2. Never dispose the anatomical waste in un-secure open areas or in water bodies

Never dispose anatomical

38 waste in open
Anatomical Waste

LABOUR ROOM

CHEMICAL
DISINFECTANT

39
 2.3 Sputum Cups and Slides

Do’s
1. Always wear personal protective gears like gloves and masks while handling sputum
cups and slides

2. Dispose the sputum cups and slides into covered containers 5% Sodium Hypochlorite
solution for at least one hour

3. After disinfection dispose the:

-Sputum cups into burial pits
-Slides into sharps pit
-Liquid waste into drains

Don’ts

1. Never handle highly infectious waste without wearing personal protective gears
2. Never break the slides after use, during disinfection or final disposal. Dispose the slides
without breaking them
3. Never dispose any infectious waste without pre-treatment

40
Sputum Cups and Slides

Slides

41
 2.4 Plastic Waste

Do’s
1. Always cut/puncture the plastic waste such as intra-venous tubes,
bottles, syringes, latex gloves and mask by scissors before disinfection

2. Disinfect the plastics in covered containers with 1% bleaching powder solution at least
for one hour

3. Dispose the disinfected and mutilated plastics in municipal dumps or send for recycling

Don’ts
1. Never dispose used plastics without any pre-treatment like disinfection and
mutilation before final disposal

2. Never reuse the disposable gloves and masks

42
Plastic Waste

Removing mask and gloves

General waste stream Mutilation

43
 2.5 Liquid Waste
Liquid waste is any blood, body fluid, pus, any discharge from wounds or liquid chemicals

2.5.1 Liquid Waste Spills

Do’s
1. Clean the liquid waste spill by adding equal or more quantity of bleaching powder
solution and leave the area for 30 minutes
2. Wipe the area with a swab/cloth
3. Discard the swab/cloth after cleaning the area into red bin meant for plastics and
other waste
4. If possible dispose the liquid waste into the drains

Don’ts
1. Never clean
liquid waste Reusing the
spills without cloth without
adding disinfecting it
disinfectant
to the spills Liquid
waste
2. Never reuse
the cloth used
for cleaning
the spills for
any other purpose Cleaning with a cloth

44
Liquid Waste Spills

CLEANING THE AREA WITH A CLOTH

45
 2.5.2 Disposal of Disinfectants

Do’s
1. Always dilute the disinfectant before disposal into drains
2. Wear personal protective gears while handling disinfectants
3. Always destroy the empty disinfectant container to avoid reuse

Don’ts
1. Never dispose the chemicals, disinfectants without diluting them
2. Never use expired chemicals or disinfectants. Send them back to the stores

46
Disposal of Disinfectants

47
 2.6 Mercury Spills
Mercury is a hazardous chemical used in different instruments like thermometers and blood pressure
instruments within the health care facilities. It has to be managed properly to ensure it does not
cause harm to the health care workers and the community at large

Do’s
1. Always wear personal protective gears like gloves and masks while handling mercury spills from
breaking of thermometers or leaking blood pressure equipments

2. Always collect mercury droplets together by using two cardboard pieces

3. Drop the collected mercury into a

bottle having some water.
Tightly cover the bottle’s lid

4. Send the bottle containing

mercury back to the stores

Don’ts
1. Never touch the mercury with
bare hands.

2. Never throw the mercury in

waste bins or drain

48
Mercury Spills

Breaking of thermometer
49
INFECTION CONTROL

51
 1. Hand Washing
1. Hand washing is one of the most important infection control
precaution to be followed by all health care workers

2. Always wash your hands before and after any procedure,

examining two patients, handling waste, eating and
drinking, collecting lab samples and handling blood and body
fluids

3. Routine hand washing can be done by using soap and water

52
2. Personal Protective Equipments
1. Always wear personal protective
gears while handling waste
Cap
2. Wearing head gears, eye covers
Glasses
(glasses), mask, apron, gloves
Mask
and boots these constitute the
barrier for transmission of Apron
infections

3. Taking immunization against

Hepatitis B and Tetanus are
important universal precautions Gloves

Boots

53
 3. Use of Disinfectants
1. Store bleaching powder in dry, dark and cool places

2. The bleaching powder container should always be kept closed

3. While preparing 1% bleaching powder solution add 1 table spoon of bleaching powder in
1 litre water

4. Stir the solution well

5. After the solution is ready, pour the solution in the waste bin meant for disinfection of used
plastics and sharps

6. Always remember to prepare new bleaching powder solution every day. Only use freshly
prepared bleaching powder solution each day

54
Use of Disinfectants

POUR THE DISINFECTANT

INTO THE BIN WITH SYRINGES

PREPARE DISINFECTANT SOLUTION EACH DAY

55
 4. Soiled Linen Management

1. Always wear gloves while handling soiled linen

2. Fold the soiled linen in such a manner that you do not get in contact with the soiled part

3. Add disinfectant to the soiled linen before sending it to washing

4. Store washed linens in clean and sterile area

56
5. Cleaning Floors

1. Wear Personal protective gears like gloves and apron while cleaning the floors

2. Clean the floors regularly

3. Use hot water and soap for routine cleaning of the floors

4. Add disinfectants to water for critical care areas like operation theater

5. Mop/cloth needs to be disinfected after every use

57
 6. Sterilization of Reusable Equipments

1. Always sterilize reusable instruments like scissor, knife, forceps, etc., before reusing them

2. Wash and clean the instruments before sending them for sterilization

3. After the instruments are sterilized, handle them with sterile gloves

4. Store the sterile instruments in special areas meant for storing them

58
Sterilization of Reusable Equipments

Used instruments
Sterlization of
used instruments

59
 7. Storing Medicines and Chemicals

1. Always store medicines and other chemicals like DDT in separate storing areas

2. Never store the chemicals and the medicines together. Chemicals may leach into the
medicines and be a reason of concern to the patients and the staff

3. Never store medicines beyond the expiry date

60
Storing Medicines and Chemicals

61
C. ANNEXURE

Schedule 1
Bio-Medical Waste (Management and Handling) Rules, 1998
Option Waste Category Treatment & Disposal
Category No. I Human Anatomical Waste incineration@/deep burial*
(human tissues, organs, body parts)

Category No. 2 Animal Waste

(animal tissues, organs, body parts carcasses, bleeding parts, fluid, incineration@/deep burial*
blood and experimental animals used in research, waste generated
by veterinary hospitals colleges, discharge from hospitals, animal
houses)

Category No 3 Microbiology & Biotechnology Waste

(wastes from laboratory cultures, stocks or specimens of micro- local autoclaving/
organisms live or attenuated vaccines, human and animal cell micro-waving/
culture used in research and infectious agents from research incineration@
and industrial laboratories, wastes from production of biologicals,
toxins, dishes and devices used for transfer of cultures)

Category No 4 Waste sharps

(needles, syringes, scalpels, blades, glass, etc. that may cause disinfection (chemical
puncture and cuts. This includes both used and unused sharps) treatment@@/autoclaving/
micro-waving) and
mutilation/shredding ##
63
 Option Waste Category Treatment & Disposal
Category No 5 Discarded Medicines and Cytotoxic drugs
(wastes comprising of outdated, contaminated and discarded incineration@/destruction
medicines) and drugs disposal in
secured landfills
Category No 6 Solid Waste
(Items contaminated with blood, and body fluids including cotton, incineration@
dressings, soiled plaster casts, lines, beddings, other material autoclaving/microwaving
contaminated with blood)
Category No. 7 Solid Waste
(wastes generated from disposable items other than the waste disinfection by chemical
sharps such as tubings, catheters, intravenous sets etc). treatment@@autoclaving/
microwaving and
mutilation/shredding##
Category No. 8 Liquid Waste
(waste generated from laboratory and washing, cleaning, house- disinfection by chemical
keeping and disinfecting activities) treatment@ and
discharge into drains
Category No. 9 Incineration Ash
(ash from incineration of any bio-medical waste) disposal in municipal
landfill
Category No. 10 Chemical Waste
(chemicals used in production of biologicals, chemicals used in chemical treatment@@
disinfection, as insecticides, etc.) and discharge into drains
for liquids and secured
landfill for solids
@@ Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures
disinfection.
## Multilation/shredding must be such so as to prevent unauthorised reuse.
64 @ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated.
* Deep burial shall be an option available only in towns with population less than five lakhs and in rural areas.
 Schedule 2
Bio-Medical Waste (Management and Handling) Rules, 1998

Colour Coding Type of Container - I Waste Category Treatment options as per Schedule I

Yellow Plastic bag Cat. 1, Cat. 2, and Cat. 3, Incineration/deep burial

Cat. 6.
Red Disinfected container/plastic bag Cat. 3, Autoclaving/Microwaving/
Cat. 6, Cat.7. Chemical Treatment

Blue/White translucent Plastic bag/puncture proof Cat. 4, Cat. 7. Autoclaving/Microwaving/ Chemical

Container Treatment and destruction/shredding
Black Plastic bag Cat. 5 and Cat. 9 and Disposal in secured landfill
Cat. 10. (solid)

Notes:

1. Colour coding of waste categories with multiple treatment options as defined in Schedule I, shall be
selected depending on treatment option chosen, which shall be as specified in Schedule I.

2. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics.

3. Categories 8 and 10 (liquid) do not require containers/bags.

4. Category 3 if disinfected locally need not be put in containers/bags.

65
 Standards for Deep Burial Pit
Bio-Medical Waste (Management and Handling) Rules, 1998
1. A pit or trench should he dug about 2 meters deep. It should be half filled with waste, then
covered with lime within 50 cm of the surface, before filling the rest of the pit with soil.

2. It must be ensured that animals do not have any access to burial sites. Covers of
galvanised iron/wire meshes may be used.

3. On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall be
added to cover the wastes.

4. Burial must be performed under close and dedicated supervision.

5. The deep burial site should be relatively impermeable and no shallow well should be
close to the site.

6. The pits should be distant from

habitation, and sited so as to
ensure that no contamination
occurs of any surface water or
ground water. The area should
not be prone to flooding or
erosion.

7. The location of the deep

burial site will be authorised
by the prescribed authority.

8. The institution shall maintain

a record of all pits for deep
66 burial.
 Form III (Accident Reporting)
Bio-Medical Waste (Management and Handling) Rules, 1998

1. Date and time of accident:...............................................................................................

2. Sequence of events leading to accident:................................................................................

3. The waste involved in accident:.........................................................................................

4. Assessment of the effects of the accidents on human health and the environment:..............................

.....................................................................................................................................

5. Emergency measures taken:...............................................................................................

6. Steps taken to alleviate the effects of accidents:.....................................................................

7. Steps taken to prevent the recurrence of such an accident

Date ............................... Signature ...........................................

Place.............................. Designation..........................................

67