A Guide to Different Types of Waste Bins in Hospitals

July 17, 2024

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Everything is made for a defined purpose anything which is not intended for further use is termed waste. In the scientific and industrial eras combined with the increasing population, the turnover of products has gone very high increasing the quantum of urban solid waste. With the increased need for health care in a changing society the role of hospitals/nursing homes comes to the forefront.

Hospital waste or types of healthcare waste should include any material generated in healthcare establishments including aqueous and other liquid waste.

Hospital waste means any solid, fluid, or liquid waste material including its container and any other intermediate product which is generated during short-term and long-term care consisting of observational, diagnostic, therapeutic, and rehabilitative services for a person suffering or suspected to be suffering from disease or injury and for parturient or during research of production and testing of biological during immunization of human being.

Types of Healthcare waste facilities are responsible for managing healthcare waste generated within their facilities, as well as waste generated through activities in the community. These facilities must undertake proper segregation, collection, in-house transportation, pre-treatment, and waste storage before handing it over to a Common Bio-medical Waste Treatment Facility (CBWTF) operator.

Therefore, proper management of healthcare waste at these facilities necessitates that all categories of staff understand and adhere to the technical requirements for waste handling as per the Biomedical Waste Management Rules, 2016.

Classifications of Waste Generated from Healthcare Sectors

1. Bio-Medical Waste

It refers to any waste produced during diagnosis, treatment, or immunization of humans or animals as well as related research activities, or during the production or testing of biologicals in health camps. This includes all waste from healthcare facilities that could potentially harm human health or the environment if improperly disposed of. Such waste is considered infectious and must be managed according to the Biomedical Waste Management Rules of 2016 to prevent adverse effects on health or the environment.

Around 10% to 15% of the total waste generated by healthcare facilities constitutes biomedical waste. This category includes materials that have come into contact with patients’ blood, secretions, infected body parts, biological fluids, chemicals, medical equipment, pharmaceutical waste, laboratory discharge, sharp objects like needles and glassware, and plastics.

According to the Biomedical Waste Management Rules of 2016, this waste is categorized into four types based on how it is segregated and color-coded. Each category includes specific types of biomedical waste, as given below:

Yellow Category
Red Category
White Category
Blue Category

These categories are divided as per the types of waste under each category as follows:

Category	Type of Waste
Yellow	Human Anatomical Waste Human tissues, organs, body parts, and fetus below the viability period (as per the Medical Termination of Pregnancy Act 1971, amended from time to time).
	Animal Anatomical Waste Experimental animal carcasses, body parts, organs, and tissues, including the waste generated from animals used in experiments or testing in veterinary hospitals or colleges, or animal houses.
	Solid Waste Items contaminated with blood, body fluids like dressings, plaster casts, cotton swabs, and bags containing residual or discarded blood and blood components.
	Discarded Medicine Pharmaceutical waste like antibiotics, and cytotoxic drugs including all items contaminated with cytotoxic drugs along with glass or plastic ampoules, and vials. Etc.
	Chemical Waste Chemicals used in the production of biological and used or discarded disinfectants.
	Chemical Liquid Waste Liquid waste is generated due to the use of chemicals in the production of biological and used or discarded disinfectants, Silver X-ray film developing liquid, discarded Formalin, infected secretions, aspired body fluids, liquid from laboratories, and floor washings, cleaning, housekeeping and disinfecting activities, etc.
	Discarded linen, mattresses, beddings contaminated with blood or body fluid, routine mask & gown.
	Microbiology, Biotechnology, and other clinical laboratory waste (Pre-treated)
	Microbiology, Biotechnology, and other clinical laboratory waste: Blood bags, laboratory cultures, stocks or specimens of microorganisms, live or attenuated vaccines, human and animal cell cultures used in research, industrial laboratories, production of biological, residual toxins, dishes, and devices used for cultures.
Red	Wastes are generated from disposable items such as tubing, bottles, intravenous tubes and sets, catheters, urine bags, syringes without needles, fixed needle syringes with their needles cut, vacutainers, and gloves.
White	Waste Sharps Including Metals Needles, syringes with fixed needles, needles from needle tip cutters or burners, scalpels, blades, or any other contaminated sharp object that may cause punctures and cuts. This includes both used, discarded, and contaminated metal sharps.
Blue	Broken or discarded and contaminated glass including medicine vials and ampoules except those contaminated with cytotoxic wastes.

2. General Waste

General waste includes all waste other than biomedical waste that has not been in contact with hazardous waste or infectious materials, chemicals, or biological secretions, and does not include sharp objects. This type of waste typically includes:

Newspaper, paper, and cardboard boxes
Plastic water bottles
Aluminum cans from soft drinks
Packaging materials
Food containers after removing leftover food
Organic or biodegradable waste, mainly food waste
Construction and demolition waste

These general wastes are classified as wet wastes and dry wastes and should be collected separately. The quantity of general waste is around 85% to 90% of the total generated from the facility.

3. Other Wastes

Other wastes include electronic devices such as batteries and radioactive materials that are not classified as biomedical waste. They must be disposed of according to specific regulations: the E-waste (Management) Rules of 2016, the Batteries ( Management & Handling) Rules of 2001, and the rules or guidelines established under the Atomic Energy Act of 1962, depending on the type of waste generated.

Guidelines for Management of Healthcare Waste Categories as per Biomedical Waste Management Rules, 2016

Figure 1: Categorization & Classifications of Wastes in Health Care Facilities.

Color Coding and 4 types of dustbins in hospitals used for Waste Segregation & Collection

According to Schedule I of the Bio-Medical Waste Management Rules of 2016, healthcare facilities (HCFs) must use specific color-coded dustbins and types of containers/bags for segregating and collecting biomedical waste generated within the facility.

Category	Type of Waste	Colored Container & Type of Container	Treatment Options as per Schedule I
Yellow Category	Animal Anatomical Waste Human Anatomical Waste Discarded or Expired Medicine Microbiology, Biotechnology, and other clinical laboratory waste Chemical Waste (yellow-e) Chemical Liquid Waste	Yellow-colored non-chlorinated Plastic Bags. NOTE: Chemical waste (yellow-e) comprising unused, residual, or date-expired liquid chemicals including spent hypo of X-Ray, should be stored in a yellow container.	Incineration/deep burial
Red Category	Contaminated Waste (Recyclable)	Red Colored Non-Chlorinated Plastic Bags (having thickness equal to more than 50u) and containers.	Autoclaving/microwaving/chemical treatment
White Category	Waste Sharps including metals	White Colored translucent puncture-proof, leak-proof, tamper-proof containers.	Autoclaving/microwaving/chemical treatment and destruction/shredding
Blue Category	Glassware Metallic Implants	Puncture-proof, leak-proof boxes or containers with blue-colored markings.	Disposal of wastes and secured landfill

Bio-Medical Waste Collection

Time of Collection

Daily Collection: Ensure daily collection from each hospital ward at fixed intervals.
Timing Adjustments: Schedule collections based on waste generation patterns throughout the day.
Separate Collection: Avoid collecting general waste concurrently with biomedical waste.
Visitor Waste Management: Collect general waste immediately after visiting hours to prevent accumulation.
Personal Protective Equipment: Provide PPE to staff handling biomedical waste.

Packaging

Filling and Sealing: Fill biomedical waste bags and sharp containers up to three-quarters full and seal them promptly.
Sealing Methods: Use ties or plastic tags to seal bags to avoid stapling.
Availability of Replacement: Ensure replacement bags or containers are readily available at collection points.
Labeling Requirements: Label bags and containers with biohazard symbols, including details like date, type of waste, quantity, and sender’s and receiver’s information.
Barcode Compliance: Affix barcoded labels on the bag as per CPCB guidelines.

Labeling

Biohazard Symbols: Clearly label all bags, containers, and bins with biohazard or cytotoxic symbols as per BMWM Rules, 2016.

Interim Storage

Minimization: Discourage interim storage of biomedical waste in patient care areas.
Designated Areas: Store biomedical waste temporarily in designated, low-traffic areas if necessary.

Treatment Option for Bio-medical Waste Types

Treatment Options	Biomedical Chemical Processes
Thermal Processes Low-heat Systems (93-177oC)	Autoclave: steam disinfection Microwave: moist heat and steam from microwave energy
High-heat Systems	Incinerator: combustion and high-temperature plasma. Hydroclaving: like incineration but at a lower temperature.
Mechanical Processes	Compaction: reduce volume. Shredding: destroy plastic and paper waste to prevent reuse.
Irradiation Processes	Exposure to ultraviolet or ionizing radiation. Require post shredding to render waste unrecognizable.
Biological Processes	Use biological enzymes to treat waste. Claim to decontaminate and destroy organic constituents.
Considerations for Processing Incineration	Design to achieve emission limits. No chemically treated waste with chlorinated disinfectants. Limit toxic metals in ash. Use only low-sulfur fuel.
Autoclaving	Dedicated autoclave for disinfection. Time, temperature, and pressure must meet stipulated limits.
Microwaving	Not for hazardous waste or radioactive waste. Must kill bacteria and pathogens at maximum capacity.
Deep Burial	Pit 2m deep, half-filled with waste. Cover with lime and soil. Close and dedicated supervision.
Sharp Materials Disposal	Circular or rectangular pits lined with masonry or concrete. Cover with concrete slab and galvanized pipe.
Radioactive Waste	Store until radioactivity is low. Expert advice for discarding radioactive equipment.
Mercury Control	Collect and store spilled mercury. Send to manufacturers. Waste with 50 ppm mercury is hazardous.

Frequently Asked Questions (FAQs)

Q1. What is clinical waste, and how is it different from infectious waste?

Ans. Clinical waste includes all waste generated from medical facilities, including non-infectious materials like packaging and expired medications, whereas infectious waste refers to waste contaminated with pathogens, such as bacteria, viruses, or other microorganisms.

Q2. What are the proper disposal techniques for biomedical waste, particularly sharps waste?

Ans. Sharp waste like needles and scalpels, must be disposed of in puncture-proof containers specifically designed for sharps disposal. These types of containers are sealed and handled carefully to prevent injuries and potential infections during disposal.

Q3. How does improper medical waste management contribute to the spread of diseases?

Ans. Improper management of biohazardous waste can lead to contamination of the environment and increase the risk of spreading infectious diseases. Pathogens present in medical waste, if not managed correctly, can infect healthcare workers, patients, and the normal public.

Q4. What is some risk associated with inadequate handling of pathological waste?

Ans. Pathological waste which includes tissues, organs, and body parts, poses significant health risks if not properly managed. Exposure to such waste can lead to infections or exposure to hazardous chemicals used in treatments.

Q5. Why is it important for medical facilities to use appropriate medical waste containers?

Ans. Medical waste containers are designed to safely store and transport various types of medical waste, including biohazardous materials and sharps. Using proper containers minimizes the risk of accidental exposure and ensures compliance with regulations for safe disposal.

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