GB 18466-2001 Requirements for wastewater discharge from medical institutions
Some standard content:
GB184662001
Chapter 4, Articles 5.1, 5.4 and 5.5 of this standard are mandatory provisions, and the others are non-mandatory provisions. This standard is a revision of GBJ48-1983 Medical Institution Wastewater Discharge Standard (Trial). In order to implement the Law of the People's Republic of China on the Prevention and Control of Infectious Diseases, control the pollution of medical institution wastewater to the environment, prevent, control and eliminate the occurrence and spread of infectious diseases, and protect human health, the "Medical Institution Wastewater Discharge Standard (Trial)" is hereby revised. This standard has made major revisions to the scope of application, standard values, sanitary requirements and inspection methods of GBJ 48-1983, and added standard supervision and implementation content.
This standard replaces GBJ48-1983 from the date of implementation. At the same time, it replaces the standard values in Table 2 No. 25 and 26 and Table 4 No. 54 and 55 in GB8978-1996 Comprehensive Wastewater Discharge Standard. This standard shall be implemented from March 1, 2002. Appendix A, B, C, D, E, F, and G of this standard are the appendices of the standard. This standard is proposed by the Ministry of Health of the People's Republic of China. The responsible drafting unit of this standard is: Environmental Health Monitoring Institute of Chinese Academy of Preventive Medicine: Participating drafting unit: Jiangsu Provincial Health Supervision Institute. The main drafters of this standard are: Fu Changqing, Li Ting, Zhang Shujie, Zhou Shuyu, Chen Changjie. This standard is entrusted by the Ministry of Health to the Environmental Health Monitoring Institute of Chinese Academy of Preventive Medicine for interpretation. 1 Scope
National Standard of the People's Republic of China
Requirements for nedical organization sewage discharge
Requirements for nedical organization sewage discharge1.1 This standard specifies the discharge standards for sewage and sludge from medical institutions. 1.2 This standard applies to the following medical institutions: 1) Medical institutions that directly discharge sewage into rivers, lakes, seas, ponds, reservoirs, streams, ditches and other surface water bodies 2) Medical institutions that directly discharge sewage into sewers without terminal sewage treatment. 3) Medical institutions with unorganized sewage discharge. 4) All infectious disease and tuberculosis medical institutions. 2 Referenced Standards
GB 18466—2001
The provisions contained in the following standards constitute the provisions of this standard through reference in this standard. When this standard is published, the versions shown are valid. All standards are subject to revision, so the parties using this standard should explore the possibility of using the latest versions of the following standards. GB3838—1988 Surface water environmental quality standard GB5084-1992 Farmland condensate water quality standard
GI35749—1985 Drinking water quality standard GB7959—1987 Excrement harmless sanitation standard GB11607-1989 Fishery water quality standard
GB12941-1991
Landscape and recreation water quality standard
GB/T11848—1993 Groundwater quality standard 3 Definitions
This standard adopts the following definitions.
3.1 Medical organization refers to an institution that has obtained a "Medical Institution Practice Permit" after registration in accordance with the Regulations on the Administration of Medical Institutions and the Regulations on the Implementation of the Regulations on the Administration of Medical Institutions.
3.2 Medical organization sewage refers to the medical, domestic and fecal waste water discharged from the outpatient clinics, wards, operating rooms, treatment rooms, various laboratories, pathological anatomy rooms, radiology rooms, laundry rooms, morgues, etc. of medical institutions.
3.3 Medical organization silt refers to the sediment and intercepted floating objects in the sewage treatment structures of medical institutions. 4 Standard value
The treated and disinfected sewage of medical institutions and the sludge after harmless treatment should meet the requirements of Table 1 and Table 2. Approved by the General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China on October 22, 2001 and implemented on March 1, 2002
Medical institutions
Comprehensive medical institutions
Infectious disease medical institutions
Tuberculosis medical institutions
Other medical institutions
Medical institutions
Comprehensive medical institutions
Infectious disease medical institutions
Tuberculosis medical institutions
Other medical institutions||t t||Health requirements
Gong Dachang
GB18466-—2001
Standardized values for wastewater discharge from medical institutions
Pathogenic bacteria
Not to be detected
Not to be detected
Not to be detected
This must be discharged
Disinfection contact time
Chlorination method
Chlorine dioxide method
Standard values for sludge discharge from medical institutions
Fan Dachang
≥10 t
Pathogenic bacteria
Must not be picked out
Must not be picked out
Must not be detected
Chlorination method
Total residual fluorine
Ammonium dioxide method
Insect eggs
Mortality rate
5.1 Sewage from medical institutions must be treated and disinfected. Sludge in sewage treatment structures of medical institutions must be harmlessly treated. Sewage and sludge that have not been disinfected or harmlessly treated shall not be discharged or used as agricultural fertilizer at will. 5.2 Newly built, expanded, and renovated medical institutions shall simultaneously construct sewage treatment facilities, and the discharge of sewage and sludge shall comply with the provisions of Tables 1 and 2.
5.3 When sewage and sludge from medical institutions are discharged after treatment and disinfection, the content of harmful substances contained in them shall also meet the requirements of G13 5749, GB3838, GJ5084, GB11607, GB7959, GB12941, GB/T14848 according to the functional requirements of the receiving water body and feces harmless sanitation standards.
5.4 It is strictly forbidden for medical institutions of all levels and types to discharge sewage and sludge into the sanitary protection zone of drinking water sources. 5.5 It is strictly forbidden for medical institutions of all levels and types to use infiltration wells and infiltration pits to discharge sewage and sludge. 5.6 The location of sewage treatment structures of medical institutions should be located on the upwind side of the local minimum frequency wind direction in summer of the medical institution building, and a green protection zone should be set between the surrounding buildings. 5.7 The design of sewage treatment structures of medical institutions shall meet the following requirements: 1) Ensure that sewage and sludge meet this discharge standard; 2) Take anti-corrosion and anti-leakage measures;
3) Have temporary disinfection facilities in case of failure; 4) When using liquid nitrogen for disinfection, emergency treatment facilities must be prepared in case of accidents such as chlorine leakage. It is strictly forbidden to directly add fluorine gas to sewage with a cylinder;
5) Be safe and durable, easy to operate, and conducive to the labor protection of operators. 5.8 Sewage from the administrative area and staff living area of medical institutions should be separated from sewage from wards. 6 Testing and Monitoring
6.1 The daily testing of sewage and sludge treatment in medical institutions shall be the responsibility of each medical institution. The testing items and frequency shall meet the following requirements: 6.1.1 Total residual chlorine in sewage of medical institutions: Sewage after continuous treatment equipment shall be tested at least twice a day; sewage after intermittent treatment equipment shall be tested before each discharge.
GB18466—--2001
6.1.2 Fecal bacteria in sewage from medical institutions: testing shall be conducted no less than once a month. 6.1.3 Pathogenic bacteria in sewage from medical institutions: testing shall be conducted no less than twice a year. Mainly testing Salmonella and Shigella, and testing tuberculosis bacilli in medical institutions for tuberculosis.
6.1.4 Hygiene indicators of sludge from medical institutions: Before each batch of sludge is discharged, it shall be inspected according to the items required in 2. 6.2 Health and epidemic prevention agencies at all levels shall conduct regular health monitoring of sewage and sludge treatment in medical institutions within their jurisdiction. And do a good job in preventive health supervision of newly built, rebuilt and expanded sewage treatment facilities in medical institutions within their jurisdiction. 6.2.1 Monitoring times: sewage from medical institutions for infectious diseases and tuberculosis shall be monitored at least 6 times a year, and sewage from other medical institutions shall be monitored at least 4 times a year. Medical institution sludge shall be monitored before each discharge. 6.2.2 Sewage monitoring items: total residual oxygen, fecal coliform group, intestinal pathogens; tuberculosis medical institutions shall add tuberculosis bacillus. 6.2.3 Sludge monitoring items: tobacco worm egg mortality, fecal coliform value; infectious disease medical institutions shall add intestinal pathogens; tuberculosis medical institutions shall add tuberculosis bacillus.
7 Inspection method
The inspection method recommended in this standard shall be implemented in accordance with Appendix A, B, C, D, E, F, and G. A1 Positioner and equipment
A1.1 Balance.
A1.2 Colorimetric tube.
A1.3 Volumetric slurry.
A2 reagent
GB 18466—2001
Appendix A
(Appendix recommended by the standard)
Detection method of total residual oxygen in sewage from medical institutions o-Tolidine solution: Weigh 1g o-Tolidine, dissolve it in 5ml, 20% (volume/volume) hydrochloric acid, adjust it into a paste, add 150200ml of distilled water to completely dissolve it, put it in a volumetric slurry and add distilled water to 505ml, finally add 20% hydrochloric acid 495ml, and store in a brown bottle.
A3 Determination steps
A3. 1 The temperature of the sample to be measured should be 15~20 ℃. If it is lower than this temperature, the sample should be immersed in warm water to raise its temperature to 15~20 (after that, the value can be measured.
A3. 2 In a colorimetric tube containing 5 ml of sample, add 2~3 drops of o-tolidine solution and mix. A3.3 Place the sample in a dark place and let it stand for 15 minutes. Then compare the color with the permanent residual gas standard colorimetric solution. The result is the total residual gas content of the sample (when comparing colors, observe from the tube mouth downward or from the front). A3.4 If the residual fluorine concentration is very high, it will produce a withered yellow color; when the sample alkalinity is too high and the residual oxygen concentration is low, it may produce a light blue-green or light blue color. At this time, 1 ml of 1:2 hydrochloric acid or 1:2 ml, o-methyl methyl amine dissolves, and a light yellow color is produced, and then the test is carried out. A4 Test result report
The test result is reported in milligrams of total residual chlorine per liter of sewage (nig/1). Appendix B
(Appendix to the standard)
Test method for fecal coliform group in sewage from medical institutions B1 Instruments and equipment
B1.1 High-speed steam sterilizer.
1.27 Drying sterilization box. bzxZ.net
B1.3 Incubator.
BT.4 Electric furnace.
B1.5 Balance.
BI.6 Sterilizer.
B1.7 Sterilized graduated pipette.
B2 Culture medium and reagents
B2.1 Lactose-bile salt culture medium
B2.1,1 Ingredients
Protein
Porcine bile salt (or cattle or sheep bile)
0. 4% bromocresol purple aqueous solution
Distilled water
B2.7.2 Preparation
GB 18466—2001
1000ml
Dissolve protein, bile salt and lactose in 1000mL distilled water and adjust the pH to 7.2~7.4. Add indicator, mix thoroughly, and dispense into test tubes with inverted tubes. Place in a high pressure steam sterilizer and sterilize at 115°C for 20 min. Store in a cool dark place for later use: B2.2 Eosin-methylene blue medium
B2.2.1 Ingredients
Protein
Dipotassium hydrogen phosphate
Distilled water
2% eosin aqueous solution
0.5% methylene blue aqueous solution
B2-2.2 Preparation of reserve medium
20 ~30 g
1 000 ml.
B2. 2. 2. 1 First add agar to 900 ml of distilled water, heat to dissolve, then add dipotassium hydrogen phosphate and protein, mix to dissolve, and then add distilled water to 1 000 mL, adjust the pH to 7.2~7. 4. B2.2.2.2 Filter with absorbent cotton or flannel, add human lactose, mix well, and then quantitatively distribute into flasks, place in a high-pressure heat sink sterilizer, and sterilize at 115 (for 20 min. Store in a cool and dark place for later use. 2.2.3 Preparation of culture medium
B2.2.3.1 Heat and melt the prepared culture medium. B2.2.3.2 According to the volume of the culture medium in the flask, use a sterilized pipette to proportionally absorb a certain amount of sterilized 2% eosin aqueous solution and a certain amount of sterilized 0.5% methylene blue aqueous solution into the melted reserve culture medium, and mix well (to prevent bubbles). Immediately pour this culture medium into the sterilized empty culture medium and wait for it to condense, and set aside. B2.3 Lactose protein culture medium
B2.3.1 Ingredients
Protein
Beef extract
Sodium nitride
1.6% bromocresol violet ethanol solution
B2. 3- 2 Preparation
1 000 ml.
Dissolve protein, beef extract, lactose and sodium nitride in 1 000 mL distilled water by heating, and adjust the pH to 7.2 ~ 7.4. Add 1 mL of 1.6% bromocresol violet ethanol solution, mix thoroughly, and dispense into inverted test tubes. Place in a high pressure steam sterilizer and sterilize at 115°C for 20 min. Store in a cool and dark place for later use. B2.4 Gram's iodine solution
B2.4.1 Crystal violet staining solution
Crystal violet
95% ethanol
1% zinc oxalate aqueous solution
GB 18466—2001
Dissolve crystal violet in ethanol and then mix with ammonium oxalate aqueous solution. B2. 4. 2 Gram's iodine solution
Potassium iodide
Distilled water
Mix iodine and potassium iodide first, add a little distilled water, shake thoroughly, wait until completely dissolved, and then add distilled water to 300mL. B2.4.3 Decolorization: 95% ethanol.
B2.4.4 Sand yellow re-staining
95% ethanol
Distilled water
Dissolve sand yellow in ethanol and then dilute with distilled water. B2.5 Staining method
B2.5.1 Fix the smear on flame. Add crystal violet staining solution, stain for 1 minute, wash with water. B2.5.2 Add Gram iodine, act for 1 minute, wash with water. B2.5.3 Add 95% ethanol to decolorize, about 305, wash with water. B2.5.4 Add re-staining solution, re-stain for 1 minute, wash with water, wait to dry, and examine under a microscope. B2.6 Staining results
Gram-adherent bacteria are purple, and Gram-negative bacteria are red. Note: 1:10 dilution of carbolic acid fuchsin can also be used as re-staining solution. The re-staining time is 105. B3 Inspection procedures
B3.1 Sampling method
Use a water filter or other sterilized container to take 100mL of sewage sample and put it in a sterilized bottle. If the sewage is treated with chlorine disinfection, add 5mL of 1.5% sodium thiosulfate solution to neutralize the residual chlorine. B3.2 Multiple tube fermentation method
B3.2.1 Initial fermentation experiment: dilute the stock solution to 1:10, 1:100, and 1:1000, and take 1 mL of 11000, 1:100, 1:10, and stock solution in turn, and inject them into the test tubes containing 10 ml of lactose bile salt culture medium and small fermentation tubes, and place the inoculated four fermentation tubes in a 44 (constant temperature incubator for 24 hours.
Note: The inoculated blood is 10 ml. When the bacteria are inoculated, a double lactose-bile salt culture medium with the same concentration as the inoculation medium can be used. B3.2.2 Plate separation: Take the culture medium from the fermentation tubes that produce acid and gas after 24 hours of culture, and the culture medium that only produces acid but not gas, and inoculate them on the eosin-methylene blue culture medium respectively. Place the culture medium in a 37°C constant temperature incubator for 18-24 hours, and select the colonies that meet the following characteristics for smear, Gram staining, and microscopic examination.
Colony color on eosin-methylene blue culture medium: dark purple-black, with Colonies with metallic luster: purple-black, colonies without or with a slight metallic luster + light purple-red, colonies with darker center color. B3.2.3 Multiple fermentation experiment: If the colonies examined by smear microscopy are Gram-negative non-spore-forming bacilli, pick the colonies and inoculate them in lactose fermentation tubes (with inverted tubes inside), place them in a 41C constant temperature incubator and culture for 24 hours. If there is acid and gas production, it is confirmed that fecal coliforms exist, and the table is checked according to the number of positive tubes.
GB 18466—2001
Depending on the degree of water pollution, determine the dilution and inoculation amount. For example, if the pollution is light, the total inoculation amount can be 11.11 mL, if the pollution is serious, the total inoculation amount can be 0.1111 mL
Table B1 Fecal coliform group test table
(Total inoculation amount 1.111 mL)
Inoculation sample plate.mL
B4 Test result report
Coliform group, MPN/L
23 000
96 000
238 000
>238 000
The total inoculation amount of water sample is the same as Table B1. The test result can be directly checked in the table to obtain the number of coliform group (MPN value). If the total inoculation amount of water sample is 10 times larger than that in Table 1 (11.11 mL), the test result is the MPN value obtained by looking up the table divided by 10. C
(Standard Appendix)
Test method for coliform value in mud in medical institutions C1 Instruments and equipment
C1.1 High pressure steam sterilizer.
C1.2 Drying sterilization box.
C1.3 Incubator: 37°C.
C1.4 Constant temperature water bath.
C1.5 Electric furnace.
C1.6 Balance.
C1.7 Sterilized blood.
C1.8 Sterilized graduated tubes.
C2 Culture media and reagents
C2.1 Lactose-bile salt culture medium: same as Appendix B2.1. C2.2 Eosin-methylene blue culture medium: same as Appendix B2.2. C2.3 Lactose protein culture medium: same as Appendix B2.3. C2.4 Gram staining solution: same as Appendix B2.4. C3 Test procedure
GB18466—2001
C3.1 Initial fermentation test: Dilute the sludge as shown in Figure C1, and inoculate the sludge samples into test tubes (with small inverted tubes) containing 10 mL of lactose bile salt culture medium. Then place the four inoculated test tubes in a 44°C constant temperature culture chamber and culture for 24 hours. 100g of sludge
100mL of sterile water
1g of sludge
Add to the fermentation tube with a small side tube
Take 1 mL (equivalent to 0.01g of sludge)
Add to the fermentation tube with a small side tube
Take 1 mL (equivalent to 0.01g of sludge)
Solution
100mL of sterile water
1g of sludge
Add to the fermentation tube with a small side tube
Take D. 1 mL (equivalent to 0.001g of sludge)
Add to the fermentation tube with a small side tube
C3. 2 Plate separation After 24 hours of cultivation, the culture fluid of the fermentation tubes that produce acid and gas and only produce acid but not gas are streaked and inoculated on eosin-methylene blue medium. Place in a 37°C constant temperature incubator for 18 to 24 hours. Select colonies that meet the following characteristics, perform smear, Gram staining, and microscopic examination.
Colony color on eosin-methylene blue medium: dark purple-black colonies with a metallic luster: purple-black colonies without or slightly metallic luster; light purple-red colonies with a darker center color. C3.3 Recurrence test: If the colonies examined by the above smear microscopy are Gram-negative non-spore-forming bacilli, pick another part of the colony and inoculate it in a lactose fermentation tube with an inverted tube inside, and place it in a 44°C constant temperature incubator for 24 hours. Those that produce acid and gas confirm the presence of cystic coliform bacteria. Table C2 Fecal coliform value retrieval table
(Total inoculation volume 1.111g)
Total inoculation volume.
Fecal coliform
Total inoculation volume
C4 Test result report
GB 18466—2001
Table C2 (end)
According to the confirmed number of fecal coliform positive tubes, report the fecal coliform value according to Table C2. Appendix D
(Standard Appendix)
Test of Salmonella in sewage and sludge of medical institutionsD1 Instruments and equipment
D11 High-pressure steam sterilizer.
D1.2 Drying and sterilizing box.
D1.3 Incubator.
D1.4 Constant temperature water bath.
D1.5 Electric furnace.
D1.6 Balance.
D1.7 Sterile balance.
D1.8 Sterile graduated pipette.
D2 Culture medium and reagents
1 Sodium sulfate (SF) enrichment solution
D2.1.1 Ingredients
Peptin (or polyvalent)
Sodium dihydrogen phosphate (NaHPO4)
Sodium dihydrogen phosphate (NaH2PO4)
Sodium hydrogen selenite
D2. 1-2 Preparation
1 000 mL.
Egg sac
Except sodium ammonium selenite, add 1:1 of each ingredient in distilled water and heat to dissolve. Then add sodium hydrogen selenite and adjust the pH to 7.0-7.1 after it is completely dissolved. Dissolve beef extract, agar and bile salt in 400 mL of distilled water, add agar to 600 mL of distilled water, boil to dissolve, mix them, and sterilize them in a circulating steam sterilizer for 15 min. 121 (autoclave) Sterilize them for 15 min and store them for later use. D2.2-SS medium
D2.2.1 Basic medium
D2.2.1.1 Ingredients
Beef extract
Bile salt
Distilled water
D2.2.1.2 Preparation method
GB 18466—2001
1 000 ml.
Dissolve beef extract, agar and bile salt in 400 mL of distilled water, add agar to 600 mL of distilled water, boil to dissolve, mix them, 121 (autoclave) for 15 min, and store them for later use. 2 Complete medium
D2.2.2.1 Ingredients
Basic medium
Sodium citrate
Sodium thiosulfate
10% ferric citrate solution
1% neutral red solution
0.1% brilliant green solution
D2.2, 2.2 Preparation
1 000 mL
Heat and dissolve the basal medium, add the components except the above-mentioned staining solution in proportion, mix thoroughly, adjust the pH to 7.0, add neutral red and brilliant green solutions, and pour into the plate. Note: The prepared medium should be used on the same day, or stored in an incubator and used within 18 hours. The brilliant green solution should be stored in a refrigerator for 10 Use within 1 day. D2.3 Sulfite agar (BS)
D2.3.1 Ingredients
Protein
Beef extract
Glucose
Ferrous sulfate
Disodium hydrogen phosphate
Bismuth ammonium citrate
Sodium sulfite
Distilled water
D2. 3.2 Preparation
18~20g
1 000 ml
Dissolve the first five ingredients in 300mL of distilled water; dissolve bismuth ammonium citrate and sodium sulfite in another 50ml of distilled water; boil agar in 600ml of distilled water and cool to 80C. Mix the first three solutions, add distilled water to 1000ml, adjust the pH to 7.5, add 5ml of 0.5% brilliant green aqueous solution. Shake the spoon. Cool to 50~55 (. Pour into a plate. Sterilize by autoclaving. Prepare one day before use and store in a dark place in a room. Do not use for more than 18 hours. D2.4 Trisaccharide iron agar (TSI)
D2.4.1 Ingredients
Protein
Beef
Glucose
Sodium chloride
Ammonium ferrous sulfate
Thiosulfate
Distilled water
D2.4.2 Preparation method
GB 18466-20D1
1 000 ml.
Dissolve all ingredients except agar and phenol red in distilled water and adjust the pH to 7.4. Add agar, heat to boil, and then add 12.5 ml of 0.2% phenol red aqueous solution and stir. Divide into test tubes, and fill more to obtain a higher bottom layer. Autoclave at 121°C for 15 min. Place the high-rise slope for later use.
D2.4.3 Diagnostic serum for Salmonella
D3 Detection procedure
1D3.1 Sample treatment
Wastewater: Take 250mL of sewage and filter it with sterile gauze or cotton wool, then filter it with a filter membrane. Put the gauze or cotton wool and filter membrane into a conical flask containing 100ml of single-fold SF enrichment solution for enrichment culture. Place it in a 37C constant temperature incubator and culture it for 24h.
Sewage: Use a sterile spoon to weigh 30g of sludge and put it into a sterile container. Add 300ml of sterile water and mix it thoroughly to make a 1110 suspension. Take 100mL of the total solution in 1. Add 100ml of double-fermented saline (SF) enrichment solution, and place it in a 37°C constant temperature incubator for 24 hours.
D3-2 Plate separation
Take the above enrichment culture solution, inoculate 5S plate and 135 plate respectively, and place them in a 37°C constant temperature incubator for 24-48 hours. Observe the characteristics of the colonies growing on each plate.
D3.3 Pick colonies
Take the colonies that are transparent or have a black center and a diameter of 1-2mm on the SS plate; pick the colonies that are black with golden spots or green colonies on the BS plate.
Take at least 5 suspected intestinal pathogen colonies from each plate, transfer them to three sugar iron medium, place them in a 37°C constant temperature incubator, and culture them for 18-24 hours. h.
D3.4 Biochemical test Serological test
In the disaccharide culture medium, if lactose is not fermented,Fermentation of glucose to produce acid and gas or only acid without gas. Generally, the blood of bovine sulfide oxygen, which has power, is first agglutinated with Salmonella group F (polyvalent blood). Those that agglutinate with polyvalent () serum are then agglutinated with () serum to determine the group to which they belong, and then the serotype is determined with H factor serum. Bidirectional strains should confirm the presence of two-phase H antigens, and strains with Vi antigen (Salmonella typhi and Salmonella paratyphi C) should be tested with V factor serum.
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