QCVN 55:2025/BNNMT
NATIONAL TECHNICAL REGULATION ON
THERMAL DISINFECTION OF INFECTIOUS HEALTHCARE WASTE
Foreword
The
QCVN 55:2025/BNNMT is compiled by the Vietnam Environment Agency, approved
by the Department of Science and Technology, appraised by the Ministry of
Science and Technology, and promulgated by the Ministry of Agriculture and
Environment under Circular No. 42/2025/TT-BNNMT dated July 14, 2025.
The QCVN
55:2025/BNNMT replaces QCVN 55:2013/BTNMT - National Technical Regulation
on thermal disinfection of infectious healthcare waste.
NATIONAL TECHNICAL REGULATION ON THERMAL DISINFECTION OF
INFECTIOUS HEALTHCARE WASTE
1. GENERAL REGULATIONS
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This
Regulation regulates requirements for technique and environmental protection
regarding thermal disinfection of infectious healthcare waste.
1.2. Regulated entities
This
Regulation applies to organizations and individuals producing, distributing and
using autoclaves and microwaves for treating infectious healthcare waste; as
well as to state management authorities and related organizations and
individuals.
1.3. Definitions
For the
purposes of this Regulation, the terms below shall be construed as follows:
1.3.1. Thermal
disinfection equipment for infectious healthcare waste refers to
devices used at specific temperatures, pressures and period of time to
inactivate bacteria, viruses and biological pathogens in healthcare waste.
Thermal disinfection equipment for infectious healthcare waste includes
autoclaves and microwave.
1.3.2. Autoclave
for healthcare waste (hereinafter referred to as autoclave) refers to the
thermal disinfection equipment for infectious healthcare waste that uses steam
at specific temperature, pressure and period of time to inactivate bacteria,
viruses and biological pathogens in infectious healthcare waste.
1.3.3.
Microwave for healthcare waste (hereinafter referred to as microwave) refers to
the thermal disinfection equipment for infectious healthcare waste that uses
electrical energy to generate high-frequency electromagnetic waves (2.450 ± 50
MHz) at a specific temperature and period of time to inactivate bacteria,
viruses and biological pathogens in infectious healthcare waste.
1.3.4. Autoclave
without a vacuum extraction process is an autoclave in which steam is
introduced into the steam chamber without removing air through a vacuum
extraction system during operation.
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1.3.6. Microwave
without shredder is a microwave that does not have a built-in shredder
(shredding is not involved in the treatment cycle of the equipment).
1.3.7.
Microwave with shredder in the processing chamber is a microwave that has a
built-in shredder within the processing chamber (shredding process directly
participates in the equipment’s treatment cycle).
1.3.8. Infectious
healthcare waste refers to waste that is absorbent, adhesive, or contains
bodily blood, or pathogenic microorganisms.
2. TECNICAL REGULATIONS
2.1. Requirements for technical features during operation
2.1.1.
Technical features of disinfection of autoclaves during operation:
2.1.1.1.
During the disinfection of infectious healthcare waste (excluding the vacuum
extraction process), the technical parameters (temperature, pressure and time)
of the autoclaves shall not be lower than the minimum values prescribed in
Table 1 of this Regulation.
Table 1. Minimum values of technical features of autoclaves
during operation
Type of autoclave
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Pressure of the steam chamber
Time (1)
(minutes)
Autoclave
without a vacuum extraction process
121
1,0
45
135
2,1
30
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121
1,0
30
135
2,1
25
Note: (1) The time is counted from the moment the
temperature and pressure in the steam chamber reach and maintain the
corresponding requirements prescribed in Table 1.
2.1.1.2.
The autoclaves shall be equipped with a valve to release steam from inside the
chamber to the outside (to be used before removing the sterilized waste).
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2.1.2.
Technical features of disinfection of microwaves during operation:
2.1.2.1.
During the disinfection of infectious healthcare waste, the technical
parameters (temperature and time) of the microwaves shall not be lower than the
minimum values prescribed in Table 2 of this Regulation.
Table 2. Minimum values of technical features of microwaves
during operation
Type of microwave
Temperature of the processing chamber
Time (1)
(minutes)
Microwave
without shredder in the processing chamber
95
25
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95
20
Note: (1) The time is counted from the moment the
temperature in the processing chamber reaches and maintains the corresponding
requirements prescribed in Table 2.
2.1.2.2.
In cases where the microwave is used to treat dry waste, there must be a unit
supplying steam in the processing chamber, or measures to moisten the waste
before or during treatment to ensure that the waste does not catch fire.
2.1.2.3.
The microwaves shall be equipped with a display panel showing the temperature
and pressure inside the processing chamber.
2.1.3. In
cases where the infectious healthcare waste treatment facility operates under a
centralized model, the thermal disinfection equipment for infectious healthcare
waste shall be additionally equipped as follows:
2.1.3.1.
An automatic control system installed with waste treatment processes and
accompanied by a display panel showing temperature, pressure and operating
time.
2.1.3.2.
A shredding or compacting device (either specially designed or integrated with
the equipment) to alter the shape and reduce the volume of the waste.
2.1.4.
The pressure inside the steam chamber shall be reduced to normal pressure
before removing the waste from the chamber of the autoclaves.
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The
disinfection efficiency of the thermal disinfection equipment for infectious
healthcare waste (autoclaves, microwaves) is determined by the inactivation
efficiency of one of the following indicator microorganisms:
2.2.1. If
the indicator microorganisms used are Mycobacterium phlei or Mycobacterium
bovis, the inactivation efficiency must reach a minimum concentration of 6
log₁₀ (equivalent to ≥ 99,9999%).
2.2.2. If
the indicator microorganisms used are the heat-resistant spores Geobacillus
stearothermophilus or Bacillus atrophaeus, the inactivation
efficiency must reach a minimum concentration of 4 log₁₀
(equivalent to ≥ 99.99%).
2.3. Requirements for supervision of the treatment
efficiency of the equipment
2.3.1.
For infectious healthcare waste treatment facilities operate under a
centralized or cluster model:
2.3.1.1.
In cases where only indicator microorganisms are used to supervise the
treatment efficiency of the equipment, the minimum supervision frequency is
once per month for the centralized model and once every two months for the
cluster model.
2.3.1.1.
In cases where both indicator microorganisms and thermal indicators are used to
supervise the treatment efficiency of the equipment, the minimum supervision
frequency using indicator microorganisms is once every three months for the
centralized model and once every four months for the cluster model.
2.3.2.
For healthcare facilities that self-treat infectious healthcare waste:
2.3.2.1.
In cases where only indicator microorganisms are used to supervise the
treatment efficiency of the equipment, the minimum supervision frequency is
once every three months.
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2.3.2.3.
In cases where healthcare facilities are located in mountainous areas, border
regions, islands, remote and isolated areas, or ethnic minority regions as
prescribed by law, the minimum frequency of using indicator microorganisms to
supervise the treatment efficiency of the equipment is once per year.
2.3.3.
The temperature of the steam chamber of autoclaves or the processing chamber of
the microwaves shall be displayed on the display panel and thermal indicator.
When supervising the treatment efficiency of the equipment as prescribed in
Sections 2.3.1.2 and 2.3.2.2 of this Regulation, the minimum supervision
frequency using thermal indicators is once per week. In cases where the thermal
disinfection equipment for infectious healthcare waste is used intermittently
with a frequency of fewer than two batches per week, the minimum frequency of
temperature supervision using thermal indicators is once every two batches. If
there are no suitable thermal indicators available for microwaves, the
supervision frequency using indicator microorganisms is once every three months
for the centralized model, once every four months for the cluster model, and
once every six months for healthcare facilities that self-treat infectious
healthcare waste.
3. METHOD FOR DETERMINATION
3.1. The method for determining the treatment efficiency of
thermal disinfection equipment for infectious healthcare waste using indicator
microorganisms is carried out as follows:
Place the
samples containing indicator microorganisms at three different positions within
the steam chamber or processing chamber. Operate the thermal disinfection
equipment for infectious healthcare waste at maximum capacity under the
conditions of time, temperature and pressure prescribed in Tables 1 and 2 of
this Regulation.
After the
operation is completed, take the samples containing the indicator
microorganisms prescribed above for culturing. The culturing is performed in a
laboratory or may be carried out using other culturing devices provided by the
equipment manufacturers (details of the culturing method are prescribed in the
Appendix of this Regulation). The treatment efficiency of the thermal
disinfection equipment for infectious healthcare waste is considered
satisfactory when the indicator microorganisms in the samples do not survive or
regrow (completely inactivated) after culturing.
3.2. The use of other appropriate indicator microorganisms or
the application of alternative methods (including: Vietnamese Standards;
national standards of any country in the Group of Seven (G7), European
Committee for Standardization (CEN/EN); standards of American Society for
Testing and Materials (ASTM), member countries of the European Union, or
International Organization for Standardization (ISO)) is accepted for
assessment of the treatment efficiency of the thermal disinfection equipment
for infectious healthcare waste.
3.3. The thermal indicator must ensure that it only changes
color (the specific color change is defined for each type of thermal indicator)
when the steam chamber temperature of the autoclave or the processing chamber
temperature of the microwave reaches a value higher than that prescribed in
Tables 1 and 2 of this Regulation.
3.4. The actual temperature and pressure shall be displayed on
the display panel of the thermal disinfection equipment for infectious
healthcare waste.
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4.1. The
treatment efficiency of disinfecting infectious healthcare waste is considered
compliant and in accordance with this Regulation when the assessment results of
the inactivation efficiency of bacteria, viruses and biological pathogens in
infectious healthcare waste meet the requirements prescribed in Section 2.2 of
this Regulation.
4.2. The
method for assessing compliance and conformity with this Regulation is carried
out as prescribed in Section 3 of this Regulation.
4.3. The
periodic assessment of the thermal disinfection equipment for infectious
healthcare waste as prescribed in this Regulation shall be carried out by the
organization or individual operating the disinfection equipment (in cases where
indicator microorganisms are provided in test tubes accompanied by cultivation
environment and equipment that meet the requirements for culturing indicator
microorganisms), or by an organization with a laboratory that meets
requirements for culturing microorganisms (in cases where it is required to
prepare cultivation environment and conditions for the indicator
microorganisms).
4.4. The
assessment results of the compliance and conformity with this Regulation serve
as a basis for state management authorities to review and handle in accordance
with the law.
4.5.
After being treated by microwaves or autoclaves in accordance with this
Regulation at infectious healthcare waste treatment facilities operating under
a centralized or cluster model, infectious healthcare waste shall be managed in
the same manner as regular industrial solid waste. After being treated on-site
at healthcare facilities by microwaves or autoclaves in accordance with this
Regulation, infectious healthcare waste shall be managed in the same manner as
domestic solid waste.
Anatomical
waste including discarded human tissues, body parts or experimental animal
carcasses shall be treated by burial or incineration in accordance with laws on
environmental protection after disinfection.
4.6.
Types of infectious healthcare waste that are recyclable after disinfection
shall be clearly labeled as disinfected infectious healthcare waste when being
transferred for recycling. Disinfected infectious healthcare waste shall not be
recycled to produce utensils or packaging in the food sector.
4.7.
Infectious healthcare waste treatment facilities using thermal disinfection
equipment in accordance with this Regulation are allowed to treat infectious
waste generated from veterinary activities.
4.8.
Healthcare facilities in mountainous, border, island, remote, and ethnic
minority areas as prescribed by law are allowed to use other thermal
disinfection equipment (such as medical instrument sterilizers, pressure
cookers or domestic microwave ovens) to treat infectious healthcare waste
generated within the facilities. Facilities shall ensure the treatment
efficiency as prescribed in Section 2.2 of this Regulation and carry out
treatment efficiency supervision in accordance with Section 2.3.2.3 of this
Regulation.
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4.10.
Autoclaves for infectious healthcare waste shall undergo occupational safety
and technical inspection in accordance with laws on occupational safety and
hygiene. The temperature and pressure measuring devices of autoclaves and
microwaves prescribed in this Regulation shall comply with calibration and
inspection requirements in accordance with laws on measurement.
4.11.
Autoclaves and microwaves for treating infectious healthcare waste shall only
be put into operation after the project or facility has completed the
environmental procedures as prescribed by law.
5. RESPONSIBILITIES OF ORGANIZATIONS
AND INDIVIDUALS
5.1.
Organizations and individuals using autoclaves or microwaves to treat
infectious healthcare waste are responsible for ensuring the technical
requirements during operation and the disinfection treatment efficiency as
prescribed in Sections 2.1 and 2.2 of this Regulation. They shall also fully
record operation logs including the estimated waste volume, waste type, time of
operation and operator’s name.
5.2.
Organizations and individuals using autoclaves or microwaves to treat
infectious healthcare waste are responsible for:
5.2.1.
Managing, treating, or transferring disinfected infectious medical waste in
accordance with Sections 4.5 and 4.6 of this Regulation and regulations on
waste management.
5.2.2.
Supervising and reporting the results of the efficiency of thermal disinfection
equipment for infectious healthcare waste. The periodic evaluation results of
the efficiency of thermal disinfection equipment as prescribed in this
Regulation shall be archived for up to 02 years and included in the periodic
environmental protection reports as prescribed by law.
5.3.
Manufacturers and distributors of microwaves for treating infectious healthcare
waste shall provide an installation and operation manual; and a
self-declaration stating that microwave leakage levels do not exceed the limits
prescribed in TCVN 5699-2-90:2011.
5.4.
Manufacturers and distributors of thermal disinfection equipment for infectious
healthcare waste are responsible for supplying test tubes containing indicator
microorganisms such as Mycobacterium phlei or Mycobacterium bovis
(at a minimum concentration of 1x106 spores) or Geobacillus
stearothermophilus or Bacillus atrophaeus (at a minimum
concentration of 1x104 CFU (colony-forming units)) in cases where
such indicator microorganism test tubes are not available on the domestic
market.
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6. IMPLEMENTATION
6.1.
State management authorities related to environmental protection are
responsible for guiding and inspecting the implementation of this Regulation.
6.2. In
cases where documents and regulations referenced in this Regulation are amended
or replaced, the new documents and regulations shall prevail./.
APPENDIX
METHOD FOR CULTURING INDICATOR
MICROORGANISMS TO TEST THE EFFICIENCY OF THERMAL DISINFECTION EQUIPMENT FOR INFECTIOUS
HEALTHCARE WASTE
A.
Laboratory culturing
After
being placed into the steam chamber or processing chamber, and processed in
accordance with the steps prescribed in Section 3.1 of this Regulation,
indicator microorganisms shall be taken out for culturing in a suitable
environment. The process of removing the indicator microorganisms from the
steam chamber or processing chamber, and transferring them into the culturing
environment shall be performed under sterile conditions. The indicator
microorganisms that have been treated by the thermal disinfection equipment for
infectious healthcare waste shall be cultured for at least 48 hours at an
appropriate temperature for each type of indicator microorganism (for example,
at 55ºC for Geobacillus stearothermophilus and at 30ºC for Bacillus
atrophaeus), or cultured in accordance with laboratory procedures that
comply with requirements for microorganism culturing to detect the survival of
the indicator microorganisms.
If the
indicator microorganisms do not survive or regrow, the treatment efficiency is
confirmed to meet the requirements.
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Use test
tubes pre-filled with spores of the indicator microorganisms (at a specific
concentration such as 1×104, 1×106), a culturing
environment suitable for the microorganism type (contained in a smaller sealed
tube to separate it from the indicator microorganisms), and a pH indicator.
After being placed into the steam chamber or processing chamber, and processed
in accordance with the steps prescribed in Section 3.1 of this Regulation, the
test tube containing spores of the indicator microorganisms shall be taken out
and twisted to break the tube containing the culturing environment in order to
mix the indicator microorganism spores with the culturing environment. This
test tube is then incubated in accordance with the supplier’s instructions
(usually for a period of 24 to 48 hours at a temperature suitable for each type
of indicator microorganism).
After
incubation, if the test tube changes color according to the pH indicator in the
test tube, the indicator microorganisms are still alive and growing, and the
treatment efficiency does not meet the requirements prescribed in Section 2.2
of this Regulation. If the test tube does not change color (a negative
culturing result), the inactivation efficiency of the thermal disinfection
equipment for infectious healthcare waste is determined based on the concentration
of microorganisms initially present in the test tube (for example, if the
concentration is 1×104, the microorganism inactivation efficiency of
the thermal disinfection equipment is 99.99% or a 4 log 10 reduction).
In cases
where the culturing environment and the microorganisms are not separated, the
test tubes shall be stored at a low temperature to prevent microbial growth
before use.