const {
  Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
  Header, Footer, AlignmentType, HeadingLevel, BorderStyle, WidthType,
  ShadingType, VerticalAlign, PageNumber, LevelFormat, TableLayoutType
} = require('docx');
const fs = require('fs');

// ─── Color palette ───────────────────────────────────────────────────────────
const CLR = {
  darkBlue:    "1B3A6B",
  medBlue:     "2E6DA4",
  lightBlue:   "D6E8F7",
  accent:      "E8501A",
  yellow:      "FFF176",
  yellowDark:  "F9A825",
  red:         "FFCDD2",
  redDark:     "C62828",
  white:       "FFFFFF",
  whiteDark:   "90A4AE",
  blue:        "BBDEFB",
  blueDark:    "1565C0",
  black:       "212121",
  tableHead:   "1B3A6B",
  tableAlt:    "EBF5FB",
  green:       "C8E6C9",
  greenDark:   "2E7D32",
};

// ─── Helpers ─────────────────────────────────────────────────────────────────
function h1(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_1,
    spacing: { before: 360, after: 160 },
    children: [new TextRun({ text, bold: true, color: CLR.darkBlue, size: 34, font: "Arial" })],
  });
}

function h2(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_2,
    spacing: { before: 280, after: 120 },
    children: [new TextRun({ text, bold: true, color: CLR.medBlue, size: 28, font: "Arial" })],
  });
}

function h3(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_3,
    spacing: { before: 200, after: 80 },
    children: [new TextRun({ text, bold: true, color: CLR.accent, size: 24, font: "Arial" })],
  });
}

function body(text, bold = false, italic = false) {
  return new Paragraph({
    spacing: { before: 60, after: 60 },
    children: [new TextRun({ text, bold, italic, size: 22, font: "Arial", color: "222222" })],
  });
}

function bullet(text, level = 0) {
  return new Paragraph({
    numbering: { reference: "bullets", level },
    spacing: { before: 40, after: 40 },
    children: [new TextRun({ text, size: 22, font: "Arial", color: "222222" })],
  });
}

function numbered(text, level = 0) {
  return new Paragraph({
    numbering: { reference: "numbers", level },
    spacing: { before: 40, after: 40 },
    children: [new TextRun({ text, size: 22, font: "Arial", color: "222222" })],
  });
}

function spacer() {
  return new Paragraph({ spacing: { before: 80, after: 80 }, children: [new TextRun("")] });
}

function divider() {
  return new Paragraph({
    spacing: { before: 120, after: 120 },
    border: { bottom: { color: CLR.medBlue, size: 6, style: BorderStyle.SINGLE } },
    children: [new TextRun("")],
  });
}

function keyPoint(label, text) {
  return new Paragraph({
    spacing: { before: 60, after: 60 },
    shading: { type: ShadingType.CLEAR, fill: CLR.lightBlue },
    children: [
      new TextRun({ text: label + ": ", bold: true, size: 22, font: "Arial", color: CLR.darkBlue }),
      new TextRun({ text, size: 22, font: "Arial", color: "222222" }),
    ],
  });
}

function warningBox(text) {
  return new Paragraph({
    spacing: { before: 100, after: 100 },
    shading: { type: ShadingType.CLEAR, fill: "FFF3CD" },
    children: [
      new TextRun({ text: "NOTE: ", bold: true, size: 22, font: "Arial", color: "856404" }),
      new TextRun({ text, size: 22, font: "Arial", color: "856404" }),
    ],
  });
}

// ─── Table factory ────────────────────────────────────────────────────────────
function makeTable(headers, rows, colWidths) {
  const headerRow = new TableRow({
    tableHeader: true,
    children: headers.map((h, i) =>
      new TableCell({
        width: { size: colWidths[i], type: WidthType.DXA },
        shading: { type: ShadingType.CLEAR, fill: CLR.tableHead },
        verticalAlign: VerticalAlign.CENTER,
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          children: [new TextRun({ text: h, bold: true, color: CLR.white, size: 22, font: "Arial" })],
        })],
      })
    ),
  });

  const dataRows = rows.map((row, ri) =>
    new TableRow({
      children: row.map((cell, ci) => {
        const isColorCell = headers[ci] === "Color" || headers[ci] === "Bag Color";
        const bgFill = ri % 2 === 0 ? CLR.white : CLR.tableAlt;
        return new TableCell({
          width: { size: colWidths[ci], type: WidthType.DXA },
          shading: { type: ShadingType.CLEAR, fill: bgFill },
          verticalAlign: VerticalAlign.CENTER,
          children: [new Paragraph({
            alignment: AlignmentType.LEFT,
            spacing: { before: 40, after: 40 },
            children: [new TextRun({ text: cell, size: 20, font: "Arial", color: "222222" })],
          })],
        });
      }),
    })
  );

  return new Table({
    layout: TableLayoutType.FIXED,
    width: { size: 9026, type: WidthType.DXA },
    rows: [headerRow, ...dataRows],
  });
}

// ─── Color-coded waste category table ─────────────────────────────────────────
function colorCategoryTable() {
  const categories = [
    { color: "YELLOW", bg: "FFF9C4", border: CLR.yellowDark,
      types: ["(a) Human anatomical waste: tissues, organs, body parts, foetus below viability period",
               "(b) Animal anatomical waste: carcasses, body parts, organs from veterinary/research",
               "(c) Soiled waste: dressings, plaster casts, cotton swabs, blood bags, blood-soiled items",
               "(d) Expired/discarded medicines: antibiotics, cytotoxic drugs, glass/plastic ampoules",
               "(e) Chemical waste: chemicals from biological production, disinfectants",
               "(f) Chemical liquid waste: formalin, X-ray developing fluid, floor washing, lab liquid",
               "(g) Discarded linen/mattresses/beddings contaminated with blood or body fluids",
               "(h) Micro/biotech lab waste: blood bags, blood samples, cultures, lab waste"],
      disposal: "Incineration / Plasma Pyrolysis / Deep burial; autoclaving for category (h)" },
    { color: "RED", bg: "FFCDD2", border: CLR.redDark,
      types: ["Contaminated recyclable plastic waste: IV tubes/sets, catheters, urine bags, syringes (without needles), vacutainers, gloves, drains, oxygen masks, ELISA plates"],
      disposal: "Autoclaving/Microwaving/Hydroclaving + shredding; then recycled" },
    { color: "WHITE (Translucent)", bg: "F5F5F5", border: CLR.whiteDark,
      types: ["Waste sharps including metals: needles, syringes with fixed needles, lancets, scalpels, blades, needles from IV sets"],
      disposal: "Autoclaving/Dry heat sterilization/Chemical treatment + shredding/mutilation; sent to metal recycler" },
    { color: "BLUE", bg: "BBDEFB", border: CLR.blueDark,
      types: ["Glassware: broken or discarded contaminated glass including medicine vials, ampoules, glass slides, glass pipettes (EXCEPT those contaminated with cytotoxic waste)"],
      disposal: "Disinfection by soaking in sodium hypochlorite (1%) for 30 mins, then shredded/mutilated and sent to glass recycler" },
  ];

  const rows = [];
  for (const cat of categories) {
    const typeText = cat.types.join("\n");
    rows.push(
      new TableRow({
        children: [
          new TableCell({
            shading: { type: ShadingType.CLEAR, fill: cat.bg },
            width: { size: 1500, type: WidthType.DXA },
            verticalAlign: VerticalAlign.CENTER,
            children: [new Paragraph({
              alignment: AlignmentType.CENTER,
              children: [new TextRun({ text: cat.color, bold: true, size: 22, font: "Arial", color: "000000" })],
            })],
          }),
          new TableCell({
            width: { size: 4526, type: WidthType.DXA },
            children: cat.types.map(t => new Paragraph({
              spacing: { before: 30, after: 30 },
              children: [new TextRun({ text: "• " + t, size: 20, font: "Arial", color: "222222" })],
            })),
          }),
          new TableCell({
            width: { size: 3000, type: WidthType.DXA },
            children: [new Paragraph({
              spacing: { before: 30, after: 30 },
              children: [new TextRun({ text: cat.disposal, size: 20, font: "Arial", color: "222222" })],
            })],
          }),
        ],
      })
    );
  }

  const headerRow = new TableRow({
    tableHeader: true,
    children: [
      new TableCell({
        shading: { type: ShadingType.CLEAR, fill: CLR.tableHead },
        width: { size: 1500, type: WidthType.DXA },
        children: [new Paragraph({ alignment: AlignmentType.CENTER, children: [new TextRun({ text: "Category (Color)", bold: true, color: CLR.white, size: 22, font: "Arial" })] })],
      }),
      new TableCell({
        shading: { type: ShadingType.CLEAR, fill: CLR.tableHead },
        width: { size: 4526, type: WidthType.DXA },
        children: [new Paragraph({ alignment: AlignmentType.CENTER, children: [new TextRun({ text: "Type of Waste", bold: true, color: CLR.white, size: 22, font: "Arial" })] })],
      }),
      new TableCell({
        shading: { type: ShadingType.CLEAR, fill: CLR.tableHead },
        width: { size: 3000, type: WidthType.DXA },
        children: [new Paragraph({ alignment: AlignmentType.CENTER, children: [new TextRun({ text: "Treatment & Disposal", bold: true, color: CLR.white, size: 22, font: "Arial" })] })],
      }),
    ],
  });

  return new Table({
    layout: TableLayoutType.FIXED,
    width: { size: 9026, type: WidthType.DXA },
    rows: [headerRow, ...rows],
  });
}

// ─── Treatment methods table ──────────────────────────────────────────────────
function treatmentTable() {
  const rows = [
    ["Incineration", "Destroys ALL types of BMW at high temp (>850°C)", "Air pollution; needs secondary chamber; high cost"],
    ["Autoclaving (Steam sterilization)", "Effective for sharps, lab waste, plastics; eco-friendly", "NOT for anatomical, chemical, or cytotoxic waste"],
    ["Microwave Treatment", "Good for infectious waste; environmentally sound; volume reduction", "Cannot treat anatomical, cytotoxic, or chemical waste"],
    ["Chemical Disinfection", "Sharps & liquid waste; sodium hypochlorite (1% for 30 min)", "Inadequate for pharmaceutical & some infectious waste"],
    ["Plasma Pyrolysis", "Highest destruction efficiency; minimal emissions", "Very high cost; requires trained operators"],
    ["Deep Burial", "Low cost; remote/rural areas only; for anatomical waste", "Risk if site not managed; not for urban areas"],
    ["Encapsulation", "Sharps: fill container with cement/lime/sand; low cost", "Only for sharps/pharmaceutical; not for infectious waste"],
    ["Shredding/Mutilation", "Prevents reuse of sharps, plastics post-treatment", "Must be done AFTER sterilization only"],
  ];
  return makeTable(
    ["Method", "Suitable For / Advantages", "Limitations"],
    rows,
    [2200, 3613, 3213]
  );
}

// ─── Document assembly ────────────────────────────────────────────────────────
const doc = new Document({
  styles: {
    default: {
      document: { run: { font: "Arial", size: 22, color: "222222" } },
    },
    paragraphStyles: [
      {
        id: "Heading1", name: "Heading 1", basedOn: "Normal", next: "Normal", quickFormat: true,
        run: { size: 34, bold: true, color: CLR.darkBlue, font: "Arial" },
        paragraph: { spacing: { before: 360, after: 160 }, outlineLevel: 0 },
      },
      {
        id: "Heading2", name: "Heading 2", basedOn: "Normal", next: "Normal", quickFormat: true,
        run: { size: 28, bold: true, color: CLR.medBlue, font: "Arial" },
        paragraph: { spacing: { before: 280, after: 120 }, outlineLevel: 1 },
      },
      {
        id: "Heading3", name: "Heading 3", basedOn: "Normal", next: "Normal", quickFormat: true,
        run: { size: 24, bold: true, color: CLR.accent, font: "Arial" },
        paragraph: { spacing: { before: 200, after: 80 }, outlineLevel: 2 },
      },
    ],
  },
  numbering: {
    config: [
      {
        reference: "bullets",
        levels: [{
          level: 0, format: LevelFormat.BULLET, text: "\u2022", alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } },
        }, {
          level: 1, format: LevelFormat.BULLET, text: "\u25E6", alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 1080, hanging: 360 } } },
        }],
      },
      {
        reference: "numbers",
        levels: [{
          level: 0, format: LevelFormat.DECIMAL, text: "%1.", alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } },
        }],
      },
    ],
  },
  sections: [{
    properties: {
      page: {
        margin: { top: 1080, bottom: 1080, left: 1080, right: 1080 },
      },
    },
    headers: {
      default: new Header({
        children: [new Paragraph({
          alignment: AlignmentType.RIGHT,
          shading: { type: ShadingType.CLEAR, fill: CLR.lightBlue },
          children: [
            new TextRun({ text: "Biomedical Waste Management  |  Nursing 1st Semester Study Notes", size: 18, font: "Arial", color: CLR.darkBlue }),
          ],
        })],
      }),
    },
    footers: {
      default: new Footer({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          children: [
            new TextRun({ text: "Page ", size: 18, font: "Arial", color: "888888" }),
            new PageNumber(),
            new TextRun({ text: "  |  Source: Park's Textbook of PSM & BMW Rules 2016 (MoEF, GoI)", size: 18, font: "Arial", color: "888888" }),
          ],
        })],
      }),
    },
    children: [

      // ══════════════════ COVER / TITLE ══════════════════
      new Paragraph({
        alignment: AlignmentType.CENTER,
        spacing: { before: 600, after: 120 },
        shading: { type: ShadingType.CLEAR, fill: CLR.darkBlue },
        children: [
          new TextRun({ text: "BIOMEDICAL WASTE MANAGEMENT", bold: true, size: 48, font: "Arial", color: CLR.white }),
        ],
      }),
      new Paragraph({
        alignment: AlignmentType.CENTER,
        spacing: { before: 0, after: 60 },
        shading: { type: ShadingType.CLEAR, fill: CLR.darkBlue },
        children: [
          new TextRun({ text: "Comprehensive Study Notes for Nursing 1st Semester Students", size: 26, font: "Arial", color: "A0C4E8", italic: true }),
        ],
      }),
      new Paragraph({
        alignment: AlignmentType.CENTER,
        spacing: { before: 0, after: 600 },
        shading: { type: ShadingType.CLEAR, fill: CLR.darkBlue },
        children: [
          new TextRun({ text: "As per BMW Management Rules, 2016 (MoEF, Government of India)", size: 22, font: "Arial", color: "7EB8DA" }),
        ],
      }),

      divider(),

      // ══════════════════ UNIT 1: INTRODUCTION ══════════════════
      h1("UNIT 1: Introduction to Biomedical Waste"),
      divider(),

      h2("1.1 Definition"),
      body("Biomedical Waste (BMW) refers to any waste generated during the diagnosis, treatment, or immunization of human beings or animals, or in research activities pertaining thereto, or in the production or testing of biologicals (BMW Rules, 2016)."),
      spacer(),

      h2("1.2 Sources of BMW Generation"),
      bullet("Hospitals and nursing homes"),
      bullet("Clinics and dispensaries"),
      bullet("Pathological laboratories"),
      bullet("Blood banks"),
      bullet("Veterinary institutions and animal houses"),
      bullet("Biotechnology and research institutions"),
      bullet("Pharmaceutical industries (testing only)"),
      bullet("Households (home care activities - e.g., insulin syringes, dressings)"),
      spacer(),

      h2("1.3 Magnitude of the Problem"),
      keyPoint("WHO Estimate", "85% of healthcare waste is general (non-hazardous). Only 10-15% is biomedical/hazardous waste."),
      keyPoint("Composition of General Waste", "Paper/cardboard 54%, Organic 18%, Plastic 15%, Metal 3%, Glass 2%."),
      keyPoint("India", "Over 600 tonnes of BMW generated daily from ~1.5 lakh healthcare facilities."),
      spacer(),

      h2("1.4 Why BMW Management Matters"),
      bullet("Prevents spread of infections (Hepatitis B, C, HIV, TB)"),
      bullet("Protects healthcare workers, waste handlers, and the public"),
      bullet("Prevents environmental pollution (soil, water, air)"),
      bullet("Avoids recycling of single-use items (needles, syringes) that can cause needle-stick injuries"),
      bullet("Legal compliance - non-compliance leads to penalties"),
      spacer(),

      h2("1.5 Persons at Risk"),
      bullet("Doctors, nurses, paramedics"),
      bullet("Hospital housekeeping/sanitation staff"),
      bullet("Waste transport workers"),
      bullet("Workers at disposal/treatment facilities"),
      bullet("Scavengers and rag pickers"),
      bullet("General public near disposal sites"),

      divider(),

      // ══════════════════ UNIT 2: LEGAL FRAMEWORK ══════════════════
      h1("UNIT 2: Legal Framework"),
      divider(),

      h2("2.1 BMW Management Rules - Historical Timeline"),
      makeTable(
        ["Year", "Rule/Act", "Key Provision"],
        [
          ["1998", "BMW (Management and Handling) Rules, 1998", "First national legislation; 10 categories of waste; applied to all generators"],
          ["2011", "Amendment Rules 2011", "Minor modifications to the 1998 rules"],
          ["2016", "BMW Management Rules, 2016 (Current)", "4 categories; colour coding revised; bar-coding; 48-hr storage limit; CBMWTF mandate"],
          ["2018", "Amendment Rules 2018", "Further refinements; inclusion of bar-coding and GPS tracking for CBMWTF vehicles"],
        ],
        [1200, 3400, 4426]
      ),
      spacer(),

      h2("2.2 BMW Management Rules, 2016 - Key Features"),
      numbered("Waste reclassified from 10 categories (1998) into 4 colour-coded categories."),
      numbered("Segregation MUST happen at the point of waste generation."),
      numbered("Untreated human/animal anatomical waste and soiled waste must NOT be stored beyond 48 hours."),
      numbered("No healthcare facility shall set up on-site BMW treatment if a CBMWTF (Common Bio-Medical Waste Treatment Facility) exists within 75 km."),
      numbered("Bar-code labels must be placed on all colour-coded bags before sending for final disposal."),
      numbered("Phase out of chlorinated plastic bags, gloves, and blood bags within 2 years of the rules taking effect."),
      numbered("GPS tracking required for CBMWTF vehicles."),
      numbered("Records of BMW generation, collection, treatment, and disposal to be maintained for 5 years."),
      numbered("Any major accident must be reported immediately and a report submitted within 24 hours."),
      spacer(),

      h2("2.3 Applicability & Exclusions"),
      body("The BMW Rules 2016 apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle BMW in any manner."),
      spacer(),
      body("NOT applicable to:", true),
      bullet("Radioactive wastes (governed by Atomic Energy Act, 1962)"),
      bullet("Municipal solid waste"),
      bullet("Lead acid batteries"),
      bullet("Hazardous chemical wastes"),
      bullet("E-waste"),
      bullet("Hazardous microorganisms (governed by separate rules)"),

      h2("2.4 Key Definitions"),
      makeTable(
        ["Term", "Definition"],
        [
          ["Occupier", "Person who has control over the institution generating BMW (hospital administrator, owner, principal)"],
          ["CBMWTF", "Common Bio-Medical Waste Treatment Facility - a facility that treats BMW from multiple healthcare facilities"],
          ["Operator", "Person who operates a CBMWTF"],
          ["Autoclaving", "Steam sterilization at 121°C/15 psi for 20-30 minutes to destroy microorganisms"],
          ["Incineration", "Controlled burning of waste at high temperatures (>850°C) to destroy pathogens and reduce volume"],
          ["Point of Generation", "Location where waste is initially generated (bedside, OT, lab bench)"],
        ],
        [2200, 6826]
      ),

      divider(),

      // ══════════════════ UNIT 3: CLASSIFICATION & COLOR CODING ══════════════════
      h1("UNIT 3: Classification and Colour-Coding of BMW"),
      divider(),

      h2("3.1 Overview of the 4-Category System (BMW Rules 2016)"),
      warningBox("MUST MEMORIZE: 4 categories based on treatment/disposal options. Segregation at point of generation is mandatory."),
      spacer(),
      colorCategoryTable(),
      spacer(),

      h2("3.2 Quick Memory Aid - Colour Coding"),
      makeTable(
        ["Bag Color", "Remember As", "Key Contents"],
        [
          ["YELLOW", "Y = Yucky organic / anatomical waste", "Body parts, organs, soiled dressings, expired drugs, lab cultures"],
          ["RED", "R = Recyclable plastic waste", "IV sets, syringes (no needle), catheters, urine bags, gloves"],
          ["WHITE (Translucent)", "W = Wounding / sharp objects", "Needles, blades, scalpels, lancets"],
          ["BLUE", "B = Broken glass", "Vials, ampoules, glass slides, pipettes"],
        ],
        [1500, 2500, 5026]
      ),
      spacer(),

      h2("3.3 Common Mistakes in Segregation"),
      bullet("Putting needle INTO the red bag instead of the white (sharp) container - HIGH RISK of needle-stick"),
      bullet("Mixing general (black bag) waste with yellow bag infectious waste"),
      bullet("Placing cytotoxic drug vials in blue bag instead of yellow"),
      bullet("Recapping needles before disposal - NEVER recap after use"),
      bullet("Overfilling sharps containers beyond 3/4 capacity"),
      warningBox("Mixing categories is a punishable offence under BMW Rules 2016 and creates serious infection risk."),

      divider(),

      // ══════════════════ UNIT 4: STEPS OF BMW MANAGEMENT ══════════════════
      h1("UNIT 4: Steps of Biomedical Waste Management"),
      divider(),
      body("BMW management follows 4 sequential steps:"),

      h2("Step 1: Segregation"),
      body("Definition: Separation of BMW at the point of generation into appropriate colour-coded containers/bags."),
      spacer(),
      body("Key principles:", true),
      bullet("Segregate IMMEDIATELY at the point of generation - do not mix and sort later"),
      bullet("Use correct colour-coded bag/container as per category"),
      bullet("Bags/containers must NOT be overfilled beyond 3/4 full"),
      bullet("Bags must be labelled with: date, category, source ward/department, name of facility"),
      bullet("Use bar-code labels on all bags before sending to CBMWTF"),
      bullet("Household BMW (insulin syringes, dressings) to be collected in sealed bags and handed to municipal collectors"),
      spacer(),
      warningBox("Do NOT segregate at a central collection point - segregation must happen at the bedside/lab bench/OT table (point of generation)."),

      h2("Step 2: Collection and Storage"),
      body("Intra-mural transport: Segregated waste moved from wards/departments to central storage area within the hospital."),
      spacer(),
      bullet("Use dedicated trolleys/carts - not shared with clean items"),
      bullet("Colour-coded bags placed in rigid outer containers during transport"),
      bullet("Avoid manual handling of open bags - always use gloves + closed containers"),
      bullet("Designated corridors and lifts for BMW transport where possible"),
      spacer(),
      body("Storage area requirements:", true),
      bullet("Separate from general storage areas"),
      bullet("Well-ventilated, secured (locked), clean"),
      bullet("Storage time limit: 48 hours maximum for anatomical/soiled waste"),
      bullet("If storage beyond 48 hours is required, the State Pollution Control Board (SPCB) must be informed"),

      h2("Step 3: Transportation"),
      body("Two types:"),
      bullet("Intra-mural: Within the healthcare facility (ward to central storage)"),
      bullet("Extra-mural: From healthcare facility to CBMWTF"),
      spacer(),
      body("Extra-mural requirements:", true),
      bullet("Dedicated vehicles with GPS tracking (from Amendment 2018)"),
      bullet("Vehicles must be leak-proof, covered, and labelled with biohazard symbol"),
      bullet("Vehicles must be cleaned/disinfected after each use"),
      bullet("Transport manifest (Form II) must accompany each BMW consignment"),
      bullet("Not shared with other goods or passengers"),

      h2("Step 4: Treatment and Disposal"),
      body("Treatment neutralizes/destroys the hazard before final disposal. See Unit 5 for details."),

      divider(),

      // ══════════════════ UNIT 5: TREATMENT METHODS ══════════════════
      h1("UNIT 5: Treatment and Disposal Methods"),
      divider(),
      treatmentTable(),
      spacer(),

      h2("5.1 Autoclaving (Steam Sterilization)"),
      body("Most widely used method in India. Used for Red, White, and Yellow (h) category waste."),
      bullet("Temperature: 121°C (minimum), pressure: 15 psi"),
      bullet("Duration: 20-30 minutes (gravity cycle) or 4-5 min (vacuum cycle)"),
      bullet("Kills all vegetative bacteria, viruses, fungi; high-level disinfection for spores with longer cycles"),
      bullet("Must be followed by shredding/mutilation for plastics and sharps"),
      warningBox("NOT suitable for: anatomical waste (yellow a,b), cytotoxic drugs (yellow d), chemical waste (yellow e,f), or linen (yellow g)."),

      h2("5.2 Incineration"),
      body("Used for Yellow category waste (anatomical, soiled, pharmaceutical, cytotoxic)."),
      bullet("Primary chamber: >800-850°C"),
      bullet("Secondary chamber: >1050°C for 2 seconds minimum"),
      bullet("Cytotoxic drugs: require >1200°C"),
      bullet("Reduces waste volume by up to 90% and weight by up to 75%"),
      bullet("Residual ash goes to secured landfill"),
      warningBox("Emission standards must be met to prevent dioxin/furan release. Old single-chamber incinerators must be phased out."),

      h2("5.3 Deep Burial"),
      body("Used when incineration/plasma pyrolysis is not available - mainly for anatomical waste in rural settings."),
      bullet("Pit: 2 metres wide, depth enough to have 1 metre of soil cover after burial"),
      bullet("Only biodegradable waste; lined with lime at bottom and top"),
      bullet("Location: within hospital premises or at approved site; protected from animals and unauthorized access"),
      bullet("Not allowed in urban/municipal areas or near surface water bodies"),

      h2("5.4 Chemical Treatment"),
      body("Used for sharps and liquid laboratory waste."),
      bullet("Sodium hypochlorite (bleach) 1% solution: immerse for at least 30 minutes"),
      bullet("Glutaraldehyde 2%: for heat-sensitive instruments (not for waste disposal)"),
      bullet("Lime (calcium hydroxide) for liquid waste pits"),

      h2("5.5 CBMWTF (Common Bio-Medical Waste Treatment Facility)"),
      body("A shared facility that receives and treats BMW from multiple healthcare facilities in a region."),
      bullet("Must be within 75 km of all linked healthcare facilities"),
      bullet("Provides: autoclave, incinerator, shredder, secured landfill"),
      bullet("Issues manifest receipts for each BMW consignment received"),
      bullet("Subject to regular inspections by SPCB"),

      divider(),

      // ══════════════════ UNIT 6: ROLES AND RESPONSIBILITIES ══════════════════
      h1("UNIT 6: Roles and Responsibilities"),
      divider(),

      h2("6.1 Duties of the Occupier (Hospital/Institution)"),
      numbered("Obtain authorization from State Pollution Control Board (SPCB) before handling BMW"),
      numbered("Segregate BMW at point of generation"),
      numbered("Ensure storage in safe, ventilated, secured area; do not exceed 48-hour limit"),
      numbered("Provide training to all staff - initial and annual refresher"),
      numbered("Provide PPE to all personnel handling BMW"),
      numbered("Set up link with CBMWTF or install own treatment facility (if CBMWTF not within 75 km)"),
      numbered("Maintain records of BMW for 5 years"),
      numbered("Submit Annual Report to SPCB by 30th June each year"),
      numbered("Phase out chlorinated plastic bags within stipulated time"),
      numbered("Report accidents to SPCB immediately, written report within 24 hours"),
      spacer(),

      h2("6.2 The Nurse's Role in BMW Management"),
      body("Nurses are at the front line of BMW generation and are directly responsible for initial segregation."),
      spacer(),
      makeTable(
        ["Activity", "Nurse's Responsibility"],
        [
          ["Post-procedure disposal", "Segregate waste immediately: gloves in red, needle in white sharps container, soiled dressing in yellow"],
          ["Needle handling", "NEVER recap needles; drop directly into white sharps container without two-hand technique"],
          ["Blood/body fluid spills", "Use 1% hypochlorite, cover, wait 30 min, then clean; report to infection control"],
          ["Expired medications", "Place in yellow bag; never flush down drain or discard in general bin"],
          ["IV set disposal", "Remove needle (into white container), then discard tubing in red bag"],
          ["Patient linen with blood", "Yellow bag; do not send to laundry directly"],
          ["Broken glass slides/vials", "Blue puncture-proof container; use forceps/scoop - never bare hands"],
          ["Documentation", "Record type and quantity of BMW per shift as per hospital policy"],
        ],
        [3000, 6026]
      ),

      h2("6.3 Personal Protective Equipment (PPE) for BMW Handling"),
      makeTable(
        ["PPE", "When Required"],
        [
          ["Heavy-duty rubber gloves", "All BMW handling; segregation, transport, cleaning"],
          ["Apron/gown", "Handling liquid, anatomical, or highly infectious waste"],
          ["Mask (minimum surgical)", "Any task with risk of aerosol generation or chemical waste"],
          ["Eye protection (goggles/face shield)", "Handling liquid waste, cytotoxics, or during autoclave loading"],
          ["Closed-toe footwear/boots", "In waste storage/treatment areas"],
          ["N95 respirator", "Handling airborne-risk waste, TB-infected waste"],
        ],
        [2500, 6526]
      ),

      divider(),

      // ══════════════════ UNIT 7: INFECTION CONTROL ══════════════════
      h1("UNIT 7: BMW and Infection Control"),
      divider(),

      h2("7.1 Diseases Associated with Poor BMW Management"),
      makeTable(
        ["Route of Transmission", "Diseases / Hazards"],
        [
          ["Needle-stick / sharps injury", "HIV/AIDS, Hepatitis B (HBV), Hepatitis C (HCV), Tetanus, Syphilis"],
          ["Direct contact with contaminated waste", "Gastroenteritis, skin infections, leptospirosis"],
          ["Inhalation of infectious aerosols", "Tuberculosis, COVID-19, other respiratory infections"],
          ["Environmental contamination", "Cholera, typhoid (water), soil-transmitted pathogens"],
          ["Improper incineration emissions", "Dioxins, furans, heavy metal toxicity (long-term)"],
          ["Recycled contaminated items", "HIV, HBV, HCV (reused needles/syringes in informal market)"],
        ],
        [3000, 6026]
      ),
      spacer(),

      h2("7.2 Needle-Stick Injury (NSI) Protocol"),
      body("A needle-stick injury is a puncture wound caused by a needle or other sharp object that has been in contact with blood/body fluids."),
      spacer(),
      body("Immediate actions (First Aid):", true),
      numbered("Do NOT squeeze/suck the wound"),
      numbered("Wash immediately with soap and running water for at least 5 minutes"),
      numbered("Allow wound to bleed freely for a short time"),
      numbered("Apply antiseptic (povidone iodine or 70% alcohol)"),
      numbered("Do NOT use caustic agents or bleach on the wound"),
      spacer(),
      body("Post-exposure protocol:", true),
      numbered("Report IMMEDIATELY to supervisor and infection control officer"),
      numbered("Document: date/time, type of device, procedure, source patient details"),
      numbered("Source patient testing (HBV, HCV, HIV) with consent"),
      numbered("Healthcare worker baseline blood sample taken"),
      numbered("Assess need for post-exposure prophylaxis (PEP):"),
      bullet("HIV PEP: Start within 2 hours (max 72 hours); 28-day course of antiretroviral drugs", 1),
      bullet("HBV prophylaxis: HBIG + vaccine if unvaccinated; vaccine booster if needed", 1),
      numbered("Follow-up at 6 weeks, 12 weeks, 6 months"),
      spacer(),
      warningBox("Hepatitis B vaccination is MANDATORY for all healthcare workers before starting clinical duties. Ensure your 3-dose schedule is complete."),

      h2("7.3 Standard Precautions Relevant to BMW"),
      bullet("Treat ALL blood, body fluids, secretions, and excretions as potentially infectious"),
      bullet("Wash hands before and after patient contact and after handling BMW"),
      bullet("Wear appropriate PPE for anticipated exposure"),
      bullet("Prevent injuries from needles, scalpels, and other sharp devices"),
      bullet("Handle soiled linen safely to prevent skin/mucous membrane exposure"),

      divider(),

      // ══════════════════ UNIT 8: NATIONAL COMPLIANCE ══════════════════
      h1("UNIT 8: Regulatory Compliance and Documentation"),
      divider(),

      h2("8.1 Authorization"),
      bullet("Every facility generating BMW must obtain an Authorization from the State Pollution Control Board (SPCB)"),
      bullet("Application in Form I; renewed annually or as specified"),
      bullet("New healthcare facilities must apply for authorization before commencement"),
      spacer(),

      h2("8.2 Records to be Maintained (5 Years)"),
      bullet("BMW generation register: category-wise, quantity per day"),
      bullet("Treatment/disposal records"),
      bullet("Transport manifests (Form II)"),
      bullet("Accident reports"),
      bullet("Staff training records"),
      bullet("Autoclave/incinerator maintenance logs and temperature charts"),
      spacer(),

      h2("8.3 Annual Report"),
      bullet("Submitted to SPCB by 30th June every year"),
      bullet("Contains: categories of waste generated, quantities, treatment details, accidents if any"),
      spacer(),

      h2("8.4 Penalties for Non-Compliance"),
      body("Under the Environment Protection Act (EPA) 1986:"),
      bullet("Imprisonment up to 5 years with fine up to Rs. 1 lakh for first offence"),
      bullet("Imprisonment up to 7 years for continuing violation"),
      bullet("Daily fine for continuous violation after conviction"),

      divider(),

      // ══════════════════ UNIT 9: QUICK REVISION ══════════════════
      h1("UNIT 9: Quick Revision - Key Points"),
      divider(),

      h2("9.1 Must-Know Facts for Exams"),
      makeTable(
        ["Topic", "Key Fact"],
        [
          ["Definition", "Waste from diagnosis/treatment/immunization of humans or animals, or research/biological production"],
          ["Current BMW Rule", "BMW Management Rules, 2016 (came into force 28 March 2016)"],
          ["Categories", "4 categories (previously 10 under 1998 rules)"],
          ["Yellow bag", "Anatomical, soiled, cytotoxic, chemical, pharmaceutical, linen, lab waste"],
          ["Red bag", "Contaminated recyclable plastics (IV sets, catheters, syringes without needles)"],
          ["White container", "Sharps ONLY - needles, blades, scalpels, lancets"],
          ["Blue container", "Broken/discarded glass - vials, ampoules, slides"],
          ["Storage limit", "48 hours maximum for anatomical/soiled/biotechnology waste"],
          ["CBMWTF distance", "No on-site treatment if CBMWTF is within 75 km"],
          ["Autoclave temp", "121°C, 15 psi, 20-30 minutes"],
          ["Cytotoxic incineration", ">1200°C required"],
          ["Records maintained for", "5 years"],
          ["Annual report due", "30th June each year to SPCB"],
          ["NSI - HIV PEP", "Start within 2 hours, maximum 72 hours; 28-day course"],
          ["Needle recapping", "NEVER recap after use - drop directly into white sharps container"],
          ["% general vs BMW", "85% general waste; only 10-15% is actual biomedical/hazardous waste"],
        ],
        [3000, 6026]
      ),
      spacer(),

      h2("9.2 BMW Rules 2016 vs 1998 - Comparison"),
      makeTable(
        ["Feature", "1998 Rules", "2016 Rules"],
        [
          ["Number of categories", "10 categories", "4 categories"],
          ["Storage time limit", "Not specified", "48 hours maximum"],
          ["Bar-coding", "Not required", "Mandatory"],
          ["GPS tracking", "Not required", "Mandatory for CBMWTF vehicles"],
          ["Chlorinated plastics", "Permitted", "Phase-out mandated"],
          ["CBMWTF mandate", "Optional", "Mandatory within 75 km"],
          ["Annual report", "Required", "By 30 June to SPCB"],
        ],
        [2800, 3113, 3113]
      ),

      divider(),

      // ══════════════════ REFERENCES ══════════════════
      h1("References"),
      divider(),
      bullet("Park K. Park's Textbook of Preventive and Social Medicine. 26th ed. Jabalpur: M/s Banarsidas Bhanot; 2021. Chapter 19."),
      bullet("Ministry of Environment, Forest and Climate Change. Bio-Medical Waste Management Rules, 2016. Government of India. Notification G.S.R. 343(E), 28 March 2016."),
      bullet("Central Pollution Control Board (CPCB). Guidelines for Management of Healthcare Waste as per BMW Management Rules, 2016. New Delhi: CPCB; June 2018."),
      bullet("World Health Organization. Safe management of wastes from health-care activities. 2nd ed. Geneva: WHO; 2014."),
      bullet("AIIMS New Delhi. Salient Features of BMW Rules 2016. Biomedical Waste Management Department."),
      bullet("Asian Journal of Nursing Education and Research, 2018: Biomedical Waste Management Rules 2016 - Orientation for Nurses."),
      spacer(),
      spacer(),
      new Paragraph({
        alignment: AlignmentType.CENTER,
        shading: { type: ShadingType.CLEAR, fill: CLR.lightBlue },
        children: [
          new TextRun({ text: "End of Study Notes  |  Good Luck with Your Exams!", bold: true, size: 22, font: "Arial", color: CLR.darkBlue }),
        ],
      }),
    ],
  }],
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