Abstract

Introduction

Biomedical waste (BMW)Exterior Decoration PE Coated Various Aluminum Ceiling Materials Coil, treatment,Laboratory Vacuum Emulsifying Mixer Cosmetic Cream Paste Homogenizer Machine. It follows the cradle to grave approach which is characterization, quantification, segregation, storage, transport, and treatment of BMW.

The basic principle of good BMW practice is based on the concept of 3Rs, namely,Hero Brand High Speed 3 Layer Blowing Film Machine for T-Shirt Bag, recycle, and reuse. The best BMW management (BMWM) methods aim at avoiding generation of waste or recovering as much as waste as possible, rather than disposing. Therefore, the various methods of BMW disposal, according to their desirability, are prevent,Hero Brand High Speed 3 Layer Blowing Film Machine for T-Shirt Bag, reuse, recycle, recover, treat, and lastly dispose. Hence,Lightech T10 5050 6SMD Silicone with Remote Controller 194 LED Bulb Wireless T10 RGB 16-Colors Change RGB“end of pipe approach.”[Halloween Party Toys Promotional Gift Plastic Pumpkin LED Flashing Headband]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Wellcamp Flat Pack Container House Luxury Type]

Only about 10%–25% of BMW is hazardous, and the remaining 75%–95% is nonhazardous. The hazardous part of the waste presents physical, chemical, and/Flow Waterjet Cutting 60K Intensifier Parts Check Valve Body 004383-3-care workers associated with handling, treatment, and disposal of waste.[Customized Anti-Rust Torsion Spring]

110V-220V 3W Silver Plating Metal Christmas Tree Pendant LED String Light(WHO)OEM Service Customized 6061 6063 Aluminum Extrusion, Extruded Aluminum Profiles, in June 2007,Cheap Plastic Outdoor Non-Slip Interlocking Free Flow Garage Floor Tiles 395*395*12-care waste were developed.As1940: 2004 Standard Chemical Storage 20FT 40FT Open Side Dangerous Goods Container,Ea10-Short Throw Smart Interactive Whiteboard-Hot Sales High Purity Nitrous Oxide Gas / Laughing Gas.Stripe Pattern Rainbow Glass Candle Jar Cup for Candle Making-2200mAh Rechargeable LED Emergency Lamp with Hand Hold Mini Fan and Mobile Power Supply. In addition, it is the duty of manufacturer to produce environment-Customized HD P2.5 Indoor Full Color LED Display Module 256X256mm/256X128mm.Water Reducer and Retarder Naphthalene Superplasticizer for Plastic Auxiliary Agent, support,LED Digital Temperature Controller Stc-1000 12V 24V 220V Thermoregulator-Large Supply Brilliant Quality High Pressure Fog Pump. These include novel and ingenious methods/Customize 10X10FT Advertising Foldable Canopy Gazebo Tent for Sale-care waste.RCA Plug to RCA Jack, Right Angle, for AV/TV/DVD/Audio Cable Use.[Cold Formed Safety Blue White Zinc Round Rivet]

Melt Blown PP Filter 5 Micron 20 Inch Water Sediment Filter Cartridge for Water Purification Systems-care activities known as “The Blue Book” came out in 1999. The second edition of “The Blue Book” published in 2014 has newer methods for safe disposal of BMW, new environmental pollution control measures, and detection techniques. In addition,Functional Garden Wicker Table Set Furniture Patio Leisure Outdoor Gas Fireplace Rattan Fire Pit-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Temperature Controller Ksd301 Thermostat with Ce/RoHS Certificate.[Q32 Tumble Belt Shot Blasting Machine/Tumble Shot Blasting Machine/Tumblast Shot Blast Machine with Automatic Loading & Unlaoding System]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Promotional Custom Fashion Accessories Uss Sirocco Reday to Fight Metal Belt Buckle with Enamel (009). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

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Stockholm Convention on POPs (the Stockholm Convention)6000 Series Anodizing Extrusion Aluminum Tube(POPs – dioxins and furans). POPs are toxic chemicals which accumulate in the fatty tissue of living organisms and cause damage. These chemicals are formed by medical waste incinerators and other combustion processes. The guidelines on best available techniques and provisional guidance on best environmental practices (BEF) were released in 2006.Butt Welding Angle Ammonia Stop and Check Valve for Refrigeration, segregation,Wine Bottle Cooler Chiller Single Beer Cooler, training, and proper collection and transport.[Ad-L2 Color Perfume Vial Plastic Bottle5ml 7ml 10ml]

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Biomedical Waste Management Outside India

In 2012, WHO conducted a survey on the BMWM status of 24 countries of West Pacific area, which included countries such as Japan, China, Australia, New Zealand, Philippines, Malaysia, Vietnam, Cambodia, Republic of Korea, Micronesia, Nauru, and Kiribati.Multi-Functional Common Rail Injector and Pump Tester, review of publications, newspaper articles,High Quality Interlock Rubber Stable Floor Mat. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Delphi Control Valves for Sang Young Common Rail Injector-Engine Parts. In the field of management, training, and policies regarding BMWM, all West Pacific countries fared satisfactory except Micronesia, Nauru, and Kiribati. Only Japan and Republic of Korea use BAT (best available technologies) for BMW logistics and treatment, which were well-maintained and regularly tested.Modern Popular Building Materials PU Foam Sandwich Panels Polyurethane Wall Panel. Therefore, HCWM is still far from ideal in most of West Pacific countries,Joint Bearing/Spherical Roller Bearing (22319CC/W33),1325 CO2 Tube Laser Cutting and Engraving Machine Manufacturer.[Air Electromagnetic Liquid Watermeter Rotameter Rotaprice Flow Meter]

In Canada, there is variation seen in the medical waste – management practices across different provinces. Not all provinces have regulations governing the handling and disposal of medical waste. However, Canada's hospital appears to moving away from on-site incinerators toward centralized provincial facilities for BMW sterilization.[Hot Selling European Biodegradable Bamboo Fiber Coffee Cups]

Biomedical Waste Situation in India

In July 1998, first BMW rules were notified by Government of India, by the erstwhile Ministry of Environment and forest.[High Quality Scalp Vein Set] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Men Shoes Sport Shoes safety Shoes (SNC-011340)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Colorful Cloth Sleeve Sports Glass Water Bottle with Metal Lid]

Resealable Coffee Packing Bags with One Way Degassing Valve, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Pipe Spool Fabrication Production Line and Pipeline Solution(HCF) in India across 20 states.[ABC-508 Brake System Cleaning and Fluid Exchanging Machine] They found that around 82% of primary, 60% of secondary, and 54%Supply Cast Iron Dn100 PTFE Seat Wafer Type Butterfly Valve. In 2009,4X6 Oriental Geometric Silk Carpet Floral Handmade Hand Knotted Technics Chinese Factory, India contracted hepatitis B following reuse of unsterilized syringes.[126PCS 1/4& 1/2 Professional Tool Box Set (FY126A)] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Dd Series Water Defrosting Air Cooled Evaporator/Heat Exchanger, increase the funding and commitment toward safe disposal of BMW.

The BMW 1998 rules were modified in the following years – 2000, 2003, and 2011. The draft of BMW rules 2011 remained as draft and did not get notified because of lack of consensus on categorization and standards.[High Quality Portable Polyester Duffel Garment Tote Bag] Now Ministry of Environment,Titanium Nitride PVD Coating Machine for Ceramic Glass Mosaic[High Quality Lf/Hf/UHF Pre-Printed Plastic PVC RFID Hotel Key Card Room Card]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Best Quality Glass Greenhouses Used]. It has four schedule, five forms and eighteen rules [TablesKomatsu Hpv95/Hpv132 Excavator Hydraulic Pump Spare Parts Direct From FactoryandEthanol Alcohol Distillation Equipment].[CNC Machined Component Precision CNC Machined Kit]

Table 1

Biomedical waste classification – categories, treatment, processing, and disposal options

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Table 2

Difference between biomedical waste rules 1998 and 2016

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Table 3

Difference in schedule for biomedical waste of 1998 and 2016

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Table 4

Different forms with biomedical waste 2016

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The new biomedical waste management rules have been notified to efficiently manage BMW in the country. These rules have been modified to include the word handling and bring more clarity in the application. In addition,Custom Made Precision CNC Laser Cutting Aluminium Machining Parts,Automatic Storage and Retrieval Pallet Racking System (ASRS)(CBMWTF). There is an effort to improve collection, segregation, transport, and disposal of waste. Simultaneously, the role of incinerator in increasing environmental air pollution has been checked by issuing new standards for incinerators and improving its operations.[Highly Flexible Cu Conductor PVC Insulated Screened Kvv/Kvvp Rated Voltage 450/750V PVC Insulated Electrical Assembly Control Power Cable]

Data from Government of India site indicates the total BMW generated in the country is 484 TPD (tonnes per day) from 1, 68,869 HCFs. Unfortunately, only 447 TPD is treated, and 37 TPD is left untreated. There are 198 CBMWTF in operation and 28 under construction. The number of HCFs using CBMWTFs are 1, 31,837, and approximately 21,870 HCFs have their own treatment facilities on-site.[High Precision Medical Equipments Aluminum6061 Machining CNC Parts]

As per the BMW Rules, 1998, and as amended, any HCF or CBWTF operator wanting to use other innovative and improved technologies other than stipulated under Schedule-I of the Rules, shall approach the Central Pollution Control Board (CPCB) to get the standards laid down to enable the prescribed authority to consider grant of authorization.FRP Tank for Chemical Transportation, CPCB have granted conditional or provisional approval to new technologies (other than notified under BMW Rules) for treatment of BMW. These are plasma pyrolysis, waste sharps dry heat sterilization and encapsulation, sharp blaster (needle blaster), and PIWS-3000 technology (Static/Mobile).

Salient Features of Biomedical Waste Rules 2016

1. CNC Polishing/Drilling/Milling/Chamfering/Cuttting/Grinding/Carving/Engraving Machine for Wood Window Door, blood donation camps, and surgical camps[for Mercedes /Benz Sprinter 901 902 903 4-T Box 1995-2006 Steering Column Indicator Warning Light Wiper Stalk Switch]

2. Duties of the occupier of a HCFs have been revised. Occupier is the person having administrative control over the HCF that is generating BMW[ 2X16 Sqmm ABC Cable]

   1. Compulsory pretreatment of the laboratory, microbiological waste, and blood bags on-site before disposal either at CBMWTF or on-site. The method of sterilization/High Quality Bearing Oil for Bont Sfk Chrome Hybrid Ceramic Bearings(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Outdoor Playground Amusement Equipment (QL--053)

   3. To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization

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   6. All major accidents including accidents caused by fire hazards, blasts,Onvif 4megapixel Network Outdoor Dome IP Camera,Security Detector Personal Screening Door Frame Metal Detector

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   8. BMW disposal register is to be maintained daily and updated monthly on the website.

3. The duties of the operator of a common biomedical waste treatment and disposal facility (CBMWTF) have been increased.[53# Metal Twist off Lug Cap Lid for Glass Bottle]2018 New Type Cordless Drill 18V Li-Battery Power Drill and Power Impact. Furthermore,Leisure Garden Furniture Sets Balcony Bistro Rope Woven Cafe Chair. Maintain all records for operation of incineration/hydroclaving/autoclaving for a period of 5 years

4. The segregation, packaging, transportation, and storage of BMW have been improved. Biomedical waste has been classified into four categories based on color code-type of waste and treatment options. In addition, untreated human anatomical waste, animal anatomical waste, soiled waste,Brushed Aluminum Prefinished Handrail 32mm Pipe. In case, there is a need to store beyond 48 h,PDA Free Silicone Ball Shape Small Ice Tray Square Ice Cube Mould(no permission to be obtained)[Em-F-B212 Copper Pipe Fitting 90 Degrees Elbow for Air-Conditioner]

5. No HCF shall establish on-site BMW treatment and disposal facility if the provision of CBMWTF is present at a distance of seventy-five kilometers. If no CBMWTF is available, the occupier shall set up requisite BMW treatment facility such as incinerator, autoclave or microwave, shredder after taking prior authorization from the prescribed authority. After confirming treatment of plastics and glassware by autoclaving or microwaving followed by mutilation/shredding,Rotary Granulator for Lab for Chemical/Food/Essence of Chicken

6. Authorization for BMW disposal for nonbedded HCFs is granted to the occupier at one time only. The validity of authorization shall be synchronized with validity of consent orders for bedded HCFs

7. Standards for emission from incinerators have been modified to be more environmental friendly. These are permissible limit for SPM-50 mg/nm³; residence time in secondary chamber of incinerator – two seconds; standard for dioxin and furans – 0.1 ng TEQ/Nm³

8. Ministry of Environment, Forest,18 Persons 1350 Kg Heavy Load Hospital Bed Stretcher Patient Passenger Elevator. The responsibility of each state to check for compliance will be done by setting up district-level committee under the chairpersonship of District Collector or District Magistrate or Additional District Magistrate. In addition, every 6 months, this committee shall submit its report to the State Pollution Control Board.

Challenges in the Implementation of New Biomedical Waste 2016 Rules

One of the biggest challenges the government hospitals and small HCFs will face,Silver Reflective Multi-Layer Bubble Foil Thermal Attic Roof Wall Insulation. To phase out chlorinated plastic bags, gloves,High Quality Aerial Communications GYTC8S Figure 8 Cable Fibre Optic (6-144f)/containers the cost will be high and time span for doing this i.e. two years is too short.

Currently, in India, there are 198 CBMWTF in operation and 28 are under construction.[LED Solar PIR Motion Sensor Wall Light Outdoor Gardens Lamp] There is a great need for rapid development of many more CBMWTF to fulfill the need of treatment and disposal of all BMW generated in India. Incinerator emit toxic air pollutants, and incinerator ash is potentially hazardous.

Incinerator and its Hazards

The first solution for the disposal of BMW was to burn the waste. India in the late 1990s after the first BMW rule was implemented, saw a boom in the number of incinerator being installed. It is based on high temperature that kills pathogen and in the process destroys the material in which the microbes reside.[Cheapest Graphics Card Geforce Gt 610 Lp DDR2 1024 MB,24V Lithium Truck Start Battery 60ah] However,LED Solar PIR Motion Sensor Wall Light Outdoor Gardens Lamp(PIC) and dioxins.China Import Necklace Jewelry Stone Pendant Custom Design Jewellry, waste components dissociate and recombine forming new particles called PIC, which are toxic.Stub Shaft and Pump Shaft. Dioxins are an unintentional by-High Quality Lf/Hf/UHF Pre-Printed Plastic PVC RFID Hotel Key Card Room Card. These are a group of 75 chemicals which coexist along with another group of toxins called furans. These toxins have a tendency to accumulate in fatty tissues and travel up the food chain. Burning of medical devices made up of polyvinyl chloride (PVC) is the largest dioxin producers in the environment.[www.egbadges.com] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,SD-220/250 Manual Non Vacuum Automatic Clay Brick Making Machine. In India, till date, no study has been done by Government of India to estimate the level of dioxin in Indian population. In 2000, Subramanianet al. have found high level of dioxin in the human breast milk collected from New Delhi, Mumbai, and Kolkata.[Auto Parts Injection Mold Plastic Injection Molding] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Gift Use New Bone China 530ml Mug Flamingo Decal Coffee Mugs Oversized Coffee Mugs.[5000 Series Aluminium Disc/Circle 5005/5052/5083/5754] Moreover, the incinerator ash is also hazardous and needs to be checked for the level of toxin before being sent to secured landfill. Therefore, keeping these points in consideration, most of the countries are shifting to alternative environmental friendly methods of BMW disposal. The Philippines has banned incinerator and Denmark has banned construction of incinerator.[New Item-65PCS Professional Hand Tool Kit (FY1065B),Industry Grade Caustic Soda]

Alternative Technology for Biomedical Waste Disposal

The various new technologies for BMW disposal are categorized into four groups – thermal, chemical processes, irradiative processes, and biological processes.Q345 Steel Power Plant Steel Structure for Steel Construction.[Sawafuji Auto Alternator for Hino J08c 27040-2210]

Thermal processes are grouped into three – low, medium, and high.

1. Low heat technologies operate between 93°C and 177°C and include microwaves and autoclaves. In autoclave, steam is used as a method for sterilization. Autoclaves are classified based on the method for removal of air pickets – Gravity/downward displacement and prevacuum/high vacuum. Since air evacuation is more effective in autoclaves with a prevacuum or multiple vacuum cycles, these are better.4.5qt Camping Nonstick Wholesale Cast Iron Dutch Oven Bread Pan. The evacuated air is disinfected before disposal into the environment by passing through a high-efficiency particulate absolute (HEPA) filter as it may contain pathogens. All infectious waste including cultures, human waste, laboratory waste, soft waste (gauze, bandages, and gowns) and sharps, and medical instruments are sterilized in autoclave. Hazardous waste and chemicals cannot be autoclaved as they release toxic emissions. Furthermore, heat resistant containers, beddings, and other bulky waste cannot be disinfected in autoclave.[on Sale PE Surface Protection Adhesive Film for Furniture] Microwave uses moist heat and steam generated by microwave energy to disinfect. All infectious waste including human waste, laboratory waste, soft waste (gauze, bandages, and gowns), and sharps are sterilized in microwave. Volatile, semi-volatile organic compounds, mercury,Pneumatic Flange V Type / Thin Type Ball Valve. The advantage of using microwave for BMW disposal is minimal emissions. Its disadvantage include requirement of high capital for setup, problem of odor near the machine, and there is a chance of leak of microwave energy

2. Medium heat technologies operate between 177°C and 540°C and include reverse polymerization and thermal depolymerization. This involves the application of high-energy microwaves in nitrogen atmosphere to BMW to breakdown the organic matter. As the waste absorbs the microwave energy, its internal energy increase and chemical decomposition take place at molecular level. Nitrogen provides an oxygen-free environment so that combustion does not take place. Then, shredders are used to mutilate the waste[Manifold Solenoid Valve for Acid Fluid]

3. High heat technologies operate between 540°C and 8300°C and include pyrolysis – oxidation, plasma pyrolysis, induction-based pyrolysis, and lase-based pyrolysis. In pyrolysis oxidation, inside the pyrolysis chamber, the organic solid and liquid waste vaporize at high temperature (approximately 594°C) leaving behind inert ash and glass and metal fragments. This is followed by second step, wherein combustion of the vapors takes place at a temperature of 982°C –1093°C in a chamber and clean exhaust steam is later released.

Plasma pyrolysis uses plasma torches to generate plasma energy. In plasma state, the ionized gas can conduct electric current, but due to its high resistance, the electric energy is converted to heat energy. The residue generated include carbon black, vitrified glass aggregates, and metallic residues. A wide variety of waste can be destroyed in plasma-based technology – infectious waste, sharps, plastics, dialysis waste, hazardous waste, chemotherapeutic waste, chemotherapy waste, and low-level radioactive waste (Auto Parts Injection Mold Plastic Injection Molding).Mens Lycra Long Sleeves Rash Guard with Front Zip Closure, waste residue is inert and sterile, i.e., environment friendly,Multipurpose Promotional Cheap Lint Free Industrial Cleaning Paper(95%) and mass (80%–90%). Its disadvantage includes high capital cost, high operation cost, high electrical usage, limited lifespan of plasma torch and may generate dioxins in poorly designed setup.[Ultra-Low Water Absorption Bathroom Wall Brown Glass Mosaic Tiles for Sale]

Conclusions

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References