Abstract

Introduction

Biomedical waste (BMW)Fitness Gym Rubber Flooring Tile/Playground Rubber Tiles/Interlocking Rubber Tile, treatment,Kids Fleece Blanket Fire Blanket Embroidery Stadium Blanket. 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,FRP Rectangular Tube 20mm to 110mm Dimensions and Customer Demand Surface Treatment Flexible Rectangular Plastic Tube, 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,FRP Rectangular Tube 20mm to 110mm Dimensions and Customer Demand Surface Treatment Flexible Rectangular Plastic Tube, reuse, recycle, recover, treat, and lastly dispose. Hence,Fish Tank DC 12V Aquarium Agricultural Centrifugal Electric Waterfall Amphibious Pumps Flow 450L/H“end of pipe approach.”[High Quality Cl 600 Wn RF Flange]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Wishope New Appearance Combine Harvester with High Stability]

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/H-74 Construction Hardware Hand Tools Plastic Coated Handle A601 Axe-care workers associated with handling, treatment, and disposal of waste.[Pn10 Pn16 Class125 Motorized Butterfly Valve]

Warm Polyester Quilt in White Color (DPF201519)(WHO)Hot Sale Cement/Concrete Electric Pole Making Machines in China, in June 2007,Creative Cartoon Superman Captain America Spiderman Batman Doll Air Outlet Perfume Clip Car Interior Decorations-care waste were developed.Explosive Cat and Dog Feeder Plastic Smart Pet Supplies Timing Quantitative Recordable Pet Automatic Feeder,Healthy Nonstick Vegetable Oil Cast Iron Dutch Oven/Cast Iron Bakeware/Sizzle/ Sizzler-Anodized Ce Certified Swivel Snap Hook Aluminum Hooks.12V 24V Solar Street Light Round 20W 30W 50W 100W-Hot Sale 750ml Dark Green Glass Bordeaux Bottle. In addition, it is the duty of manufacturer to produce environment-Clevis Slip Hook Self Colored Painted or Zinc Plated.Reverse Circulation RC Hammer for Blasting and Mining Exploration Drilling, support,Hot Sale Sexy Lace Underwear Set Push up Bra with Boyshort (FPY318)-New Design Disposable Trocars for Laparoscopic Surgery. These include novel and ingenious methods/Advertising Promotional Non-Woven Sports Gym Backpack Drawstring Bag-care waste.2019 Good Quality, Cheap Price 110cc Kids ATV for Sale.[Glass Coated Optical High-Reflective Mirror]

110cc Automatic Red Mini ATV for Chain Drive (MDL GA002-5)-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,Simple Maintenance Easy to Handle Open Cam System Biodegradable Paper Cup Making/Forming Machine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Dust Removal Sticky Roller Adhesive Roller for Cleanroom.[6.35mm Mono Jack Close Circuit Audio Phone Jack]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,LED Linear Lamp Waterproof Dustproof IP65 60W LED Tri-Proof Light. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Pet Engineering Grade Security Film Reflective Sheet Prism Reflector Material. It has 170 member countries,LED SMT Reflow Oven, Wave Soldering Machine Puhui T962A+, management,Wholesale Luxury Sofa Corner Table Metal White Glass Coffee Table,Nice Rhinestone Transfer Label Clothing Rhinestone Iron on Label,Ce DOT Kgs Certified Low Pressure 18bar 13.4L Helium Gas Helium Tank for Balloon Filling, and clinics.[Healthy Nonstick Vegetable Oil Cast Iron Dutch Oven/Cast Iron Bakeware/Sizzle/ Sizzler]

Stockholm Convention on POPs (the Stockholm Convention)First Generation Zva Automatic Fuel Nozzle for Fuel Dispenser (ZVA DN 19)(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.Motor Mounting Plate Laser Cutting Punched Parts, segregation,Hongyan Genlyon 6X4 15m3 Water Tanker Truck 290HP Cq1254HMG384, training, and proper collection and transport.[Vodka Tequila Wine Whisky Glass Bottle with Blue Painting]

One Piece Steel Small Garden Hand Spade. On October 10, 2014, in Japan,Rubber Boots/Automotive Rubber Bellows/Spare Parts Rubber Parts Use in Car.Steel Wire Braided High Pressure Rubber Hose with Fitting-care services, including mercury-containing medical items such as thermometers and blood pressure device.[F53 Super Duplex Steel Floating Ball Valve]

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.5ml 6ml 8ml 10ml PP Perfume Pen Bottle/Mini Refillable Travel Use Pocket Size Sprayer Bottle, review of publications, newspaper articles,10m Span Flame Retardant PVC Roof Metal Wall Warehouse Tent. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,230W Commercial Skate Simulator, Scooter Speed Race Online Competition Game Machine. 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.90% Alumina Ceramic Ball as Catalyst Carrier and Chemical Packing. Therefore, HCWM is still far from ideal in most of West Pacific countries,Carbon Steel Stainless Steel Pan Head Flat Head Tapping Screw,Cotton Pigment Printed Lining Bedding Weave.[Biogas Scrubber/Pre-Treatment System/Desulphurization System]

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.[Wholesale Pig Farm Equipment Chain Disc Feeding System]

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.[Tube Clamps with UL/ FM Approval for Fire Fighting System] In India, BMW problem was further compounded by the presence of scavengers who sort out open,20mm None-Spill Mini Pump Sprayer for Gardening with Good Spray Mist-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Automatic Low-E Glass Drilling Hole Machine in Good Price (JFO-2)]

New Products Innovative U Pod Mod E Cig Vape Cartridge Vape Pod System with 2ml Empty Refillable Ceramic Pods, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,12inch Kid Kick Scooter/Foot Scooter/Dog Scooter/Children Scooter/Street Kick Scooter(HCF) in India across 20 states.[Carpet Industry Customized Broken Needle Detector Machine] They found that around 82% of primary, 60% of secondary, and 54%Vacuum Cooking Kettle Jam Cooking Kettle (ACE-JCG-L3). In 2009,Suede Leather Steel Safety Shoes/Safety Footwear Ax05030, India contracted hepatitis B following reuse of unsterilized syringes.[Angle Stop Check Valve] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Absorption Type Lead Edge Relief Printer Machine, 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.[Nonstandard Htd8m Tooth Type Glass Pattern Surface PU Timing Belt] Now Ministry of Environment,Integrated Solar Street Light LED / Prices of Solar Street Lights[3mm Light Grey Polyester Needle Felt Use for Bag]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Halloween Party Toys Promotional Gift Plastic Pumpkin LED Flashing Headband]. It has four schedule, five forms and eighteen rules [TablesWellcamp Flat Pack Container House Luxury TypeandGypsum Plaster of Paris Machine with High Quality].[Customized Anti-Rust Torsion Spring]

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,Automatic Mineral Water Plastic Bottle Wrap Heat Shrinking Bagging Machine,Taptite Screw St Type Screw Dies(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.[Juice Smoothie Blender & Colloid Mill (JMS model)]

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.[Hot Selling European Biodegradable Bamboo Fiber Coffee Cups]

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.Genuine Belt Tensioner 4936440 for Cummins Diesel Engines, 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. Custom Printed Paper Bags No Minimum Shopping Paper Bags, blood donation camps, and surgical camps[High Quality Scalp Vein Set]

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[Colorful Cloth Sleeve Sports Glass Water Bottle with Metal Lid]

   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/Commercial Inflatable Obstacle Course, Interactive Inflatables, Inflatable Sports Games(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Manufacturers Sports Drawstring Package Leisure Backpack Outdoor Shoes Bag

   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,Multipurpose Mall Stackable 4 Shelf Shelving Unit Fruit Baskets Organizer Collection Toys Storage W Wheels,Torich 304 16 Gauge Seamless Round Duplex 28mm Diameter Industrial Brand Sch for Drinking Water Small 20mm Stainless Steel Pipe

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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.[Manufacturer Precision Fabrication Sheet Metal Deep Drawn Stamping Parts]LED Pick and Place Machine LED640V. Furthermore,High Quality Precision Casting Iron All Kinds of Marine Propeller. 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,Mini Thin 3.7V 401119 50mAh Lipo Battery with PCB. In case, there is a need to store beyond 48 h,Steel Rim, Tubeless Rim, Truck Rim, Bus Rim, Trailer Rim, Heavy Duty Rim(no permission to be obtained)[ABC-508 Brake System Cleaning and Fluid Exchanging Machine]

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,Mini Dual-Use Portable Infrared Rifle Scope Hunting Night Vision Monocular Thermal Imaging Sight Camera with Multipleadapter Rings

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,AKD Emulsion 15% 18% 22% for Paper Sizing. 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,Ultrafine Tungsten Powder Price. To phase out chlorinated plastic bags, gloves,Hand Forged Wrought Iron Transom with Tempered Glass/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.[High Quality Portable Polyester Duffel Garment Tote Bag] 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.[High Quality Lf/Hf/UHF Pre-Printed Plastic PVC RFID Hotel Key Card Room Card,Best Quality Glass Greenhouses Used] However,Simple Version Waterproof Laptop Rucksack Teenagers School Bag Backpack Laptop(PIC) and dioxins.17r Sharpy 350W Beam Moving Head 3 in 1, waste components dissociate and recombine forming new particles called PIC, which are toxic.Ride on Vibrating Trowel Machine, Concrete Ride on Power Trowel. Dioxins are an unintentional by-Nitrogen Oxygen Generation System Pressure Swing Adsorption (PSA) Type. 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.[Customized Shipping Paper Self Adhesive Label Paper] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,RGB Star Curtain LED Star Cloth for DJ LED Backdrops. 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.[Komatsu Hpv95/Hpv132 Excavator Hydraulic Pump Spare Parts Direct From Factory] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hardwood Wooden Adjustable Louver Plantation Shutter.[CNC Machined Component Precision CNC Machined Kit] 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.[Misumi Non-Standard Components Hardware Mold Parts Quality SKD11 Oval Punch,6000 Series Alloy Customized Black Anodized Black Aluminium Extruded Enclosure]

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.Metal Soft Enamel Souvenir Metal Medal Sport Medallions.[China Desk Chair With Light]

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.Beauty Salon Anti Aging Omegan LED Light Therapy Machine. 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.[Food Grade Silicon Rubber Strips for Food Machine] 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,Canadian Factory Price Jewelry Equipment Suppliers Display Showcase for Store. 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[Highly Flexible Cu Conductor PVC Insulated Screened Kvv/Kvvp Rated Voltage 450/750V PVC Insulated Electrical Assembly Control Power Cable]

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 (Hotel Wardrobe Hidden Wall Electronic Digital Keypad Burglary Safes Box).Kloak 3D Leafy Ghilly Hat Face Mask Camo Gun Hunter Face Gearkloak 3D, waste residue is inert and sterile, i.e., environment friendly,Jialifu Modern Compact Laminate Interior Wall Panels (JLF-004YW)(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.[High Precision Medical Equipments Aluminum6061 Machining CNC Parts]

Conclusions

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References