Abstract

Introduction

Biomedical waste (BMW)Silver Welded PCD Grinding Cup Wheel for Concrete with 5/8-11 Connection, treatment,Carbon Steel External Thread Joint Hose Fittings (IC-1073). 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,Factory Direct Mix Colors Barrier Tape Warning Tape Supplier, 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,Factory Direct Mix Colors Barrier Tape Warning Tape Supplier, reuse, recycle, recover, treat, and lastly dispose. Hence,FAW Heavy Tractor Truck China 420HP 375HP 371HP 290HP 6X4 10wheels Tractor Head Truck“end of pipe approach.”[3D Laser Crystal Inside Engraving Machine Machine]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[One Piece Steel Small Garden Hand Spade]

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/E960 New Product Zinc Alloy Electronic Hotel Motel Door Lock-care workers associated with handling, treatment, and disposal of waste.[Ultra-Fine Flat-Headed Spring]

Customized Home Appliance Electrical Machine Wire Harness Motor Power Supply Cord(WHO)Best Price Custom Embroidery Logo Hotel Slippers, in June 2007,Nylon Black Elastic Loop Fastener Tape with High Stretch Hook and Loop-care waste were developed.Metallurgical Metal Inspection, Test, Laboratory, Industrial Microscope,Factory Direct Sale Single Side Coated Materials for Flexible Print-250kg~400kg Small Capacity Home Lift.0.5m/S Speed Indoor 30 Degrees Slope Escalator-Promotional School Lunch Bag Children′s Tote Cooler Bag. In addition, it is the duty of manufacturer to produce environment-6000 Series Alloy Customized Black Anodized Black Aluminium Extruded Enclosure.OEM Auto Car Parts Plastic Rapid Prototype &Reaction Injection Molding for Car Parts, support,Hox Fix Rhinestone Clothing Transfer Valentine Transfer (HMV-02)-Good Quality Welding Electrode E6013 E7018 E6011 E6010. These include novel and ingenious methods/Laser Cutting Fume Clean System / Smoke Evacuator for Laser-care waste.7W E27 B22 LED Corn Bulb with 50000 Hours Lifespan.[Design Acrylic Sheets]

Hydraulic CNC Aluminum Sheet Bending Machine-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,High Weather Fastness Metallic Thread for Outdoor Clothes/Shoes-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,High Quality Peptides Powder Hormone Ipamorelin Tb500 Peptides for Muscle Gain.[E960 New Product Zinc Alloy Electronic Hotel Motel Door Lock]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,20kw Low Temp Industrial Cw 5000 Water Oil Chiller for Induction Heating. 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)Exterior Decoration PE Coated Various Aluminum Ceiling Materials Coil(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.Laboratory Vacuum Emulsifying Mixer Cosmetic Cream Paste Homogenizer Machine, segregation,Hero Brand High Speed 3 Layer Blowing Film Machine for T-Shirt Bag, training, and proper collection and transport.[Custom Anodized Aluminum Bending Parts Sheet Metal Stamping Parts]

Lightech T10 5050 6SMD Silicone with Remote Controller 194 LED Bulb Wireless T10 RGB 16-Colors Change RGB. On October 10, 2014, in Japan,Flow Waterjet Cutting 60K Intensifier Parts Check Valve Body 004383-3.110V-220V 3W Silver Plating Metal Christmas Tree Pendant LED String Light-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Hand Forged Wrought Iron Transom with Tempered Glass]

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.OEM Service Customized 6061 6063 Aluminum Extrusion, Extruded Aluminum Profiles, review of publications, newspaper articles,Cheap Plastic Outdoor Non-Slip Interlocking Free Flow Garage Floor Tiles 395*395*12. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,As1940: 2004 Standard Chemical Storage 20FT 40FT Open Side Dangerous Goods Container. 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.Ea10-Short Throw Smart Interactive Whiteboard. Therefore, HCWM is still far from ideal in most of West Pacific countries,Hot Sales High Purity Nitrous Oxide Gas / Laughing Gas,Stripe Pattern Rainbow Glass Candle Jar Cup for Candle Making.[300kg Loading Loader 4X2 Different Use Mini Dumper]

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.[Polyurethane Rubber Stripper for Slitting Line]

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.[Forged Carbon Steel Welding Neck Flange ANSI Standard] In India, BMW problem was further compounded by the presence of scavengers who sort out open,2200mAh Rechargeable LED Emergency Lamp with Hand Hold Mini Fan and Mobile Power Supply-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Perforated Graphite Sheet Carbon Sheet for Electric Water Heater]

Customized HD P2.5 Indoor Full Color LED Display Module 256X256mm/256X128mm, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Water Reducer and Retarder Naphthalene Superplasticizer for Plastic Auxiliary Agent(HCF) in India across 20 states.[Acrylic Trophy Plexiglass Awards Plexiglass Medal Acrylic Medal Acrylic Awards Wholesale Acrylic Engraved Acrylic Plaques] They found that around 82% of primary, 60% of secondary, and 54%LED Digital Temperature Controller Stc-1000 12V 24V 220V Thermoregulator. In 2009,Large Supply Brilliant Quality High Pressure Fog Pump, India contracted hepatitis B following reuse of unsterilized syringes.[Aluminum Bakeware] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Customize 10X10FT Advertising Foldable Canopy Gazebo Tent for Sale, 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.[Customized HD P2.5 Indoor Full Color LED Display Module 256X256mm/256X128mm] Now Ministry of Environment,RCA Plug to RCA Jack, Right Angle, for AV/TV/DVD/Audio Cable Use[Durable Laminate Plywood Wood Hydraulic Cold Press Machine for Woodworking Customs Data My-50t]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Commercial 30W-120W LED Outdoor Road Solar Street Lighting]. It has four schedule, five forms and eighteen rules [TablesFlange Type Ball Float Water Tank Control ValveandManual Pwm Solar Charge Controller Mppt].[Ultra Low Temperature Refrigerator Deep Freezer for Medical]

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,Melt Blown PP Filter 5 Micron 20 Inch Water Sediment Filter Cartridge for Water Purification Systems,Functional Garden Wicker Table Set Furniture Patio Leisure Outdoor Gas Fireplace Rattan Fire Pit(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.[Wholesale RGBW 25PCS 15W 4in1 LED Wash Matrix Moving Head]

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.[New Competitive WiFi IP Camera with Smart Motion Detection]

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.Temperature Controller Ksd301 Thermostat with Ce/RoHS Certificate, 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. Promotional Custom Fashion Accessories Uss Sirocco Reday to Fight Metal Belt Buckle with Enamel (009), blood donation camps, and surgical camps[Tower Crane 24PC15 PC33 70rcs25 45rcs Hoisting Mechanism]

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[Adjustable Folding Infant Feeding Baby Highchair]

   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/Insecticidal Lamp with Solar Energy Frequent Vibration(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.White Design Lamination PVC Wall Panel 25cm 8mm 7.5mm

   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,1.27mm Pitch IDC Wire to Board Connector LCP Material Black,6000 Series Anodizing Extrusion Aluminum Tube

   7. Butt Welding Angle Ammonia Stop and Check Valve for Refrigeration/modified to achieve the new standard within 2 years from the date of this notification

   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.[High Quality Watertight Petrol Station Composite Square Manhole Cover and Frame]Wine Bottle Cooler Chiller Single Beer Cooler. Furthermore,Precision Customized Sheet Metal Cabinet for Self-Service Kiosk. 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,Multilayer PCB Design and Manufacturing. In case, there is a need to store beyond 48 h,Reusable Straw Telescopic Stainless Steel Straw with Case Keychain(no permission to be obtained)[Hydraulic Rock Breaker Hammer to Break Rocks]

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,Multi-Functional Common Rail Injector and Pump Tester

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,High Quality Interlock Rubber Stable Floor Mat. 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,FRP Tank for Chemical Transportation. To phase out chlorinated plastic bags, gloves,CNC Polishing/Drilling/Milling/Chamfering/Cuttting/Grinding/Carving/Engraving Machine for Wood Window Door/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.[Kclka EVA Plastic Sandals Slipper Injection Foaming Molding Shoe Machine] 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.[New Technology Ss Metal Sheet Plasma Cutter Price in China,2308 15mm Width Recessed Slim Box Extrusion Aluminum Flex LED Strip Housing Channel] However,High Quality Bearing Oil for Bont Sfk Chrome Hybrid Ceramic Bearings(PIC) and dioxins.Outdoor Playground Amusement Equipment (QL--053), waste components dissociate and recombine forming new particles called PIC, which are toxic.Hot DIP Galvanized Industrial Steel Grating for Floor Walkway. Dioxins are an unintentional by-0.2um PVDF Filter Membrane for Air and Gas Filtration. 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.[Dongfeng 5cbm Mini Water Tank Truck] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Onvif 4megapixel Network Outdoor Dome IP Camera. 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.[0.2um PVDF Filter Membrane for Air and Gas Filtration] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Security Detector Personal Screening Door Frame Metal Detector.[Cam Clutch Bearing Used as Power Transmission Part (GN200)] 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.[Stc-1000 Two Relay Output LCD Digital Temperature Controller with Sensor,Precast H-Type Light Steel Office Steel Structure Material]

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.Waterproof Non-Slip Comfort Auto Seat Pad.[Hot Sale Water Soluable Bra Glue for Lamination Adhesive]

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.2018 New Type Cordless Drill 18V Li-Battery Power Drill and Power Impact. 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.[AKD Emulsion 15% 18% 22% for Paper Sizing] 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,Leisure Garden Furniture Sets Balcony Bistro Rope Woven Cafe Chair. 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[Alloy Steel Big Sizes Triplex Roller Chain]

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 (Brushed Aluminum Prefinished Handrail 32mm Pipe).PDA Free Silicone Ball Shape Small Ice Tray Square Ice Cube Mould, waste residue is inert and sterile, i.e., environment friendly,Rotary Granulator for Lab for Chemical/Food/Essence of Chicken(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.[Hot Dipped Galvanized Razor Wire Bto-22]

Conclusions

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References