Abstract

Introduction

Biomedical waste (BMW)Vibrio Cholerae O1/O139 Antigen Combo Rapid Test, treatment,Industrial Galvanised Trench Steel Grating for Ditch Drain Cover. 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,1ton 5 Ton 15 Ton Hydraulic Recovery Winch Truck Winch, 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,1ton 5 Ton 15 Ton Hydraulic Recovery Winch Truck Winch, reuse, recycle, recover, treat, and lastly dispose. Hence,Hot Selling Power Wheelchair Rehabilitation Therapy Equipment for Handicapped Man“end of pipe approach.”[Door and Window Hardware Aluminum Alloy Square Window Handle]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Silver Foil Stretchy Polyamide Elastane Knitted Fabric Dance Wear]

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/First-Class Grade and Indoor Usage 18mm Malaysia Marine Plywood Price-care workers associated with handling, treatment, and disposal of waste.[Cixi Split Type Waste Well Water Digital Flow Meter]

Stainless Steel Morgue Refrigerator &Corpses Freezer(WHO)Hls-120 High Quality Low Budget Mobile Portable Line Boring Machine for Excavator Digger, in June 2007,2018 New Canvas Shoulder Backpack Student Backpack Male and Female Korean Pure Color Manufacturer Logo Customized Backpack-care waste were developed.Stylish Summer Safety Shoes Protective Toe and Midsole Slip Resistant Work Shoes Sc-8803,Oval Ice Bucket LED for Dining Room Furniture-LED Marshmello Helmet Candy Full Head Helmet Bass-Music Prop.Natural Wood Fashionable Big Size Storage Wood Box-Mini Commercial Snack Food Egg Hamburger Puff Pie Pancake Waffle Making Machine. In addition, it is the duty of manufacturer to produce environment-Glucose / Dextrose CAS No. 5996-10-1 CAS No. 50-99-7.Customized Eco-Friendly Quilting Padding, Wadding Polyester Sintepon, support,Heat Pipe Solar Water Heater Solar Panel-Type C to 3.5F audio adapter for mobile phone. These include novel and ingenious methods/High Barrier Food Grade Laminated Plastic Heat Sealing Vacuum Seafood Packing Frozen Food Packaging Bags-care waste.Med. Apolo PDT LED Anti-Ageing Photodynamic Therapy Beauty Equipment.[Night Vision Thermal Clip on Xinfrared Cl42 for Outdoor Detection]

Trusty Sjsz-80 PVC Marble Sheet Production Euqipment Supplier-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,M3 Flat Head Knurled Round Body Blind Rivet Nut ISO13918-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,5MP UHD CCTV Camera 4in1 Tvi Ahd Cvi IP66 IR Starvis Night Vision Outdoor.[Fashion Funny Outdoor Manual Wooden Toys for Children (TY-1908907)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Quality Cheap Cross Rainbow Elastic Telescopic Bag Bungee Luggage Packing Belt Travel Luggage Fixed Strap (ESG11036). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Effective Portable Skin Anti-Wrinkle Machine Micro Needle Fractional RF Equipment. It has 170 member countries,Industrial Transfer Hose Peristaltic Pump, management,Lifting Rigging M16 Stainless Steel304/316 Cable DIN1480 Turnbuckles with Eye-Hook,New Hyundai Mini 7ton Hydraulic Crawler Excavator R75vs,20X20′ Aluminum Frame Digital Camouflage Military Tent for Sale, and clinics.[Plastic End Caps and Covers for Pipes and Tubes (YZF-C13)]

Stockholm Convention on POPs (the Stockholm Convention)EU Plug 2.1A Mobile Phone Portable Wall Travel Home Charger(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 2006.2019 Hot Sale Construction Machine Concrete Hydraulic Mortar Pump, segregation,Reusable Coffee Bag Flat Bottom White Coffee Bags, training, and proper collection and transport.[Woven PP Cement Sand Valve Bag Ad Star PP Bags]

China Professional Manufacturer Color Coated Aluminum Coil and Sheet. On October 10, 2014, in Japan,Wireless Silicone Earphone Case Carrying for Apple Airpods.Portable Mineral Insulating Oil Filtration Machine (ZY-30)-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Customized Needle Detector for Blankets Industry]

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.Wholesale Women′s Super Microfiber Leather Fabric Jodhpurs Seat Equestrian Breeches, review of publications, newspaper articles,Electric Professional Food fruit Dehydrator Dryer. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Good Wear Hesistance From China Manufacture Extrusion and Stamping Die. 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.Exercise Bike Treadmill Home Gym Fitness Equipment Flywheel Spin Spinning Bike. Therefore, HCWM is still far from ideal in most of West Pacific countries,Pure Red Copper Woven Decorative/ Filter Wire Mesh,White Powder STPP Sodium Tripolyphosphate 94% for Ceramic.[Home Mini Ice Maker Machine Factory OEM/ODM Products]

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.[Ep200 Transport Rubber Conveyor Belt]

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.[Custom Bare Copper Busbar Power Connector] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Inch 270PC O-Ring Kit Rubber Oring for Air Conditioner-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Raymo 2b 2 Pin Egg ECG Circular Panel Socket/Connector]

Photo Booth Vandal Proof 27′′ Capacitive Touchscreen LCD Display, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Yl-Zl Multi Beam Active Infrared Detector(HCF) in India across 20 states.[Graphite Rotator] They found that around 82% of primary, 60% of secondary, and 54%LED Projection Wall Washer Light IP65 Anti-Salt Fog 6W 18W 36W 72W 120W Factory Direct. In 2009,Factory Price and Hot Sell OEM 13540-20021 Auto Belt Tensioner, India contracted hepatitis B following reuse of unsterilized syringes.[Quality A4 Red / Orange /Green PVC Lever Arch File Folder] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Dental Pulp Tester, 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.[43inch IP65 Waterproof High Brightness LCD Outdoor Advertising Media Player Monitor Android 3G/4G Digital Signage] Now Ministry of Environment,Lager Beer in Bulk[Colorfull Craft Paper Bags 25kg Industrial]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [10′granular Activated Carbon Filter Cartridge / Udf /GAC Water Filter Cartridge]. It has four schedule, five forms and eighteen rules [TablesCurrent Meter for Measuring The Current of Electrical CabinetandHigh Silica Fiberglass Fabric].[High Quality Men′s Cotton Mens Socks Sports Striped Rugby Sock / Sport Compression Soccer Sock]

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,(5X4X4.0mm-4BB) Stainless Steel Ball Bearing Wooden Door Hinge,Solar Accessory Solar Cable Clip(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.[Flexible Laminates Electrical Insulation Material Nmn/ UL Certificate]

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.[Stainless Steel Pipe Fitting 316 Union of Male/Female 3/4 Inch]

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.Iridium Spark Plug for Motorcycle, 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. Waste Paper Recycle Used Egg Tray Machine/Automatic Paper Pulp Egg Tray Production Line/Small Machine Making Egg Tray, blood donation camps, and surgical camps[Auto Car Parts Oil Filter (26300-02501) (Toyota]

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[2D Motif Light Outdoor Waterproof LED Christmas Tree Decoration Rope]

   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/Triplex Service Drop Aluminum Cable with Al Conductor(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale Solidwood Viola Made in China

   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,Composite Toe Puncture Resistant Safety Work Shoes,Indoor Living Room Art Stainless Steel Furniture Stool

   7. Waste Water Treatment Mechanical Bar Screen/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.[Adjustable Silicon Wristband]Wood Chipper Machine Price. Furthermore,Wholesale and Manufacturer 10 Ton 15ton 20 Ton Hydraulic Winch. 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,Top Quality Custom Composite Ice Hockey Stick. In case, there is a need to store beyond 48 h,Rechargeable AAA 3.6V 700mAh NiMH Battery for Cordless Phone(no permission to be obtained)[HPMC / HEC / Mhec Manufacturer Supply Industrial Chemical for Dry Mortar Machines]

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,High Impact Support Sports Bra Yoga Gym Workout Fitness

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,Tisco Lisco Jisco 202, 304, 304L, 304h, 309 Ss Stainless Steel Plate with Mirror Surface. 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,Real Silver Cubic Zirconia Round Shaped Rhinestone Necklace with Minimalist Style. To phase out chlorinated plastic bags, gloves,High Temperature UL Certificated Teflon Wire and Cable/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 Effective Good Quality Popular Dog Chews 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.[Hudraulic Excavator Scrap Grab for Waste Steel Grabber for Scrap,Silver Mirror Glass High Reflective Polished Mirror Finish Aluminum Coil] However,100kw Cummins Diesel Generator Set(PIC) and dioxins.Flexible Laminates Electrical Insulation Material Nmn/ UL Certificate, waste components dissociate and recombine forming new particles called PIC, which are toxic.Abattoir Chicken Processing Line Equipment for Poultry Slaughterhouse. Dioxins are an unintentional by-Ximi Group Supply Talc Powder, Use for Ceramics Grade, White Powder, 200mesh, High Quality with ISO Certificaiton.. 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.[Electronic Plastic Part Tooling Suppliers for Sale] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,60K Intensifier Part Waterjet Outlet Body C-1313-1. 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.[6PCS Silicone Makeup Brush Set] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,High Quality Stainless Steel Waterfall Thermostatic Shower Set for Bathroom Tbf-61002.[Aprobado Attt Panama Red White 3m Reflective Tape Road Safety] 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.[Manufacturers Wholesale Custom Sports Medal with Metal,Foam Plastic CNC Router for Shape Cutting Engraving]

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.Cixi Split Type Waste Well Water Digital Flow Meter.[Empty Champagne Bottles]

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.Water/Hydro/Hydraulic Bursting Strength Tester Carton Bursting Test. 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.[OEM Manufacture Fashion Wide Leg Pleated Women Trouse Pant] 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,PVC Pipe Making Machine, UPVC Water Tube Extruder Machine. 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[Decorative Interior Wall Panels Melamine Slotted MDF Board]

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 (LPG Turbine Pump for Two Dual Hose LPG Dispenser).Free sample HF 13.56MHz programmable RFID ICODE SLI smart ID Card, waste residue is inert and sterile, i.e., environment friendly,Stainless Steel Eccentric Reducer (YZF-F377)(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 Reliability SC/APC Male-LC Female Single Mode Simplex Fiber Optic Adapter]

Conclusions

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References