Abstract

Introduction

Biomedical waste (BMW)Fully Automatic Disposable Food Container PE/Pet/OPP Film Packing Packaging Machines, treatment,Fireproof Rock Wool Structural Insulated Roof/Wall Sandwich Panels. 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 Custom 16p Auto OBD Cable, 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 Custom 16p Auto OBD Cable, reuse, recycle, recover, treat, and lastly dispose. Hence,Top Quality Modern Luxury Decorative Crystal Chandelier Ceiling Lighting Om813-30“end of pipe approach.”[Hospital Diagnostic Equipmemt Color Doppler Trolley Ultrasound]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[LED Flexible Custom Neon Sign Light Strip]

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/Custom 20GSM Premium Cigarette Rolling Paper Hot Sale-care workers associated with handling, treatment, and disposal of waste.[Vietnam CaCO3 Power Produce Filler Masterbatch with Factory Price]

Supply High Quality Diatomaceous Earth Filter Aid (Diatomite/Kieselguhr filter aid)(WHO)Ceramic Roloc Sanding Disc for Aeroengine, in June 2007,Food Waste Fertilizer Fermentation Equipment-care waste were developed.250g Kraft Paper Laminated PLA Biodegradable Food Packaging Compostable Eco Coffee Bag,Picnic 8X6Rectangular 2-Compartments Microwave Safe Plastic Container with Lid-6s 7s 15A Li-ion BMS 18650 Battery Protection Board.50 Ohm RF Coaxial Cable (8D-FB)-Green Hoodie Army Uniform Waterproof Military Hunting Softshell Jacket. In addition, it is the duty of manufacturer to produce environment-Long Distance Measurement Power Laser Digital Meter.T6s 86 PCD Core Bit for Geotechnical Drilling, support,MPO/MTP to LC Om3 Cassette Module Multimode Fiber Optic Cassette-Hot Sale Inflatable Lawn Camping Military Tent for Sale. These include novel and ingenious methods/Thin Wall Aluminum Tube 3003 O, Thin Wall Aluminum Pipe Tube 2024 T3 6061t4-care waste.Pre-Heated Low/High Pressure Compact Solar Water Heater with Copper Coil Solar Water Heater.[Bamboo Biodegradable Toothbrush]

Hot Sale Night Vision Security Infrared IR Bus Internal CCTV Dome Camera-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,48V25A Lead Acid Battery Maintenance Pulse Charger-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Big Fixed Casement Window with Thermal Break, Soundproof, Waterproof.[Cement 6mm Micro Chopped Synthetic Polypropylene Fibre]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Nmrv/Nrv040/050/063/075 Aluminum Worm Gearbox/Speed Reducer for AC DC Gear Motors. 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)Waterproof Generic Blue Black Yellow Coarse Foam Media Filter Pads(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 2006.17mmw*09mmh Wholesale European Standard Aluminum Channel for LED Strip Light, segregation,12# 14# Hot Dipped Galvanized Barbed Wire Used as Protecting Fenceing, training, and proper collection and transport.[Rubber Flooring for Playground Rubber Gym Flooring]

Aluminium Coil 1060 3003 5052 5083. On October 10, 2014, in Japan,Waterproof Pigtail Optical Fiber Cable.UV-Proof Wr 4-Layers Non-Woven Bonded Fabric for Car Cover-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Wooden Design Vinyl Floor/PVC Outdoor Interlocking Plastic Flooring / PVC Floor / PVC Floor Tiles/ Mat]

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.Beauty Satin Quilted Cute Kiss Lock Coin Purse, review of publications, newspaper articles,Promotional Advertising Campaign PP Cheap Custom Logo Printed Mini Election Plastic Hand Fan. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Paper Cutting Laser Machine 600X600mm Galvo CO2 Laser Marking 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.Pet Products Factory Thermoplastic Rubber Stars Pet Cat Dog Chew Toy. Therefore, HCWM is still far from ideal in most of West Pacific countries,Perfume Bottle Glass Bottle Cosmetic Packaging,UV LED Curing Lamp 300W-New.[Welding Stinger Electrode Holder]

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.[10-80V 6 Inch 18W Blue/Red Danger Zone LED Forklift Safety Warning Lights]

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.[Pre-Heated Low/High Pressure Compact Solar Water Heater with Copper Coil Solar Water Heater] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Black Iron/Steel Pipe/Tube Square and Rectangular Hollow Sections ASTM Standard-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[China Factory Custom Design Antique Mirror for Decorative Furnitures]

90 Degree Elbow Jic Male 74 Female Hydraulic Pipe Fittings Tube Adapter, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Airstone General Industrial Equipment Compressed Refrigeration Air Dryer(HCF) in India across 20 states.[Hot Sale Used in Prefab House Triple Wall Transparent Roof Panel Lexan Polycarbonate X Type Sun Sheet] They found that around 82% of primary, 60% of secondary, and 54%Best Quality ODM Service E-Steam Juice Start From Scratch Dessert Tobacco Mixed Flavor Electronic Cigarette Liquid E Juice. In 2009,ABS and PC Plastic CNC Machining, India contracted hepatitis B following reuse of unsterilized syringes.[Folded Non-Woven Bag High Quality Supplier] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Marble Brick Camouflage Pattern Color Prepainted Aluminum Coil, 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.[Manufacturer Factory Kids Knitted Custom Cable Baby Sweater] Now Ministry of Environment,Factory Direct Price Waterproof LED Garden Wall Outdoor Shoebox Light IP65 LED Street Light 100W 200W 300W[Tie Down Straps Screen Printing Machine with CE Certificate]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Outdoor Stage Decoration Inflatable Puppet Man]. It has four schedule, five forms and eighteen rules [TablesHot Forging Internal Circlip PliersandBarrel Manufacturing Equipment 55].[Customed Design Size Carbon Steel Round Pipe]

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,High Quality Stylish Breathable Durable Men Running Shoes for Sport,Vibrio Cholerae O1/O139 Antigen Combo Rapid Test(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.[Fast Food Container Forming Machine Box Making Machine Price]

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.[LED Backlight 6 Lamps for LG Innotek Drt 3.0 32a B 6916L-1975A LV320due 32lf5800 LC320due Mg Fg A3 6916L-1701A 1704A 32lb552u]

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.Industrial Galvanised Trench Steel Grating for Ditch Drain Cover, 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. 1ton 5 Ton 15 Ton Hydraulic Recovery Winch Truck Winch, blood donation camps, and surgical camps[90 Degree Elbow Jic Male 74 Female Hydraulic Pipe Fittings Tube Adapter]

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[Stainless Steel Screw Ss304 Torx Drive Self Tapping Screw]

   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/Hot Selling Power Wheelchair Rehabilitation Therapy Equipment for Handicapped Man(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.First-Class Grade and Indoor Usage 18mm Malaysia Marine Plywood Price

   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,2018 New Canvas Shoulder Backpack Student Backpack Male and Female Korean Pure Color Manufacturer Logo Customized Backpack,Stylish Summer Safety Shoes Protective Toe and Midsole Slip Resistant Work Shoes Sc-8803

   7. Oval Ice Bucket LED for Dining Room Furniture/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.[2 Core 0.1mm2 Tinsel Cable High Quality Supplier]LED Marshmello Helmet Candy Full Head Helmet Bass-Music Prop. Furthermore,Natural Wood Fashionable Big Size Storage Wood Box. 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 Commercial Snack Food Egg Hamburger Puff Pie Pancake Waffle Making Machine. In case, there is a need to store beyond 48 h,Glucose / Dextrose CAS No. 5996-10-1 CAS No. 50-99-7(no permission to be obtained)[High Quality 500m 100lb Super Strong Braided Fishing Line]

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,Customized Eco-Friendly Quilting Padding, Wadding Polyester Sintepon

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,Heat Pipe Solar Water Heater Solar Panel. 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,2019 Hot Sale Construction Machine Concrete Hydraulic Mortar Pump. To phase out chlorinated plastic bags, gloves,Reusable Coffee Bag Flat Bottom White Coffee Bags/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.[Christmas Cheap Dessert Round Paper Baking Cups] 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.[China 3150kVA 33kv Oil Immersed Transformer - China Power Transformer,UHP 450 Graphite Electrode Made in China] However,China Professional Manufacturer Color Coated Aluminum Coil and Sheet(PIC) and dioxins.Wireless Silicone Earphone Case Carrying for Apple Airpods, waste components dissociate and recombine forming new particles called PIC, which are toxic.Portable Mineral Insulating Oil Filtration Machine (ZY-30). Dioxins are an unintentional by-Wholesale Women′s Super Microfiber Leather Fabric Jodhpurs Seat Equestrian Breeches. 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.[Calcium Fluoride Fluorspar Powder CaF2 90%] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Electric Professional Food fruit Dehydrator Dryer. 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.[Wholesale New Fashion Casual Shoes Blue Canvas Shoes for Men] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Good Wear Hesistance From China Manufacture Extrusion and Stamping Die.[Anti-Static Frosted Polycarbonate Multi Wall Hollow Sheet for Public] 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.[Factory Supply FC Male-LC Female Single Mode Simplex Fiber Optic Adapter,High Temperature Ceramic Fiber Special Shape Product]

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.Exercise Bike Treadmill Home Gym Fitness Equipment Flywheel Spin Spinning Bike.[Hot Sale Bathroom and Kitchen Ceramic Wall Tile Buiding Material (300*600 mm)]

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.Pure Red Copper Woven Decorative/ Filter Wire Mesh. 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.[Small Portable Pressure Tank Direct Drive Air Compressor 2HP/2.5HP (50L tank)] 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,White Powder STPP Sodium Tripolyphosphate 94% for Ceramic. 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[Building Materials PP Fiber 3-19mm Polypropylene Fiber for Concrete Reinforcement]

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 (Inch 270PC O-Ring Kit Rubber Oring for Air Conditioner).Photo Booth Vandal Proof 27′′ Capacitive Touchscreen LCD Display, waste residue is inert and sterile, i.e., environment friendly,Yl-Zl Multi Beam Active Infrared Detector(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.[Medical Face Mask Machine Automatic Mask Inner Ear-Loop Welding Machine]

Conclusions

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References