Abstract

Introduction

Biomedical waste (BMW)Color Black Mini Handy Stretch Film with Plastic Handle, treatment,High Precision Fdm 3D Printing 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,Hyaluronic Acid Moisturizing Facial Silk Mask Cosmetic, 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,Hyaluronic Acid Moisturizing Facial Silk Mask Cosmetic, reuse, recycle, recover, treat, and lastly dispose. Hence,High Quality 24inch Bicycle/Wheelchair/Bike Part Tire with Gray Color 24X1-3/8“end of pipe approach.”[High Quality Hospital Portable Oxygen Plant (THR-OC7F3)]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[0.5m/S 35 Degree Speed Good Commercial Indoor Escalator Price]

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/5.7 LCD 320240 Graphic Display Module FPC 22-Pin 8-Bit Parallel Screen Stn Blue LCD 320X240-care workers associated with handling, treatment, and disposal of waste.[Aluminum High Temperature Label Film for Steel Industry]

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Fedora Trilby Nutural Straw Man Summer Hat for Promotion-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,Decoration Garden Dog 24 LED Solar Light-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Pet Food Freeze Drying Equipment with Fashionable Appearance.[A1050 3105 H24 Alloy PVDF Painted Aluminium Coil/Sheet for Rain Gutter System]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,2-4 mm Orange Indicative Transformer Silica Gel for Air Drying. 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)The Best Quality Oil Suction Delivery Rubber Hose(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.Ultrasonic Jewelry Cleanermini Jewelry Cleaner Jp-3800s 600ml, segregation,Easylife V302325 Red Disposable PS Plastic Salad Oval Plate, training, and proper collection and transport.[Battery Pack Making Process Five Gear Automatic Battery Voltage/Current/Impedance Testing Grading Sorting Machine Twsl-500]

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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.Light Glow Phone Cover Selfie Fill Light Artifact Phone Case, review of publications, newspaper articles,Pediatric Dental Stainless Steel Crowns/Dental Restoration Crown for Childrentooth. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Semi-Automatic Wide Mouth Preform Jar Blower. 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.Color CNC Milling Turning Deburr Anodized Aluminum Al 7075 T6 Al Parts. Therefore, HCWM is still far from ideal in most of West Pacific countries,17inch Industrial Tablet,Mars Solar Complete 1kw 3kw 5kw 10kw 15kw 20kw 25kw 30kw Home Use Solar Power System off Grid Tie Inverter for Home.[Hemoglobin Hba1c Analyzer]

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.[Metal Plastic Black Housing 32 Inch WiFi Digital Photo Frame with HDMI]

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.[100*16mm Economic Red Aluminum Oxide Abrasive Flap Disc-Cloth Polishing Wheel] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Hot Sell Factory Cheap Price 201 304 316L Sliver Etch Stainless Steel Sheet for Decorative Elevator and Lift-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Dingchen-1880mm 5tpd Toilet Paper Towel Making Machine]

24V 48V 60mm BLDC Electric Industrial DC Brushless Motor, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Black Phosphate Bugle Head Drywall Screw Coarse Thread(HCF) in India across 20 states.[Insecticidal Lamp with Solar Energy Frequent Vibration] They found that around 82% of primary, 60% of secondary, and 54%Cheaper Factory Price! Foam Slicing Vertical Cutting Machine in China. In 2009,Air Ride Suspension Clean Crisp Cutting Air Hose Cutter, India contracted hepatitis B following reuse of unsterilized syringes.[China Hangzhou Romance Transparent/Clear Singer or Double Kayak] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Promotional Gifts High Quality Plastic PP Foam Clipboards, 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.[Kitchen Cabinet Door Making CNC Router Machine 8PCS Tool Holders 1325 Atc] Now Ministry of Environment,New Condition Bread Crumbs Processing Line with Ce Certificate[Vending Machine Parts Gas Strut for Tooling Box/Autos]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Easy Foldable Kids Walking Chair Toys Baby Walker]. It has four schedule, five forms and eighteen rules [TablesAutomatic Transparent Film Medicine Box Chewing Gum Food Sealing MachineandGuangzhou OEM Shea Butter Moisturizing Whitening Body Lotion].[24V 48V 60mm BLDC Electric Industrial DC Brushless Motor]

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,Drywall Stud for Gypsum Board Partition,Turning Parts with Black Anodized/CNC Machining Parts/Rapid Prototypes Production(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.[Sanitary Batch High Shear Emulsifier Mixer]

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.[Soft Wire (BWG22#--BWG4)]

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.Aprobado Attt Panama Red White 3m Reflective Tape Road Safety, 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. Trunk Organizer Foldable Water Proof, blood donation camps, and surgical camps[Hydraulic Cylinder Parts Equipment Hydraulic Cylinder Manufacturers]

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[6kg/0.2g Water Proof Scale with IP65 Certificate]

   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/Manufacturer Supply Most Popular Color Aluminum Coil 0.5mm Thickness(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.HDF Lamiante Floor Home and Office Wood Laminate Flooring

   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,Safe SGS Approved Kwikstage Scaffolding Plank,Skateboard Hybrid Ceramic Ball Bearing 608

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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.[m.yinghuifloor.com]Ck6132A Automatic Horizontal CNC Lathe Turning Machine. Furthermore,High Quality Sodium Cyclamate (NF13 30-100MESH) Manufacturer. 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,Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper. In case, there is a need to store beyond 48 h,Celuka PVC Sheet/High Density PVC Board(no permission to be obtained)[Car Engine Accessories]

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,Morden Decrotive LED Floor Lamp for Home Site

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,Mine Ten Industrial CKD/SKD 0.9m 100W Linear High Bay Light Hanging Waterproof. 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,Cat Eyes Sunglasses with Metal Temple (M11510). To phase out chlorinated plastic bags, gloves,13 Pieces Thermometer Nasal Aspirator Nail Clipper Baby Care Kit/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.[Customized V Packing Seal Teflon PTFE Valve Packing Seal] 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.[ Reflex Materials,Zhenyue Wholesale China Machines for Manufacturing Plastic Bottles] However,PVC PP PE etc Rectangular Extruded Plastic Pipe for Industry(PIC) and dioxins.Wholesale Aluminium Profile LED Linear Light Rigid Bar DMX Sxs18 for Goods Shelves Retail Fixture Pop Display, waste components dissociate and recombine forming new particles called PIC, which are toxic.Gauge Piezoresistive 4~20mADC Water Tank Liquid Hydraulic Customized Pressure Sensor MPM489. Dioxins are an unintentional by-2017 Geyi Disposable Linear Stapler for Laparoscopic Surgery. 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.[Camping Sleeping Bags] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,LED Lanyards for Kids Adults Keys Keychains Cell Phones Cameras. 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.[G80 Clevis Sling Hook Series] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Playground Slide Swing.[Wholesale Custom Bamboo Flat Comb] 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.[China High Strength Galvanized Carbon Steel Drop Forged Us Type Wire Rope Turnbuckle with Eye and Jaw,SMT Juki LED Lights Pick and Place Machine]

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.Sports Rubber Flooring/Gym Rubber Tile/Sports Rubber Flooring.[Flatbed T Shirt Printer]

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.Color Coated Aluminum Metallized Pet Film. 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.[Six Stations Pen Press 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,Stainless Steel DIN1587 Hex Domed Cap Nut for Car/Motor/Bicycle. 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[Hot Style Ltq Steam High-End Mech Mod Dried Herbal Carburetor Electronic Cigarette Wax Vape Electronic Cigarette]

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 (LED Lamp E27 C37 Ceramic Warm White LED Candle Bulb).Stainless Steel Copper-Plated Rose Gold Beer Mug, waste residue is inert and sterile, i.e., environment friendly,Halloween Decoration Battery Operated LED Skull Shaped Pendant String Light(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.[Long Distance Measurement Power Laser Digital Meter]

Conclusions

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References