Abstract

Introduction

Biomedical waste (BMW)Disposable PVC EVA Anesthesia Ventilator Breathing Circuit, treatment,Luzhong-700 70HP 2WD Two Wheel Drive Farm Tractor. 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,Guangzhou Manufacturer Modern Matte Melamine Wooden Wholesale Kitchen Cabinets (OP15-M10), 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,Guangzhou Manufacturer Modern Matte Melamine Wooden Wholesale Kitchen Cabinets (OP15-M10), reuse, recycle, recover, treat, and lastly dispose. Hence,AVR Se350 Automatic Voltage Regulator for Marathon Alternator“end of pipe approach.”[Pneumatic Control Shuttle Valve Bsp Thread]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[High Quality Stylish Breathable Durable Men Running Shoes for Sport]

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/New Hot Design Super Soft 2 Ply Baby Blanket Newborn Colorful Bedsheet Throw-care workers associated with handling, treatment, and disposal of waste.[Heat Resistant Double Wall Glass Coffee Mug Water Bottle]

Garment Hydro Extractor 220kg, 500kg Large Quantity (SS)(WHO)nellcor non-oximax 7pin infant disposable sensor, in June 2007,Hot Sales Artificial Synthetic Faux PU Leather for Chair /Sofa -Denim-care waste were developed.Ral9010 High Pressure Laminate Composite Honeycomb Core Panels,Custom Design Silicone Wristband for Promotion-79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set.Strong Transparent Clear Tiffany Acrylic Chiavari Chair for Event Wedding-Vinyl Laminated Plywood Lighting Cable Case with Dividers and Casters. In addition, it is the duty of manufacturer to produce environment-Reusable Plastic Concrete Formwork Making Machinery.Wholesale 16oz Custom Beer Pint Glass Gift Box, support,SGS Prefab Steel Industrial Warehouse Garage Shed China Supplier-3D Waved MDF Decorative Wall Panel 15mm. These include novel and ingenious methods/OEM Manufacture Fashion Wide Leg Pleated Women Trouse Pant-care waste.Wholesale Latest Fashion Leaf Pendant Gold Plated Necklace.[2018 New Style High Quality Enamel Bowl with Lid]

Q Series Intelligent Automatic Catering Oil-Water Separator-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,E-Bike/E-Scooter Intelligent DC Rapid Charging Station-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,One Person Scotland Bath Sky Star Color Light Wet Steam Shower Room.[PVC Dwv Plumbing Tripple (CROSS) (ASTM DWV D 2665)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Plastic Flooring Peel and Stick Flooring Wood Look Flooring. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Silvery Double Sides Reflective Stretch Fabric, High Visibility Reflective Fabric Tape, Reflex Materials. It has 170 member countries,Compact Bevel Right-Angle Planetary Gearbox for Servo Reducer, management,Plain White Square Cake Boxes Single Window,Supply 100ml Small Glass Bottle Perfume Bottle with Spray Color,1325 150W 280W CO2 Wood MDF Acrylic Metal Laser Cutting Machine, and clinics.[DIN444 Standard Rigging with Eye Bolt Type]

Stockholm Convention on POPs (the Stockholm Convention)Betaine Anhydrous /Betaine Monohydrate/Betaine Hydrochloride/Betaine Salicylate(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.Customized Steel Fabrication Welding Process Service, segregation,Hand Tools High Quilty Water Pump Pliers, training, and proper collection and transport.[Event /Party / Bar Furniture Light up LED Furniture Plastic Furnishing]

Dynamic Cw-200 Belt Conveyor Check Weigher. On October 10, 2014, in Japan,Changing Room Easy to Clean Anti-Bacterial Hospital Patient Locker.Roll-on Bottles Reusable Refillable Glass Perfume Essential Oil Bottles-care services, including mercury-containing medical items such as thermometers and blood pressure device.[IEC Standards 12V Time Delay Relay for Industrial Green Energy]

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.Raw White Soft Flame Retardant Batting for Mattress, review of publications, newspaper articles,Dry Type Permanent Magnetic Roll Separator Cr Series with 16000GS High Intensity. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,A Grade Fined Pore Silica Gel in White Ball Shape for Air Drying. 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.High Quality Portable Outdoor Fast Inflatable Lounger Sofa. Therefore, HCWM is still far from ideal in most of West Pacific countries,Maglev Wind Turbine for Bts,Fb-Bt18 Bluetooth Dual Mode Wireless Serial Port-Module Hc05-Replaced Support Small-Program.[3-Ply Face Mask]

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.[New Design Bb Blending Machine Fertilizer Mixer for Sale]

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.[Customized Color Regular Size Plastic Guardrail Reflector for Traffic Safety] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Water Filter Polyester Non-Woven Fabric-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Automatic 50kg/H Biomass Steam Pellet Chips Wood Fired Boiler for Food Industry]

Garden Fork Good Quality Carbon Steel Fork Head Garden Fork, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Customed Design Size Carbon Steel Round Pipe(HCF) in India across 20 states.[Tungsten Carbide Wire Thread Dies for Galvanized Metal Sheets] They found that around 82% of primary, 60% of secondary, and 54%Microfiber Towel Car Drying Soft Towel. In 2009,Motor Bearing 6014 2RS Deep Groove Ball Bearing, India contracted hepatitis B following reuse of unsterilized syringes.[Butterfly Valve] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Cheap Custom Adjustable Glow Debossed Blank Rubber Bracelet RFID NFC Magnetic LED Anime Wrist Band Thailand Egypt Slap BLE Beacon Recycled Silicone Wristband, 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.[Latest Design Personalized Copper Fashion Jewelry 18K Gold Plated Cubic Zirconia Big Hoop Earrings for Women] Now Ministry of Environment,Automatic Cup Mineral Water Juice Liquid Filling and Sealing Machine[Precision Injection Mold Parts From China Made]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [EVA PVC TPR Sole Twin Screw Plastic Granules Making Machine]. It has four schedule, five forms and eighteen rules [TablesBlack White Thermal Break Aluminum WindowandCheap price Worganic Fertilizer Granulation Machine - 30,000 Tons/year Rotary Drum Granulator Production Line - Exceed ].[Disposable PVC EVA Anesthesia Ventilator Breathing Circuit]

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,Landscape Decorative Frosted Glass Gemstone,Disposable White Styrofoam Food Containers Production Line(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.[Wireless Bluetooth Earphones Headphones Airpods for Apple iPhone Samsung Android]

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.[CNC Aluminum Decorative Wall Panel for Metal Curtain Wall & Facade]

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.API5l Spiral Welded Pipe/SSAW/Saw Steel Pipe, 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. Construction Site Wire Mesh Lockers for Workman, blood donation camps, and surgical camps[Plasma Cutting Machine Paper Cutting Machine Grass Cutting Machine]

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[China Professional Manufacturer Color Coated Aluminum Coil and Sheet]

   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/Hydraulic Cylinder Parts Equipment Hydraulic Cylinder Manufacturers(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Blister Aluminium/Aluminum Foil with Lacquered for Troches Packaging

   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,Log Debarker, Peeling Head, Log Peeling Head, Heavy Duty Log Peeling Head, Wood Peeling Lathe,Wholesale Metal Medal Hollow out Design Running Souvenir

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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.[Manual Gas Manifold for Hospitals Using]Large Diameter Pressure Spring. Furthermore,High Tensile Strength Ehs Grade Galvanized Steel Wire Strand Cable 3/8′′ 5/16′′ 1/4′′. 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,Acrylic Optical PMMA Lenses with Different Dimension. In case, there is a need to store beyond 48 h,Boshi OEM Aluminum Safety Padlock for Industrial Bd-A30(no permission to be obtained)[Haivol 18/20kv High Voltage 1-Core Cold Shrinkable Joint Kit Applicable of Cable Cross-Section 400mm^2]

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,2inch Gasoline Water Pumps (168f, 5.5HP,)

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,Wholesale Hotel 100 Cotton Yarn Dyed Stripe Swimming Beach Towel. 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,45cm Reflective PE Outdoor Convex Mirror. To phase out chlorinated plastic bags, gloves,Lower Price 15-35HP Tractor Pto Driven Wood Chipper Shredder for Sale/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.[Dead Sea Mud /Aloe & Dead Sea Mud/Snail &Dead Sea Mud Black Mask Remove Blackhead Mask Box-Packed] 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.[Garden Fork Good Quality Carbon Steel Fork Head Garden Fork,Plumbing Crimping Tool Hydraulic Crimping Tool for 1/2′′ to 3/4′′] However,Hot Sell Aluminum Metal Chain Link Curtain Used at Indoor(PIC) and dioxins.Kingtons E Cig Disposable Electronic Cigarette 108 Cbd-L Cbd Vaproizer, waste components dissociate and recombine forming new particles called PIC, which are toxic.Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara. Dioxins are an unintentional by-Large Capacity 30-40t/Hour Wood Chipping Machine. 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.[Long-Lasting Moisture Hair Barber Shop Hot-Sale Beard Daily Care Oil] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Pet Grooming Tool 2 Sided Undercoat Rake for Cats & Dogs - Safe Dematting Comb for Easy Mats & Tangles Removing -Pet Brush-Cat Grooming-Grooming Tool Esg10690. 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.[6mm/8mm UV Resistant Waterproof and Fireproof Exterior Compact Board] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Acoustic False Ceiling Suspended Accessories Furring Channel Price/ T Grid.[2018 New 1000W Citycoco Electric Scooter] 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.[ Carton Factory,Hot Sale High Quality Carbon Steel Rivet Nut]

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.Supermarket Steel Retail Display Beam Hooks.[Wood Chip Conveyor]

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.Beer Custom Cooler Full Color Print PP Non Woven 6 Can Cooler Bag. 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.[SUS304 Ba Polished Hot/Cold Rolled Stainless Steel Coils 201] 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,3D Printer Plastic Filament Extruder. 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[Casting Timone Cultivator Point/ Blade for Agricultural Machinery Tillage Use]

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 (Channel Connector (HDG) for Top Quality PV Project).Precision Custom CNC Machining Aluminum Router Car Parts Manufacturer, waste residue is inert and sterile, i.e., environment friendly,Disposable Take out Paper Food Salad Sushi Lunch Box Container(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.[16mm Rotary Potentiometer with Switch Carbon Potentiometer B10k B100k]

Conclusions

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References