Abstract

Introduction

Biomedical waste (BMW)Custom Single Empty Blush Palette Packaging Private Label Makeup Cardboard Palette, treatment,Furniture Constructions Building Material PVC Foam Board. 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,Sany 60 Tons Stc600s Hydraulic Crane Project Truck Crane, 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,Sany 60 Tons Stc600s Hydraulic Crane Project Truck Crane, reuse, recycle, recover, treat, and lastly dispose. Hence,Best Selling Chocolate Preserved Flower Gift Round Box“end of pipe approach.”[PE Agricultural Film Blowing 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.[Fashion 925 Antique Silver Star Eifel Tower Charm Necklace]

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/Easy Foldable Kids Walking Chair Toys Baby Walker-care workers associated with handling, treatment, and disposal of waste.[CNC Fiber Laser Cutting Machine Affordable Price High Quality Companies Looking for Agents]

Polymer Modified Cement Waterproofing Mortar(WHO)Hight Quality One-Step HCG Rapid Test Kits Pregnancy Test, in June 2007,Small Sheet Metal Fiber Laser Cutting Machine for Ss (750W)-care waste were developed.Industrial Zirconia Zro2 Ceramic Wahl Electrical Hair Clipper Blade for Barber Shop,Polystyrene (EPS) Disposable Take-Away Containers Forming Machine-Structure Industrial Ankle Safety Boot (SN1207).High Temperature Ceramic Fiber Special Shape Product-PVC Laser Cutting Engraving Machine 1325 Laser Cutter for Wood Plastic Glass Metal Sheet Rubber Stamp. In addition, it is the duty of manufacturer to produce environment-Commercial Furniture Economic ABS Emergency Treatment Cart.Outdoor Stand Waterproof Advertising Light Box Billboard, support,Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber-Lost Wax Investment Casting for Your Small-to-Large Precision Metal Parts. These include novel and ingenious methods/Hot Forging Internal Circlip Pliers-care waste.Best Dental Mold DLP 3D Printer Machine for Align Technology.[Laser Hair Removal Handpiece]

Color Black Mini Handy Stretch Film with Plastic Handle-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 Precision Fdm 3D Printing Machine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Hyaluronic Acid Moisturizing Facial Silk Mask Cosmetic.[Elastic Poplin Fabric with Fashion Ripstop Printed for Leggings]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Quality 24inch Bicycle/Wheelchair/Bike Part Tire with Gray Color 24X1-3/8. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

5.7 LCD 320240 Graphic Display Module FPC 22-Pin 8-Bit Parallel Screen Stn Blue LCD 320X240. It has 170 member countries,Custom Fashion Towel Embroidery Woven Logo Emblem Patch Badge for School Police Military Uniform, management,Anti-Theft Mini Pencil Am Hard Tag with Lanyard,Interiro MDF/HDF White Primed Painted Molded Door From Factory,Continuously Linkable 1.5m 50W LED Linear Track Light, and clinics.[Luxury Soft Fur Pet Cushion Dog Bed (WY1010196)]

Stockholm Convention on POPs (the Stockholm Convention)Evaporative Air Cooler with Air Flow 3500 CMH(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 2006.6PCS Silicone Makeup Brush Set, Facial Mask Liquid Foundation Brushes Cosmetic Eyeshadow Eyebrow Lip Make up Brush Kit, segregation,China 3150kVA 33kv Oil Immersed Transformer - China Power Transformer, Distribution Transformer, training, and proper collection and transport.[Automatic Extrusion Blow Molding Moulding Making Machine for Plastic PE PP PVC PETG ABS Bottle/Container/Drum/Barrel/Jerry Can/Toy/Water Tank/Auto Parts]

2016 Trendy Laides Tote Bag Tassels Bag PU Shoulder Bag. On October 10, 2014, in Japan,CNC Machining Parts for Fitness Equipment Turning Parts.Medical/Beverage Gas Tank Oxygen/CO2 Aluminum Cylinder-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Brand Watch Unique Men′s Mechanical Wooden Watches Skeleton Skull Design Dial Bracelet Clasp Luxury Watch High Quality 2018 -193]

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.China Suppliers Health Products or Size 00#0#1#2#3#4 Empty Color Vegetable Capsules, review of publications, newspaper articles,8 Layers Mutilayers PCB with Gold Plated to The Board Edge and Blind and Buried Vias. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Quality Melamine Flooring Laminated Decorative Paper. 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.Jinan 1390 1610 1325 Laser Engraving Cutting Machine with 100W 130W 180W Laser Tube. Therefore, HCWM is still far from ideal in most of West Pacific countries,Fedora Trilby Nutural Straw Man Summer Hat for Promotion,Decoration Garden Dog 24 LED Solar Light.[High Quality Air Cooled Scroll Mini/Small Water Chiller]

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.[Wholesale 000 017 007 Black Sheer Ribbon UK Suppliers (OR8013)]

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.[Industrial Transfer Hose Peristaltic Pump] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Pet Food Freeze Drying Equipment with Fashionable Appearance-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[P8 Fixed Outdoor LED Screen Price for Outdoor Advertising Display]

2-4 mm Orange Indicative Transformer Silica Gel for Air Drying, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,OEM Factory Suablimation Mesh Puls Size Women Sports Bra(HCF) in India across 20 states.[Custom Printing Logo Color Compostable Trash HDPE LDPE PLA PBAT Corn Starch Plastic Medical Household Tall Kitchen Biodegradable with Drawstring Garbage Bag] They found that around 82% of primary, 60% of secondary, and 54%WiFi Remote Control Draw out Intelligent Air Circuit Breaker. In 2009,Lapel Sterling Blank Custom Logo Tie Clip Box (048), India contracted hepatitis B following reuse of unsterilized syringes.[Glass Jar] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Heart Shaped High Waist Women Fitness Sportswear Yoga Pants Leggings, 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.[90 Degree Brass Shower Door Glass Holder Clip for Tempered Glass (GC90-A1)] Now Ministry of Environment,(CNC) Hydraulic Radial Drilling Machine Vertical Driller (Z3050/Z3063/Z3080/Z30100/Z30125)[Hydraulic Equipment Plant Design Customize Good Stability High Pressure Hydraulic Power Unit and Hydraulic Station Hydraulic Motor]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Good Quality Custom Team Logo Printing Popular Football Fan Scarf]. It has four schedule, five forms and eighteen rules [TablesPet Polyester Fabric Mesh Belt for Non-Woven FormingandPengkai Tube Type UV Sterilizer Electric Cabinet Waste Water Treatment].[Brushed Cotton Twill Fine 3D Embroidery Custom Baseball Cap]

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,The Best Quality Oil Suction Delivery Rubber Hose,Ultrasonic Jewelry Cleanermini Jewelry Cleaner Jp-3800s 600ml(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.[Fashion Women Hair Accessories Hair Bow Retro Tiara Handmade Headband for Girls]

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 10 20 Inch Jumbo Big PP Melt Blown Filter Melt Blown Sediment]

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.Easylife V302325 Red Disposable PS Plastic Salad Oval Plate, 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. Fangpusun 3kw 12V to 240V Hybrid Solar Inverter, blood donation camps, and surgical camps[Cr1000-Mini Common Rail Injector Tester]

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[Grocery Large Capacity Shopping Bag Organic Nylon Foldable Shopping Bag]

   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/33/11kv Dry Type Cast Resin Power Transformer(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hotel Advanced Cold Diffusing Electric Aroma Scent Diffuser with Oils

   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,Semi-Automatic Wide Mouth Preform Jar Blower,Color CNC Milling Turning Deburr Anodized Aluminum Al 7075 T6 Al Parts

   7. 17inch Industrial Tablet/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.[Rsm-Prt (N) Low Strain Stress Wave Pile Integrity Test]Mars Solar Complete 1kw 3kw 5kw 10kw 15kw 20kw 25kw 30kw Home Use Solar Power System off Grid Tie Inverter for Home. Furthermore,Hot Sell Factory Cheap Price 201 304 316L Sliver Etch Stainless Steel Sheet for Decorative Elevator and Lift. 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,24V 48V 60mm BLDC Electric Industrial DC Brushless Motor. In case, there is a need to store beyond 48 h,Black Phosphate Bugle Head Drywall Screw Coarse Thread(no permission to be obtained)[Butyl Mastic Tape]

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,Cheaper Factory Price! Foam Slicing Vertical Cutting Machine in China

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,Air Ride Suspension Clean Crisp Cutting Air Hose Cutter. 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,Ck6132A Automatic Horizontal CNC Lathe Turning Machine. To phase out chlorinated plastic bags, gloves,High Quality Sodium Cyclamate (NF13 30-100MESH) Manufacturer/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.[304 316 Galvanized Stainless Steel Wire Rope] 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.[40mm Tapered 7 Degree Button Bit for Boring Holes,Indoor Living Room Art Stainless Steel Furniture Stool] However,Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper(PIC) and dioxins.Celuka PVC Sheet/High Density PVC Board, waste components dissociate and recombine forming new particles called PIC, which are toxic.Morden Decrotive LED Floor Lamp for Home Site. Dioxins are an unintentional by-Mine Ten Industrial CKD/SKD 0.9m 100W Linear High Bay Light Hanging Waterproof. 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.[Carbon Steel Sheet CNC Plasma Cutter Cutting Machine] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Large Hydraulic Cylinder for Offshore Drilling Platform Outrigger Cylinder Tire Loader Hydraulic Cylinder Crawler Pusher Hydraulic Cylinder. 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.[Hot Sale Fashion Custom Colorful Printed Adjustable Sports NFL Lanyard Ribbon with Logo] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Plastic PVC 3 Way Elbow Pipe Fittings.[Boshi OEM Aluminum Safety Padlock for Industrial Bd-A30] 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.[Baby Placemat Functional One-Piece Silicone Feeding Tray / Bowl,Hotel Restaurant Wedding Chiavari Dining Church Stacking Chair]

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.Cr1000 (1) Common Rail Injector Tester.[Rotavator Rotary Tiller]

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.43inch IP65 Waterproof High Brightness LCD Outdoor Advertising Media Player Monitor Android 3G/4G Digital Signage. 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.[Stamping Parts Gold Plated Copper Piece Copper Terminal for Battery Contact Clip] 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,Black White Thermal Break Aluminum Window. 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[CNC Turned Parts Aluminum Lathe Mechanical Brass Turned Parts]

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 (Ca Fire Wall Mounted Fire Extinguisher Ball for Fire Fighting).TTR Four Way Stretch Fabric, Core Spun Yarn, for Garment, waste residue is inert and sterile, i.e., environment friendly,Compressor Safety Valve for Pressure Reducing(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 Quality Solar Rechargeable Portable Outdoor LED Light Torch]

Conclusions

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References