Abstract

Introduction

Biomedical waste (BMW)Commercial Furniture Economic ABS Emergency Treatment Cart, treatment,Outdoor Stand Waterproof Advertising Light Box Billboard. 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,Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber, 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,Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber, reuse, recycle, recover, treat, and lastly dispose. Hence,Lost Wax Investment Casting for Your Small-to-Large Precision Metal Parts“end of pipe approach.”[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]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[China Best Price Sweet Donut Bread Mini Donut Packing Machine]

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/Hot Forging Internal Circlip Pliers-care workers associated with handling, treatment, and disposal of waste.[Coil Winder Accessories Tension Controller Device Coil Winding Machine Magnetic Tensioner]

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CNC Machining Parts for Fitness Equipment Turning Parts-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,Medical/Beverage Gas Tank Oxygen/CO2 Aluminum Cylinder-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,China Suppliers Health Products or Size 00#0#1#2#3#4 Empty Color Vegetable Capsules.[China Exporter Hydraulic Control Valve Dlt3a/4 for Combine Harvester]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,8 Layers Mutilayers PCB with Gold Plated to The Board Edge and Blind and Buried Vias. 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)2-4 mm Orange Indicative Transformer Silica Gel for Air Drying(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.OEM Factory Suablimation Mesh Puls Size Women Sports Bra, segregation,WiFi Remote Control Draw out Intelligent Air Circuit Breaker, training, and proper collection and transport.[Custom Colorful Silk Easy to Tear 3 Sides Sealing cosmetic Bags for Facial Mask Eye Mask]

Lapel Sterling Blank Custom Logo Tie Clip Box (048). On October 10, 2014, in Japan,Heart Shaped High Waist Women Fitness Sportswear Yoga Pants Leggings.(CNC) Hydraulic Radial Drilling Machine Vertical Driller (Z3050/Z3063/Z3080/Z30100/Z30125)-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Miniature Size 5A DC24V Power Relay for Smart Meter]

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.The Best Quality Oil Suction Delivery Rubber Hose, review of publications, newspaper articles,Ultrasonic Jewelry Cleanermini Jewelry Cleaner Jp-3800s 600ml. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Easylife V302325 Red Disposable PS Plastic Salad Oval Plate. 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.Fangpusun 3kw 12V to 240V Hybrid Solar Inverter. Therefore, HCWM is still far from ideal in most of West Pacific countries,33/11kv Dry Type Cast Resin Power Transformer,Hotel Advanced Cold Diffusing Electric Aroma Scent Diffuser with Oils.[China Auto Rapid Rolling Doors]

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 Water Jug BPA Free]

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.[OEM Farm Garden Wrought Iron Metal Casting Fence Head] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Light Glow Phone Cover Selfie Fill Light Artifact Phone Case-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[20kg-50000kg/Industrial Ice Cube Making Machine]

Pediatric Dental Stainless Steel Crowns/Dental Restoration Crown for Childrentooth, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Semi-Automatic Wide Mouth Preform Jar Blower(HCF) in India across 20 states.[Manufacturer Supply Most Popular Color Aluminum Coil 0.5mm Thickness] They found that around 82% of primary, 60% of secondary, and 54%Color CNC Milling Turning Deburr Anodized Aluminum Al 7075 T6 Al Parts. In 2009,17inch Industrial Tablet, India contracted hepatitis B following reuse of unsterilized syringes.[Trailer Parts] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Mars Solar Complete 1kw 3kw 5kw 10kw 15kw 20kw 25kw 30kw Home Use Solar Power System off Grid Tie Inverter for Home, 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.[Tuya Tybt4 Tlsr 8266 Bluetooth/BLE 4.0 Module Chip Develop and Design] Now Ministry of Environment,Hot Sell Factory Cheap Price 201 304 316L Sliver Etch Stainless Steel Sheet for Decorative Elevator and Lift[New Product Electric Bicycle Aluminum Bicycle Heavy Duty Ebike]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [S8800c Micro Crystal Dermabrasion Nitrous Oxide Sale System]. It has four schedule, five forms and eighteen rules [TablesPromotional Advertising Campaign PP Cheap Custom Logo Printed Mini Election Plastic Hand FanandIron Steel Oxford Butt Hinge Ball Bearing Door Hinge (4X3X2.5mm/3mm-4BB)].[New Fan Cogged Belt in China (AX BX CX)]

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,24V 48V 60mm BLDC Electric Industrial DC Brushless Motor,Black Phosphate Bugle Head Drywall Screw Coarse Thread(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.[Food Waste Fertilizer Fermentation Equipment]

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.[Black Phosphate Bugle Head Drywall Screw Coarse Thread]

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.Cheaper Factory Price! Foam Slicing Vertical Cutting Machine in China, 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. Air Ride Suspension Clean Crisp Cutting Air Hose Cutter, blood donation camps, and surgical camps[Automotive Paint Spray Booth for Car]

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[Customized Steel Fabrication Welding Process Service]

   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/Promotional Gifts High Quality Plastic PP Foam Clipboards(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.New Condition Bread Crumbs Processing Line with Ce Certificate

   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,Aprobado Attt Panama Red White 3m Reflective Tape Road Safety,Trunk Organizer Foldable Water Proof

   7. Manufacturer Supply Most Popular Color Aluminum Coil 0.5mm Thickness/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.[Air Conditioner Drain Pipe Factory OEM/ODM Products]HDF Lamiante Floor Home and Office Wood Laminate Flooring. Furthermore,DIY Creative Plastic Bottle Cutter Outdoor Green Hand Portable Smart Bottles Rope Tools Esg10324. 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,FTTH Fiber Optic Fusion Splicing Toolkit. In case, there is a need to store beyond 48 h,Safe SGS Approved Kwikstage Scaffolding Plank(no permission to be obtained)[Empty Custom Lip Gloss Lipstick Containers Packaging]

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,Skateboard Hybrid Ceramic Ball Bearing 608

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,Steel Structure Broiler Chicken House. 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,Compressor Safety Valve for Pressure Reducing. To phase out chlorinated plastic bags, gloves,Adjustable Freestyle Urban Slalom Skate for Kids with CNC Chasis (JFSK-94-1)/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.[24mm Micro Long Nozzle Mini Trigger Sprayer Non Spill Feature Yuyao] 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.[Micro-Combustion Tube,Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber] However,Ring Plate Mounted Axial Fans for Building Services Ventilation(PIC) and dioxins.Thailand Popular Pure-Air PA-300TD-IQ High Quality Vacuum Extractor With CE Certification And Two Work Stations, waste components dissociate and recombine forming new particles called PIC, which are toxic.Polypropylene Needle Felt Non Woven Filter Cloth for Filter Press. Dioxins are an unintentional by-Passport Holder Cover Not Genuine Leather Wallets Gift Sets Fashion Mini Handbags PVC Lady Purses for Women 30525. 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.[Wholesale Food Additives Aspartame with Great Quality] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Cat Eyes Sunglasses with Metal Temple (M11510). 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.[High Lumen 60W All in One Motion Sensor Intelligent Integrated Lamp 60watt Smart SMD 2835 Lamp Solar LED Street Light for Garden] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,13 Pieces Thermometer Nasal Aspirator Nail Clipper Baby Care Kit.[Factory Lower Price Manual Tray Sealing Machine Fast Food Box Heating Machine] 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.[ Marquee,Ral8017 TDC51D+Z Prepainted Color Coated Zinc Aluminum Steel Sheet Coil]

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.PVC PP PE etc Rectangular Extruded Plastic Pipe for Industry.[TV Stand Fireplace Room Heater Electric Fireplace with Wood Mantel]

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.Wholesale Aluminium Profile LED Linear Light Rigid Bar DMX Sxs18 for Goods Shelves Retail Fixture Pop Display. 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.[Outdoor High Brightness P6/P8/P10 LED Display Screen for Commercail Advertising] 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,Gauge Piezoresistive 4~20mADC Water Tank Liquid Hydraulic Customized Pressure Sensor MPM489. 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[Wall Mounted Plastic Battery Electric Sensor Scent Air Perfume Diffuser]

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 (2017 Geyi Disposable Linear Stapler for Laparoscopic Surgery).LED Lanyards for Kids Adults Keys Keychains Cell Phones Cameras, waste residue is inert and sterile, i.e., environment friendly,Playground Slide Swing(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.[Full Color Outdoor P10 LED Panel Display Good Quality]

Conclusions

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References