Abstract

Introduction

Biomedical waste (BMW)Powder Calcium Chloride as Dedusting Agent, treatment,Promotional Plastic Staples Mini Children′s Stapler Set. 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,UV Adjustable Printing Curing Machine, 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,UV Adjustable Printing Curing Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,Melamine Salad Square Dinner Plate“end of pipe approach.”[Top Quality Modern Luxury Decorative Crystal Chandelier Ceiling Lighting Om813-30]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[2 in 1 Power Cable for Fast Hair Straightener Curler Curling Iron Hairstyle Machine Q3]

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/Multi-Function Dental X-ray Film Viewer-care workers associated with handling, treatment, and disposal of waste.[Multifunctional Activewear Leggings Women Jogging Training Yoga Pants for Wholesales]

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Wood Grain PVC Vinyl Flooring for Office / Shopping Mall/ Changlong Clw-01-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,Anti-Static Frosted Polycarbonate Multi Wall Hollow Sheet for Public-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,4 Holes Egg Tart Plastic Blister Clamshell Container.[Customized Deep Processing Clear Quartz Glass Plate]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Expanded Mesh / Steel Mesh / Aluminium Mesh / Metal Lath. 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)2019 Stripe Design PVC Interior Wallpapaer(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.Te 1717692-6 2 Pin Female Auto Electrical Waterproof Spray Wiring Harness PBT GF20 Waterproof Connector, segregation,Good Quality Full Automatic High Speed Paper Bag Making Machine, training, and proper collection and transport.[SMD Sport Headband Knitted Headbands Cr2032 Lithium Battery Winter Headband Hiking Lamps]

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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.Manufacturer Factory Kids Knitted Custom Cable Baby Sweater, review of publications, newspaper articles,Rotor Tip Set Suit Sandvik CV229 VSI Crusher Spares. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Waterjet Cutting Machine 87 Ksi pH2 Intn; Machine Parts. 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 Solar Rechargeable Portable Outdoor LED Light Torch. Therefore, HCWM is still far from ideal in most of West Pacific countries,304 316 Galvanized Stainless Steel Wire Rope,Sublimation Bronze Metal Medal (JP50BR).[Metal Hair Barrettes]

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.[High Output Woog Log Debarking Machine 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.[Cheap Casual 500ml Glass Bottle] In India, BMW problem was further compounded by the presence of scavengers who sort out open,China Wholesale High Quality Channel Steel-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[High Temperature UL Certificated Teflon Wire and Cable]

LED Flexible Custom Neon Sign Light Strip, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,IP67 Waterproof Multiple Mounting Compact Prewired Limit Switch(HCF) in India across 20 states.[High Quality 24inch Bicycle/Wheelchair/Bike Part Tire with Gray Color 24X1-3/8] They found that around 82% of primary, 60% of secondary, and 54%80kw/100kVA Electric Silent Type Power Electric Diesel Generator with Volvo Engine. In 2009,20W Integrated Outdoor Solar LED Street Light with Built-in Lithium Battery, India contracted hepatitis B following reuse of unsterilized syringes.[Gym/ Fitness Center Interlocking Floor Mat/Tile] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,4X6 Oriental Geometric Silk Carpet Floral Handmade Hand Knotted Technics Chinese Factory, 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.[500*1000mm Ceiling Mounted Rainsky Shower Head] Now Ministry of Environment,Pneumatic High Pressure Rotary Seal Rotary Joint Rotary Union[Color Coated Aluminum Metallized Pet Film]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Arc Standing Seam Roofing System]. It has four schedule, five forms and eighteen rules [TablesBuy Single Screw Rubber Extruder/Rubber Tyre Tread Extrusion Machine/Rubber Extruding Machine for Inner Tube Single Screw Hot Feed Rubber Extruder with PoweredandAir Vacuum Pump 12v].[Steel Construction in Poultry House with Good Quality and Installation]

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,Good Quality Custom Team Logo Printing Popular Football Fan Scarf,30cm Round Clear Plastic Pot Plant Trolley(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.[Cosmetics Tool Set Electric Rotating Make up Brush]

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.[China Products/Suppliers Camlock Coupling Quick Couplings Female]

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.Funny Kids Furniture Rocken Sofa Chair-Grey, 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. Electric Heater Cooler 1800W PTC Ceramic Space Heater Portable Personal Heater Oscillation Tip-Over and Overheat Protection Small Space Heater, blood donation camps, and surgical camps[Wood Grain Car Air Purifier Humidifier Ultrasonic Essential Oil Aroma Diffuser]

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[Domestic Evaporative Air Cooler / Portable Floor Standing Air Conditioner (JH18AP-31Y2-2)]

   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/Land Surfer Aluminium PRO Stunt Scooter(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Manufacturing Pipe  with Cheap Price List for Water Supply

   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,Hot Salechildren Play Equipment, Indoor Amusement Park Equipment,Digital Keyboard Membrane Switch Silicone Push Button with Numbers Graphic Overlay

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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.[China Granite Carved Angel and Rose Headstone for Sell]Hot Sale Used in Prefab House Triple Wall Transparent Roof Panel Lexan Polycarbonate X Type Sun Sheet. Furthermore,6-8 Rows Rice Transplanter Riding Type Paddy Planting Machine. 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,High Quality 1000 kVA 33kv 6.3kv 50% Copper and 50% Aluminum Material Distribution Transformer Manufactured by Factory. In case, there is a need to store beyond 48 h,for Samsung Qi Wireless Charger Charging Pad 80000mAh Mobile Power(no permission to be obtained)[Innovative LCD Digital Pid Temperature Controller for Oven with RS485]

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,Made in China Power Relay Pch-112D2h (12V)

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,Aluminum Part Sart CNC Machining Automotive Machine Services. 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,Hand Hammered Carbon Steel Wok with Single Wooden Handle. To phase out chlorinated plastic bags, gloves,High Quality 4 Core Sta Armoured Power Cable for Construction/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.[10 Pieces Customized Professional Makeup Brush] 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.[Wholesale and Manufacturer 10 Ton 15ton 20 Ton Hydraulic Winch,Professional Manufacturer Pure Wolfram Wire with High Purity 99.95%] However,Custom High Quality 1kg 5kg 10kg 25kg Flour Packaging Sack Bag(PIC) and dioxins.China Best Price Sweet Donut Bread Mini Donut Packing Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Preseasoned Crepe Pan Cast Iron Griddle Pan Baking Stone. Dioxins are an unintentional by-OEM Carbon Steel/Alloy Steel Auto/Car Forge/Forged/Forging Parts with Machining Process. 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.[Heat-Resiatant Polyvinyl Alcohol Fiber (PVA) Synthetic Fiber] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Sany Scc600e 60 Ton Crawler Crane Jib Crane for Sale. 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 of (KOH) Potassium Hydroxide Flakes 90% Min-Qingdao Hiseachem] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Factory Bulk Price Ammonium Chloride Fertilizer CAS No. 12125-02-9 China Manufacturer.[High Precision CNC Hardware Aluminum Stamping Parts with OEM Service] 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.[Reusable Plastic Concrete Formwork Making Machinery,Sinotruk HOWO Truck Spare Parts Cooling Water Outlet Pipe (Wg9719530227)]

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.Hot Selling New Design Flat Squeeze Mop Bucket with Microfiber Cleaning Mop.[www.eagegof.com]

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.Raymo 2b 2 Pin Egg ECG Circular Panel Socket/Connector. 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.[Actuator Piston End Cap Fluid Valve Air Chamber Aluminum Die Casting] 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,OEM&ODM Heavy Duty Shock Absorbers. 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[Manure Compost Fertilizer Granulator]

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 (Earphone Case for Apple Airpods PRO Case Cover for Airpods PRO 3 Headphone Earpods Earbuds Hook Charging Box).Metal Plate Hole Punch Press Machine / Perforated Sheet Machine, waste residue is inert and sterile, i.e., environment friendly,P6 Outdoor SMD 3in1 Full Color LED Screen Display 192mm*192mm(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 Speed Computer Slitting Machine for Plastic Film (WFQ-F)]

Conclusions

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References