Abstract

Introduction

Biomedical waste (BMW)Customized Logo Wooden Wine Bottle Storage Box with Six Compartment (1535), treatment,Nylon Anchor, Nylon Frame Fixing Anchor. 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,OEM Custom 5 Axis CNC Machining Turning Stainless Steel Products, 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,OEM Custom 5 Axis CNC Machining Turning Stainless Steel Products, reuse, recycle, recover, treat, and lastly dispose. Hence,Cheap Modular Prefabricated Steel Frame Fireproof Mobile Prefab Tiny House“end of pipe approach.”[Disposable Medical Stainless Steel Blood Lancet]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Hot Sell Aluminum Metal Chain Link Curtain Used at Indoor]

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/Woven PP Cement Sand Valve Bag Ad Star PP Bags-care workers associated with handling, treatment, and disposal of waste.[CNC High-Speed Wood Acrylic Leather Granite Stone CO2 Laser Engraving Cutting Machine]

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Three Wheels Mini Tractor Wheel Barrow for Farm Transportation-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,Trendy High Quality 925 Stering Silver Tennis Glod Charm-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Textile Price 1309 Engraving Laser Cutting Machine with CCD Camera.[Sublimation Bronze Metal Medal (JP50BR)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Fashion Women Hair Accessories Hair Bow Retro Tiara Handmade Headband for Girls. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Factory Lower Price Manual Tray Sealing Machine Fast Food Box Heating Machine. It has 170 member countries,Wheel Bolt/Hexagon Socket Head Bolt/T-Type Bolt/Full Tread Bolt/Female /Male Bolt, management,014 Reflective Ribbon with Black Color,Car Engine Accessories, Auto Engine Parts, Spare Parts, Auto Parts Plastic Injection Mold,Women Big Plus Size Swimwear Bathing Suits Swimsuit, and clinics.[Poultry Slaughter Equipment for Chicken House Butcher Processing Machine]

Stockholm Convention on POPs (the Stockholm Convention)Prefabricated 20/40 Foot Modula Container Homes Buildings, Office Container for Sale(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 2006.400-600 Grit 201 304 Grade Polished Stainless Steel Pipe, segregation,Multi Span Glass Greenhouse Intelligent Glass/PC Greenhouse for Planting/Cultivation/Agriculture, training, and proper collection and transport.[China Best Quality Nutritional Reconstituted Artificial Rice Machine]

Soda Ash 99.2% for Washing Soda. On October 10, 2014, in Japan,Factory Custom Zinc Alloy Gold Plating Personalized 3D Emblem Award Military Army Us Police Pins Badges School Sport Enamel Metal Crafts Badges.1700c 1800c 1900c L W U Type Molybdenum Disilicide Rod-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Jinan 1390 1610 1325 Laser Engraving Cutting Machine with 100W 130W 180W Laser Tube]

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.Zlrc FRP GRP Pressure Fibre-Reinforced Plastic Water Filter Treatment Tank Softener, review of publications, newspaper articles,355nm Plastic Phone UV Printer Machine Laser Marking Engraving Machine. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Sachet Stick Sugar Packing Machine (XFL-KB). 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.UHF 400-470MHz Short Antenna for Icom F21 Radio. Therefore, HCWM is still far from ideal in most of West Pacific countries,High Strength Continuous Filament Polyester Nonwoven Geotextile for Construction,35kw Air Cooled Water Cooled Industrial Water Chiller Machine for Industry Application.[Epe Foam Sleeve Net]

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.[17 Languages Waterproof IP65 Biometric Network Fingerprint Access Control with ID Card]

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.[Ozone Water Production Equipment for Agricultural Irrigation] In India, BMW problem was further compounded by the presence of scavengers who sort out open,90 Degree Brass Shower Door Glass Holder Clip for Tempered Glass (GC90-A1)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[20W All in One Integrated Solar Street Light (BR-IT20W)]

High Performance 150 Tph Ya Circular Vibrating Screen, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Ultrasonic Non Woven Bag Sealing Machine Price in India(HCF) in India across 20 states.[Q1322 Plastic Pipe Screw Manual Pipe Thread Cutting Lathe] They found that around 82% of primary, 60% of secondary, and 54%Diapramp Pump Airless Hand Sprayer. In 2009,Reusable Custom Logo Stainless Steel Drinking Straws/Metal Straw, India contracted hepatitis B following reuse of unsterilized syringes.[16-315mm PVC Pipe Making Production Machine] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Aluminum High Temperature Label Film for Steel Industry, 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.[NPK Compound Fertilizer Making Machine] Now Ministry of Environment,Ge Holter Cable Snap Type Holter ECG Cable[100ml Clear Glass Beer Bottle Manufacturer Factory Price Supplier in China 1076]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Home Office Bolt Less Storage Book Display Shelf]. It has four schedule, five forms and eighteen rules [TablesFashion Color Enamel Rings Men′s Cubic Zirconia Alloy Ring Jewelryand650nm Diode Laser Hair Regrowth/Hair Scalp Analyzer/ Hair Growth/Hair Analysis Beauty Device].[Cat Eyes Sunglasses with Metal Temple (M11510)]

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,Xanthan Gum,High Capacity 200-1000t/H Primary Mobile Jaw Crusher Machinery Price(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.[Compact Bevel Right-Angle Planetary Gearbox for Servo Reducer]

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.[Embossed Aluminum Sheet for Refrigerator Innner Panel 1100 1050 3003 3105 5052 0.4mm 0.6mm 0.8mm]

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.Anhydrous Calcium Chloride with High Quality and Best Services Calcium Chloride Desiccant, 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. PTFE Teflon Coated Fiberglass Fabrics at Low Price Good Quality, blood donation camps, and surgical camps[Residential Artificial Grass for Garden Landscaping Artificial Grass]

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[Outrun Racing/Driving Car Arcade Game Machine Coin Oeprated Vending Game Machine for Indoor Amusement Game Room]

   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/Scaffolding Galvanized Steel Planks/Metal Deck for Construction(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.CNC CO2 Laser Cutting and Engraving Machine with CCD Camera Machine for Clothing, Carton Factory

   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,Mixing Equipment for Metallic Powder Coatings,Gold Supplier Metallic Golden Decorative Ribbon

   7. Automatic Super Power Feed CNC Horizontal Milling Machine with Taiwan Spindle/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.[Silicone Coated Glass Fiber Fabric Silicone Impregnated Cloth Thermal Insulation Cover][Qisong] SUS409L Steel Pipes for Auto Exhaust Pipe and Muffler Pipe. Furthermore,Guangzhou Ce RoHS SAA Saso ISO9001 Waterproof Outdoor Ra>80 IP65 100W 100 Watt LED Floodlight Powerful Solar LED Flood Light Outdoor. 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,Fashion Funny Outdoor Manual Wooden Toys for Children (TY-1908907). In case, there is a need to store beyond 48 h,Large Damping Compression Spring for Stage Spring (10*89*177*7.5)(no permission to be obtained)[Hot Sale Custom Women Yoga Pants Fitness Sports Leggings]

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,Electrical German Specification Copper Tube Terminals Cable Lugs

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,Fiberglass Fabric Heat Treated Factory Price. 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,Wet Material Mixer Horizontal Dry Powder Mixer Machine. To phase out chlorinated plastic bags, gloves,Custom Woven Polyester Sport Wristband Wholesale/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.[AVR Se350 Automatic Voltage Regulator for Marathon Alternator] 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.[ 316,Oval Ice Bucket LED for Dining Room Furniture] However,Butyl Mastic Tape(PIC) and dioxins.JIS G3444 Stk290 -540steel Spiral Hot Dipped Galvanized Steel Pipe Used for Water, Oil and Gas, waste components dissociate and recombine forming new particles called PIC, which are toxic.Skin Stapler Disposable Surgery. Dioxins are an unintentional by-Custom CNC Machining Plastic Part for Auto Parts. 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.[Camouflage Leggings High Quality Supplier] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,L Shape Outdoor Sofa Set with Cushion and Coffee Table (DW-SF1906). 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.[Bamboo Wood Computer Desk Laptop Stand Bt-2207] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Sale High Quality Mining CMC.[Hot Sell Factory Cheap Price 201 304 316L Sliver Etch Stainless Steel Sheet for Decorative Elevator and Lift] 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.[Polypropylene Micro Synthetic Fiber Fibratex Fibrillated / Mesh / Reticular Shape,Preseasoned Crepe Pan Cast Iron Griddle Pan Baking Stone]

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.Cheap Lighting Truss System Aluminum Concert Stage Roof Truss.[Fr-218 Kun Shan Furi Quality Slitting Rewinding Machine for BOPP/Paper/Film]

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.Stainless Steel Swage Stub End Rigging Screw Closed Body Turnbuckle. 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.[ Yellow Resistance Resin] 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,High Purity Press-Sintered Tungsten Crucibles. 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[Natural Fabric Wool Dryer Balls Handmade 6 Pack]

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 (SMT Juki LED Lights Pick and Place Machine).Full Automatic Liquid Filling Machine, waste residue is inert and sterile, i.e., environment friendly,Custom Medical Polish Stainless Steel Capillary Tube Supplier(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.[Medical/Beverage Gas Tank Oxygen/CO2 Aluminum Cylinder]

Conclusions

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References