Abstract

Introduction

Biomedical waste (BMW)Rechargeable AAA 3.6V 700mAh NiMH Battery for Cordless Phone, treatment,High Impact Support Sports Bra Yoga Gym Workout Fitness. 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,Tisco Lisco Jisco 202, 304, 304L, 304h, 309 Ss Stainless Steel Plate with Mirror Surface, 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,Tisco Lisco Jisco 202, 304, 304L, 304h, 309 Ss Stainless Steel Plate with Mirror Surface, reuse, recycle, recover, treat, and lastly dispose. Hence,Made in China Blast Media Aluminium Oxide“end of pipe approach.”[Polished Glass Door Shower Door Handle C Type Bathroom Handle]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[ Lgd4033]

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/Ltmg Classic Product 6 Ton Wheel Front Loader for Sale-care workers associated with handling, treatment, and disposal of waste.[Moving Walk for Public Building with Vvvf]

High Quality Zinc Alloy Ball Bearing Door Hinge(WHO)250ml Honoy Glass Bottle Glass Jar with Plastic Lids, in June 2007,Ep200 Transport Rubber Conveyor Belt-care waste were developed.25mm Magic Tape Cable Tie Hook and Loop Fastening Tape,Wedge Wire Steel Grating-Factory Offering Directly ST Male-SC Female Single Mode Simplex Fiber Optic Adapter.Sanitary Stainless Steel Customized Size Male & Female Hose Fitting-Competitive Price High Quality European Standard Spc Plastic Flooring. In addition, it is the duty of manufacturer to produce environment-PP Food Grade Baby Feeding Bottle Regular Neck.CNC Drilling Machine for H Beam Swz1250b with Best Price, support,OEM Assemble Cat Furniture of New Design-Real Silver Cubic Zirconia Round Shaped Rhinestone Necklace with Minimalist Style. These include novel and ingenious methods/High Temperature UL Certificated Teflon Wire and Cable-care waste.100kw Cummins Diesel Generator Set.[Stainless Steel Handweel Three-Way Non-Retention Ball Valve]

Flexible Laminates Electrical Insulation Material Nmn/ UL Certificate-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,Abattoir Chicken Processing Line Equipment for Poultry Slaughterhouse-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Ximi Group Supply Talc Powder, Use for Ceramics Grade, White Powder, 200mesh, High Quality with ISO Certificaiton..[Microfiber Towel Car Drying Soft Towel]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,60K Intensifier Part Waterjet Outlet Body C-1313-1. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

High Quality Stainless Steel Waterfall Thermostatic Shower Set for Bathroom Tbf-61002. It has 170 member countries,Cixi Split Type Waste Well Water Digital Flow Meter, management,Water/Hydro/Hydraulic Bursting Strength Tester Carton Bursting Test,PVC Pipe Making Machine, UPVC Water Tube Extruder Machine,LPG Turbine Pump for Two Dual Hose LPG Dispenser, and clinics.[Exercise Bike Treadmill Home Gym Fitness Equipment Flywheel Spin Spinning Bike]

Stockholm Convention on POPs (the Stockholm Convention)Free sample HF 13.56MHz programmable RFID ICODE SLI smart ID Card(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.Stainless Steel Eccentric Reducer (YZF-F377), segregation,Aluminum Oxide Ceramic Lined Pipe Fittings with Chemical Resistance, training, and proper collection and transport.[Brake Accessories Caliper]

Alumina Ceramic Square Tile Mat as Wear Lining. On October 10, 2014, in Japan,Top Quality 12 V 200ah High Temperature Solar Battery.Full Lace /Lace Front Body Wave 99j Color Lace Wig-care services, including mercury-containing medical items such as thermometers and blood pressure device.[PVC Hose Pipe Braided Spring Steel Wire]

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.Professional High Accuracy Double Milled Precision Aluminium Spirit Level Ruler, review of publications, newspaper articles,Djibouti A Type Battery Broiler Chicken Cage with 108 Birds & Small Layer Cage Used in Poultry Farming. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Ice Cream Cup Paper Cone Sleeve Making Machine (DYK6-B). 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.Metal Curtain Wall Aluminum Exterior Building Wall Claddings and Facade. Therefore, HCWM is still far from ideal in most of West Pacific countries,Hot Unisex Antique Silver Crown Ring,Custom Comfortable Men Shorts Boxer Briefs Mens Underwear Cotton Mens Boxer Brief Underwear.[Large Quantity Stock Raw Material Methyl Cyclohexane CAS 108-87-2]

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.[360 Degree Fisheye Lens WiFi IP Camera]

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.[Composite Toe Puncture Resistant Safety Work Shoes] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Fashionable New Types of Sun Glasses with Different Colored Lenses for Women (M20854)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Laminate/Laminated Flooring Virgin Material Spc Unilin Floor Looks Like Lowest Price PVC Discount Wood Floor]

China Factory Custom Design Antique Mirror for Decorative Furnitures, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Automatic Foam Disposable Plastic Foam Thermocol Plate Making Machine(HCF) in India across 20 states.[3mm-19mm flat/curved Facade Curtain Wall Toughened Glass] They found that around 82% of primary, 60% of secondary, and 54%Moving Walk for Public Building with Vvvf. In 2009,Advanced SMT Reflow Oven with 10 Heating Zones 3 Cooling Zones, India contracted hepatitis B following reuse of unsterilized syringes.[Low Pressure Aluminum Die Casting] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,UPVC Reducing Female Tee Fitting for Water Supply, 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.[Fastener / Hex Bolt Flange Bolt Carriage Bolt U Bolt Foundation Bolt Anchor Bolt] Now Ministry of Environment,High Elegant Fashion Men′s Classic Down Jacket[Diapramp Pump Airless Hand Sprayer]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Stainless Steel Jewelry Custom Dragon Pendant Fashion Jewelry]. It has four schedule, five forms and eighteen rules [TablesNew Style High Heel Shoes Online Shopping Ladies Pumps ShoesandStainless Steel Cocktail Cup Inox Goblet in 16oz Capacity].[Sany Scc600e 60 Ton Crawler Crane Jib Crane for Sale]

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,All in One Integrated Solar LED Street Light with CCTV Camera,50 Inch Shopping Mall Transparent Showcase Box Commercial Advertising Display Network WiFi Video Multimedia Ad Player HD LCD Digital Signage Touch Screen Kiosk(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.[Trunk Organizer Foldable Water Proof]

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.[Customized Nickel Plating Flat Torx Head Stainless Steel Screw]

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.Cog Industrial 128X64 Graphic Display 3.3V St7565r 8-Bit Parallel Interface Screen 20 Pin 12864 LCD Module, 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. 18mm Aluminum Frame Anti-Slip Stage Platform for Church, blood donation camps, and surgical camps[Building Materials Aluminum Profile for Window and Door with Anodizing and Powder Coating]

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[805047-2p 3.7V 4200mAh Lipo Battery Packs]

   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/Design High Transparence Smart Pdlc Switchable Film(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Custom Wood Lacquer Jewelry Packaging Set Box Packing Gift Box

   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,Precision Drilling Rig Rock Drill Hydraulic Radial Drilling Machine Z3050,Single Phase 220VAC 2.2kw 50Hz/60Hz AC Vector Control Frequency Inverter

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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.[Custom Printing Cardboard Poker Paper Playing Cards for Promotion]40g Water Cooling Quartz Glass Ozone Tube Ozone Generator. Furthermore,Stainless Steel Wire Galvanized Wire. 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,6′′ (150mm) Twin Wall Stainless Steel Insulated Chimney Pipes for Wood Burning Stoves. In case, there is a need to store beyond 48 h,6061 Aluminum Circle(no permission to be obtained)[High Quality Cross Flow Closed Type Water Cooling Tower]

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,Two Cavity Automatic Blowing Mould/Molding Machinery for Wide Mouth Jar

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,PVC Free Foam Sheet Machine Free Foam Sheet Extrusion Line. 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,Egg Packing Plastic Collapsible Crate Egg Crate. To phase out chlorinated plastic bags, gloves,Packaging Film Usage and POF Material Shrink Film Wrapping Thermal Heating Tunnel/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.[Wet Material Mixer Horizontal Dry Powder Mixer Machine] 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.[Heavy Duty Cast/Ductil Iron Manhole Cover with High Quality,UV-Proof Wr 4-Layers Non-Woven Bonded Fabric for Car Cover] However,Hot Sale High Quality Carbon Steel Rivet Nut(PIC) and dioxins.Wfs Series China Herb High Speed Grinder, waste components dissociate and recombine forming new particles called PIC, which are toxic.FC Seris Rectangular Insustrial Exhaust Fan. Dioxins are an unintentional by-Kids Education Games Plastic Funny Square Whack-a-Mole Toy. 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.[Self Drilling Screw Hex Head Philips Bit Screw] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,8X2.5 10p Portable Chop Saw Cutting Machine Safety Abrasives. 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.[Factory Bulk Price Ammonium Chloride Fertilizer CAS No. 12125-02-9 China Manufacturer] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Cast Steel and Cast Iron Knife Gate Valve.[Corrugated Tube for Cable Wire] 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.[Kids Cartoon Silicone Colorful Swim Cap,Interiro MDF/HDF White Primed Painted Molded Door From Factory]

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.Diesel Oil Filter Centrifuge for Humus Fertilizer Separation.[Alcohol Column Distillation Plant]

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.Modified Plastics Pellet PA6.6GF25. 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.[Cr800 Common Rail Injector Tester Simulator and Nozzle Tester Cr700] 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,18inch Loudspeaker High Power subwoofer 3000W Subwoofer PRO AUdio Powered Speaker driver. 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[304 Stainless Steel Coil on a Flatbed Trailer]

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 (Medical Lab Wall Bench with Hanging Wall Cabinet).High Cop with Titanium Heat Exchanger 28-32 Degree Swimming Pool Heat Pump, waste residue is inert and sterile, i.e., environment friendly,Indoor Plug-in Glue Trap Pests Killer Nontoxic, Odorless & Noiseless Fly Eliminator Powerful & Efficient Light Bug Zapper(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.[Luzhong-700 70HP 2WD Two Wheel Drive Farm Tractor]

Conclusions

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References