Abstract

Introduction

Biomedical waste (BMW)Heat Resistant Double Wall Glass Coffee Mug Water Bottle, treatment,2D Motif Light Outdoor Waterproof LED Christmas Tree Decoration Rope. 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,Towed Bitumen Mixer Slj5, 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,Towed Bitumen Mixer Slj5, reuse, recycle, recover, treat, and lastly dispose. Hence,Yitai Die Making Birch Plywood Flat Die Mould Die Making“end of pipe approach.”[High Temperature Ceramic Fiber Special Shape Product]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Small Portable Pressure Tank Direct Drive Air Compressor 2HP/2.5HP (50L tank)]

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-Ports Rj11 Connector with Right Angle-care workers associated with handling, treatment, and disposal of waste.[Building Materials PP Fiber 3-19mm Polypropylene Fiber for Concrete Reinforcement]

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Stainless Armrest Styling Furniture Beauty Hair Barber Chair-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,HDMI to VGA with Power Audio Adapter-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Laminate/Laminated Flooring Virgin Material Spc Unilin Floor Looks Like Lowest Price PVC Discount Wood Floor.[Medical Face Mask Machine Automatic Mask Inner Ear-Loop Welding Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Painted Structure Steel Light Prefabricated Workshop Building. 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)S1p China Factory Men/Women Basic Embossed Leather Safety Shoes Hot Selling Industrial Army Boot Work Footwear Steel Toe PU Injection Shoes Best Quality Sn1358(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 2006.3 Way 1000W Dual 12 Inch Line Array Speaker Audio (L12), segregation,Wood Grain PVC Vinyl Flooring for Office / Shopping Mall/ Changlong Clw-01, training, and proper collection and transport.[5FT3′ 160cm Love Doll Real Adult Toys with 3 Realistic Entries Full Real Size Doll Sex Toys for Men]

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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.Mesh Belt Shot Blast Cleaning Machine for Iron or Aluminum Alloy Castings, review of publications, newspaper articles,Wheat Edible Alcohol Distillation Plant. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Farm Machinery Auto Mechanical Straw Crusher for Poultry. 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.Fireplace Glass. Therefore, HCWM is still far from ideal in most of West Pacific countries,Custom Quality Products Cast Iron Agricultural Machinery Tiller Blade,2019 Stripe Design PVC Interior Wallpapaer.[Positive Yarn Feeder Circular Knitting Machine]

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.[Marble Brick Camouflage Pattern Color Prepainted Aluminum Coil]

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.[Prefabricated 20/40 Foot Modula Container Homes Buildings] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Te 1717692-6 2 Pin Female Auto Electrical Waterproof Spray Wiring Harness PBT GF20 Waterproof Connector-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[High Quality Sale Promotion Good Taste Vaporizer Pen Refillable Nic Salt Devices]

Good Quality Full Automatic High Speed Paper Bag Making Machine, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Disposable EPE Foam Board/Sheet Extrusion Line for 40-105mm Thick(HCF) in India across 20 states.[Handheld Portable Veterinary Ultrasound Equipment for Farm Horse Cow Sheep] They found that around 82% of primary, 60% of secondary, and 54%Tiny Tassel Earrings for Women Fashion Jewelry Vintage Velvet Ball Statement Fringed Drop Earring Female Jewellery 2018 New. In 2009,2000mm Blind Ultrasonic Cleaning Machine Two Tanks for Rinsing with Free Project Design, India contracted hepatitis B following reuse of unsterilized syringes.[Chicken Cage Mesh Hexagonal Wire Netting Machine Good Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Manufacturer Factory Kids Knitted Custom Cable Baby Sweater, 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.[0.2-4mm Thickness PVC Edge Banding for Furniture Tables] Now Ministry of Environment,Rotor Tip Set Suit Sandvik CV229 VSI Crusher Spares[Ultrasonic Jewelry Cleanermini Jewelry Cleaner Jp-3800s 600ml]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Wfs Series China Herb High Speed Grinder]. It has four schedule, five forms and eighteen rules [Tables925 Sterling Silver Dangle Filigree Earrings JewelryandFactory Directly Modern Home Wooden Furniture Kitchen Cabinets].[Natural Rotary Cutting Okoume Face Wood Veneer for Plywood]

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,Waterjet Cutting Machine 87 Ksi pH2 Intn; Machine Parts,High Quality Solar Rechargeable Portable Outdoor LED Light Torch(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.[1325 150W 280W CO2 Wood MDF Acrylic Metal Laser Cutting Machine]

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.[Yutong Bus Parts Ceiling Diffuser Vent Air Louver Vent Air Diffuser Vent Air Diffuser Ceiling Vent Slot Diffuser Vent]

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.304 316 Galvanized Stainless Steel Wire Rope, 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. Sublimation Bronze Metal Medal (JP50BR), blood donation camps, and surgical camps[Belt Conveyor Roller and Frame]

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[Best Dental Mold DLP 3D Printer Machine for Align Technology]

   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/China Wholesale High Quality Channel Steel(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.LED Flexible Custom Neon Sign Light Strip

   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,20W Integrated Outdoor Solar LED Street Light with Built-in Lithium Battery,4X6 Oriental Geometric Silk Carpet Floral Handmade Hand Knotted Technics Chinese Factory

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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.[Double Spade Terminals]Good Quality Custom Team Logo Printing Popular Football Fan Scarf. Furthermore,30cm Round Clear Plastic Pot Plant Trolley. 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,Funny Kids Furniture Rocken Sofa Chair-Grey. In case, there is a need to store beyond 48 h,Electric Heater Cooler 1800W PTC Ceramic Space Heater Portable Personal Heater Oscillation Tip-Over and Overheat Protection Small Space Heater(no permission to be obtained)[Low Temperature Water Cooled Screw Industrial Water Chiller]

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,Land Surfer Aluminium PRO Stunt Scooter

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,Manufacturing Pipe  with Cheap Price List for Water Supply. 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,Stainless Steel 10 20 Inch Jumbo Big PP Melt Blown Filter Melt Blown Sediment. To phase out chlorinated plastic bags, gloves,Plastic Sunshade Net in Flat Wire and Round Wire/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.[Waterproof Molded Custom Cable Assembly M12 M8 M5 M6] 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.[ Pneumatic Punching Machine,A2-70 A4-80 Stainless Steel 304 316 Square Head Cage Nut] However,2400mm Model 30tpd Waste Paper Recycling Machine Prices(PIC) and dioxins.Wholesale Perfume Spray Bottles 5ml 3ml 8ml 10ml PP Pen Shape, waste components dissociate and recombine forming new particles called PIC, which are toxic.Brake Accessories Caliper. Dioxins are an unintentional by-PCE Snf Superplasticizer Concrete Water Reducing Admixture Powder Liquid Flake. 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.[All in One Integrated Solar LED Street Light with CCTV Camera] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Yg Anticorrosion Cloth Duct Tape. 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.[Textile Price 1309 Engraving Laser Cutting Machine with CCD Camera] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Sale High Quality Aneroid Sphygmomanometer with Stethoscope.[Metal Processing Machinery Parts/Sheet Metal Fabrication Racks] 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.[(5X4X4.0mm-4BB) Stainless Steel Ball Bearing Wooden Door Hinge,925 Sterling Silver Chain Oval Shape Natural Sky Blue Topaz Stone Silver Pendant Necklace]

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.Natural Rotary Cutting Okoume Face Wood Veneer for Plywood.[Pure Hemp Oil]

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.Heavy Duty Cast/Ductil Iron Manhole Cover with High Quality. 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.[V Type Dry Powder Blender Equipment] 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,Portable Digital Skin Analyzer Machine/Moisture Facial Analyser for Face. 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[Single Wall Corrugated Pipe Extruding Machine&Extrusion Machine&Extruding Line]

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 (Hand Hammered Carbon Steel Wok with Single Wooden Handle).High Quality 4 Core Sta Armoured Power Cable for Construction, waste residue is inert and sterile, i.e., environment friendly,Custom High Quality 1kg 5kg 10kg 25kg Flour Packaging Sack Bag(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.[79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set]

Conclusions

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References