Abstract

Introduction

Biomedical waste (BMW)Kids Education Games Plastic Funny Square Whack-a-Mole Toy, treatment,8X2.5 10p Portable Chop Saw Cutting Machine Safety Abrasives. 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,Cast Steel and Cast Iron Knife Gate Valve, 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,Cast Steel and Cast Iron Knife Gate Valve, reuse, recycle, recover, treat, and lastly dispose. Hence,Diesel Oil Filter Centrifuge for Humus Fertilizer Separation“end of pipe approach.”[Shower Room Bathroom Stainless Steel Glass Door 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.[Fashion Women Hair Accessories Hair Bow Retro Tiara Handmade Headband for Girls]

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/Modified Plastics Pellet PA6.6GF25-care workers associated with handling, treatment, and disposal of waste.[Stainless Steel 10 20 Inch Jumbo Big PP Melt Blown Filter Melt Blown Sediment]

18inch Loudspeaker High Power subwoofer 3000W Subwoofer PRO AUdio Powered Speaker driver(WHO)Medical Lab Wall Bench with Hanging Wall Cabinet, in June 2007,High Cop with Titanium Heat Exchanger 28-32 Degree Swimming Pool Heat Pump-care waste were developed.Indoor Plug-in Glue Trap Pests Killer Nontoxic, Odorless & Noiseless Fly Eliminator Powerful & Efficient Light Bug Zapper,Peaking Focus 1920X 1080 IPS Panel 5.7 LCD-Hot Sale Fashion Custom Colorful Printed Adjustable Sports NFL Lanyard Ribbon with Logo.Shunfu Sales Napkin Printing Embossed Paper Folding Machinery-Greenhouse Plastic Covering 150 Micron 200 Micron LLDPE Agricultural Plastic Po Film. In addition, it is the duty of manufacturer to produce environment-Self-Standing Aluminum Foil Moisture Barrier Bag for Snacks/ Nuts/ Tea Bag.Customized Metal Screw Stainless Steel Sanitary Fittings Hex Allen Screw, support,Free Design Toughened Glass with Digital Printing-Cr1000-Mini Common Rail Injector Tester. These include novel and ingenious methods/Paint Rollers Brush Household Wall Paint Roller Fabric Making Machine, Portable Home Use Hand Brushes Roof Paintroller Machinery-care waste.Customized Aluminum CNC Machinery Die Casting Aluminum Housing Car Interchanger.[Ceramic Coffee Mug With Lid Wholesaler Quotes & PriceList]

Original Mobile Phone LCD for Samsung Galaxy S8 G950 with Digitizer Touch Screen Assembly-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,Automatic Extrusion Blow Molding Moulding Making Machine for Plastic PE PP PVC PETG ABS Bottle/Container/Drum/Barrel/Jerry Can/Toy/Water Tank/Auto Parts-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,54303-ED50b 333391 Front Left Japanese Cheap Shock Absorbers for Nissan.[Cr1000-Mini Common Rail Injector Tester]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Optical Laser Achromatic Triplet Lens. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

High Quality 1680d PVC Coating Fabric Textile. It has 170 member countries,Small Stainless Steel Dry Powder Drum Mixer for Tea, Feed, Chemical, Pesticide, Fuel, Food10-50L, management,High Tension Hot Dipped Galvanized Steel Wire Strand Guy Wire,Elastic Poplin Fabric with Fashion Ripstop Printed for Leggings,China Best Quality Nutritional Reconstituted Artificial Rice Machine, and clinics.[Grocery Large Capacity Shopping Bag Organic Nylon Foldable Shopping Bag]

Stockholm Convention on POPs (the Stockholm Convention)Motorcycle Tube Making Machine/Inner Tube Making Machine(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.Gearbox for Rolling Mill, segregation,Professional Electric Hair Clipper Cordless Beard Trimmer Men, training, and proper collection and transport.[Butyl Mastic Tape]

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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.Canvas Leather Laptop Rucksack Backpack Sac a DOS Pour Ordinateur Portable Men Travel Time Mochilas, review of publications, newspaper articles,Plastic Injection Mould for Auto/Car Air Condition System (XDD-0165). The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,MDF and Solid Wood modern Glass Top TV Stand Sets. 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.Diam38mm Tapered Cross Drilling Bit for Quarry. Therefore, HCWM is still far from ideal in most of West Pacific countries,French Restaurant Interior in Antique Classic Style Furniture,10L -30 Celsius Low Temperature Small Recirculating Chiller for Lab.[OEM Industrial Rubber Gasket/O Ring]

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.[40mm Tapered 7 Degree Button Bit for Boring Holes]

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.[Indoor Living Room Art Stainless Steel Furniture Stool] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Hospital Portable Oxygen Plant (THR-OC7F3)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Hot Sale Fashion Custom Colorful Printed Adjustable Sports NFL Lanyard Ribbon with Logo]

Single Zone High Sensitivity Weapon Detector, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,8 Port Poe Switch with 2 Giga Uplink Ports Support Max 250m Long Transmission Internal Power Supply(HCF) in India across 20 states.[Boshi OEM Aluminum Safety Padlock for Industrial Bd-A30] They found that around 82% of primary, 60% of secondary, and 54%Event /Party / Bar Furniture Light up LED Furniture Plastic Furnishing. In 2009,Forged Aluminum Truck Wheel Rim, Aluminium Wheel Rim, Alloy Wheel Rim, Truck Wheel Rim, India contracted hepatitis B following reuse of unsterilized syringes.[2000L/H Capacity Reverse Osmosis Systems Water Treatment Equipment] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Factory Price Waterproof RFID Paper Tyvek Wristbands for Concerts, 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.[Baby Placemat Functional One-Piece Silicone Feeding Tray / Bowl] Now Ministry of Environment,Oscillating Knife Cutting Machine EVA/Foam/Cardboard Cutter Plotter[Hotel Restaurant Wedding Chiavari Dining Church Stacking Chair]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Stamping Parts Gold Plated Copper Piece Copper Terminal for Battery Contact Clip]. It has four schedule, five forms and eighteen rules [TablesCNC Turned Parts Aluminum Lathe Mechanical Brass Turned PartsandBall Screw 3000mm].[High Quality Solar Rechargeable Portable Outdoor LED Light Torch]

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,Auto Car Parts Oil Filter (26300-02501) (Toyota, Honda, Hyundai, etc),Building Materials PP Fiber 3-19mm Polypropylene Fiber for Concrete Reinforcement(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.[Hot Sale Night Vision Security Infrared IR Bus Internal CCTV Dome Camera]

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.[White Powder STPP Sodium Tripolyphosphate 94% for Ceramic]

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.New Design Bb Blending Machine Fertilizer Mixer for Sale, 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. Hot Sale of (KOH) Potassium Hydroxide Flakes 90% Min-Qingdao Hiseachem, blood donation camps, and surgical camps[Medical Surgical Instrument Mini Handpiece Sagittal Saw Bone Cutting Machine]

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[with Full Length Handrails Hospital Platform Madison Avenue Baby Bedding]

   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/Hot Sale Custom Women Yoga Pants Fitness Sports Leggings(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Scratch Resistant Wholesale Restaurant Outdoor Furniture Classical Cast Iron Dining Table Leg Base

   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,Best Teeth Whitening Herbal Toothpaste Squeezer with Basil Ingredient,Classic Damascus Pattern PVC Wall Paper for Home

   7. Outdoor Stage Decoration Inflatable Puppet Man/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.[China Ring Die Biomass Wood Pellet Machine]8mm+2mm+8mm Switchable Tempered Window Pdlc Smart Glass. Furthermore,Compression Knee Sleeve Best Knee Brace for Men & Women Knee Support. 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,Sanhe FC-2 Poultry Air Vent. In case, there is a need to store beyond 48 h,P1iu-A9 Ingersoll Rand Twin Stack Small Portable Reciprocating Air Compressor 1 HP(no permission to be obtained)[925 Sterling Silver Jewelry Pearl Love Pendant Necklace Platinum Plated]

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,Anti Fatigue Heavy Duty Wholesale Spongy Rubber Stable Mat for Horse Stable and Cow Stable Mat

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,Hydroxypropyl Methyl Cellulose Ether HPMC E5 E15. 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,ISO Certificate ERW Stainless Steel Welded Tube SUH409L, SUS409, 1.4512, 1.4509 for exhaust systems. To phase out chlorinated plastic bags, gloves,Solution for Insulating Glass Processing Silicone Pump Secondary Sealant Sealing/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.[ Graphite Felt & Battery Felt] 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.[12kn Manual Winch with Hand Band Brake,Picnic 8X6Rectangular 2-Compartments Microwave Safe Plastic Container with Lid] However,Large Three Lobe Roots Blower Bore Size Dn300, Oxygen Generator Roots Compressor(PIC) and dioxins.304 321 310 310S Welded Decorative Stainless Steel Pipe, waste components dissociate and recombine forming new particles called PIC, which are toxic.316 Epoxy Coated Ladder Single Barb Lock Stainless Steel for Shipbuilding. Dioxins are an unintentional by-Commercial Crossfit Fitness Gym Equipment/Home Gym Equipment. 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.[Office/Conference Room Equipment Desktop Electronic Signature Card] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Bmvr200 Roots Type Vacuum Pump for Air vacuum System. 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.[Chinese Manufacturers Anodized Seamless 1435 Extruded Large Diameter Round Seamless Aluminum Pipe/Tube] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,60ml Pet Plastic Empty Bottle Mini Liquor Juice Bottles.[Galvanized Jaw and Jaw Type Closed Body Rigging Screw Turnbuckle] 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.[High Quality Prepayment Energy Meter 12 Volt DC Latching Relays 24V DC Magnetic Contactor Relays,Professional Customized Belly Dance Costume]

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.Door and Window Hardware Aluminum Alloy Square Window Handle.[Double Seal Cast Iron Composite Sewer Manhole Cover Imcd-18]

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.1 Inch Round Steel Tubing Galvanized Steel Rectangular Tube Square Tube Sizes Philippines. 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.[Vt4880 Dual 18 Inch Line Array Speakear PRO Audio] 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,Refillable Glass Spray Bottle for Perfume. 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[High Quality Peptides Powder Hormone Ipamorelin Tb500 Peptides for Muscle Gain]

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 (Red Sandstone Tiles for Flooring/Wall).Pole Mount Automatic Recloser 38kv/1600A, waste residue is inert and sterile, i.e., environment friendly,PVC/Pet/PC Cr80 Inkjet Printable Plastic Blank NFC Access Smart/Membership Card/Chip Card/Proximity/RFID MIFARE ID Greeting Card for Hotel Company Library(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.[2020 Oversized Custom Brand Italian Designer Sun Glasses Sunglasses]

Conclusions

Custom Bare Copper Busbar Power Connector,Medical Face Mask Machine Automatic Mask Inner Ear-Loop Welding Machine-care workers and HCFs, continuous monitoring of BMW practices,Colorful Cosmetic Pigment Powder Color Mica Powder for Soap Making. It is our fundamental right to live in clean and safe environment.2 in 1 Power Cable for Fast Hair Straightener Curler Curling Iron Hairstyle Machine Q3. The current BMWM 2016 rules are an improvement over earlier rules in terms of improved segregation, transportation, and disposal methods,Automatic 50kg/H Biomass Steam Pellet Chips Wood Fired Boiler for Food Industry, patients, and public. Moreover, more use of non-PVC medical devices and development of newer novel, eco-Original Brand New Disposable E Cig Best Vape Pen No Leak Salt Vape Devices.Japan Quartz Movement Stainless Steel Mesh Strap Wrist Watches (71391).

References