Abstract

Introduction

Biomedical waste (BMW)Folding Stainless Steel 4 Steps Household Ladder, treatment,3L Cold Tank 03 Model Water Dispenser with Refrigerator. 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,CNC Turned Parts Aluminum Lathe Mechanical Brass Turned Parts, 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,CNC Turned Parts Aluminum Lathe Mechanical Brass Turned Parts, reuse, recycle, recover, treat, and lastly dispose. Hence,Good Quality Tungsten Carbide Round Nose End Mill“end of pipe approach.”[DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Phillips/Slot Shaft of The British Flat Tail Screws]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Sh-MTB379 26inch 21 Speed Mountain Bicycle]

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/Aluminum Steel Roofing House Shingles Stone Coated Metal Roof Tile Sheet Building Material-care workers associated with handling, treatment, and disposal of waste.[Cheap Modular Prefabricated Steel Frame Fireproof Mobile Prefab Tiny House]

17 Languages Waterproof IP65 Biometric Network Fingerprint Access Control with ID Card(WHO)Custom Spheroidal Cast Iron/Aluminum Sand Casting Machine Parts, in June 2007,Cheap New Design Light Prefab Steel Structure Chicken House Poultry Farm Building for Sale-care waste were developed.Steel Yarn Reinforced 1.18mm Thick PU Fiberglass Fabric,Wholesale New Fashion Casual Shoes Blue Canvas Shoes for Men-Pengkai Domestic Underground Sewage Treatment Plant Aao Process.Washing Machine Mold for Plastic Injection Molding-Custom Brand Women Bomber Jackets Sport out Wear with Zip. In addition, it is the duty of manufacturer to produce environment-9u 600X450 Single Section Wall Cabinet with Glass Door.Best Selling Spun Concrete Electric Pole/Pile Making Machines in China, support,800-3200kg Wire Rope Puller with Ce-IMTEK High Precision and Rigidity Linear Guides for CNC machinery. These include novel and ingenious methods/Galvanized Iron Wire/ Gi. I. Wire/ Binding Wire Tie Wire-care waste.Disposable Helium Steel Gas Cylinder with Guard.[Dot Spunlace Non-Woven Fabric Factory OEM/ODM Products]

Roll 45GSM Sublimation Paper in High Quality Wholesale-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,LLDPE Stretch Wrapped Pallet Wrap Stretch Film Jumbo Roll-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,High Quality Pigment Color Titanium Dioxide Anatase Food Grade Manufacturer.[Full Lace /Lace Front Body Wave 99j Color Lace Wig]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Small Poultry Pig Feed Farm Steel Silo for Sale. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Wholesale Good Quliaty Silicone Coated Fabrics. It has 170 member countries,Corrugated Tube for Cable Wire, management,Abrasive Tools Woolen Fiber Buffing Cutting Sanding Polishing Wool Felt Disc,Hydraulic Nc Bending Machine,Nordberg C110 C125 C140 Jaw Crusher Spare Parts Fixed / Swing Jaw Plate, and clinics.[Ahyw-Anhui Yawei Tandem CNC Press Brake Machine]

Stockholm Convention on POPs (the Stockholm Convention)Zinc Galvanized Allen Drive Flat Head Self-Tapping Screws(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.Automatic Press Roller Net Type Veneer Drying Machine for Plywood Making, segregation,EVA Foam Press Molding Machine Used for Rubber Shoes, training, and proper collection and transport.[Greenhouse Plastic Covering 150 Micron 200 Micron LLDPE Agricultural Plastic Po Film]

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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.350ml/500ml Insulated Classic Stainless Steel Double Wall Thermos Milk Bottle Flask, review of publications, newspaper articles,JIS Misumi Standard Round Latch Locks for Injection Molds Parts Return Units for Moulds Components. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Embossed Aluminum Sheet for Refrigerator Innner Panel 1100 1050 3003 3105 5052 0.4mm 0.6mm 0.8mm. 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.Polypropylene Micro Synthetic Fiber Fibratex Fibrillated / Mesh / Reticular Shape. Therefore, HCWM is still far from ideal in most of West Pacific countries,Colored Palm Coated PVC Dotted Cotton Gloves with Logo,1-3/8 (34mm) Diamond Coated Flush Cut Blade for Oscillating Tools.[Agriculture Hay Silage Wrapping Film]

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.[Disposable Breathing Exchange Filter Bacterial & Virus Filter Breathing Filter]

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.[Good Price Electronic Ignition Coil Pack for Skoda VW Transporter Caddy Seat 867905105b 547905104] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Bianco Carrara/Arabescatocorchia/Fishbelly White/Snow Flake White/Ariston/Volakos/Dong Fang Bai/White Marble for Wall Table Countertop Floor Bathroom Kitchen-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Hot! ! Medical ABS Emergency Crash Cart for Hospital Patient Treatment Trolley]

High Quality Stainless Steel Single bowl Rectangle Kitchen Basin 5338h, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Full Automatic Onion Powder Packing / Packaging / Filling Machine(HCF) in India across 20 states.[Triplex Service Drop Aluminum Cable with Al Conductor] They found that around 82% of primary, 60% of secondary, and 54%Indoor Desktop LED Display Scrolling Message Programmable Blue Tooth Mobile Phone Update Message, Language Customized Display Screen. In 2009,Customized Communication Equipment Metal/Steel/Stainless Steel/Aluminum Sheet Metal Fabrication, India contracted hepatitis B following reuse of unsterilized syringes.[m.xzbl.com] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,24mm Micro Long Nozzle Mini Trigger Sprayer Non Spill Feature Yuyao, 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.[EU Plug 2.1A Mobile Phone Portable Wall Travel Home Charger] Now Ministry of Environment,China 55*105 White Color Woven Polypropylene Bag 50kg Packing Bag for Rice Corn Dog Food[Cheap New Design Light Prefab Steel Structure Chicken House Poultry Farm Building for Sale]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [3L Cold Tank 03 Model Water Dispenser with Refrigerator]. It has four schedule, five forms and eighteen rules [Tables PotatoandFactory Supply Plastic Aluminum Foil Stand up Packing Bag for Snack Food].[Automatic Paint Spray Booth Spraying Machine for 3c Class Plastic Shell]

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,CNC Aluminum Decorative Wall Panel for Metal Curtain Wall & Facade,20kg-50000kg/Industrial Ice Cube Making Machine(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.[Fashion 925 Antique Silver Star Eifel Tower Charm Necklace]

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.[CNC Fiber Laser Cutting Machine Affordable Price High Quality Companies Looking for Agents]

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.Continuous Casting Graphite Mold Long Service Life, 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. 1 1.8 2 Inch High Pressure Centrifugal Stand 4.5cm DC Fan Axial Fan, blood donation camps, and surgical camps[Elastic Poplin Fabric with Fashion Ripstop Printed for Leggings]

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[Luxury Soft Fur Pet Cushion Dog Bed (WY1010196)]

   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/Boat Shelter, Boat Tent, Canopy, Car Parking, Boat Cover (TSU-1333/TSU-1333H)(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.A5 Landscape PVC Lever Arch Clip File Folder Office 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,Plasma Cutting Machine Paper Cutting Machine Grass Cutting Machine,Q1322 Plastic Pipe Screw Manual Pipe Thread Cutting Lathe

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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.[14PCS 3W Indoor Pixel Matrix DMX LED Bar Stage Wall Washer DJ Light]Welding Electrode Price of Welding Rod E7018/E7016/E7015 Welding Electrodes Sea Bridge Brand. Furthermore,Silver Foil Stretchy Polyamide Elastane Knitted Fabric Dance Wear. 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,Filter for Edible Oil Filtered Edible Oil Brands in India. In case, there is a need to store beyond 48 h,40X4 COB Character LCM Display, MCU 8bit, Stn LCD Module, FSTN LCM Panel(no permission to be obtained)[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]

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,DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Phillips/Slot Shaft of The British Flat Tail Screws

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,High Effective Good Quality Popular Dog Chews Machine. 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,Industrial Zirconia Zro2 Ceramic Wahl Electrical Hair Clipper Blade for Barber Shop. To phase out chlorinated plastic bags, gloves,Polystyrene (EPS) Disposable Take-Away Containers Forming Machine/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.[Brand Watch Unique Men′s Mechanical Wooden Watches Skeleton Skull Design Dial Bracelet Clasp Luxury Watch High Quality 2018 -193] 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 000 017 007 Black Sheer Ribbon UK Suppliers (OR8013),Industrial Transfer Hose Peristaltic Pump] However,Structure Industrial Ankle Safety Boot (SN1207)(PIC) and dioxins.High Temperature Ceramic Fiber Special Shape Product, waste components dissociate and recombine forming new particles called PIC, which are toxic.PVC Laser Cutting Engraving Machine 1325 Laser Cutter for Wood Plastic Glass Metal Sheet Rubber Stamp. Dioxins are an unintentional by-Commercial Furniture Economic ABS Emergency Treatment Cart. 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.[m.gl-fiber.com] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Outdoor Stand Waterproof Advertising Light Box Billboard. 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.[P8 Fixed Outdoor LED Screen Price for Outdoor Advertising Display] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber.[Custom Printing Logo Color Compostable Trash HDPE LDPE PLA PBAT Corn Starch Plastic Medical Household Tall Kitchen Biodegradable with Drawstring Garbage Bag] 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.[90 Degree Brass Shower Door Glass Holder Clip for Tempered Glass (GC90-A1),Hydraulic Equipment Plant Design Customize Good Stability High Pressure Hydraulic Power Unit and Hydraulic Station Hydraulic Motor]

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.Lost Wax Investment Casting for Your Small-to-Large Precision Metal Parts.[Antique Brown Marble Mosaic Tile for Floor/Wall/Bathroom/Backsplash/Table/Patterns]

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.Hot Forging Internal Circlip Pliers. 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.[Good Quality Custom Team Logo Printing Popular Football Fan Scarf] 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,Best Dental Mold DLP 3D Printer Machine for Align Technology. 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[Pet Polyester Fabric Mesh Belt for Non-Woven Forming]

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 (Color Black Mini Handy Stretch Film with Plastic Handle).High Precision Fdm 3D Printing Machine, waste residue is inert and sterile, i.e., environment friendly,Hyaluronic Acid Moisturizing Facial Silk Mask Cosmetic(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.[Brushed Cotton Twill Fine 3D Embroidery Custom Baseball Cap]

Conclusions

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References