Abstract

Introduction

Biomedical waste (BMW)Promotional Gifts High Quality Plastic PP Foam Clipboards, treatment,New Condition Bread Crumbs Processing Line with Ce Certificate. 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,Drywall Stud for Gypsum Board Partition, 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,Drywall Stud for Gypsum Board Partition, reuse, recycle, recover, treat, and lastly dispose. Hence,Turning Parts with Black Anodized/CNC Machining Parts/Rapid Prototypes Production“end of pipe approach.”[Compression Knee Sleeve Best Knee Brace for Men & Women Knee Support]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[PVC Free Foam Sheet Machine Free Foam Sheet Extrusion Line]

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/Aprobado Attt Panama Red White 3m Reflective Tape Road Safety-care workers associated with handling, treatment, and disposal of waste.[Three Phase Yrkk Series 630kw Motor]

Trunk Organizer Foldable Water Proof(WHO)Manufacturer Supply Most Popular Color Aluminum Coil 0.5mm Thickness, in June 2007,HDF Lamiante Floor Home and Office Wood Laminate Flooring-care waste were developed.DIY Creative Plastic Bottle Cutter Outdoor Green Hand Portable Smart Bottles Rope Tools Esg10324,FTTH Fiber Optic Fusion Splicing Toolkit-Safe SGS Approved Kwikstage Scaffolding Plank.Skateboard Hybrid Ceramic Ball Bearing 608-Steel Structure Broiler Chicken House. In addition, it is the duty of manufacturer to produce environment-Ck6132A Automatic Horizontal CNC Lathe Turning Machine.High Quality Sodium Cyclamate (NF13 30-100MESH) Manufacturer, support,Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper-Celuka PVC Sheet/High Density PVC Board. These include novel and ingenious methods/Morden Decrotive LED Floor Lamp for Home Site-care waste.Mine Ten Industrial CKD/SKD 0.9m 100W Linear High Bay Light Hanging Waterproof.[Agriculture Double Layer Multi-Span PE Film Greenhouse]

Large Hydraulic Cylinder for Offshore Drilling Platform Outrigger Cylinder Tire Loader Hydraulic Cylinder Crawler Pusher Hydraulic Cylinder-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,Plastic PVC 3 Way Elbow Pipe Fittings-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Cr1000 (1) Common Rail Injector Tester.[New 2019 5g Mobile Phone for Huawei Mate 30 Dual SIM Smart Phone Cellphone]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,43inch IP65 Waterproof High Brightness LCD Outdoor Advertising Media Player Monitor Android 3G/4G Digital Signage. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Black White Thermal Break Aluminum Window. It has 170 member countries,Ca Fire Wall Mounted Fire Extinguisher Ball for Fire Fighting, management,TTR Four Way Stretch Fabric, Core Spun Yarn, for Garment,Compressor Safety Valve for Pressure Reducing,Adjustable Freestyle Urban Slalom Skate for Kids with CNC Chasis (JFSK-94-1), and clinics.[Dark Blue Color Texture Indoor Swimming Pool Glass Mosaic Tile]

Stockholm Convention on POPs (the Stockholm Convention)Ring Plate Mounted Axial Fans for Building Services Ventilation(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.Thailand Popular Pure-Air PA-300TD-IQ High Quality Vacuum Extractor With CE Certification And Two Work Stations, segregation,Polypropylene Needle Felt Non Woven Filter Cloth for Filter Press, training, and proper collection and transport.[Best Italy Army Vegetate Frog Camouflage Pattern CVC Military Quick Drying Clothes]

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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.PVC PP PE etc Rectangular Extruded Plastic Pipe for Industry, review of publications, newspaper articles,Wholesale Aluminium Profile LED Linear Light Rigid Bar DMX Sxs18 for Goods Shelves Retail Fixture Pop Display. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Gauge Piezoresistive 4~20mADC Water Tank Liquid Hydraulic Customized Pressure Sensor MPM489. 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.2017 Geyi Disposable Linear Stapler for Laparoscopic Surgery. Therefore, HCWM is still far from ideal in most of West Pacific countries,LED Lanyards for Kids Adults Keys Keychains Cell Phones Cameras,Playground Slide Swing.[10ml Plastic Children Proof Bottle Vape Juice for Asian Market]

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.[Custom Cable and Custom Wiring Harness Assembly]

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.[Wfj Series Fine Grinding Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Sports Rubber Flooring/Gym Rubber Tile/Sports Rubber Flooring-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Chicken Farm Battery Chicken Layer Cage Sale for Pakistan farming equipment]

Color Coated Aluminum Metallized Pet Film, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Stainless Steel DIN1587 Hex Domed Cap Nut for Car/Motor/Bicycle(HCF) in India across 20 states.[Aluminium Coil 1060 3003 5052 5083] They found that around 82% of primary, 60% of secondary, and 54%LED Lamp E27 C37 Ceramic Warm White LED Candle Bulb. In 2009,Stainless Steel Copper-Plated Rose Gold Beer Mug, India contracted hepatitis B following reuse of unsterilized syringes.[1.3t Mini Digger with Adjustable Guide Rail and Arm Deflected] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Halloween Decoration Battery Operated LED Skull Shaped Pendant String Light, 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.[NEMA23 Round Motor for Cutting Plotter Stepping Motor 57byg059A] Now Ministry of Environment,3D Printer Filament Extruder[LLDPE Stretch Wrapped Pallet Wrap Stretch Film Jumbo Roll]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [High Quality Best Price Sodium Hyaluronate CAS 9067-32-7]. It has four schedule, five forms and eighteen rules [TablesElectric Massage Bed Pedicure Chair with Double Dust CollectorandHigh Pressure Standard 6000 Psi SAE 90 Deg Forged Hydraulic Flange 87691].[Modified Plastics Pellet PA6.6GF25]

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,Rebar Threaded Rebar Adding Length Splice Connector,Flexible Composite Insulation Nomex Paper 6640nmn(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.[Ice Cream Cup Paper Cone Sleeve Making Machine (DYK6-B)]

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.[80kw/100kVA Electric Silent Type Power Electric Diesel Generator with Volvo Engine]

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.Baby Placemat Functional One-Piece Silicone Feeding Tray / Bowl, 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. Sporting Football Polyester Checker Soccer Solid Color Signal Custom Soccer Referee Flags, blood donation camps, and surgical camps[Custom High Precision Plastic Injection Molding Small Parts]

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[OEM Grey/Ductile Iron Foundry Sand Casting Boat Cover]

   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/Dingchen-1880mm 5tpd Toilet Paper Towel Making Machine(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Fabric Auto Feeding Laser Cutting Machine Roll to Roll GS1625

   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,High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen,Agricultual Hand Sprayer/Garden Hand Sprayer /Home Hand Sprayer (TF-1.5)

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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.[www.zirae.com]Custom High Quality Resealable Zipper Flat Bottom Stand up Pouch Animal Feed Plastic Packing Bag. Furthermore,220V 20g Plate Type Ozone Air Purifier. 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,OEM Custom Nonstandard Reducer Housing /Gear Box Housing with Lost Foam Casting and Machining. In case, there is a need to store beyond 48 h,Factory Supply FC Male-LC Female Single Mode Simplex Fiber Optic Adapter(no permission to be obtained)[FTTH Adapter MPO/MTP Flange Plastic Fiber Optic Adapter Used for MPO/MTP Patchcord]

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,Low Fat and High Protein Peanut Butter Without Sugar and Without Salt

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,SMD Sport Headband Knitted Headbands Cr2032 Lithium Battery Winter Headband Hiking Lamps. 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,Anatase Titanium Dioxide TiO2 for Paint and Coating La101. To phase out chlorinated plastic bags, gloves,Buy Single Screw Rubber Extruder/Rubber Tyre Tread Extrusion Machine/Rubber Extruding Machine for Inner Tube Single Screw Hot Feed Rubber Extruder with Powered/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.[ PLA Biodegraded Tea Filters] 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.[Customized Precision Aluminum Die Casting Parts,Pet Food Freeze Drying Equipment with Fashionable Appearance] However,Brass Hollow Rivet(PIC) and dioxins.C1 / C2 / C3 / C4 Rock Silent Cracking Chemicals, waste components dissociate and recombine forming new particles called PIC, which are toxic.3-8mm Clear and Colored Textured Pattern Figured Glass with Ce. Dioxins are an unintentional by-Custom High Precision Plastic Injection Molding Small 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.[Wholesale Camping Family Caravan Large Luxury Glamping House Tipi Bell Military Tent] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Manure Compost Fertilizer Granulator. 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.[Stainless Steel DIN1587 Hex Domed Cap Nut for Car/Motor/Bicycle] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Plastic End Caps and Covers for Pipes and Tubes (YZF-C13).[ Portable Home Use Hand Brushes Roof Paintroller Machinery] 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.[Hotsale Children′s Apparel Summer Cotton Dress for Kids,Yb Series Electric Power Distribution Equipment Prefabricated Substation Transformer]

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.Yh9273 Lock Pick Set with Case Locksmith Tools Goso Lock Pick Set.[ESD Anti-Slip Anti-Static PVC Dotted Glove Lint Free]

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.Hydraulic Automatic Aluminum Sheet Gantry Shearing Machine. 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.[1 1.8 2 Inch High Pressure Centrifugal Stand 4.5cm DC Fan Axial Fan] 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,Motherboard Asrock Board Samsung Board Circuit. 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[2W 3W Motorcycle Tire Automatic Bom Hydraulic Curing Press Machine with Individual PLC]

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 (Prepainted Steel Sheet for Roofing Sheet).Electric Massage Bed Pedicure Chair with Double Dust Collector, waste residue is inert and sterile, i.e., environment friendly,Custom Design Luminous Vinyl Heat Transfer Printing for Clothing(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.[Fancy Stainless Steel Door Handles for Antique Doors]

Conclusions

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References