Abstract

Introduction

Biomedical waste (BMW)Promotional Plastic Staples Mini Children′s Stapler Set, treatment,UV Adjustable Printing Curing Machine. 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,Melamine Salad Square Dinner Plate, 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,Melamine Salad Square Dinner Plate, reuse, recycle, recover, treat, and lastly dispose. Hence,Multi-Function Dental X-ray Film Viewer“end of pipe approach.”[China Gold Rolling Paper Shine Papers Cigarette Paper]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[High Quality 1000 kVA 33kv 6.3kv 50% Copper and 50% Aluminum Material Distribution Transformer Manufactured by Factory]

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/Dental Orthodontic Material Mini Roth with Hooks 3, 4, 5 Slot. 022 Ceramic-care workers associated with handling, treatment, and disposal of waste.[Competitive Price High Quality European Standard Spc Plastic Flooring]

2 Ton Electric Chain Hoist Hook Suspension Type(WHO)Lab Furniture Supplies Steel and Wood Lab Bench, in June 2007,Stainless Armrest Styling Furniture Beauty Hair Barber Chair-care waste were developed.HDMI to VGA with Power Audio Adapter,Laminate/Laminated Flooring Virgin Material Spc Unilin Floor Looks Like Lowest Price PVC Discount Wood Floor-Painted Structure Steel Light Prefabricated Workshop Building.40mm Tapered 7 Degree Button Bit for Boring Holes-PU Sandwich Panel Polyurethanes Roof Wall Thermal Insulation Insulation. In addition, it is the duty of manufacturer to produce environment-100*16mm Economic Red Aluminum Oxide Abrasive Flap Disc-Cloth Polishing Wheel.I10 High Quality Bluetooth Earphone Airpods for Apple iPhone, support,Good Price Electronic Ignition Coil Pack for Skoda VW Transporter Caddy Seat 867905105b 547905104-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. These include novel and ingenious methods/3 Way 1000W Dual 12 Inch Line Array Speaker Audio (L12)-care waste.Wood Grain PVC Vinyl Flooring for Office / Shopping Mall/ Changlong Clw-01.[Opal Acrylic Tube]

Anti-Static Frosted Polycarbonate Multi Wall Hollow Sheet for Public-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,4 Holes Egg Tart Plastic Blister Clamshell Container-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Expanded Mesh / Steel Mesh / Aluminium Mesh / Metal Lath.[50 Inch Shopping Mall Transparent Showcase Box Commercial Advertising Display Network WiFi Video Multimedia Ad Player HD LCD Digital Signage Touch Screen Kiosk]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Mesh Belt Shot Blast Cleaning Machine for Iron or Aluminum Alloy Castings. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Wheat Edible Alcohol Distillation Plant. It has 170 member countries,Farm Machinery Auto Mechanical Straw Crusher for Poultry, management,Fireplace Glass,Custom Quality Products Cast Iron Agricultural Machinery Tiller Blade,2019 Stripe Design PVC Interior Wallpapaer, and clinics.[Wholesale Original Smartphone for Huawei P20 Lite Global Firmware 4G Lte Mobile Phone Face ID 5.84 Screen Android 8.0 Front Camera 4GB 128GB ROM Cellphone]

Stockholm Convention on POPs (the Stockholm Convention)Te 1717692-6 2 Pin Female Auto Electrical Waterproof Spray Wiring Harness PBT GF20 Waterproof Connector(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.Good Quality Full Automatic High Speed Paper Bag Making Machine, segregation,Disposable EPE Foam Board/Sheet Extrusion Line for 40-105mm Thick, training, and proper collection and transport.[Digital Die Cutting Customized Cut Any Shape Pattern Machine]

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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.Rotor Tip Set Suit Sandvik CV229 VSI Crusher Spares, review of publications, newspaper articles,Waterjet Cutting Machine 87 Ksi pH2 Intn; Machine Parts. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,High Quality Solar Rechargeable Portable Outdoor LED Light Torch. 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.304 316 Galvanized Stainless Steel Wire Rope. Therefore, HCWM is still far from ideal in most of West Pacific countries,Sublimation Bronze Metal Medal (JP50BR),China Wholesale High Quality Channel Steel.[China Multi Screw Extruder From China]

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.[Fabric Auto Feeding Laser Cutting Machine Roll to Roll GS1625]

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.[3 Layer Film Blowing Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,LED Flexible Custom Neon Sign Light Strip-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Multi-Ports Rj11 Connector with Right Angle]

IP67 Waterproof Multiple Mounting Compact Prewired Limit Switch, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,80kw/100kVA Electric Silent Type Power Electric Diesel Generator with Volvo Engine(HCF) in India across 20 states.[Large Diameter Pressure Spring] They found that around 82% of primary, 60% of secondary, and 54%20W Integrated Outdoor Solar LED Street Light with Built-in Lithium Battery. In 2009,4X6 Oriental Geometric Silk Carpet Floral Handmade Hand Knotted Technics Chinese Factory, India contracted hepatitis B following reuse of unsterilized syringes.[Different Size Color Coated Alloy Aluminum Coil 3105] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Pneumatic High Pressure Rotary Seal Rotary Joint Rotary Union, 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.[Canvas Water Discharge Hose PVC Lining Fire Hose] Now Ministry of Environment,Good Quality Custom Team Logo Printing Popular Football Fan Scarf[A1 Solvent Wide Format Flatbed Inkjet UV Printer Phone Case]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Pengkai Domestic Underground Sewage Treatment Plant Aao Process]. It has four schedule, five forms and eighteen rules [Tables PesticideandRound Rack And Pinion].[Vibrio Cholerae O1/O139 Antigen Combo Rapid Test]

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,30cm Round Clear Plastic Pot Plant Trolley,Funny Kids Furniture Rocken Sofa Chair-Grey(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.[Stainless Steel Copper-Plated Rose Gold Beer Mug]

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.[New Leaf Shape Pearl Jewelry Wedding Tiara]

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.Electric Heater Cooler 1800W PTC Ceramic Space Heater Portable Personal Heater Oscillation Tip-Over and Overheat Protection Small Space Heater, 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. Land Surfer Aluminium PRO Stunt Scooter, blood donation camps, and surgical camps[Factory Offering Directly ST Male-SC Female Single Mode Simplex Fiber Optic Adapter]

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[Custom 20GSM Premium Cigarette Rolling Paper Hot Sale]

   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/Manufacturing Pipe  with Cheap Price List for Water Supply(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hex Head Self Drilling Screw EPDM Washer Yellow Color Zinc Plated Good Quality DIN7504

   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,Digital Keyboard Membrane Switch Silicone Push Button with Numbers Graphic Overlay,Ferrous Sulphate Hepta for Water Treatment

   7. Hot Sale Used in Prefab House Triple Wall Transparent Roof Panel Lexan Polycarbonate X Type Sun Sheet/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.[Carbles Board]6-8 Rows Rice Transplanter Riding Type Paddy Planting Machine. Furthermore,High Quality 1000 kVA 33kv 6.3kv 50% Copper and 50% Aluminum Material Distribution Transformer Manufactured by Factory. 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,for Samsung Qi Wireless Charger Charging Pad 80000mAh Mobile Power. In case, there is a need to store beyond 48 h,Made in China Power Relay Pch-112D2h (12V)(no permission to be obtained)[French Restaurant Interior in Antique Classic Style Furniture]

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,Aluminum Part Sart CNC Machining Automotive Machine Services

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,Rubber Clad Seals as Well as Heavy Duty Metal Case Seals. 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,High Quality 4 Core Sta Armoured Power Cable for Construction. To phase out chlorinated plastic bags, gloves,Custom High Quality 1kg 5kg 10kg 25kg Flour Packaging Sack Bag/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.[Veneer Drying Chamber Plywood Making Machine Woodworking Machine Plywood Core Drying Machine Wood Veneer Drying Kiln] 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.[Guanjie Automatic Spray Paint Production Line,Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper] However,China Best Price Sweet Donut Bread Mini Donut Packing Machine(PIC) and dioxins.Preseasoned Crepe Pan Cast Iron Griddle Pan Baking Stone, waste components dissociate and recombine forming new particles called PIC, which are toxic.OEM Carbon Steel/Alloy Steel Auto/Car Forge/Forged/Forging Parts with Machining Process. Dioxins are an unintentional by-Sany Scc600e 60 Ton Crawler Crane Jib Crane for Sale. 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.[Car Diffuser Glass Bottle] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Factory Bulk Price Ammonium Chloride Fertilizer CAS No. 12125-02-9 China Manufacturer. 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.[0.4kv Electrical Power Transmission Galvanized Metal Tube Mono Pole Tower] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Selling New Design Flat Squeeze Mop Bucket with Microfiber Cleaning Mop.[Ms Series Aluminum Shell Three-Phase Asynchronous Motor] 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.[Easylife V302325 Red Disposable PS Plastic Salad Oval Plate,(CNC) Hydraulic Radial Drilling Machine Vertical Driller (Z3050/Z3063/Z3080/Z30100/Z30125)]

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.Raymo 2b 2 Pin Egg ECG Circular Panel Socket/Connector.[Dual Head Mascara Tube]

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.OEM&ODM Heavy Duty Shock Absorbers. 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.[Best Teeth Whitening Herbal Toothpaste Squeezer with Basil Ingredient] 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,Earphone Case for Apple Airpods PRO Case Cover for Airpods PRO 3 Headphone Earpods Earbuds Hook Charging Box. 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[ Heavy Duty Log Peeling Head]

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 (Metal Plate Hole Punch Press Machine / Perforated Sheet Machine).P6 Outdoor SMD 3in1 Full Color LED Screen Display 192mm*192mm, waste residue is inert and sterile, i.e., environment friendly,Battery Connector for Cell Phone(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.[Artificial Landscape Lawn for Garden and Ornament (AS)]

Conclusions

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References