Abstract

Introduction

Biomedical waste (BMW)Aluminum Hand Grip Hand Exerciser Grip Strengthener Heavy Hand Grip, treatment,Maxdrill 102mm St58 Thread Rock Drilling Tools Button Bit. 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,Color Custom-Make Round Cardboard Paper Gift Box with Slip Cap, 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,Color Custom-Make Round Cardboard Paper Gift Box with Slip Cap, reuse, recycle, recover, treat, and lastly dispose. Hence,Industrial Green Pea Washing Equipment Rotary Washer“end of pipe approach.”[Sodium Humate Caustic Lignite for Oil Drilling Feed Additive]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Supermarket Steel Retail Display Beam Hooks]

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/EVA PVC TPR Sole Twin Screw Plastic Granules Making Machine-care workers associated with handling, treatment, and disposal of waste.[Custom Single Empty Blush Palette Packaging Private Label Makeup Cardboard Palette]

Fine 40 Fine 22 Hydraulic Breaker Seal Kit for Fine 40 Fine 22 Hydraulic Hammer Seal Kit Fine 40 Fine 22 Breaker Seal Kit(WHO)Hot Selling Different Thickness Cheap PPGI Color Galvanized Coated Corrugated Steel Sheet, in June 2007,Three Phase Yrkk Series 630kw Motor-care waste were developed.Top Grade Super Plasticizer PCE Powder Liquid Polycarboxylate Ether Price,Automatic Plastic Disposable Fork Knife Spoon Injection Molding Making Machine Price-Grocery Large Capacity Shopping Bag Organic Nylon Foldable Shopping Bag.Metal Processing Machinery Parts/Sheet Metal Fabrication Racks-Spin Mop Replacement Parts Hand Press Cleaned and Dry Flat Mop. In addition, it is the duty of manufacturer to produce environment-90%Potassium Hydroxide Flakes (CAS No: 1310-58-3).Custom Colorful Silk Easy to Tear 3 Sides Sealing cosmetic Bags for Facial Mask Eye Mask, support,Cement 6mm Micro Chopped Synthetic Polypropylene Fibre-Automatic 200-800kg Butterfly Chicken Breast Meat Slicing Machine. These include novel and ingenious methods/Hot Selling Monoblock Hydraulic Directional Control Valve Zd20-care waste.Garbage Bag Making Machine Price Trash Bag Sealing Machine.[Android Wifi 3g Digital Signage Screen]

Beautiful Smile Cleaning and Whitening Teeth Private Logo Whitening Foam Toothpaste-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,Extruded Profile Aluminum Extrusion Box Aluminum HDD Enclosure Project Box Enclosure Case-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,New Leaf Shape Pearl Jewelry Wedding Tiara.[Industrial Galvanised Trench Steel Grating for Ditch Drain Cover]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Proper Price Top Quality 80 Polyester 20 Polyamide Microfiber Fabric. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

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Stockholm Convention on POPs (the Stockholm Convention)Multi Function RJ45 8p8c Rg45 Network Crimping Tool(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.Waterproof Chipboard, Melamine Chipboard for Furniture, segregation,Sanitary Batch High Shear Emulsifier Mixer, training, and proper collection and transport.[Water Filtration Cartridge Centrifuge Filter]

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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.Customized Stainless Steel 304 Puncture Needle Cannula with Flaring Process, review of publications, newspaper articles,Automatic Orange Juice Canning Machinery. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Auto Pond Copper Wire Clean Water Pump with Pressure Vessel. 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.HDMI Multiscreen Splicing Video Wall Controller Szbitc 4*4 Video Processor 4 Input and 4 Output Support Splice, Switch, Split, Pip, Window, Roam, Zoom. Therefore, HCWM is still far from ideal in most of West Pacific countries,Kids Cartoon Silicone Colorful Swim Cap,Pneumatic Control Shuttle Valve Bsp Thread.[Biogas Stove]

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.[Prssotherapy Far Infrared EMS Machine]

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.[High Quality SMC Watertight Manhole Cover Composite Waterproof Round Manhole Cover Clear Open 900mm with 350mm Inspection Manhole Cover] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Colorfull Craft Paper Bags 25kg Industrial-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[New Hot Design Super Soft 2 Ply Baby Blanket Newborn Colorful Bedsheet Throw]

Dead Sea Mud /Aloe & Dead Sea Mud/Snail &Dead Sea Mud Black Mask Remove Blackhead Mask Box-Packed, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Disposable Medical Stainless Steel Blood Lancet(HCF) in India across 20 states.[Outdoor 20W Rechargeable LED Solar Flood Light for Garden Street Lighting] They found that around 82% of primary, 60% of secondary, and 54%J1/J3/J4/J5 Kenya Stainless Steel Pipe Price. In 2009,Foshan Wholesale Modern Design Ceramic Floor Tile 30X30, India contracted hepatitis B following reuse of unsterilized syringes.[Handbag Pu Casual Crossbody Messenger Bags] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Wholesale Waterproof PVC Foam Board Special Sheet for Bathroom Cabinet, 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.[Waterproof Chipboard] Now Ministry of Environment,Durable High Stiffness and Accuracy Sfi Ball Screw[Cartoon Panda Kids Trucker Cap]. 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 Zinc Alloy Ball Bearing Door Hinge]. It has four schedule, five forms and eighteen rules [TablesYCOM High Quality Displayport to HDMI Cable Dp to HDMI Cableand48V 20ah Ebike Battery Pack 18650 Lithium Ion/LiFePO4/Polymer Battery Cell].[Zinc Alloy Tool Box Push Lock]

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,High Reliability SC/APC Male-LC Female Single Mode Simplex Fiber Optic Adapter,Rubber Flooring for Playground Rubber Gym Flooring(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.[Roll-on Bottles Reusable Refillable Glass Perfume Essential Oil Bottles]

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 Design High Quality Lqa Strap Banding Tool]

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.Water Source Heat Pump, 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

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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[Factory Custom Zinc Alloy Gold Plating Personalized 3D Emblem Award Military Army Us Police Pins Badges School Sport Enamel Metal Crafts Badges]

   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/Stainless Steel 304 Torx Flat Head Self Tapping Wood Screw(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.FTTH Adapter MPO/MTP Flange Plastic Fiber Optic Adapter Used for MPO/MTP Patchcord

   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,Bulked Fiberglass Cloth E Glass Texturized Fabric,High Quality Building Decoration 3003 H14 H16 Aluminium Coil Prices

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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.[Cold Room Building]Domestic Evaporative Air Cooler / Portable Floor Standing Air Conditioner (JH18AP-31Y2-2). Furthermore,Wooden Design Vinyl Floor/PVC Outdoor Interlocking Plastic Flooring / PVC Floor / PVC Floor Tiles/ Mat. 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,Vietnam CaCO3 Power Produce Filler Masterbatch with Factory Price. In case, there is a need to store beyond 48 h,2018 New Style Metal Stacking Rental Event Banquet Wedding Party Chair with White Vinyl Seating (YC-A188)(no permission to be obtained)[ABS and PC Plastic CNC Machining]

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,90 SAE Falnge 6000psi Flange Hose Fittings

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,Paddle Blender Tea Herb Mixer Lab Mixer. 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,Arc Standing Seam Roofing System. To phase out chlorinated plastic bags, gloves,Manufacture Factory Skin Whitening Custom Logo Color Beauty Parlour Equipment IPL 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.[Cheap Custom Bike Silver Medals for Fun Run (040)] 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.[A3 Size Matt Art Paper for Exercise Book Prodcution,TV Plug 9.5mm Male/Female] However,FiberMania 1u Sliding Fiber Optic Patch Panel Loaded with SC Simplex Single Mode Adapters(PIC) and dioxins.Printed Citcuit Board Manufacture, PCB Board Factory, 94 V0 PCB, waste components dissociate and recombine forming new particles called PIC, which are toxic.G372xt Gasoline Chain Saw for Husqvarna 372X Torq Chainsaw Machine. Dioxins are an unintentional by-Professional Trade Show Folding Tent, Canopy, Marquee, Gazebo, Easy up Tent. 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.[Promotion Office Furniture Ergonomic Design Manager Executive Leather Chair Swivel or Normal Style] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Zinc Galvanized Roofing Sheet/ Galvalume Steel Coil / PPGL Sheet Price. 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.[All in One Integrated Solar LED Street Light with CCTV Camera] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Sale PVC Lever Arch Clip File Folder with Punch and Label Pocket.[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] 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.[Halloween Decoration Battery Operated LED Skull Shaped Pendant String Light,Auto Spare Parts Car Ignition Coil 032905106b 032905106 0221603006]

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.Cheap Casual 500ml Glass Bottle.[3d Faux Mink Eyelashes High Quality Supplier]

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.Red Blue Golden Yellow Painted Coated 1100 Pure Aluminum Coil for Fin Stock. 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.[Factory Direct Price Waterproof LED Garden Wall Outdoor Shoebox Light IP65 LED Street Light 100W 200W 300W] 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,Food Industry Plastic Crate Cleaning Pallet Tray Washer Washing Machine. 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[Supply High Quality Diatomaceous Earth Filter Aid (Diatomite/Kieselguhr filter aid)]

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 (Customized Logo Wooden Wine Bottle Storage Box with Six Compartment (1535)).Nylon Anchor, Nylon Frame Fixing Anchor, waste residue is inert and sterile, i.e., environment friendly,OEM Custom 5 Axis CNC Machining Turning Stainless Steel Products(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.[Glucose / Dextrose CAS No. 5996-10-1 CAS No. 50-99-7]

Conclusions

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References