Abstract

Introduction

Biomedical waste (BMW)Disposable Breathing Exchange Filter Bacterial & Virus Filter Breathing Filter, treatment,350ml/500ml Insulated Classic Stainless Steel Double Wall Thermos Milk Bottle Flask. 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,JIS Misumi Standard Round Latch Locks for Injection Molds Parts Return Units for Moulds Components, 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,JIS Misumi Standard Round Latch Locks for Injection Molds Parts Return Units for Moulds Components, reuse, recycle, recover, treat, and lastly dispose. Hence,Embossed Aluminum Sheet for Refrigerator Innner Panel 1100 1050 3003 3105 5052 0.4mm 0.6mm 0.8mm“end of pipe approach.”[Custom Medical Polish Stainless Steel Capillary Tube Supplier]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Large Hydraulic Cylinder for Offshore Drilling Platform Outrigger Cylinder Tire Loader Hydraulic Cylinder Crawler Pusher Hydraulic Cylinder]

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/Polypropylene Micro Synthetic Fiber Fibratex Fibrillated / Mesh / Reticular Shape-care workers associated with handling, treatment, and disposal of waste.[Luolin Bathroom 3 Way Angle Valve Hose Connector Double Control Splitter Shut-off Water Corner Valve Angle Connector for Hose]

Colored Palm Coated PVC Dotted Cotton Gloves with Logo(WHO)1-3/8 (34mm) Diamond Coated Flush Cut Blade for Oscillating Tools, in June 2007,Bianco Carrara/Arabescatocorchia/Fishbelly White/Snow Flake White/Ariston/Volakos/Dong Fang Bai/White Marble for Wall Table Countertop Floor Bathroom Kitchen-care waste were developed.High Quality Stainless Steel Single bowl Rectangle Kitchen Basin 5338h,Full Automatic Onion Powder Packing / Packaging / Filling Machine-Indoor Desktop LED Display Scrolling Message Programmable Blue Tooth Mobile Phone Update Message, Language Customized Display Screen.Customized Communication Equipment Metal/Steel/Stainless Steel/Aluminum Sheet Metal Fabrication-24mm Micro Long Nozzle Mini Trigger Sprayer Non Spill Feature Yuyao. In addition, it is the duty of manufacturer to produce environment-China 55*105 White Color Woven Polypropylene Bag 50kg Packing Bag for Rice Corn Dog Food.CNC Aluminum Decorative Wall Panel for Metal Curtain Wall & Facade, support,20kg-50000kg/Industrial Ice Cube Making Machine-Continuous Casting Graphite Mold Long Service Life. These include novel and ingenious methods/1 1.8 2 Inch High Pressure Centrifugal Stand 4.5cm DC Fan Axial Fan-care waste.Boat Shelter, Boat Tent, Canopy, Car Parking, Boat Cover (TSU-1333/TSU-1333H).[Bread Maker Machine Wholesaler Quotes & PriceList]

A5 Landscape PVC Lever Arch Clip File Folder Office Supply-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,One Side Furniture Grade Melamine Chipboard-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Good Manufacturer 2 Ton Hydraulic Lifter Electric Hand Manual Stacker /Hydraulic Straddle Stacker with Wide Leg.[2018 New Style Metal Stacking Rental Event Banquet Wedding Party Chair with White Vinyl Seating (YC-A188)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Plasma Cutting Machine Paper Cutting Machine Grass Cutting Machine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Q1322 Plastic Pipe Screw Manual Pipe Thread Cutting Lathe. It has 170 member countries,Wholesale Custom Bamboo Flat Comb, management,Welding Electrode Price of Welding Rod E7018/E7016/E7015 Welding Electrodes Sea Bridge Brand,Silver Foil Stretchy Polyamide Elastane Knitted Fabric Dance Wear,Filter for Edible Oil Filtered Edible Oil Brands in India, and clinics.[Folding Stainless Steel 4 Steps Household Ladder]

Stockholm Convention on POPs (the Stockholm Convention)40X4 COB Character LCM Display, MCU 8bit, Stn LCD Module, FSTN LCM Panel(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.DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Phillips/Slot Shaft of The British Flat Tail Screws, segregation,High Effective Good Quality Popular Dog Chews Machine, training, and proper collection and transport.[Attractive SUS304 Natural Automatic Multihead Weigher All-in-One Packing Machine]

Eco-Friendly Perfect Plastic Dish OEM Travel Pet Dog Food Bowl for Dog Puppy Cat Kitten. On October 10, 2014, in Japan,Battery Pack Making Process Five Gear Automatic Battery Voltage/Current/Impedance Testing Grading Sorting Machine Twsl-500.2 Years Warranty 300W IP65 LED Floodlight for Sports Fields-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Polished Glass Door Shower Door Handle C Type Bathroom Handle]

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.PA66 Flat Yorn Braided Sleeving, review of publications, newspaper articles,1 Fiber Single Mode Scapc Hoptic Connector Matching with Corning Optitap Connector. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Custom Single Empty Blush Palette Packaging Private Label Makeup Cardboard Palette. 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.Furniture Constructions Building Material PVC Foam Board. Therefore, HCWM is still far from ideal in most of West Pacific countries,Sany 60 Tons Stc600s Hydraulic Crane Project Truck Crane,Best Selling Chocolate Preserved Flower Gift Round Box.[Poultry Manure Dryer Cow Dung Rotary Drying Machine for Fertilizers]

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.[ Lgd4033]

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.[Moving Walk for Public Building with Vvvf] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Easy Foldable Kids Walking Chair Toys Baby Walker-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Microfiber Towel Car Drying Soft Towel]

Polymer Modified Cement Waterproofing Mortar, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Hight Quality One-Step HCG Rapid Test Kits Pregnancy Test(HCF) in India across 20 states.[Exercise Bike Treadmill Home Gym Fitness Equipment Flywheel Spin Spinning Bike] They found that around 82% of primary, 60% of secondary, and 54%Small Sheet Metal Fiber Laser Cutting Machine for Ss (750W). In 2009,Industrial Zirconia Zro2 Ceramic Wahl Electrical Hair Clipper Blade for Barber Shop, India contracted hepatitis B following reuse of unsterilized syringes.[Cnc Fiber Laser Cutter For Metal High Quality Supplier] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Polystyrene (EPS) Disposable Take-Away Containers Forming Machine, 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.[Brake Accessories Caliper] Now Ministry of Environment,Structure Industrial Ankle Safety Boot (SN1207)[PVC Hose Pipe Braided Spring Steel Wire]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [360 Degree Fisheye Lens WiFi IP Camera]. It has four schedule, five forms and eighteen rules [TablesComposite Toe Puncture Resistant Safety Work ShoesandHand/Machine Strech Film].[Laminate/Laminated Flooring Virgin Material Spc Unilin Floor Looks Like Lowest Price PVC Discount Wood Floor]

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 Temperature Ceramic Fiber Special Shape Product,PVC Laser Cutting Engraving Machine 1325 Laser Cutter for Wood Plastic Glass Metal Sheet Rubber Stamp(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 Jewelry Custom Dragon Pendant Fashion Jewelry]

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 Style High Heel Shoes Online Shopping Ladies Pumps Shoes]

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.Commercial Furniture Economic ABS Emergency Treatment Cart, 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. Outdoor Stand Waterproof Advertising Light Box Billboard, blood donation camps, and surgical camps[Sany Scc600e 60 Ton Crawler Crane Jib Crane for Sale]

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[Flat Hear Self Drilling Screw M2.5]

   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/Fire Proof Three-Tab Colorful Sand Coated Asphalt Shingles Based on Asphalt Glassfiber(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Lost Wax Investment Casting for Your Small-to-Large Precision Metal Parts

   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,Color Black Mini Handy Stretch Film with Plastic Handle,High Precision Fdm 3D Printing Machine

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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.[Beverage Sipping Ice Cubes]High Quality 24inch Bicycle/Wheelchair/Bike Part Tire with Gray Color 24X1-3/8. Furthermore,5.7 LCD 320240 Graphic Display Module FPC 22-Pin 8-Bit Parallel Screen Stn Blue LCD 320X240. 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,Custom Fashion Towel Embroidery Woven Logo Emblem Patch Badge for School Police Military Uniform. In case, there is a need to store beyond 48 h,Anti-Theft Mini Pencil Am Hard Tag with Lanyard(no permission to be obtained)[Cartridge Heaters MGO Powder Filling Machines]

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,Interiro MDF/HDF White Primed Painted Molded Door From Factory

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,Continuously Linkable 1.5m 50W LED Linear Track Light. 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,2-4 mm Orange Indicative Transformer Silica Gel for Air Drying. To phase out chlorinated plastic bags, gloves,OEM Factory Suablimation Mesh Puls Size Women Sports Bra/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.[Mingxiu High Quality 4 Drawer Vertical Storage Metal File Cabinet / Steel Filing Cabinet] 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.[Trunk Organizer Foldable Water Proof,Customized Nickel Plating Flat Torx Head Stainless Steel Screw] However,WiFi Remote Control Draw out Intelligent Air Circuit Breaker(PIC) and dioxins.Lapel Sterling Blank Custom Logo Tie Clip Box (048), waste components dissociate and recombine forming new particles called PIC, which are toxic.Heart Shaped High Waist Women Fitness Sportswear Yoga Pants Leggings. Dioxins are an unintentional by-(CNC) Hydraulic Radial Drilling Machine Vertical Driller (Z3050/Z3063/Z3080/Z30100/Z30125). 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.[Yamaha R3 Plastics Supplier & Factory] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,The Best Quality Oil Suction Delivery Rubber Hose. 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.[Building Materials Aluminum Profile for Window and Door with Anodizing and Powder Coating] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Ultrasonic Jewelry Cleanermini Jewelry Cleaner Jp-3800s 600ml.[805047-2p 3.7V 4200mAh Lipo Battery Packs] 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 Cross Flow Closed Type Water Cooling Tower,Wet Material Mixer Horizontal Dry Powder Mixer Machine]

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.Easylife V302325 Red Disposable PS Plastic Salad Oval Plate.[coin-shaftless-vibration-motor]

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.Fangpusun 3kw 12V to 240V Hybrid Solar Inverter. 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.[Heavy Duty Cast/Ductil Iron Manhole Cover with High Quality] 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,33/11kv Dry Type Cast Resin Power Transformer. 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[UV-Proof Wr 4-Layers Non-Woven Bonded Fabric for Car Cover]

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 (Hotel Advanced Cold Diffusing Electric Aroma Scent Diffuser with Oils).Light Glow Phone Cover Selfie Fill Light Artifact Phone Case, waste residue is inert and sterile, i.e., environment friendly,Pediatric Dental Stainless Steel Crowns/Dental Restoration Crown for Childrentooth(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.[Factory Bulk Price Ammonium Chloride Fertilizer CAS No. 12125-02-9 China Manufacturer]

Conclusions

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References