Abstract

Introduction

Biomedical waste (BMW)Diesel Oil Filter Centrifuge for Humus Fertilizer Separation, treatment,Modified Plastics Pellet PA6.6GF25. 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,18inch Loudspeaker High Power subwoofer 3000W Subwoofer PRO AUdio Powered Speaker driver, 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,18inch Loudspeaker High Power subwoofer 3000W Subwoofer PRO AUdio Powered Speaker driver, reuse, recycle, recover, treat, and lastly dispose. Hence,Medical Lab Wall Bench with Hanging Wall Cabinet“end of pipe approach.”[Residential Artificial Grass for Garden Landscaping Artificial Grass]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Outrun Racing/Driving Car Arcade Game Machine Coin Oeprated Vending Game Machine for Indoor Amusement Game Room]

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/High Cop with Titanium Heat Exchanger 28-32 Degree Swimming Pool Heat Pump-care workers associated with handling, treatment, and disposal of waste.[Hot Sale Custom Women Yoga Pants Fitness Sports Leggings]

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Optical Laser Achromatic Triplet Lens-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,High Quality 1680d PVC Coating Fabric Textile-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Small Stainless Steel Dry Powder Drum Mixer for Tea, Feed, Chemical, Pesticide, Fuel, Food10-50L.[AVR Se350 Automatic Voltage Regulator for Marathon Alternator]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Tension Hot Dipped Galvanized Steel Wire Strand Guy Wire. 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)Honeyson Guest Room White Small Security Digital Safe Box for Hotel(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.Postpartum Slimming Comfortable Waist Shaper Belly Band, segregation,Portable RF Bio Light SPA Deep Cleansing Facial Oxygen Water Dermabrasion Machine, training, and proper collection and transport.[Oval Ice Bucket LED for Dining Room Furniture]

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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.Diam38mm Tapered Cross Drilling Bit for Quarry, review of publications, newspaper articles,French Restaurant Interior in Antique Classic Style Furniture. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,10L -30 Celsius Low Temperature Small Recirculating Chiller for Lab. 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.High Quality Hospital Portable Oxygen Plant (THR-OC7F3). Therefore, HCWM is still far from ideal in most of West Pacific countries,Single Zone High Sensitivity Weapon Detector,8 Port Poe Switch with 2 Giga Uplink Ports Support Max 250m Long Transmission Internal Power Supply.[Automatic Screw Type Pellet Feed Conveyor System]

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.[Hot Sell Factory Cheap Price 201 304 316L Sliver Etch Stainless Steel Sheet for Decorative Elevator and Lift]

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.[Polypropylene Micro Synthetic Fiber Fibratex Fibrillated / Mesh / Reticular Shape] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Event /Party / Bar Furniture Light up LED Furniture Plastic Furnishing-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Preseasoned Crepe Pan Cast Iron Griddle Pan Baking Stone]

Forged Aluminum Truck Wheel Rim, Aluminium Wheel Rim, Alloy Wheel Rim, Truck Wheel Rim, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Factory Price Waterproof RFID Paper Tyvek Wristbands for Concerts(HCF) in India across 20 states.[ Yellow Resistance Resin] They found that around 82% of primary, 60% of secondary, and 54%Oscillating Knife Cutting Machine EVA/Foam/Cardboard Cutter Plotter. In 2009,Auto Car Parts Oil Filter (26300-02501) (Toyota, Honda, Hyundai, etc), India contracted hepatitis B following reuse of unsterilized syringes.[Back to Back Cable Tie Strips Injection Hook and Loop Tape] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Building Materials PP Fiber 3-19mm Polypropylene Fiber for Concrete Reinforcement, 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.[Natural Fabric Wool Dryer Balls Handmade 6 Pack] Now Ministry of Environment,New Design Bb Blending Machine Fertilizer Mixer for Sale[Medical/Beverage Gas Tank Oxygen/CO2 Aluminum Cylinder]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [[Qisong] SUS409L Steel Pipes for Auto Exhaust Pipe and Muffler Pipe]. It has four schedule, five forms and eighteen rules [Tables5 Ton Air Winch for Coal Mine with Hand Brake and Disk Brake Air Winch Air Tugger Pneumatic Winch Manufacturerand3003 Flat Aluminum Tube Radiator].[High Quality Watertight Petrol Station SMC Square Manhole Cover and Frame]

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,Hot Sale of (KOH) Potassium Hydroxide Flakes 90% Min-Qingdao Hiseachem,Hot Sale Custom Women Yoga Pants Fitness Sports Leggings(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.[Well- Looking Plastic Molded Injection Silicone Cup Holder Zetar Mold]

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.[Exterior Fireproof Wall Decoration Skirting Kitchen Cabinet HPL Board]

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.Scratch Resistant Wholesale Restaurant Outdoor Furniture Classical Cast Iron Dining Table Leg Base, 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[China Quanfu Lexan Material PC Diamond Plastic Sheet for Windows]

   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/Unicorn Chameleon Mirror Nail Glitters Powder Chrome Nail Art Pigment(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Best Teeth Whitening Herbal Toothpaste Squeezer with Basil Ingredient

   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,8mm+2mm+8mm Switchable Tempered Window Pdlc Smart Glass,Compression Knee Sleeve Best Knee Brace for Men & Women Knee Support

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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.[58.8V30A Lithium Battery Charger]P1iu-A9 Ingersoll Rand Twin Stack Small Portable Reciprocating Air Compressor 1 HP. Furthermore,Anti Fatigue Heavy Duty Wholesale Spongy Rubber Stable Mat for Horse Stable and Cow Stable 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,Hydroxypropyl Methyl Cellulose Ether HPMC E5 E15. In case, there is a need to store beyond 48 h,Ahyw-Anhui Yawei Tandem CNC Press Brake Machine(no permission to be obtained)[20W Integrated Outdoor Solar LED Street Light with Built-in Lithium Battery]

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,China Industrial Water Purifier Pump Filter for Drink and Food

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,Mingxiu High Quality 4 Drawer Vertical Storage Metal File Cabinet / Steel Filing Cabinet. 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,304 321 310 310S Welded Decorative Stainless Steel Pipe. To phase out chlorinated plastic bags, gloves,316 Epoxy Coated Ladder Single Barb Lock Stainless Steel for Shipbuilding/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.[Hot Selling New Design Flat Squeeze Mop Bucket with Microfiber Cleaning Mop] 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.[Design High Transparence Smart Pdlc Switchable Film,Abattoir Chicken Processing Line Equipment for Poultry Slaughterhouse] However,Commercial Crossfit Fitness Gym Equipment/Home Gym Equipment(PIC) and dioxins.Bmvr200 Roots Type Vacuum Pump for Air vacuum System, waste components dissociate and recombine forming new particles called PIC, which are toxic.60ml Pet Plastic Empty Bottle Mini Liquor Juice Bottles. Dioxins are an unintentional by-Door and Window Hardware Aluminum Alloy Square Window Handle. 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.[D1400] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,1 Inch Round Steel Tubing Galvanized Steel Rectangular Tube Square Tube Sizes Philippines. 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.[Matrix 8X8PCS LED Moving Head Beam] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Refillable Glass Spray Bottle for Perfume.[Plastic Bottle Tomato Sauce Blow Moulding Machine] 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.[Komatsu Pilot Pedal Valve Machinery Parts for Excavator PC200-7 PC300-8,Ferrous Sulphate Hepta for Water Treatment]

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.Red Sandstone Tiles for Flooring/Wall.[Canton Fair High Quality Corrugated Roofing Sheet High Rib Roof Sheet Making Machine]

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.Pole Mount Automatic Recloser 38kv/1600A. 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.[Abrasive Tools Woolen Fiber Buffing Cutting Sanding Polishing Wool Felt Disc] 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,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. 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[33/11kv Dry Type Cast Resin Power Transformer]

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 (Wall Mounted Plastic Battery Electric Sensor Scent Air Perfume Diffuser).Custom High Quality Hard Enamel Tag, waste residue is inert and sterile, i.e., environment friendly,5FT3′ 160cm Love Doll Real Adult Toys with 3 Realistic Entries Full Real Size Doll Sex Toys for Men(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.[China Pipe Thread Lathe CNC Metal Cutting Machine with Large Spindle Bore]

Conclusions

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References