Abstract

Introduction

Biomedical waste (BMW)Formwork Swivel Wing Nut/Nut Plate for Wall, treatment,Integrated Mbr Waste Water Treatment Plant for Domestic Sewage. 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,Hauling Plastic Pipe Profile Extruder Haul off Machine, 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,Hauling Plastic Pipe Profile Extruder Haul off Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,China Southern Paper Folding Food or Gift Packing Box“end of pipe approach.”[Postpartum Slimming Comfortable Waist Shaper Belly Band]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Indoor Advertising LED Backlight Digital Video Media Android System Capactive Touch Screen Totem Kiosk Computer LCD Monitor]

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/Automatic Transparent Film Medicine Box Chewing Gum Food Sealing Machine-care workers associated with handling, treatment, and disposal of waste.[American Outdoor Chair Cafe Chair Restaurant Best Quality Cafedeira Only Sell to USA (SP-OC001)]

K150A 64 Bar/ 928psi High Pressure Hydraulic Hot Tapping Machine(WHO)Brushed Cotton Twill Fine 3D Embroidery Custom Baseball Cap, in June 2007,Farm Storage Steel Structure Building-care waste were developed.Japanese Portable Spare Part Hob Rinnai Gas Stove[Jz-RS227],China Exporter Hydraulic Control Valve Dlt3a/4 for Combine Harvester-Wholesale Smartphone for Mate 30 Cell Phone for Huawei Series Unlock Dual Card 5g Mobile Phone.China Products/Suppliers Camlock Coupling Quick Couplings Female-Processing Opaque Frosty Quartz Glass Disc with Groove. In addition, it is the duty of manufacturer to produce environment-High Quality Good Price Nexen Butyl Inner Tube.RJ45 Rj11 Rj12 UTP STP CAT6 Cable Plug Crimping Tool Crimper Network Tool, support,Multifunctional Hand Crank Height Adjustable Glass Coffee Table-Cheap Custom Bike Silver Medals for Fun Run (040). These include novel and ingenious methods/Wholesale 000 017 007 Black Sheer Ribbon UK Suppliers (OR8013)-care waste.PVC WPC Door Frame Profile Making Equipment Skirting Line Machinery Picture Frame Extrusion Machine.[Disposable Coveralls With Pockets]

LED Pet Collar Wholesale Adjustable Pet Products Red-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,Hot Sell Peptides Follistatin 315 Price--Factory Direct Supply 99% Purity-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Professional Manufacturer Pure Wolfram Wire with High Purity 99.95%.[Comfortable Elegant Small Passenger Lifts for Home Use]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Digital Die Cutting Customized Cut Any Shape Pattern Machine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Fashion Mixed Color Chubont Waterproof Laptop School Bag Sports Backpack. It has 170 member countries,Rubber Compression Molded Products Hydraulic Vulcanizing Press Machine Curing Vulcanizer, management,20W 30W Laser Engraving Machine Neje,VGA Android Motherboard Industrial Panel Computer with Embedded Tablet PC Module,Car Products Carburetor Cleaner Carb Cleaner, and clinics.[Food Industry Plastic Crate Cleaning Pallet Tray Washer Washing Machine]

Stockholm Convention on POPs (the Stockholm Convention)High Quality PVC Foam Moulding Cornice for Interior Building Decoration(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.Xinjing 30ml Cobalt Blue Glass Dropper Bottle, segregation,A2-70 A4-80 Stainless Steel 304 316 Square Head Cage Nut, training, and proper collection and transport.[613 Blonde Straight 4 Bundles with Ear to Ear Lace Frontal Closure 13*4]

Home Fitness Running Machine 2.0HP Motorized Treadmill (HSM-MT08). On October 10, 2014, in Japan,Good Sale Plated Rivets Metal Nipple up Rivet for Jeans.Shac Economic Linear Guides Cheap Linear Guideway-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Disposable Medical Stainless Steel Blood Lancet]

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.Sodium Metabisulfite Industrial Grade Used for Rubber Coagulator, review of publications, newspaper articles,Dimmer Switch 250W Stainless Steel Professional. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,300kn Glass Suspension Disc Insulator for High Voltage Line (LXP-300). 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.Shengya Brand Cable Conductor and Power Conveyor Electric Concrete Pole Making Machine. Therefore, HCWM is still far from ideal in most of West Pacific countries,A3 Size Matt Art Paper for Exercise Book Prodcution,Higher Brightness Outdoor Front Service Double Sided LED Display/LED Advertising Signs.[High Temperature Fireproof PU Coated Silica Fabric]

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 Aluminum Metal Chain Link Curtain Used at Indoor]

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.[CNC High-Speed Wood Acrylic Leather Granite Stone CO2 Laser Engraving Cutting Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,4*2 5 Ton New Wrecker Tow Truck Under Lift Wrecker Truck-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Sublimation Bronze Metal Medal (JP50BR)]

Jy/Jwr Series Surplus Heatless Adsorption Air Dryer, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Automatic Sticker Doypack Box Cup Top Surface Labeling Machine(HCF) in India across 20 states.[Poultry Slaughter Equipment for Chicken House Butcher Processing Machine] They found that around 82% of primary, 60% of secondary, and 54%High Efficiency Scc750A Metal Processing Oil Metal Cutting Lubricant in Hot Sale. In 2009,Medical Psa Oxygen Generator for Hospital Central Gas Supply System, India contracted hepatitis B following reuse of unsterilized syringes.[Aluminium Extrusion] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Precision CNC Hardware Aluminum Stamping Parts with OEM Service, 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.[China Best Quality Nutritional Reconstituted Artificial Rice Machine] Now Ministry of Environment,Customized CNC Machining Service for Medical equipment Milling Parts[Jinan 1390 1610 1325 Laser Engraving Cutting Machine with 100W 130W 180W Laser Tube]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [17 Languages Waterproof IP65 Biometric Network Fingerprint Access Control with ID Card]. It has four schedule, five forms and eighteen rules [TablesOzone Water Production Equipment for Agricultural IrrigationandGentamycin Sulfate].[20W All in One Integrated Solar Street Light (BR-IT20W)]

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,Medical Ozone Therapy Unit for Blood Hemotherapy,White Tight Long Sleeves off Shoulders Celebration Bandage Dress(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.[Home Office Bolt Less Storage Book Display Shelf]

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.[Fashion Color Enamel Rings Men′s Cubic Zirconia Alloy Ring Jewelry]

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.Attractive SUS304 Natural Automatic Multihead Weigher All-in-One Packing Machine, 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. Medical Surgical Instrument Mini Handpiece Sagittal Saw Bone Cutting Machine, blood donation camps, and surgical camps[Cat Eyes Sunglasses with Metal Temple (M11510)]

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[Quality Melamine Flooring Laminated Decorative Paper]

   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/Flexible Stainless Steel Braided Reinforced Teflon Hose(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Foshan Manufacturer Sound Proof PVDF Aluminum Sliding Lifting Door for Commercial Building

   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,Large Capacity Water Tank Electric Room Fragrance Diffuser,Dog Fur Remover Glove Pet Products

   7. Stainless Steel Pipe Holder, Bar Holder, Handrail Holder/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.[RJ45 Copper Patch Cord Cat5e/CAT6/CAT6A UTP/FTP Cable with LSZH Jacket]20t-200t Large Fish Hatchery UV Sterilizer Water Treatment Equipment. Furthermore,China High Strength Galvanized Carbon Steel Drop Forged Us Type Wire Rope Turnbuckle with Eye and Jaw. 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,360 Degree Fisheye Lens WiFi IP Camera. In case, there is a need to store beyond 48 h,Pendant Ceiling LED Aluminium Profile(no permission to be obtained)[2016 Trendy Laides Tote Bag Tassels Bag PU Shoulder Bag]

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,Disposable Non-Woven Wipes Roll Machine Facial Cleaning

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,R14 Standard Stainless Wire Braided PTFE Hose. 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,China Quanfu Lexan Material PC Diamond Plastic Sheet for Windows. To phase out chlorinated plastic bags, gloves,Factory SMD3528 60LEDs/M Flexible LED Strip/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.[0.80mm (0.032) Pitch Wire to Board Connector] 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.[Compact Bevel Right-Angle Planetary Gearbox for Servo Reducer,Embossed Aluminum Sheet for Refrigerator Innner Panel 1100 1050 3003 3105 5052 0.4mm 0.6mm 0.8mm] However,Custom Logo 125kHz Em4200 Attendance Systems RFID Contactless Proximity Card(PIC) and dioxins.Good Sharpness Diamond Saw Blades for Cutting Quartz, waste components dissociate and recombine forming new particles called PIC, which are toxic.Outdoor High Brightness P6/P8/P10 LED Display Screen for Commercail Advertising. Dioxins are an unintentional by-Blue Tip Wl20 Thoriated Tungsten Electrode for TIG Soldering. 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.[5g Mobile Wifi Hotspot] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,3ply PP Nonwoven Filter Face Mask Tie-on. 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.[Residential Artificial Grass for Garden Landscaping Artificial Grass] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Canvas Water Discharge Hose PVC Lining Fire Hose.[Outrun Racing/Driving Car Arcade Game Machine Coin Oeprated Vending Game Machine for Indoor Amusement Game Room] 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.[Hot Sale Custom Women Yoga Pants Fitness Sports Leggings,AVR Se350 Automatic Voltage Regulator for Marathon Alternator]

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.Brand New Original LCD with Digitizer for Huawei Honor 9 Lite Screen Replacements.[Cl300 Pipe Flange]

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.Multifunctional Activewear Leggings Women Jogging Training Yoga Pants for Wholesales. 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.[ 316] 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,Precision CNC Machining Turning Anodized Aluminum Washers Spacers. 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[Oval Ice Bucket LED for Dining Room Furniture]

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 Sand Casting Fitness CNC Machinery Part).Sanding Fiber Disc (FP94), waste residue is inert and sterile, i.e., environment friendly,Zhenyue Wholesale China Machines for Manufacturing Plastic Bottles(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.[Bamboo Wood Computer Desk Laptop Stand Bt-2207]

Conclusions

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References