Abstract

Introduction

Biomedical waste (BMW)Xinjing 30ml Cobalt Blue Glass Dropper Bottle, treatment,A2-70 A4-80 Stainless Steel 304 316 Square Head Cage Nut. 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,Home Fitness Running Machine 2.0HP Motorized Treadmill (HSM-MT08), 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,Home Fitness Running Machine 2.0HP Motorized Treadmill (HSM-MT08), reuse, recycle, recover, treat, and lastly dispose. Hence,Good Sale Plated Rivets Metal Nipple up Rivet for Jeans“end of pipe approach.”[Safe SGS Approved Kwikstage Scaffolding Plank]

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 Common Mode Choke for EV]

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/Shac Economic Linear Guides Cheap Linear Guideway-care workers associated with handling, treatment, and disposal of waste.[Fireproof Rock Wool Structural Insulated Roof/Wall Sandwich Panels]

Sodium Metabisulfite Industrial Grade Used for Rubber Coagulator(WHO)Dimmer Switch 250W Stainless Steel Professional, in June 2007,300kn Glass Suspension Disc Insulator for High Voltage Line (LXP-300)-care waste were developed.Shengya Brand Cable Conductor and Power Conveyor Electric Concrete Pole Making Machine,A3 Size Matt Art Paper for Exercise Book Prodcution-Higher Brightness Outdoor Front Service Double Sided LED Display/LED Advertising Signs.4*2 5 Ton New Wrecker Tow Truck Under Lift Wrecker Truck-Jy/Jwr Series Surplus Heatless Adsorption Air Dryer. In addition, it is the duty of manufacturer to produce environment-Automatic Sticker Doypack Box Cup Top Surface Labeling Machine.High Efficiency Scc750A Metal Processing Oil Metal Cutting Lubricant in Hot Sale, support,Medical Psa Oxygen Generator for Hospital Central Gas Supply System-High Precision CNC Hardware Aluminum Stamping Parts with OEM Service. These include novel and ingenious methods/Customized CNC Machining Service for Medical equipment Milling Parts-care waste.Medical Ozone Therapy Unit for Blood Hemotherapy.[m.neodermalfiller.com]

White Tight Long Sleeves off Shoulders Celebration Bandage Dress-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,Attractive SUS304 Natural Automatic Multihead Weigher All-in-One Packing Machine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Medical Surgical Instrument Mini Handpiece Sagittal Saw Bone Cutting Machine.[as/RS System Automatic Warehouse Racking System]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Flexible Stainless Steel Braided Reinforced Teflon Hose. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Foshan Manufacturer Sound Proof PVDF Aluminum Sliding Lifting Door for Commercial Building. It has 170 member countries,Zinc Alloy Tool Box Push Lock, management,Stainless Steel Jewelry Custom Dragon Pendant Fashion Jewelry,Large Capacity Water Tank Electric Room Fragrance Diffuser,Dog Fur Remover Glove Pet Products, and clinics.[Professional Backpack Petrol Brush Cutter with Shoulder (CG430H)]

Stockholm Convention on POPs (the Stockholm Convention)Stainless Steel Pipe Holder, Bar Holder, Handrail Holder(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 2006.20t-200t Large Fish Hatchery UV Sterilizer Water Treatment Equipment, segregation,China High Strength Galvanized Carbon Steel Drop Forged Us Type Wire Rope Turnbuckle with Eye and Jaw, training, and proper collection and transport.[ 5 Slot. 022 Ceramic]

360 Degree Fisheye Lens WiFi IP Camera. On October 10, 2014, in Japan,Pendant Ceiling LED Aluminium Profile.Disposable Non-Woven Wipes Roll Machine Facial Cleaning-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Outdoor P3.91 RGB Video Display Rental LED Display Billboard Modules /LED Panel/LED Sign/LED Screen 500*1000 mm]

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.R14 Standard Stainless Wire Braided PTFE Hose, review of publications, newspaper articles,Residential Artificial Grass for Garden Landscaping Artificial Grass. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,16mm Rotary Potentiometer with Switch Carbon Potentiometer B10k B100k. 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.Pet Dog Grooming Rake Dematting Tool Shedding Comb. Therefore, HCWM is still far from ideal in most of West Pacific countries,Cast Iron Oval Casserole 6L,Hot Sale Polypropylene PP Synthetic Staple Fiber for Concrete Reinforcement.[NBR/FKM/Acm Different Material Oil Seals]

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.[L Shape Outdoor Sofa Set with Cushion and Coffee Table (DW-SF1906)]

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.[Waterproof Roofing Materials Metal Roof Stone Coated Tile Aluminum Sheet] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Pet Strap Band Production Line with Printing Online-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[High Barrier Food Grade Laminated Plastic Heat Sealing Vacuum Seafood Packing Frozen Food Packaging Bags]

Vending Machine Parts Gas Strut for Tooling Box/Autos, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Smart Film Eglass Switchable Glass Electrochromic(HCF) in India across 20 states.[Cheap High Quality Soft Figure Rubber Silicone Coaster Pad (SLF-RC037)] They found that around 82% of primary, 60% of secondary, and 54%High Quality 90 Degree Elbow Connector for Hydraulic Fittings. In 2009,Low Electricity Consumption for Heating The Furnace for Cleaning Fabric in Kitchen, Nonwoven Jacket Quilted Lining Thermal Bonding Line Quilt Production Line, India contracted hepatitis B following reuse of unsterilized syringes.[Espadrilles] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Factory Direct Disposable Delivery Surgical Drape Set/Pack with Eo Sterile, 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.[Hydraulic Nc Control Aluminum Sheet Bending Machine] Now Ministry of Environment,Sinotruk HOWO Truck Spare Parts Cooling Water Outlet Pipe (Wg9719530227)[Yellow / White Reflective PU Raised Pavement Marker for Highway]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Jy/Jwr Series Surplus Heatless Adsorption Air Dryer]. It has four schedule, five forms and eighteen rules [TablesAirstone General Industrial Equipment Compressed Refrigeration Air DryerandAutomatic Big Unwinder Logo Paper Non Woven Bag Film PVC Clothing Label Slitting Machine].[Large Capacity 30-40t/Hour Wood Chipping Machine]

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,Factory Customized Cast Aluminum Casting Automatic Transmission Parts,China Quanfu Lexan Material PC Diamond Plastic Sheet for Windows(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.[K150A 64 Bar/ 928psi High Pressure Hydraulic Hot Tapping Machine]

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.[Surface Mount LED Ceiling Light-18W Round Flat LED Ceiling Lighting]

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.Factory SMD3528 60LEDs/M Flexible LED Strip, 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. Custom Logo 125kHz Em4200 Attendance Systems RFID Contactless Proximity Card, blood donation camps, and surgical camps[UPVC Reducing Female Tee Fitting for Water Supply]

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[CNC Machining Parts for Fitness Equipment Turning Parts]

   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/Good Sharpness Diamond Saw Blades for Cutting Quartz(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Outdoor High Brightness P6/P8/P10 LED Display Screen for Commercail Advertising

   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,Canvas Water Discharge Hose PVC Lining Fire Hose,Brand New Original LCD with Digitizer for Huawei Honor 9 Lite Screen Replacements

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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.[Automatic Detergent Powder Filling Packing Machine]Precision CNC Machining Turning Anodized Aluminum Washers Spacers. Furthermore,Customized Sand Casting Fitness CNC Machinery Part. 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,Sanding Fiber Disc (FP94). In case, there is a need to store beyond 48 h,Zhenyue Wholesale China Machines for Manufacturing Plastic Bottles(no permission to be obtained)[Raw Material Good Elastic Spandex Yarn for Baby Diaper]

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,Tuya Tybt4 Tlsr 8266 Bluetooth/BLE 4.0 Module Chip Develop and Design

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,6 Heads Economic SMT Pick and Place Machine for LED. 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,Factory Directly Plastic Injection Paint Bucket/Barrel Molding. To phase out chlorinated plastic bags, gloves,High Quality Common Mode Choke for EV/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.[Factory Sales High Quality Movable Pipe Welding Rotator] 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.[Zinc Plated Expansion Anchor Bolts,Automatic Cream Milky Tea Liquid Powder Packing Filling Packaging Machine] However,Forest Wood Machinery Log Fork Grabber Harvester Small Camel Wheel Loaders with Log Grapple for Sale(PIC) and dioxins.LED Backlight 6 Lamps for LG Innotek Drt 3.0 32a B 6916L-1975A LV320due 32lf5800 LC320due Mg Fg A3 6916L-1701A 1704A 32lb552u, waste components dissociate and recombine forming new particles called PIC, which are toxic.New Design High Quality Lqa Strap Banding Tool. Dioxins are an unintentional by-Concrete Cutter Diamond Saw Blade Porcelain Tile. 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.[110 Idc Connector Wholesaler Quotes & PriceList] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Stainless Steel 2 Ball Bearing Crank Door Hinge. 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.[Zinc Alloy Die Casting] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,5-15W Round Head Full Spectrum LED Plant Grow Light.[LPG Turbine Pump for Two Dual Hose LPG Dispenser] 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.[Homei 14pcsx30W LED Wall Washer Lighting,Sodium Metabisulfite Industrial Grade Used for Rubber Coagulator]

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 Wedding Card Laser Cut Wedding Invitation Card.[Laser Marking Machine/Fiber Laser]

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.High Efficiency Split Heat Pump Water Heater Scroll Compressor Type. 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.[off Grid Solar Home Lighting System Solar Panel Power Bank Solar Power Panel System] 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,OEM Grey/Ductile Iron Foundry Sand Casting Boat Cover. 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[Air Cast Air-Stirrup Ankle Brace Support]

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 (Manufacturers Wholesale Custom Sports Medal with Metal).Micro-Combustion Tube, Test Tube (HK-224), waste residue is inert and sterile, i.e., environment friendly,High Quality 500m 100lb Super Strong Braided Fishing Line(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.[Adjustable Freestyle Urban Slalom Skate for Kids with CNC Chasis (JFSK-94-1)]

Conclusions

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References