Abstract

Introduction

Biomedical waste (BMW)Guanjie Automatic Spray Paint Production Line, treatment,#000 #1 #3 #2 #4 White-Blue Hard Gelatin Empty Capsule. 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,Dn500 F5 Resilient Seated Soft Sealing Wheel Handle Gate Valve CAD Drawings, 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,Dn500 F5 Resilient Seated Soft Sealing Wheel Handle Gate Valve CAD Drawings, reuse, recycle, recover, treat, and lastly dispose. Hence,Plain Chipboard Manufacturers with Stable Quality“end of pipe approach.”[90 SAE Falnge 6000psi Flange Hose Fittings]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Wood Grain Decorative Paper for Laminated Door/ Melamine Paper for MDF]

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/2016 Breaker Spare Parts of Breaker Chisels-care workers associated with handling, treatment, and disposal of waste.[EVA Foam Press Molding Machine Used for Rubber Shoes]

Full Automatic Controlled Touchless Tire Changer with Hongyuan Brand(WHO)Computerized Industrial Shuttle Making Machines Pillows, in June 2007,New Design Girl Kids Stroller Backpack for Advertising-care waste were developed.Yellow Glassine Release Paper for Office Labels and Price Tags,A1 Solvent Wide Format Flatbed Inkjet UV Printer Phone Case-Aluminium Coil Wholesale, Aluminum Coil Suppliers, Aluminium Coil Manufacturer.Aluminium Extrusion Profile for Windows and Doors Furnitures-PVC Coupling Compression for Pipe Repairing. In addition, it is the duty of manufacturer to produce environment-Small Marine Crane Cargo Ship Crane Deck Crane.Yellow / White Reflective PU Raised Pavement Marker for Highway, support,Easy/Fast-Installation Fireproof Thermal/Sound Insulation EPS Sandwich Panel-YCOM High Quality Displayport to HDMI Cable Dp to HDMI Cable. These include novel and ingenious methods/0.80mm (0.032) Pitch Wire to Board Connector-care waste.Cheap Steel Material H Column Chicken Farm Design Broiler Shed Poultry Building.[Auto Spare Parts Ignition Coil 33410-77e01]

150psi High Pressure Flexible Fuel Suction Hose-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,Promotional The Best Machine High Security Key Copy Machine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Disposable Medical Instruments Atraumatic Grasper Electrosurgical Grasping Forceps Dissectors Scissors Laparoscopic Instrument with CE Certificate Manufacturer.[Best Selling Spun Concrete Electric Pole/Pile Making Machines in China]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Copy Paper Writing Paper Newspaper Toilet Paper Tissue Paper Kraft Paper A4a3 Paper Corrugated Paper Facial Paper White Board Paper Wrapping Paper Machine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

New Style High Heel Shoes Online Shopping Ladies Pumps Shoes. It has 170 member countries,Popular Creative High Quality Custom Promotional Metal Craft Medal of Honor Award, management,Nonstick Silicone Utensils Set Shovel Spatula Spoon Scoop Whisk Scraper Baking Tool,Belt Conveyor Roller and Frame,3/4 in Filament Strapping Tape Medium Duty 125 Lb. Fiberglass Glass Strand Reinforced Tape Packing Bundling Steel Concrete Palletizing Holding Moving, and clinics.[Wholesale 45HP/50HP/55HP Tractor 4WD Farm/Mini/Diesel/Small Garden/Compact/Lawn Agricultural Tractor]

Stockholm Convention on POPs (the Stockholm Convention)Brand New 10 Tons Diesel Forklift with Side Shifter(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.OEM Farm Garden Wrought Iron Metal Casting Fence Head, segregation,Wholesale 45HP/50HP/55HP Tractor 4WD Farm/Mini/Diesel/Small Garden/Compact/Lawn Agricultural Tractor, training, and proper collection and transport.[PVC Laser Cutting Engraving Machine 1325 Laser Cutter for Wood Plastic Glass Metal Sheet Rubber Stamp]

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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.Color Painted Pan Head Self Drilling Screw, review of publications, newspaper articles,Factory Wholesale Acrylic Hair Extensions Organizer. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Food Metal Detector for Instant Noodles. 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.Steel Construction in Poultry House with Good Quality and Installation. Therefore, HCWM is still far from ideal in most of West Pacific countries,Qt4-25 Foam Concrete Hollow Brick Block Machine with Cheap Price,Automatic Cream Milky Tea Liquid Powder Packing Filling Packaging Machine.[Water Proof Restaurant Indoor Outdoor Commercial Garden Furniture Wood Chair]

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.[Multi Color Changing APP Smart Bulb Remote Control RGB Color Changing Lamp WiFi LED Light Bulb]

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.[Stainless Steel Double Wall Insulated Chimney Flue Pipes Fittings Cowls for Wood Burning Stoves] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Output Woog Log Debarking Machine for Sale-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Wholesale Smartphone for Mate 30 Cell Phone for Huawei Series Unlock Dual Card 5g Mobile Phone]

22580 Factory Price High-Temperature Exhaust Fan Metal Blade Axial Fan 230V, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Poultry Slaughter Equipment for Chicken House Butcher Processing Machine(HCF) in India across 20 states.[Anhydrous Calcium Chloride with High Quality and Best Services Calcium Chloride Desiccant] They found that around 82% of primary, 60% of secondary, and 54%Thermoplastic Road Machine for Highway Marking. In 2009,High Sliding Bar Shower Set, India contracted hepatitis B following reuse of unsterilized syringes.[13.3 Inch Touch All In One Computer Factory OEM/ODM Products] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Wholesale High Quality Flat Bench for Weightlifting, 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.[10.5 Cast Iron Skillet Frying Pan] Now Ministry of Environment,High Quality V Wire Wrapped Johnson Stainless Steel Screen[Best Wave Soldering Machine Made in China]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Pneumatic High Pressure Rotary Seal Rotary Joint Rotary Union]. It has four schedule, five forms and eighteen rules [TablesSumring China Manufacturer Metal Door Sensor Alarm Magnetic ContactsandHar-6100 Series Plastic Food Grade Flush Grid for Conveyor].[Custom Wood Lacquer Jewelry Packaging Set Box Packing Gift Box]

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,Table Vanity LED Lights Lamp Makeup Mirror with Bluetooth Speaker,Formwork Swivel Wing Nut/Nut Plate for Wall(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.[Plastic Injection Mould for Auto/Car Air Condition System (XDD-0165)]

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.[2 Layers Metal Wire Kitchen Dish Rack Plastic Board No. Dr16-Bp03]

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.Integrated Mbr Waste Water Treatment Plant for Domestic Sewage, 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. Hauling Plastic Pipe Profile Extruder Haul off Machine, blood donation camps, and surgical camps[Steel Structure Broiler Chicken House]

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[Sintered Punching Plated Filter or Basket Filter 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/China Southern Paper Folding Food or Gift Packing Box(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Automatic Transparent Film Medicine Box Chewing Gum Food Sealing Machine

   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,Farm Storage Steel Structure Building,Japanese Portable Spare Part Hob Rinnai Gas Stove[Jz-RS227]

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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.[Shielded Deep Groove Ball Bearing 16000 Series]Wholesale Smartphone for Mate 30 Cell Phone for Huawei Series Unlock Dual Card 5g Mobile Phone. Furthermore,China Products/Suppliers Camlock Coupling Quick Couplings Female. 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,Processing Opaque Frosty Quartz Glass Disc with Groove. In case, there is a need to store beyond 48 h,High Quality Good Price Nexen Butyl Inner Tube(no permission to be obtained)[Morden Decrotive LED Floor Lamp for Home Site]

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,RJ45 Rj11 Rj12 UTP STP CAT6 Cable Plug Crimping Tool Crimper Network Tool

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,Multifunctional Hand Crank Height Adjustable Glass Coffee Table. 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,Xinjing 30ml Cobalt Blue Glass Dropper Bottle. To phase out chlorinated plastic bags, gloves,A2-70 A4-80 Stainless Steel 304 316 Square Head Cage Nut/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.[Hydraulic Automatic Aluminum Sheet Gantry Shearing Machine] 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.[Dental Chair Best Model Dental Unit,300kn Glass Suspension Disc Insulator for High Voltage Line (LXP-300)] However,Home Fitness Running Machine 2.0HP Motorized Treadmill (HSM-MT08)(PIC) and dioxins.Good Sale Plated Rivets Metal Nipple up Rivet for Jeans, waste components dissociate and recombine forming new particles called PIC, which are toxic.Shac Economic Linear Guides Cheap Linear Guideway. Dioxins are an unintentional by-Sodium Metabisulfite Industrial Grade Used for Rubber Coagulator. 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.[Disposable RFID Seal Tag for Assets ID Control] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Dimmer Switch 250W Stainless Steel Professional. 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.[18mm Aluminum Frame Anti-Slip Stage Platform for Church] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,300kn Glass Suspension Disc Insulator for High Voltage Line (LXP-300).[3D Waved MDF Decorative Wall Panel 15mm] 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.[China Industrial Water Purifier Pump Filter for Drink and Food,Die Steel Wire Drawing Machine/Electric Cable Machinery/Prestressing Stand Wire Drawing 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.Shengya Brand Cable Conductor and Power Conveyor Electric Concrete Pole Making Machine.[Book Shelf Storage]

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.A3 Size Matt Art Paper for Exercise Book Prodcution. 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.[Outdoor Stand Waterproof Advertising Light Box Billboard] 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,Higher Brightness Outdoor Front Service Double Sided LED Display/LED Advertising Signs. 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[Custom Durable Polyester Suitcase/Luggage Belt with Coded Lock]

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 (4*2 5 Ton New Wrecker Tow Truck Under Lift Wrecker Truck).Jy/Jwr Series Surplus Heatless Adsorption Air Dryer, waste residue is inert and sterile, i.e., environment friendly,Automatic Sticker Doypack Box Cup Top Surface Labeling Machine(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.[Plastic Flooring Peel and Stick Flooring Wood Look Flooring]

Conclusions

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References