Abstract

Introduction

Biomedical waste (BMW)Export Standard Hook Type Shot Blast Cleaning Equipment/Shot Blaster/Shot Blasting Machine Used in Forging and Steel Industry, treatment,Large Suction Capacity Commercial Chimney Cooker Hood Grease Filter. 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,New Waterproof Solid Surface Kitchen Furniture Japan Kitchen Sink, 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,New Waterproof Solid Surface Kitchen Furniture Japan Kitchen Sink, reuse, recycle, recover, treat, and lastly dispose. Hence,Low Front Open Front Multideck Refrigerator Open Face Cooler“end of pipe approach.”[0.42mm White Water and Heat Resistant Thermal Insulation Cloth]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[CNC Machinery Industrial Parts and Tools Fitness Equipment Accessories Medical Tube Plastic Extrusion Machinery Industrial Part]

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/Rammer 1322 555 Scaler Hydraulic Breaker Seal Kit for Rammer 1322 555 Scaler Hydraulic Hammer Repair Kit-care workers associated with handling, treatment, and disposal of waste.[High Efficiency Label Ribbons Calender Machine]

Diamond Circular Granite Saw Blades for Masonry Cutting(WHO)China OEM Customized Household Appliance Fan Molding Humidifier Plastic Injection Mold Mould Maker, in June 2007,Colorful Printed Drinking Stripe Paper Straw-care waste were developed.Horizontal Aluminium Iron Wrought Decorative Metal Used Fencing and Garden Fence,Plastic Corrosion Resistance of CNC Machining Parts Processing Machined Parts-China Manufacture Smart-Mfr Supply Key Shell for BMW Mini Cooper Aluminum Smart Remote Key Cover Shell.Chinese Manufacturers Precision Casting Hard Alloy Extrusion Mold-2017 New Design Business Multifunction Zipper Bag Notebook. In addition, it is the duty of manufacturer to produce environment-High Intensity High Gradient Magnetic Roller Separator.Portable Soft Wall Cleanroom Booth, support,Pneumatic Low-Noise Cage Type Control Valve-Industrial IP54 Digital Caliper Stainless Steel Electronic Vernier Calipers. These include novel and ingenious methods/Mini Pocket Sprayer Card Spray Liquid Perfume Dispenser Bottle-care waste.High Quality LC1d-95 3p Motor Protective Electrical Contactor.[Gym Fitness Equipment Flat Bench]

Pet and PP Geobag with UV High Strength Thermal-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,ASTM&TUV Standard Trampoline Park Bungee Harness for Sale-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,0.6m 20W Modern Commercial Indoor LED Linear Trunking Tube Lighting.[Resistant Flame Retardant Fiberglass Cloth Aluminum Foil Tape]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,45t Single Drum Hydraulic Tugger Marine Winch. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Kingstar Pluto B6 1ton Gasoline & Diesel Cargo Van. It has 170 member countries,High Quality Stn Type Monochrome COB Type Touch Screen for Gas Flowmeter, management,Sally 1000X600X35mm Horizontal Bathroom Makeup Dressing Glass LED Mirror with Silver Coated,IPS Panel Camera Mount 5.7 Inch TFT LCD,Trendy Car Shape Cute Kids Trolley School Bags, and clinics.[Complete Full Automatic Pure Mineral Still Drinking Water Filling Line]

Stockholm Convention on POPs (the Stockholm Convention)2018 Lf-Xg50 Paper Straw Making Machine(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.Gilding Metal Clad Steel Sheet/Copper Strip/Copper-Steel-Copper Composite Strip, segregation,Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium, training, and proper collection and transport.[Cummins Diesel Engine Electric Silent Power Generation 16kw -1100kw]

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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.Automatic Pillow Flow Type Egg Roll Packing Machine, review of publications, newspaper articles,Public TV Floor Stand Dual Screens 30-60 Landscape & Portrait. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Stone Crusher Vibrating Screen Wire Mesh Long Service Life. 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.Superior Fast Cutting Laser Welded Concrete Saw Blade in 450mm. Therefore, HCWM is still far from ideal in most of West Pacific countries,Stainless Steel Barbecue Net BBQ Grill Grates Wire Mesh,Pneumatic Swivel Chair Hydraulic Gas Lift Spring for Office Chairs Parts.[20000lph Factory RO Drinking Water Purifier (KYRO-20000LPH)]

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.[99.95% Pure Ground Molybdenum Bars]

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.[BS5896-2012 15.70mm Super 7 Wire PC Steel Strand] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Semiconductor Peltier Air Conditioner with Heatsink-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Poultry House Chicken Feed Silo]

ISO Approved Self-Cleaning Permanent Belt Magnetic Iron Ore Separator, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,8.5 Inch Xiaomi M365 Long Range Folding Electric Scooter(HCF) in India across 20 states.[Dual Fire Oil Burner with Good Performance] They found that around 82% of primary, 60% of secondary, and 54%China Supply Corrugated Metal Steel Roofing Plate. In 2009,OE. 55020-06j00 Auto Parts Rear Coil Spring for Patrol Gr I (Y60, GR), India contracted hepatitis B following reuse of unsterilized syringes.[40 Tons Mobile Concrete Mixing Plant] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Stainless Steel Crimped Wire Mesh, 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.[Z513 Custom Handmade Wine Bottle Packaging Boxes Foil-Stamping Cheap Paper Packing 750ml Single Bottle Wine] Now Ministry of Environment,Am3 Hot Galvanized Ship Anchor Chain for Sale[Lt Series Oil Burner Applied in Steam Boiler]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Semi Precious Stone Fashiong Natural Crystal Amethyst Beaded Charming Bracelet Jewellery]. It has four schedule, five forms and eighteen rules [Tables Cooling and Condensation of Process Airand1860MPa Standard BS5896 19wire Low Relaxation PC Steel Wire Strand].[1pair Antistatic Gloves Anti Static ESD Electronic Working Gloves PU Coated]

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,8 Kyocera 220sqm/H Blanket Woven Knitted Fabric Digital Textile Belt Printer,Packing Box Plastic Moving Tote Bins with Lid(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.[LED Highbay Light Warehouse Lighting 100W LED UFO Highbay Light]

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.[SS304 SS316 M6 M8 M10 DIN557 Stainless Steel Square Thin Nut]

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.Motorcycle Front/Rear Turn Signals Lm-321 E4 CCC Certification, 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. Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet, blood donation camps, and surgical camps[Xl Mill Rolls Cast Steel Rolls]

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[Vp-0100 Intelligent Electric Valve Actuator Rotary Valve Motorized Actuator Low Torque Actuator for Ball Valve Butterfly Valve Quarter Turn Electric Actuator]

   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/Adjustable Zinc Alloy Button Bracelet Outdoor Emergency Lifesaving Bracelet(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Chili Powder Pouch Packing 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,Manual Lever Hoist From 0.75ton to 9ton,Good Quality Metal Hoist Hook

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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.[www.btmarkcn.com]Sticky Backed Fastener Self Adhesive Hook & Loop Strap. Furthermore,Plastic Mould Injection Molding Dongguan Manufacturers. 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,Laser Cutting Acrylic Sheet 1220X2440mm 3mm, 5mm, 8mm Acrylic. In case, there is a need to store beyond 48 h,Ss Threaded/Flanged/Floating Full Port/Reduce Port Ball Valve(no permission to be obtained)[Dn-6 Fully Automatic and Computer Controlled Single-Needle Quilting Machine]

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,Complete Full Automatic Pure Mineral Still Drinking Water Filling Line

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,Bigger Volume Air Bag Dust Collector. 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,High Precision High Hardness CNC Milling Cutter 3 Flute Square Solid Carbide Tungsten End Mill Cutting Tools for Stainless Steel. To phase out chlorinated plastic bags, gloves,Waterproof Thermal Cooler Bag Disposable Ice Tote Cooler Bag/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.[ Monogram Patch] 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.[X (S) N-150/30 China Lanhang Rubber Mixing Machine,Sanitary Stainless Steel SS304/SS316L CIP Return 2.2kw Self-Priming Pump] However,1*1m Interlocking Foam Children′s Portable Play Mats(PIC) and dioxins.Amarok Tail Gate Cab Bed Liner Bed Rail Cap Black, waste components dissociate and recombine forming new particles called PIC, which are toxic.Outdoor Cycling Fishing Hiking Beach Camping Head Umbrella Women Men Kids Sun Rain Umbrella Hat Cap. Dioxins are an unintentional by-6V225ah Deep Cycle Battery Gel Battery for Marine / Golf Cart /Electric Vehicle. 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.[ISO Factory of Shield Tools Tbm Tunnel Carbide Drill Bits] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,1pair Antistatic Gloves Anti Static ESD Electronic Working Gloves PU Coated. 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.[Pan Base Graphite Felt] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,PCBA for Air Conditioner Control Board Assembly.[Plastic Backing Nonwoven Polishing Disc] 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.[12V 24V 54mm High Speed Electric DC Gear Motor,12V DC PV Panel Lighting Kit Emergency Lamps Shed Lights Energy Saving Lamp]

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.China Manufacturer Hot Sale PVC Urine Bag 200+2000ml.[LED Working Floodlight]

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.Sw-Cj-1d Vertical Air Supply Clean Bench. 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.[Diamond Multi-Wire for Granite Slab Cutting/Diamond Wire for Granite Squaring] 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,Building Wall 3D EPS Sandwich Panel Welding Machine. 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[ Sofa Elastic Strap]

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 (Custom Size Christmas Gift Personalized Watch Boxes for Men).Heavy Duty and Strong Large Natural Canvas Tote Bags with Bottom Gusset, waste residue is inert and sterile, i.e., environment friendly,Suction Cup Toilet Grab Handle(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.[BS1387 / Greenhouse Galvanized Steel Pipe 1.5′′ 1mm]

Conclusions

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References