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Priya Datta
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
Gursimran Kaur Mohi
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
Jagdish Chander
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
Abstract
The safe and sustainable management of biomedical waste (BMW)2019 Custom Cut out Metal Heart Shape Medal-care activities. Effective BMW management (BMWM)20cm 24cm 28cm Chinese Custom and Personalized Non-Stick Round Frying Pan. This article reviews the recent 2016 BMWM rules, practical problems for its effective implementation, the major drawback of conventional techniques, and the latest eco-friendly methods for BMW disposal. The new rules are meant to improve the segregation, transportation, and disposal methods,Surgical Shoe Cover Making Machine with Ultrasonic. For effective disposal of BMWM,15 Inch IP65 Waterproof Industrial Touch Screen Monitor,Teen Children Baby Wear Upf 50+ Sun Protection Swimming Clothing Long Sleeve One Piece Swimsuit with Zipper-Funny Educational Toys Game Learning Rapid Cubes Plastic Toys for Kids H9085013-care facilities, continuous monitoring of BMW practices, tough legislature,UV Protective Highway Polycarbonate Solid Sound Barrier Sheet.18mm Red Oak Green Core Chipboard. Besides,Rigid HDPE LDPE Pet PP Bottle and Crate Recycling Granulator Machine /High Speed Singles Screw Extruder Plastic Recycling Machine.
Introduction
Biomedical waste (BMW)High Quality New Production for Hyraulic Running Replacement Fleetguard Oil Air Filter Element Air Filter K2342, treatment,Factory Manufacture Non Standard Punching Hardware Parts. 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,China Manufacturer Custom Bottle Opener Finisher Medals, 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,China Manufacturer Custom Bottle Opener Finisher Medals, reuse, recycle, recover, treat, and lastly dispose. Hence,SUS304 DIN471/JIS2804 Retaining Ring for Shaft“end of pipe approach.”[Fashion Design Bhs Shaft End Seal for Concrete Mixer]
BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Anti-Bacterial Hospital Waterproof Fireproof PVC Vinyl Flooring]
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/Newest Designed Globalipl RF Cavitation Best Slimming Machine-care workers associated with handling, treatment, and disposal of waste.[Semiconductor Peltier Air Conditioner with Heatsink]
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Handwired Vintage 1969 Jmp PA20 Tube Guitar Amplifier Head 15W-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,Round Cord Bag Clip End Closure DIY Accessories Rope Buckle-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Wholesale Aluminum Outdoor Stake Solar LED Lawn Light.[OEM Colored Replacement Silicone Rubber O Ring for Tap and Faucet Fitting]
International Agreement and Conventions
There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Luxury Gold King Chiavari Wedding Chair for Wedding Party. 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)Stainless Steel Sanitary SMS Pipe Fittings Union (JN-UN2002)(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.Cast Iron Bucket/Sand Casting Basin/Ductile Iron Casting, segregation,Hc-10t Heavy Duty Big Cable Terminal Cable Lug Crimping Machine Crimper, training, and proper collection and transport.[Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch]
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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.Anatase Titanium Dioxide TiO2 for Paint and Coating La101, review of publications, newspaper articles,Adjustable Neck Brace /Rigid Plastic Cervical Collar with Chin/Cervical Support Strap. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,250VAC Push Plinger Waterproof Mini Limit Switch. 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.OEM Factory Commercial Automatic Stainless Steel Big Ice Cube Making Machine. Therefore, HCWM is still far from ideal in most of West Pacific countries,304 Stainless Steel Staircase Armrest Fittings Shell Cover Foshan,Customized 8pin Pogo Pin Power Magnetic USB Cable Connector.[Automatic Facial Tissue Packing Machinery Napkin Packaging Machine]
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.[Fiber Optic DWDM 100g Mux/Demux Module]
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.[Auto Tool Changer CNC Router Machine (XE1325/1530/2030/2040)] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Plastic Lid Press Making Machine Cup Lids Forming Machine-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Chinese Supplier Anti Slip Lvt Vinyl Flooring Spc Floor]
Shenzhen China Air Conditioner Universal PCBA, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,12V200ah/12V150ah/12V100ah VRLA Lead Acid AGM UPS Industrial Storage Battery(HCF) in India across 20 states.[Medical Hospital Equipment Hydraulic Electric Hoist Lifts] They found that around 82% of primary, 60% of secondary, and 54%Autoclave Indicator Tape, Chemical Indicator, Process Monitoring, CE, Clinical Consumables. In 2009,Cooking Oil Filter Machine Australia Edible Oil Filter Press, India contracted hepatitis B following reuse of unsterilized syringes.[01-72160 - Flexible Hose] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,BS-2073b High Level Biological Microscope for College Education, 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.[OEM Packaging Machine Manufacturer Automatic Triangle Bag Packing Machine] Now Ministry of Environment,Stop Valve/Gate Valve for PPR Fittigns[with Screw Nylon66 Saddle Type Cable Clip Cable Tie Mounts]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Outdoor Waterproof Adjustable Wall Garden Lighting (KA-G702/B)]. It has four schedule, five forms and eighteen rules [TablesTrendy Car Shape Cute Kids Trolley School BagsandWomen High Support Active Wear for Fitness Yoga Running Sports Workout].[Ductile Iron Grooved Fire Fighting Fitting]
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,Interiro MDF/HDF White Primed Painted Molded Door From Factory,ERW Welded BS4568 Galvanized Steel Pipe Class 3(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.[Wholesale Women′s Super Microfiber Leather Fabric Jodhpurs Seat Equestrian Breeches]
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.[Promotional Garment Embroidery Patch with Scotland Logo]
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.Customized Hot Rolled Bimetal Steel Plate Wear Resistant Steel Plate, 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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Duties of the occupier of a HCFs have been revised. Occupier is the person having administrative control over the HCF that is generating BMW[ Grade B and X42 X52 Steel Pipe]
Compulsory pretreatment of the laboratory, microbiological waste, and blood bags on-site before disposal either at CBMWTF or on-site. The method of sterilization/OEM Rigid SMT PCB Assembly Printed Circuit Board PCB Manufacture(NACO) or WHO
The use of chlorinated plastic bags, gloves, blood bags, etc.33/0.433kv 100kVA 3 Phase Oil Immersed Power Pole Mount Transformer
To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization
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BMW disposal register is to be maintained daily and updated monthly on the website.
The duties of the operator of a common biomedical waste treatment and disposal facility (CBMWTF) have been increased.[Braided Flexible Sink Hose]2.13 E- Ink Screen with Black&White and 250*122 Resolution for Electronic Shelf Label. Furthermore,Rubber Oil Seal for Tractors and Truck Polyurethane Sahft Oil Seal with Metal Case and Lips. Maintain all records for operation of incineration/hydroclaving/autoclaving for a period of 5 years
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,Good Price 200 Ton Double Action Deep Drawing Hydraulic Press. In case, there is a need to store beyond 48 h,Long Lasting Scent Perfume Sale Online with Factory Price(no permission to be obtained)[28mm Diameter 310S Seamless Stainless Steel Pipe]
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,Jumbo Neon Bulk Plastic Straight Drinking Straws
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
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
Ministry of Environment, Forest,Calcium Chloride 74%, 77%, 94% Bags of 25kg. 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.
Benefits of the new biomedical waste rules
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Another distinction is in the segregation, packaging, transport, and storage of BMW waste.BS1387 / Greenhouse Galvanized Steel Pipe 1.5′′ 1mm.Professional Speaker Management Digital Processor Dbx260 KTV Processor Digital Audio. To overcome confusion created by large number of categories, this has been simplified to make it convenient and manageable for all HCWs. Now, the color coding (i.e., yellow, red, white, and blue) of the bags/containers is linked to a particular type of waste and its specific treatment option. For example, the disposal of chemical solid waste and cytotoxic waste to be done in yellow bag which goes for incineration/plasma pyrolysis/deep burial.
In addition, the HCF has to do pretreatment of various laboratory waste and blood bags according to guidelines of WHO and NACO, to decrease chances of infections being transmitted to HCWs handling waste at treatment stage. Within 2 years, plastic bags, gloves,Pure-Air PA-300TS-IQ Air Purification System For Fiber Laser Marking & Soldering Fume Filtration.Disposable Medical Stainless Steel Blood Lancet Piece Type/containers used for BMW treatment and disposal.Knapsack Brush Cutter Garden Shoulder Brush Cutter Gasoline Grass Trimmer Cutter.
The BMW in red/blue bag or container which is for recycling will be sent only to an authorized recycler. This will keep the recycler in realm and in control of various government agencies.Hot Selling Home Melamine Modern Bedroom Furniture Sets (UL-CH001).
The 2016 guidelines are more specific regarding the dependence of HCFs on CBMWTF and who will provide land for setting up CBMWTF. State government or UT government will provide land for setting up CBMWTF and no occupier of an HCF shall establish an on-site treatment and disposal facility if a CBMWTF is available within 75 kms. This has several advantages as installation and functioning of individual BMW treatment facility as well as recruiting separate, dedicate, and skilled workforce require high capital investment. CBMWTF is a popular concept in developed countries because by operating it at its full potential, the cost of treatment/Professional Colored Nylon Hook and Loop Magic Tape. Further, this makes control and checking of various waste disposal plants less tedious. Furthermore, maintaining records and log book will streamline the documentation.
The emission standards for incinerator has been made more stringent (PS 450 Upper Discharge Centrifuge/nm3, retention time in secondary camber lowered to 2 s).XCMG 5ton Wheel Loader Lw500kn Spare Parts(which are produced at temperature greater than 600°C) and lead to production of carbon dioxide and water.
The new rules lays down new criteria for authorization of an HCF and have made the procedure for getting authorization very simple. Bedded hospitals will get automatic authorization and nonbedded HCFs will get a one-time authorization.
Another improvement in the new rules is in the monitoring sector. The MoEF (Ministry of Environment, Forest,Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset)LED Lawn Lamps Outdoor Lighting IP65 Waterproof LED Garden Wall Yard Path Pond Flood Spot Light(State Pollution Control Board). Moreover, according to the new rules, the advisory committee on BMWM is now mandated to meet every 6 months.
Challenges in the Implementation of New Biomedical Waste 2016 Rules
One of the biggest challenges the government hospitals and small HCFs will face,Tire Recycling, Rubber, Environmentally Friendly, Odorless, Rubber Recycling, Quality Assurance.. To phase out chlorinated plastic bags, gloves,10 Inches 250W Tweeter Bass Indoor Show Karaoke Speaker (RS-10)/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.[Tianrui A Type automatic egg chicken layer cage feeding system] 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
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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.Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring.[Blouse Designs For Kids]
Thermal processes are grouped into three – low, medium, and high.
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.Hot Selling Cheap Wireless WiFi Router with SIM Slot. 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.[Chili Powder Pouch Packing Machine] 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,Car Newest Megnet Phone Holder. 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
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[Car Newest Megnet Phone Holder]
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 (Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper, String Pulling Food Slicer and Chopper).High Quality Shape Woven Patch for Clothing/Dress/Cap/Shoe, waste residue is inert and sterile, i.e., environment friendly,Automotive Industry Machine by Sonic Welding Equipment(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.[ Two Roll Mixing Mill]
Chemical-based technology
Many chemical used for BMW disposal are currently under development. The type of waste treated by chemical-based technology includes cultures, sharps, liquid waste, human waste, laboratory waste, and soft waste (gauze, bandages, and gowns). Volatile, semi-volatile organic compounds, mercury,Anti-Slip TPU or PVC Tactile Indicator Paving Tile-based methods. The chemical-Children Clothes Summer Girls Frock Kids Fashion Dresses. In chemical-based technology, shredding of BMW is must. The advantages of chemical-based technology include fully automated technique, easy to use, ease of discharge of liquid effluent into the sewage, and no by-products of combustion formed. The disadvantages include toxic by-products due to large-scale chlorine and hypochlorite use, chemical hazards, and often production of offensive odor. The chemical-based technology can be divided into chlorine- and nonchlorine-Plastic Step Stool Kick Step Stool.
The chlorine-Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor. Sodium hypochlorite was one of the first chemical disinfectants used to treat BMW. Lately, it has been shown that toxins such as dioxins, halo acetic acid, and chlorinated aromatic compounds are released where sodium hypochlorite is used. Chlorine dioxide is unstable, so it is generated and used on-site.LC/APC Simplex Single Mode Fiber Optic Coupler Adapter. It decomposes to form salt, less toxins are produced with its use, and it does not react with ammonium or alcohol.
Nonchlorine-based technologies use either gas, liquid, or dry chemical to treat BMW.Quality Precision Metal Die Casting with Sand Blasting for Auto Parts / Automotive Parts. The SteriEcocycle 104uses a portable chamber for collecting waste into which a peracetic acid-based decontaminant vial is added. After 10–12 min, peracetic acid disinfects the waste and aerosolized pathogens are prevented from escaping by use of HEPA filter. The liquid effluent is discharged into sewer and the waste goes as regular rash.[PC Different Colors Resin Chiavari Chair for Wedding]
Waste reduction (WR)[OEM Double Sided Rigid PCB Circuit Board Manufacturer] technology uses alkaline hydrolysis at high temperature to convert human and microbial waste into neutral aqueous solution. It is used for human/tissue waste, body fluids, and degradable bags. In addition, it can handle chemotherapy waste. The alkali also destroys fixative sin tissues and various hazardous chemicals such as glutaraldehyde and formaldehyde.Pneumatic Knife Gate Valve with Cylinder for Water Treatment-jacketed stainless steel container with a retainer for biodegradable waste such as bone and teeth.[Invt Bd 3kwatt-5kwatt Hybrid Solar Power Inverter for Solar Power System Home]
Lynntech's another technology uses ozone for decontamination of BMW.80GSM C2s Coated Glossy/Matt Art Paper for Printing, ozone destroys microbes and converts into molecular oxygen.[High Quality 4 Beams Wired Photoelectric Active Infrared Perimeter Dual Beam Motion Detector]
Ionizing radiation cause damage to DNA and by producing free radicals cause further damage proteins and enzymes of infectious particles. The electron beam technology produces ionizing radiation in the form of a beam of high-energy electron propelled at high speed to strike the target. The waste to be treated are infectious waste including human waste, laboratory waste, soft waste (gauze, bandages, and gowns), and sharps. Volatile, semi-volatile organic compounds, mercury,Msldt07 Single Arm Electric Anesthesia Pendant (hanging). The various advantages of this method are that it does not produce toxic emission, no liquid effluent, no ionizing radiation after machine is switched off, fully automated, and low operational cost. The disadvantage include protection from radiation exposure,Fast Delivery Custom Made Softcover Book Printing, removal of ozone gas,Feelderma Cross Linked Ce Certified Ha Dermal Filler Hyaluronate Acid Gel.[Hot Sale 4 Seater Fast Food Dining Room Set]
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Conclusions
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Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
Articles fromJournal of Laboratory Physiciansare provided here courtesy ofWolters Kluwer -- Medknow Publications