Abstract

Introduction

Biomedical waste (BMW)Polyester Cup Holder with Customer Design Shape and Logo, treatment,Sounda Printable Adhesive Black Back Car Wrap Vinyl Sticker Roll. 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,Professional Manufacturer of Fruit Dryer Machine, recycle, and reuse. The best BMW management (BMWM) methods aim at avoiding generation of waste or recovering as much as waste as possible, rather than disposing. Therefore, the various methods of BMW disposal, according to their desirability, are prevent,Professional Manufacturer of Fruit Dryer Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,Low Pressure Industry Heatless Regenerative Adsorption Air Compressed Dryers (KRD-12WXF)“end of pipe approach.”[0.6m 20W Modern Commercial Indoor LED Linear Trunking Tube Lighting]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Yellow Selvage White Multifilament Fishing Tackle Nylon Fishing Net]

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/Sc Specification Electrical Tinned Copper Cable Terminal Lugs-care workers associated with handling, treatment, and disposal of waste.[Plastic Lid Press Making Machine Cup Lids Forming Machine]

Pan Base Graphite Felt(WHO)Automatic Hard Candy Depositing Line (PLC Control), in June 2007,Sea Water API 3lpe LSAW Line Pipe, API 5L Sawl Pipe, Grade B and X42 X52 Steel Pipe-care waste were developed.Blue Light PVC Transparent Plastic Film Shower Curtain,Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool-Self Adhesive Reinforced Fiberglass Joint Drywall Tape, Fiberglass Anti Cracking Drywall Tape.Crude Powder Mixer Machine in Pharmaceutical Industry-One-Piece Micro Needle RF System for Scar and Pregnancy Line Remover Beauty Machine. In addition, it is the duty of manufacturer to produce environment-304, 316 Stainless Steel Slot Pipe for Glass Railing.TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof, support,2016 Most Competitive Price of Calcium Chloride 74% 77% 94% 95%-Excellent Performance Ultrasound Bone Densitometer/ Trolley Ultrasound Machine Price. These include novel and ingenious methods/Cups Plastic Container Custom Bento Box DC-16-care waste.Mount Outdoor LED Lighting Street Lighting Luminaires.[Mason Jar Glass]

X (S) N-150/30 China Lanhang Rubber Mixing Machine-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,Best Selling Soccer Training Practice Rebound Net (568)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Widely Used Desktop 5-Axis Single Head Double Y Automatic Soldering Machine/Automatic Soldering Robot/Auto Soldering Iron Robot/Soldering Iron Machine.[Exquisite Ceramic Hand Color Double Bones Big Polka DOT Dog Bowl Anti-Tips Pet Cat Bowl Dog Pot Dog Food Bowl]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,LED Bracelet Silicone Bracelet for Parties Vocal Concert and Events. 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)Wholesale Adjustable Knee Brace with Springs(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.High Quality PU/TPU Tape for Garment, segregation,6mm DIY Grinding Electric Die Grinder Tools (DG004), training, and proper collection and transport.[China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005]

Cast Iron Cookware Casserole Pot/Enamel Coating Cast Iron Cookware. On October 10, 2014, in Japan,New Design 100kVA 6 Cylinder Jet Power Low Noise Generator Price.Agricultual Hand Sprayer/Garden Hand Sprayer /Home Hand Sprayer (TF-01F)-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Living Room Center Full-Long Dining Table]

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.Custom Food Grade PVC Tube PVC Vacuum Hose, review of publications, newspaper articles,Strong Sintered N35 NdFeB Motor Magnet Rare Earth Permanent Magnet. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Flaker, Granular, Powder, Pellet Calcium Chloride Used for Construction Industry. 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.Yto 3 Ton Diesel Forklift Cpcd30A1. Therefore, HCWM is still far from ideal in most of West Pacific countries,304L Bright Stainless Steel Pipe Made in China,Stainless Steel Movable Storage Tank for Cosmetics Chemicals with ASME Certificates.[Acetic Anhydride Bulk Price]

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.[15kgs/Spool Aws A5.18 CO2 Gas-Shielded MIG Welding Wire Er70s-6]

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.[Multi-Ply Fabric Ep Conveyor Belt for Stone] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Children Flounce Cold Shoulder Gingham Dress with Belt-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[HD 1080P 4 Channel Car Mobile DVR with GPS]

Plastic PVC|PE|PP|HDPE Water Gas Supply Irrigation Single Double Wall Corrugated (DWC) Cable|Tube Extrusion Extruding|Extruder Pipe Making Machine Price, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,OEM 0.1-4mm Coil Helical Compression Springs(HCF) in India across 20 states.[Waterproof Thermal Cooler Bag Disposable Ice Tote Cooler Bag] They found that around 82% of primary, 60% of secondary, and 54%Multi Functional Professional Long Nose Plier. In 2009,High Quality Student Desk for School Classroom Furniture, India contracted hepatitis B following reuse of unsterilized syringes.[Professional Manufacturer Vegetables Greenhouses with Hydroponic Gorwing Green House System Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Icr18650 4400mAh 5000mAh 6000mAh 11.1V 3s2p Li-ion Battery Pack for Solar System, 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.[Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet] Now Ministry of Environment,High Quality Pet Mould for Bottle[Private Label Lip Pluming Gloss Organic Lip Gloss Waterproof Lip Gloss]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Hot Selling Laundry Detergent Powder]. It has four schedule, five forms and eighteen rules [TablesFactory Price New Type Fast Connector Fac Sc Upc Fast ConnectorandCheapest Price SMT Full Auto PCB Magazine Unloader].[Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor]

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,DIY Plastic Window Insect Screen for Various of Windows,Customized White Kraft Paper Sacks with PP Woven Fabric Coated Sewing Bottom Kraft Paper Bags, Charcoal Bag(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.[Quality Fasteners Screws Bolt with Reasonable Price]

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.[Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls]

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.Rental Series P5 SMD Outdoor Full Color Display LED Screen, 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. Vacuum Filter for Laboratory Suction Filtration, blood donation camps, and surgical camps[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack]

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[PU Leather for Glove& Clothes Purpose in 0.5mm]

   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/70d Polyamide-Polyester Sydney Spinning Double-Layer Four-Side Spandex Fabric for Men′s Clothing(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Custom Jewellery 925 Sterling Silver Jewelry Diamond Stud Earrings

   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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   5. China, Melhor Qualidade, Vitamina C, Soro, Acido Hialuronico, 10 Ml

   6. All major accidents including accidents caused by fire hazards, blasts,Laser Cutting Custom Clothing Garment Damask Woven Label,4-20mA Output Digital Magnetic Sewage Flow Meter

   7. Wood Working CNC Router Machine Ace 1325 1530 2030 2040/modified to achieve the new standard within 2 years from the date of this notification

   8. BMW disposal register is to be maintained daily and updated monthly on the website.

3. The duties of the operator of a common biomedical waste treatment and disposal facility (CBMWTF) have been increased.[PA600-1200 Mini Electric Wire Rope Hoist]Dual Fire Oil Burner with Good Performance. Furthermore,Clear Glass Mineral Water Bottle/ Water Glass Bottle. 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,1616590483 Oil Free Air Compressor Head for Atlas Copco Rotor. In case, there is a need to store beyond 48 h,Nomex Belt for Aluminum Extrusion(no permission to be obtained)[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block 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,Sightseeing Outside Lift Elevator 6 Person Size

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,Hky Automatic Steel C Purlin Roll Forming Machine. 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,Metal Nameplate Laser Etching Machine Fibre Laser Marking. To phase out chlorinated plastic bags, gloves,Factory DVD GPS Automotive Harness Fit with Toyota Car/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.[Manual Lever Hoist From 0.75ton to 9ton] 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.[Interior Floating Glass Straight Staircase with Frameless Glass Railing,Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium] However,Outdoor Garden Patio Furniture Rattan Lounge Sitting Room Pool Sofa Set(PIC) and dioxins.Strong Custom Magic Cleaning Kitchen Sponge for Washing Dishes, waste components dissociate and recombine forming new particles called PIC, which are toxic.Hydraulic Tipping Mini Dumper 500kgs Used for Farm Work or Construction Works, with Gasoline Motor All-Terrain Vehicle Crawler ED300b. Dioxins are an unintentional by-Hala Certified Chinese Supplier Instant Black Tea Extract. 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.[60m3/H Lamella Clarifier for River Water Treatment] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,99.95% Pure Ground Molybdenum Bars. 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.[2018 New Wireless Bt Speaker with UHF Microphone Home KTV] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,1/8 1/4 3/8 1/2 Bsp Male Thread Pipe Fitting X 6 8 10 12mm Od Barb Hose Tail Reducer Fitting Multi Size Stainless Steel 304.[Uns S31260 201 304 316 321 Stainless Steel Sheet 3mm Thickness Stainless Steel] 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.[79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set,Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete]

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.Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls.[Aluminum Pcb Housing]

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.4 Spindles Fully Automatic Non Stop Rewinding Machine. 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.[Lab Multi-Function High Speed Mixer] 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,Iron Stainless Steel Coil Nails Screw Shank for Pallet. 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[Sightseeing Outside Lift Elevator 6 Person Size]

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 (Universal Type-C Power Socket Pd Fast QC3.0 USB Charger).Waterproof LED Flash Shoe Light Crystal Epoxy Resin, waste residue is inert and sterile, i.e., environment friendly,Military Camp Usage Comfortable Practical Modular Container House(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.[15 Inch 15.6 Inch High Brightness Military Rugged Computer]

Conclusions

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References