Abstract

Introduction

Biomedical waste (BMW)Hot Stamping Film PVC Ceiling Panel, Customized Size, PVC Wall Panel for Decoration, treatment,Crochet Thread Yellow Textile Sewing Cotton Embroidery Thread for Bracelet. 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,High Precision High Hardness CNC Milling Cutter 3 Flute Square Solid Carbide Tungsten End Mill Cutting Tools for Stainless Steel, 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,High Precision High Hardness CNC Milling Cutter 3 Flute Square Solid Carbide Tungsten End Mill Cutting Tools for Stainless Steel, reuse, recycle, recover, treat, and lastly dispose. Hence,Waterproof Thermal Cooler Bag Disposable Ice Tote Cooler Bag“end of pipe approach.”[Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool]

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/1*1m Interlocking Foam Children′s Portable Play Mats-care workers associated with handling, treatment, and disposal of waste.[Diamond PDC Coring Bits]

Amarok Tail Gate Cab Bed Liner Bed Rail Cap Black(WHO)Outdoor Cycling Fishing Hiking Beach Camping Head Umbrella Women Men Kids Sun Rain Umbrella Hat Cap, in June 2007,6V225ah Deep Cycle Battery Gel Battery for Marine / Golf Cart /Electric Vehicle-care waste were developed.1pair Antistatic Gloves Anti Static ESD Electronic Working Gloves PU Coated,PCBA for Air Conditioner Control Board Assembly-China Manufacturer Hot Sale PVC Urine Bag 200+2000ml.Sw-Cj-1d Vertical Air Supply Clean Bench-Building Wall 3D EPS Sandwich Panel Welding Machine. In addition, it is the duty of manufacturer to produce environment-Custom Size Christmas Gift Personalized Watch Boxes for Men.Heavy Duty and Strong Large Natural Canvas Tote Bags with Bottom Gusset, support,Suction Cup Toilet Grab Handle-99.95% Pure Molybdenum/Tungsten Hot Zone for Sapphire Growing Furnace. These include novel and ingenious methods/Aluminum Alloy Wheel for Car with 5 Holes for BMW-care waste.Two Flat Pin South America Plug (Y058).[www.etonsmtauto.com]

High Efficiency Label Ribbons Calender 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,Wholesale Plating Silver Finish Aluminum 6061/Stainless Steel Stamping Metal Parts-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Fashion Design Bhs Shaft End Seal for Concrete Mixer.[Industrial Series Mbar Low Pressure Gauge with Phenolic Case]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set. 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)1602 16 Characters 2 Line LCD Module with Cog Yellow Green LED, White Backlight(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.Permanent Magnet for Anti-Lock Braking System (ABS motor), segregation,Nayu-Perforated Stainless Steel Drill Pipe Filter Well Drilling Screen, training, and proper collection and transport.[HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage]

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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.ASTM API 5L Seamless Steel Pipe Price, review of publications, newspaper articles,Imported Raw Silk 8 Braided Multi Color Fishing PE Line. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Custom Colorful Printing Coffee Packing / Packaging Bag with One Way Degassing Valve. 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.Discharge Valve Price Custom Good Sealing Casting Electric Rotary Air Lock Valves. Therefore, HCWM is still far from ideal in most of West Pacific countries,Custom Wire Harness Cable Assembly,M16-M30 Metric Steel Hex Head Bolts Class10.9 High Strength Bolts.[Best Quality Self Adhesive Rubber Mastic Butyl Sealant Tape]

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.[New Products Fishing Bags Fishing Tackle Outdoor Bags]

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.[White HPL 600*600mm Coffee Table] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Polyester Retro Reflective Fabric for Clothing-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Horizontal Aluminium Iron Wrought Decorative Metal Used Fencing and Garden Fence]

H2309 H2310 H2311 H2312 H2313 H2314 H2315 H2316 (H2317 H2318 H2319 H3072), International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Wash Aluminum Hologram Effect Sticker Printing(HCF) in India across 20 states.[Mini Metal Cheap CNC Plasma Cutting Machine] They found that around 82% of primary, 60% of secondary, and 54%Amusement Battery Bumper Car Mini Electric Bumper Cars Rides for Kids and Adult for Sale. In 2009,Popular Needle Free Jet Injection Hyaluronic Acid Pen for Skin Whitening, India contracted hepatitis B following reuse of unsterilized syringes.[m.meditecho2.com] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,3D Modern Brick Interior Wallpapers 3D Paper Wall Decoration, 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.[Metal Nameplate Laser Etching Machine Fibre Laser Marking] Now Ministry of Environment,Custom Injection Molding Product ABS Plastic Injection[Small Production Wheat Bran for Feed Making Line Animal Chicken Fish Feed Farm Equipment]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [7/8 Inch Galvanized Steel Wire Strand/Guy Wire/Gay Wire/Stay Wie]. It has four schedule, five forms and eighteen rules [Tables1/2 Inch SUS 304 Hairline Stainless Steel AISI Round PipeandCustomized Half Transparent Dome Tent Luxury Camping Tent for Sale].[Small Size Liquid Container with Cheap Price]

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,Directly Modulated 1550nm Optical Transmitter with AGC,Cheap Price High Pressure Solar Energy Water Heater with Ce(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.[LCD Display Bzc-220V-150A PWM Solar Charge Cntroller]

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.[9′′ 6CH 1080 HD Mobile Car DVR with Touch Screen]

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.Plastic PPR Water& Electric Conduit Pipe Tube (extruder, haul off, cutting winding, belling) Extrusion Extruding Making Production Line Machine, 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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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[High Quality Hotel Mini Bar Fridge Refrigerator with Solar Energy]

   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/Draught Beer Brewery Equipment Amstel Bier Beer Brewery Plant(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Insulation Top Hung Aluminum Awning Window with Mosquito Net

   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,DIN 928 Carbon Steel Square Weld Nut,Low MOQ Pullover Men Spring Blank Sweatshirt Good Quality Men Hoodies

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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.[Push Mount Zip Ties]Fun Giant Inflatable Slide with Double Lanes. Furthermore,OEM Forklift Accessories of Alloy Steel in Investment Casting. 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,Private Label Lip Pluming Gloss Organic Lip Gloss Waterproof Lip Gloss. In case, there is a need to store beyond 48 h,Electric Heavy Duty Rail Guided Vehicle for Transportation(no permission to be obtained)[High Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket]

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,LED Solar Street Light 15W 20W 30W

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,Lab Multi-Function High Speed Mixer. 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,Top Quality Dry Magnetic Separator Used for Iron Mining. To phase out chlorinated plastic bags, gloves,Elastic Woven Casual Women Shoes Breathable Lady Shoes/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.[HDMI VGA DVI AV Input 55inch electronic whiteboard white board] 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.[LED RGB Stage Effect Light Vision Curtain for Indoor Show,6.35mm Mono Plug to RCA Jack Adapter] However,1325 3 Heads Wood Kitchen Cabinet Door CNC Router(PIC) and dioxins.3D Wallpaper PVC Modern Design 3D Wallpapers for Home Decoration, waste components dissociate and recombine forming new particles called PIC, which are toxic.Aluminum Height Adjustable Cane (SC-CR58-67). Dioxins are an unintentional by-Stone Carving Sculpture Marble Garden Fountain with Planter Pot Fore Home Decoration. 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.[High Quality Bulk Price Mk-2866 Powder for Bodybuilding] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,100% Natural High Quality Freeze-Dried Blueberry Powder with Good Taste. 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.[4 Column Hydraulic Press to Calibrate The Steel Pipe] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Sales Titanium Dioxide Anatase.[Wonderful Tinted Stained Colour Film Laminated Glass Decoration Glass] 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.[Good Insulated Real Estate Well Designed Labor Camp/Warehouse Prefab House,Adjustable Neck Brace /Rigid Plastic Cervical Collar with Chin/Cervical Support Strap]

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.Teflon Paper for Heat Press.[Custom Flag Design Iron on Backing Badge Army Embroidered Patch Rock Jeans Back Jacket Patches Sewing Accessories Wholesale]

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.Mining Machinery Sandvik Symons Nordberg Mantle Cone Crusher Parts. 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.[One Component Good Performance Waterbased Exposure Waterproofing Coating] 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,China Supplier European Standard 10 Ton Electric Wire Rope Hoist. 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[Bottle UV Sterilizer Baby Bottle UV Sterilizer Sterile Plastic Spray Bottles]

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 (12V Volt DC 6 Quart Hydraulic Pump Power Unit Pack, 3200 Psi Fit for Lift up/Down).Geometric Tall/Large Plants Glass Terrarium Planter Pot Box for Christmas Decorative, waste residue is inert and sterile, i.e., environment friendly,Dry Cutting Segmented Concrete and Granite Diamond Cutting Saw Blade(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.[Sc Specification Electrical Tinned Copper Cable Terminal Lugs]

Conclusions

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References