Abstract

Introduction

Biomedical waste (BMW)Ductile Iron Flexible Coupling and Flange Adaptor, treatment,Top Quality Customized Hospital Wristband Free Artwork Silicon Rubber Watch. 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,Egg Table Lamp Rechargeable Table Lamp Color Change Decoration Lamp, 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,Egg Table Lamp Rechargeable Table Lamp Color Change Decoration Lamp, reuse, recycle, recover, treat, and lastly dispose. Hence,Three Phase a. C. Synchronous Alternator/Generator (STC 3KW-50KW)“end of pipe approach.”[Stainless Steel Crimped Wire Mesh]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Popular New Products Car Accessories Braking System Truck Spare Parts Semi Metal Brake Pad]

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/Good Quality Wooden Wine Bottle Holder-care workers associated with handling, treatment, and disposal of waste.[Geometric Tall/Large Plants Glass Terrarium Planter Pot Box for Christmas Decorative]

2PC/3PC Pn10/Pn16 Handlever Cast Steel Floating Ball Valve(WHO)Stainless Steel Pipe Fiber Laser Cutting Machine with Round Square Tube, in June 2007,14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag-care waste were developed.High Brightness P10 Outdoor Green Color LED Display of Outdoor,Digital Smart Sensor Body No Contact Infrared Radiation Thermometer-High Quality Enamel Camping Set Tableware Set Food Container Dinner Set Bowl Plate Dish Mug Cup Dinnerware Party Supplies.Humizone Ultra Potassium Humate Leonardite Source Foliar Fertilizer-Modern Green 4 Person Cross Workstation with File Cabinet (CAS-W31456). In addition, it is the duty of manufacturer to produce environment-OEM CNC Machine Aluminum and ABS Mock up Prototypes.Plastic Moldstamping Mould,Molding,Tooling for Air Machine ,Water Heater,Cooler,Cooling,Air Conditiner,Refrigerator,Washing Machine,TV,LED,Lighting,Auto Parts,, support,Advertising Exhibition Floor Metal Frame Display Rack Banner Poster Stand-Hot Sale Supermarket Chiller Supermarket Cooler with Ce Certificate. These include novel and ingenious methods/Machine to Make Disposable Plates-care waste.Abelly 6.3m All Welded Aluminum Fishing Boat.[Aluminium Corner Extrusion]

Medical Hospital Equipment Hydraulic Electric Hoist Lifts-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,High Quality 304 316 Bsp Threaded Stainless Steel Reducing Tee-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Manufacturer Digitaizer Mobile Phone LCD for iPhone 6s LCD.[Quality Fasteners Screws Bolt with Reasonable Price]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,BDS Digital Compass Military Marking Thermal Imaging Fusion Night Vision. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

High Purity Magnesium Ingot 99.99%, Factory Sale Metal Magnesium Ingots Price. It has 170 member countries,Aluminum Alloy Die Casting for Window/Door Hardware/Hinge (STK-ADC-167), management,500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire,Dual Head Medical Aluminum Stethoscope for Child,Best Price Food Grade Citric Acid Monohydrate, and clinics.[Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls]

Stockholm Convention on POPs (the Stockholm Convention)Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors(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.Ultrasonic Laminating / Embossing / Welding Clvnv-012, segregation,High Quality Softcover School Graduation Book Printing, training, and proper collection and transport.[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack]

Disposable Plastic 28g Twist Blood Lancet. On October 10, 2014, in Japan,Digital Printing Light Weight UV Resistant Air Drone Race Gate.First-Class DIP Soldering Machine for PCBA Production Line-care services, including mercury-containing medical items such as thermometers and blood pressure device.[PU Leather for Glove& Clothes Purpose in 0.5mm]

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.Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch, review of publications, newspaper articles,Rubber Compound Two Roll Mill, Two Roll Mixing Mill. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Good Quality Wall-Mounted Ozone Generator with 10g/H Ozone. 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.Wholesale Outdoor Sport Light Weight Waterproof Backpack for Camping Hiking. Therefore, HCWM is still far from ideal in most of West Pacific countries,Stainless Steel Automatic Commercial Coffee Machine for Sale with CE Approved,Wood Log Debarker and Rounding Machine.[John Deere 490d Final Drive]

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.[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block Machine]

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.[Manual Lever Hoist From 0.75ton to 9ton] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Ultrasonic Fabric Underwear Spot Welding Bonding Cutting Machine-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Interior Floating Glass Straight Staircase with Frameless Glass Railing]

Micro DC Motor - Auto (Car) Windows Motor, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,5/16 Rubber Twin Welding Hose W. P 300psi(HCF) in India across 20 states.[Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium] They found that around 82% of primary, 60% of secondary, and 54%Blackened Helical Large Damping Compression Spring for Medical Machinery Spring with ISO 19001 Certification (10*89*177*7.5). In 2009,Optical Workstation Aluminum Die Casting Housing (XD-11), India contracted hepatitis B following reuse of unsterilized syringes.[egbadges.com] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Cheap White Pastry Packaging Box with Window, 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.[2018 New Wireless Bt Speaker with UHF Microphone Home KTV] Now Ministry of Environment,ASTM A269 317 Seamless Coil Tubes Stainless Steel Pipe Manufacturer[Uns S31260 201 304 316 321 Stainless Steel Sheet 3mm Thickness Stainless Steel]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set]. It has four schedule, five forms and eighteen rules [TablesPolycarboxylate Super Plasticizer PCE Flakes Crude Powder for ConcreteandPlastic Flange Housing Ucf310-115 for Electric Hand Tools].[Lab Multi-Function High Speed Mixer]

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,Hot Selling Laundry Detergent Powder, Washing Powder for Hand Wash&Machine,Unique Die Cut Coloring Hard Cover Kids Board Comic Alarm Clock Book Printing China(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.[1000VDC 30A T Branch Mc4 Solar DC Connector for PV Photovoltaic System (4 TO 1)]

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.[Double& Single Faced Tube Storage Cantilever Rack System with 500kg~1200kg]

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.Polyester Cup Holder with Customer Design Shape and Logo, 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. Sounda Printable Adhesive Black Back Car Wrap Vinyl Sticker Roll, blood donation camps, and surgical camps[High Quality White Spray Glass Candle Jar Container for Wedding Centerpiesce]

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[Dental Chair Foot Pad Dental Mat Cushion Seat Unit Dustproof Cover Protector]

   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/Professional Manufacturer of Fruit Dryer Machine(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Low Pressure Industry Heatless Regenerative Adsorption Air Compressed Dryers (KRD-12WXF)

   3. To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization

   4. Sc Specification Electrical Tinned Copper Cable Terminal Lugs

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   6. All major accidents including accidents caused by fire hazards, blasts,Automatic Hard Candy Depositing Line (PLC Control),Sea Water API 3lpe LSAW Line Pipe, API 5L Sawl Pipe, Grade B and X42 X52 Steel Pipe

   7. Blue Light PVC Transparent Plastic Film Shower Curtain/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.[Shoulder Stability Brace with Pressure Ice Pad Made of Light and Breathable Neoprene]Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool. Furthermore,Self Adhesive Reinforced Fiberglass Joint Drywall Tape, Fiberglass Anti Cracking Drywall Tape. 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,Crude Powder Mixer Machine in Pharmaceutical Industry. In case, there is a need to store beyond 48 h,One-Piece Micro Needle RF System for Scar and Pregnancy Line Remover Beauty Machine(no permission to be obtained)[Automatic Aluminum Roller Shutter Garage Door (HF-J328)]

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,304, 316 Stainless Steel Slot Pipe for Glass Railing

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,TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof. 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,Wholesale Adjustable Knee Brace with Springs. To phase out chlorinated plastic bags, gloves,High Quality PU/TPU Tape for Garment/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.[Commercial High Capacity Bread Toast Spiral Cooler Tower Machine] There is a great need for rapid development of many more CBMWTF to fulfill the need of treatment and disposal of all BMW generated in India. Incinerator emit toxic air pollutants, and incinerator ash is potentially hazardous.

Incinerator and its Hazards

The first solution for the disposal of BMW was to burn the waste. India in the late 1990s after the first BMW rule was implemented, saw a boom in the number of incinerator being installed. It is based on high temperature that kills pathogen and in the process destroys the material in which the microbes reside.[Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient,Public TV Floor Stand Dual Screens 30-60 Landscape & Portrait] However,6mm DIY Grinding Electric Die Grinder Tools (DG004)(PIC) and dioxins.Cast Iron Cookware Casserole Pot/Enamel Coating Cast Iron Cookware, waste components dissociate and recombine forming new particles called PIC, which are toxic.New Design 100kVA 6 Cylinder Jet Power Low Noise Generator Price. Dioxins are an unintentional by-Agricultual Hand Sprayer/Garden Hand Sprayer /Home Hand Sprayer (TF-01F). 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.[Wholesale Spa Socks] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Custom Food Grade PVC Tube PVC Vacuum Hose. 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.[Ductile Iron Flexible Coupling and Flange Adaptor] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Strong Sintered N35 NdFeB Motor Magnet Rare Earth Permanent Magnet.[Vibratory Deburring Bowls Tumbler with Sound Enclosure] 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.[LED for Skin Rejuvenation,Gasoline Water Pump (WX-WP20H-A)]

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.Flaker, Granular, Powder, Pellet Calcium Chloride Used for Construction Industry.[Roof Tile Roll Forming Machine]

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.Yto 3 Ton Diesel Forklift Cpcd30A1. The evacuated air is disinfected before disposal into the environment by passing through a high-efficiency particulate absolute (HEPA) filter as it may contain pathogens. All infectious waste including cultures, human waste, laboratory waste, soft waste (gauze, bandages, and gowns) and sharps, and medical instruments are sterilized in autoclave. Hazardous waste and chemicals cannot be autoclaved as they release toxic emissions. Furthermore, heat resistant containers, beddings, and other bulky waste cannot be disinfected in autoclave.[Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2)] 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,304L Bright Stainless Steel Pipe Made in China. 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[Coal Rock Crawler Mucking Loader Machine Rock Mucking Loader for Underground]

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 (Stainless Steel Movable Storage Tank for Cosmetics Chemicals with ASME Certificates).Children Flounce Cold Shoulder Gingham Dress with Belt, waste residue is inert and sterile, i.e., environment friendly,Plastic PVC|PE|PP|HDPE Water Gas Supply Irrigation Single Double Wall Corrugated (DWC) Cable|Tube Extrusion Extruding|Extruder Pipe Making Machine Price(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.[Universal Type-C Power Socket Pd Fast QC3.0 USB Charger]

Conclusions

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References