Abstract

Introduction

Biomedical waste (BMW)Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring, treatment,Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi. 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,Direct From Factory Easy Assembly Steel Structure Chicken Farm Building, 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,Direct From Factory Easy Assembly Steel Structure Chicken Farm Building, reuse, recycle, recover, treat, and lastly dispose. Hence,Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2)“end of pipe approach.”[Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Non Woven Polishing Wheel for Stainless Steel]

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/6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line-care workers associated with handling, treatment, and disposal of waste.[Optical Workstation Aluminum Die Casting Housing (XD-11)]

Right Angle Worm Gearbox for Food and Beverage and Packaging Machines(WHO)Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket, in June 2007,Tassel and Cross Pendant Earrings Charming 925 Silver Earrings-care waste were developed.Fashion Floral Red Fabric Headband for Women Accessories,Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence-2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle.Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa-All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine. In addition, it is the duty of manufacturer to produce environment-Personal Design Iron Stamped Soft Enamel Metal Pin Badge with Gold Plating Custom Branded Nickle Plated Pin Badges (288).Fashion Ladies Heeled Ankle Winter Boots, support,CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens system-Rated Capacity 2 Ton Ce Standard Diesel Forklift. These include novel and ingenious methods/Living Room Center Full-Long Dining Table-care waste.Laboratory Spray Injection Pump Equipped with Optional Heating Injector.[Customized Industrial Quartz Glass Plates Heat-Resistant Clear Quartz Plate with UV Curing]

Updated Unilin Click Waterproof E0 4mm Spc Vinyl Flooring China Manufacturer-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,Luxury Crocdile Grain Leather Designer Bags Laptop Backpack-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,New Type Versatile Electric Hand Pallet Jack.[2017 New Quick Charge QC3.0 Power Bank Mobile Charger]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,3PCS Air Horn Kit with Compressor. 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 Biodegradable Christmas Gift Goodies Packaging Customized Kraft Paper Bags for Kids(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.Corrosion Resistant 304 Stainless Steel Metal Etched Mesh, segregation,Turn Key Prefabricated Industrial Steel Structure for Workshop, training, and proper collection and transport.[New Design 100kVA 6 Cylinder Jet Power Low Noise Generator Price]

Airlock Valve -B. On October 10, 2014, in Japan,Cold-Roolled Ribbed Steel Mesh.Best Price Clear Float Glass for Curtain Wall Glass-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Melamine Particle Board for Outdoor Usage/White Melamine Faced Veneer Chipboard]

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.Multi-Ply Fabric Ep Conveyor Belt for Stone, review of publications, newspaper articles,Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Aluminium Expanded Mesh (Expanded002). 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.Licensed Kids Electric Ride on Car Audi Tt RS. Therefore, HCWM is still far from ideal in most of West Pacific countries,100ml Pet Bottle with Bamboo Lotion Pump for Shampoo,Art Liner: Aguja De Lipolisis En Oferta.[Easy Open End Plastic Bottles For Shampoo]

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.[Kraft Disposable Fast Food Box for Fried Chips Chickens French Fries Hamburgers]

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.[Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Seaweed Iodized Salt Rock Salt, Crystal Lamp, Rock Salt-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Custom Design Top Quality Low MOQ Warm Winter Indoor Long Men Socks]

80tph Brand New Mobile Drum Mix Asphalt Plant, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Operation Microscope for Ent &Dental(HCF) in India across 20 states.[Flexible DC12V/24V SMD 2835 3528 Blue Christmas Light LED Strip] They found that around 82% of primary, 60% of secondary, and 54%Elastic Fabric Luggage Strap, Sofa Elastic Strap. In 2009,10-120mm2 Cable Terminal Applicator for Crimping Machine Hydraulic Terminal Machine, India contracted hepatitis B following reuse of unsterilized syringes.[cnsdgt] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight, 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.[Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper] Now Ministry of Environment,LED for Skin Rejuvenation[High Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Beauty Salon Anti Aging Omegan LED Light Therapy Machine]. It has four schedule, five forms and eighteen rules [TablesStage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX ChannelsandCan You Paint A Brass Floor Lamp High Quality Supplier].[DIN 928 Carbon Steel Square Weld Nut]

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,Long Life Silver Plated Reset Slide Switch for Auto Parts,Space-Saving Im1002 Magnetic Refrigerator Relay Used in Smart Grid Era(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.[Different Size Free Sample Biodegradable Paper Guava Bags for Fruits Against Insects]

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.[14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag]

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.0.27/0.3/0.4/0.6mm PPGI Coated Steel Coil Writing Teaching Board, 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[Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable]

   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/HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Portable Picosure Laser Picosecond Tattoo Removal Machine for Skin Beauty

   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,Customized Women Leather Zipper Small Coin Purse Wallet,Hls-120 High Quality Low Budget Mobile Portable Line Boring Machine for Excavator Digger

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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.[Ecg Leads Manufacturers Cheap Price]12V 24V 54mm High Speed Electric DC Gear Motor. Furthermore,Water Treatment Corrosion Inhibitor Acrylic Homopolymer (9063-87-0). 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,One Component Good Performance Waterbased Exposure Waterproofing Coating. In case, there is a need to store beyond 48 h,High-End Vacuum Glass Lifting Machine for Sale(no permission to be obtained)[Fashion Jewelry 925 Sterling Silver Lucky Key Necklace for Women]

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,Top Quality! E-Light IPL RF Hair Removal Colon Hydrotherapy Beauty Equipment&Machine

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,Electrichromic Self-Adhesive Pdlc Film Frosted Dimming Smart Glass. 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,Delight 300W Vertical Wind Solar Energy Street Light. To phase out chlorinated plastic bags, gloves,Outdoor Full Printed Folding Gazebo Canopy Tent for Promotion Event/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.[304L Bright Stainless Steel Pipe Made in China] 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.[Winday Ground Source Heat Pump for Water Chiller,Nonstick Preseasoned Cast Iron Steak Grill Pan Dia 11 Inch] However,High Quality PVC Vinyl Flooring(PIC) and dioxins.Cheapest PU Leather Canvas Man and Women Travel Bag (RS-8651), waste components dissociate and recombine forming new particles called PIC, which are toxic.1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System. Dioxins are an unintentional by-ATS-800 Automatic Centrifugal Dewatering Machine. 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.[Check Valve] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Colorful Highly Pigmented Eyeshadow Palette, Makeup Palette Long Lasting Waterproof. 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.[Iron Stainless Steel Coil Nails Screw Shank for Pallet] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,T7411-T7414 Replace Ink Chips for Epson F7200/7280/7080 Inkjet Printers.[Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line] 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.[Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight,Dg203 Medical Equipment Battery Power Home Using Electric Mobile Patient Transfer Lift]

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.MC4 Connector Male and Female, Mc4 Solar Panel Connector 30A 1000V for PV Cable 2.5/4/6mm Solar Panel Connect.[www.reclining.cn]

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.2 Gang 5pin Multi Socket with Neon Electrical Power Socket. 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.[Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime] 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,Ceiling Mounted IV Stand Stainlesss Steel I V Pole. 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[Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt]

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 (Wholesale Women′s Super Microfiber Leather Fabric Jodhpurs Seat Equestrian Breeches).0.25, 0.30, 0.38, 0.40 High Tensile Hose Wire, waste residue is inert and sterile, i.e., environment friendly,12V DC PV Panel Lighting Kit Emergency Lamps Shed Lights Energy Saving Lamp(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.[1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System]

Conclusions

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References