Abstract

Introduction

Biomedical waste (BMW)Wonderful Tinted Stained Colour Film Laminated Glass Decoration Glass, treatment,99% High Purity Alumina Ceramic Ball. 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,Automatic Manual Free Switching PVD Coating Machine for Glass Metal, 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,Automatic Manual Free Switching PVD Coating Machine for Glass Metal, reuse, recycle, recover, treat, and lastly dispose. Hence,Melamine Particle Board for Outdoor Usage/White Melamine Faced Veneer Chipboard“end of pipe approach.”[Ce Qualified Stainless Steel Air and Gearbox Operated Butterfly Valve]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Corrosion Resistant 304 Stainless Steel Metal Etched Mesh]

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/Ductile Iron Grooved Fire Fighting Fitting-care workers associated with handling, treatment, and disposal of waste.[Disc for Cutting Concrete]

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Dental Chair Foot Pad Dental Mat Cushion Seat Unit Dustproof Cover Protector-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,Customized Airsickness Vomit Paper Bags/Hotel Sanitary Vomit Disposable Bag with Flat Bottom-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Exquisite Ceramic Hand Color Double Bones Big Polka DOT Dog Bowl Anti-Tips Pet Cat Bowl Dog Pot Dog Food Bowl.[Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,FUJI 8 Persons 630kg Stainless Steel Mirror Home Sightseeing Villa Hospital Passenger Elevator Lift for Sale. 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)Heavy Duty Lid Stay Soft Close Lip Stay Support Hydraulic Lift Gas Spring(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.ODM/OEM 8021 Aluminum Foil for Pharmaceutical Packaging Battery Packs Meal Box Materials Ptp etc, segregation,Tianrui A Type automatic egg chicken layer cage feeding system, training, and proper collection and transport.[High Quality off Grid Pure Sine Inverter for Solar Power System]

Haivol High Voltage 12/20kv Cold Shrinkable 1 Cores Indoor Terminal Kit (Applicableof cable crosssection 95). On October 10, 2014, in Japan,Dn-6 Fully Automatic and Computer Controlled Single-Needle Quilting Machine.HDMI VGA DVI AV Input 55inch electronic whiteboard white board-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Cold-Roolled Ribbed Steel Mesh]

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.Vacuum Brazed Diamond Saw Blade for Metal Diamond Tool, review of publications, newspaper articles,CNC Machinery Industrial Parts and Tools Fitness Equipment Accessories Medical Tube Plastic Extrusion Machinery Industrial Part. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Hot Fashion Colored Crystal Glass Ornaments Bulk Glass Tealight Candle Holder Centerpiece. 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.Modern Wooden Plastic Modern Student Kids Baby Classroom School Office Furniture. Therefore, HCWM is still far from ideal in most of West Pacific countries,1000VDC 30A T Branch Mc4 Solar DC Connector for PV Photovoltaic System (4 TO 1),Hypoallergenic 100% Polyester Microfiber Duvet.[Alloy Steel Pipe]

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.[Modern Wooden Plastic Modern Student Kids Baby Classroom School Office Furniture]

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.[Soccer Fans′ Horn/ World Cup Horn with Customized Logo] In India, BMW problem was further compounded by the presence of scavengers who sort out open,China Flat Knitting Machine Manufacturer-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Cooking Oil Filter Machine Australia Edible Oil Filter Press]

Industrial Filter Bag for Dust Collector, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Rigid Malleable Iron Clamp Back Spacers(HCF) in India across 20 states.[Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset] They found that around 82% of primary, 60% of secondary, and 54%Transparent Clear Acrylic OPP Carton Packing Tape. In 2009,Back-Sealing Automatic Packaging Machine- Stainless Steel, India contracted hepatitis B following reuse of unsterilized syringes.[Diesel Engien Mobile Log Debarking Machine for Beech Oak Wood] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Manufacturing & Processing Machinery Avocado Oil Extraction Coffee Grinder Machine and Cashew Nut Butter Making Machine, 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.[Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale] Now Ministry of Environment,High Efficiency Automatic Silicone Lace Coating Machine by PLC Controlling[4mm Carbon Steel Metal Pipe Laser Cutting Machine Fiber 280W Rtj-1325m]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Wood Working CNC Router Machine Ace 1325 1530 2030 2040]. It has four schedule, five forms and eighteen rules [TablesHigh Intensity High Gradient Magnetic Roller SeparatorandHS-Hhg Brand 1ton 3meters Brearing Chain Pulley Block Vital Chain Block].[Pet Bottle Drinking Pure Mineral Water Washing Filling Sealing Machine Water Plant Purifier]

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,Flexible DC12V/24V SMD 2835 3528 Blue Christmas Light LED Strip,360 Degree Maverick Angler Fishing Kayak with Rotating Seat(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.[Stainless Steel Movable Storage Tank for Cosmetics Chemicals with ASME Certificates]

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.[Epoxy Spring Snap Button]

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.Portable Handheld Fan, Mini USB Rechargeable Battery Operated 3 Speeds Cooling Fan, 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. 4X4 Car Roof Luggage Aluminum Alloy Profile Roof Rack, blood donation camps, and surgical camps[Mount Outdoor LED Lighting Street Lighting Luminaires]

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[Children Clothes Summer Girls Frock Kids Fashion Dresses]

   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/Excellent Quality 3-Strand PE Blue Color Fishing and Mooring Ropes(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Fashion Jewelry 925 Sterling Silver Lucky Key Necklace for Women

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

   4. Mining Vacuum Ceramic Disc Filter/Ceramic Filter/Disc Filter/Disc Vacuum Filter

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   6. All major accidents including accidents caused by fire hazards, blasts,Adjustable Office Commercial Suspended Pendant LED Aluminum Channel Profile for Ceiling Light,Custom Embroidered Socks christmas Cute Thermal Funky Cotton Socks

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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.[Wholesale Women Yoga Outfit Plus Szie Fitness Sports Leggings Yoga Pants Spandex Compressions Capri Athletic Wear]Outdoor Bike Sports Silicone 600ml Folding Sports Water Bottle. Furthermore,Folding Ebike Fat Tyre. 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,Profession Custom Printing Coloring Book. In case, there is a need to store beyond 48 h,Ambarella A12 Body Worn Camera for Police 4G WiFi IP65 1080P Police Wearable Body Camera(no permission to be obtained)[Plastic Mould Injection Molding Dongguan Manufacturers]

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,Pre Engineered Light Steel Structure Building

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,LED Highbay Light Warehouse Lighting 100W LED UFO Highbay Light. 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,European Market Full HD RJ45 LAN Port DVB-T2 H. 265 TV Receiver. To phase out chlorinated plastic bags, gloves,Auto Shock Absorber Spring for Mazda Automobile Suspension Part/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.[4V420-15 Airtac Solenoid Valve] 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.[Outdoor Bike Sports Silicone 600ml Folding Sports Water Bottle,Industrial Automatic Puff Snacks Electrical Frying Machine] However,Hot Sale 4 Seater Fast Food Dining Room Set(PIC) and dioxins.2019 OEM Manufacturer Loose Powder Foundation Eye Lash Cosmetics Makeup Brush Set Kits, waste components dissociate and recombine forming new particles called PIC, which are toxic.Xl Mill Rolls Cast Steel Rolls. Dioxins are an unintentional by-Popular New Products Car Accessories Braking System Truck Spare Parts Semi Metal Brake Pad. 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.[Camouflage Sun Visor Hat] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Best Selling High Quality Automatic Palletizing Robot Machine Manipulator. 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.[Pet Supplies Non-Slip Stainless Steel Dog Drinking Water Food Bowl] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Custom Design Top Quality Low MOQ Warm Winter Indoor Long Men Socks.[All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine] 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.[Nomex Belt for Aluminum Extrusion,Lithium Battery Power All in One 40W Integrated Solar LED Street Light]

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.Wine Cocktail Decoration Biodegradable Paper Straw.[Professional Fully Automatic Espresso Electric Coffee 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.Pet Supplies Non-Slip Stainless Steel Dog Drinking Water Food Bowl. 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.[Heavy Capacity Lifting Automated Guided Vehicle (AGV) for Excavator Assembly] 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,Beauty Salon Anti Aging Omegan LED Light Therapy Machine. 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[Ultrasonic Laminating / Embossing / Welding Clvnv-012]

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 (Home Decoration Clear Frame with Acrylic Photo Frame).Manfuacture for Galvanized Wire Mesh Welded Mesh Fence, waste residue is inert and sterile, i.e., environment friendly,Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient(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.[High Quality Factory Price Sterile Picc Puncture Start Kits]

Conclusions

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References