Abstract

Introduction

Biomedical waste (BMW)New Design Decorative High-Pressure Laminate Board, treatment,N35 N42 N52 Permanent Disc NdFeB Neodymium Magnet. 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,Twin Screw Extruder Fish Feed Treats Making Machinery, 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,Twin Screw Extruder Fish Feed Treats Making Machinery, reuse, recycle, recover, treat, and lastly dispose. Hence,China Professional High Quality CNC Lathe with Milling Drilling Function (CK61160)“end of pipe approach.”[Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Hc-10t Heavy Duty Big Cable Terminal Cable Lug Crimping Machine Crimper]

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/Custom Logo 3D PVC Soft Rubber Sew on Clothing Band PVC Silicone Patch-care workers associated with handling, treatment, and disposal of waste.[High Quality off Grid Pure Sine Inverter for Solar Power System]

1.6m Hydraulic Small Home Lift for Disabled(WHO)Hot Sale High Quality House Roof Tile Roman Type, in June 2007,Hot Selling Glass Amber Color Beer Bottles 500 Ml Glass Bottle-care waste were developed.Gym Equipment, Fitness, Body Building, Hammer Strength, Adjustable Bench (PRO Style) (HP-3056),Delight 300W Vertical Wind Solar Energy Street Light-Outdoor Full Printed Folding Gazebo Canopy Tent for Promotion Event.High Quality PVC Vinyl Flooring-Cheapest PU Leather Canvas Man and Women Travel Bag (RS-8651). In addition, it is the duty of manufacturer to produce environment-1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System.ATS-800 Automatic Centrifugal Dewatering Machine, support,Colorful Highly Pigmented Eyeshadow Palette, Makeup Palette Long Lasting Waterproof-T7411-T7414 Replace Ink Chips for Epson F7200/7280/7080 Inkjet Printers. These include novel and ingenious methods/MC4 Connector Male and Female, Mc4 Solar Panel Connector 30A 1000V for PV Cable 2.5/4/6mm Solar Panel Connect-care waste.2 Gang 5pin Multi Socket with Neon Electrical Power Socket.[Membrane Building Structure]

Ceiling Mounted IV Stand Stainlesss Steel I V Pole-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 Women′s Super Microfiber Leather Fabric Jodhpurs Seat Equestrian Breeches-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,0.25, 0.30, 0.38, 0.40 High Tensile Hose Wire.[Cold-Roolled Ribbed Steel Mesh]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,12V DC PV Panel Lighting Kit Emergency Lamps Shed Lights Energy Saving Lamp. 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)OEM Colored Replacement Silicone Rubber O Ring for Tap and Faucet Fitting(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.Kids Sneakers School Shoes for Girls with Design Wholesale High-Quality Custom Dropshipping Running Shoes, segregation,Stainless Steel Fittings, training, and proper collection and transport.[Soccer Fans′ Horn/ World Cup Horn with Customized Logo]

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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.Aluminum Foil Container Making Machine, Pneumatic Punching Machine, review of publications, newspaper articles,LED RGB Wash Wall Lighting. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,14 Inch Silent Core Low Noise Segmented Granite Cutting Diamond Saw Blade. 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.Ce Certificated Acm-60 PTFE Powder Grinding Mill. Therefore, HCWM is still far from ideal in most of West Pacific countries,Check Weigher Using After Packaging Machine,Pet Bottle Drinking Pure Mineral Water Washing Filling Sealing Machine Water Plant Purifier.[Polished Brushed Aluminum Alloy Doors and Windows]

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.[Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset]

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.[Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale] In India, BMW problem was further compounded by the presence of scavengers who sort out open,FRP Cooling Tower Blower Fan Manufacturers-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[4mm Carbon Steel Metal Pipe Laser Cutting Machine Fiber 280W Rtj-1325m]

Teflon Hose, PTFE Hose, High Temperature Resistant Hose, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,16W Corn Bulb 4u IC Driver Corn LED Light Bulbs(HCF) in India across 20 states.[Wood Working CNC Router Machine Ace 1325 1530 2030 2040] They found that around 82% of primary, 60% of secondary, and 54%Head Dimension Integral Drill Rod. In 2009,China Textile Factory Produces Dye Sublimation Beach Flag Fabric, India contracted hepatitis B following reuse of unsterilized syringes.[Long Life Silver Plated Reset Slide Switch for Auto Parts] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Aluminium Profile Roller Shutters OEM/Rolling Screen Aluminium, 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.[High Intensity High Gradient Magnetic Roller Separator] Now Ministry of Environment,Semi-Automatic Headlight Tester/Headlamp Tester/Automobile Headlight Detector[Pet Bottle Drinking Pure Mineral Water Washing Filling Sealing Machine Water Plant Purifier]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Custom Printed Adhesive Security Warranty Void Packing Seal Tape]. It has four schedule, five forms and eighteen rules [TablesExplosion-Proof Diaphragm Valve for Bag Filtert Since 1992andEas Sunglasses Security Tag].[Digital Smart Sensor Body No Contact Infrared Radiation Thermometer]

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,Hard Rock Drilling Company Drill Bit Taper Angle Hard Rock Tool Catalog 7 Degree Taper,Shot Gun Hot Stick with 1.4m 10kv Fiberglass Operating Rod(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.[Children Clothes Summer Girls Frock Kids Fashion Dresses]

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.[Plastic Mould Injection Molding Dongguan Manufacturers]

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.Production Line Make Pre Cooked Corn Meal Maize Powder Flour Making 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[Outdoor Bike Sports Silicone 600ml Folding Sports Water Bottle]

   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/Plated Gold Metal Blank Lapel Pins(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hot Air 25kg Pet Plastic Hopper Dryer for Injection Molding Machine

   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,Tungsten Metal Powder Cast Tungsten Carbide Powder in Various Size,Semi Auto 5 Gallon PC Bottle Blow Molding Machine

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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.[Tp321 Stainless Pipe /Heat Exchanger/Condenser Tube]Galvanized Aluminum Wire Mesh Window Screen. Furthermore,Gear Box Carbon Steel U Type Flange Butterfly Valve High Performance. 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,Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight. In case, there is a need to store beyond 48 h,Home Radiator Heating Electric Fireplace with Mantel Packages (319B)(no permission to be obtained)[Industrial Automatic Puff Snacks Electrical Frying 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,Moisturizing Lipglpss Make Your Own Clear Lip Gloss Custom

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,Heavy Capacity Lifting Automated Guided Vehicle (AGV) for Excavator Assembly. 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,Diagnostic Medical Clinical Alpk2 Palm Aneroid Digital Bp Blood Pressure Sphygmomanometer. To phase out chlorinated plastic bags, gloves,60m3 Bulk Silo Trailer Wheat Transport for Sale/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.[Pet Supplies Non-Slip Stainless Steel Dog Drinking Water Food Bowl] 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.[All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine,Nomex Belt for Aluminum Extrusion] However,Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised(PIC) and dioxins.Plastic Flange Housing Ucf310-115 for Electric Hand Tools, waste components dissociate and recombine forming new particles called PIC, which are toxic.12 Pin Car Mirror ISO Wiring Harness Manufacturer. Dioxins are an unintentional by-Potassium Humate Powder, Humic Acid Powder. 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.[0.91 Inch 128X32 DOT Matrix FSTN Cog LCD Module] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Poultry House Chicken Feed Silo. 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.[Lithium Battery Power All in One 40W Integrated Solar LED Street Light] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,HD 1080P 4 Channel Car Mobile DVR with GPS, 3G/4G, WiFi.[Heavy Capacity Lifting Automated Guided Vehicle (AGV) for Excavator Assembly] 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.[Ultrasonic Laminating / Embossing / Welding Clvnv-012,High Quality Factory Price Sterile Picc Puncture Start Kits]

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.Secondary Stainless Steel Coil and Sheet.[Bag Sachet Packing 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.Free Sample Promotion Holographic E-Liquid Paper Box Package. 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.[Fun Giant Inflatable Slide with Double Lanes] 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,White Flake Calcium Chloride Dihydrate for Oil. 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[Leather Tanning Agent BCS Basic Chrome Sulphate 24%-26%]

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 (1000W 1500W 3 Meters Pipe Laser Cutter CNC Fiber Laser Cutting Machine for Metal Sheet).High Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket, waste residue is inert and sterile, i.e., environment friendly,10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys for Women(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.[Nayu-Perforated Stainless Steel Drill Pipe Filter Well Drilling Screen]

Conclusions

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References