Abstract

Introduction

Biomedical waste (BMW)Heat Exchanger in Heating, Cooling and Condensation of Process Air, treatment,PLC Servo Piston Liquid Bottle Oil Detergent Shampoo Disinfectant Bleaching Soap Cleaner Corrosive Bottling Filling Machine. 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,Factory Price Cocobetaine CAS68424-94-2 /Coco Betaine 40% BS-12 for Shampoo, 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,Factory Price Cocobetaine CAS68424-94-2 /Coco Betaine 40% BS-12 for Shampoo, reuse, recycle, recover, treat, and lastly dispose. Hence,Qingdao Us Type Load Binder Lever Chain Tensioner“end of pipe approach.”[for Oil Fields Clay Stabilizer]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Am3 Hot Galvanized Ship Anchor Chain for Sale]

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/Plastic Machinery for Producing IC Electronics Package Pipe-care workers associated with handling, treatment, and disposal of waste.[Custom Factory Ribbon Shape Metal Enamel Awareness Lapel Pins]

800mm Slurry Shield MTB Machine(WHO)Screw Self Drilling Screw/Self Tapping Screw/Fastener, in June 2007,Epoxy Spring Snap Button-care waste were developed.Handheld Digital Infrared Thermometer Temperature Gun,Winday Ground Source Heat Pump for Water Chiller-ASTM A53 Carbon Steel Hot Dipped Galvanized Pipe Nipples.Sidewinder Rubber Cable Protector Ramp, Rubber Cable Cross-Sintec Full Auto Glass Processing Machine CNC Cutting Machine. In addition, it is the duty of manufacturer to produce environment-12 Inch King Mattress Latex Foam Memory Foam Mattress.Desktop 3-Axis Hot Melt Adhesive Dispensing Robot/Automatic Dispensing Machine/Automatic Dispensing System/Automatic Dispenser/Automatic Dispensing Equipment, support,Jeans Denim Fabric Blanch Ozone Generator-2019 Advance Technologies Double Twist Hexagonal Wire Machine. These include novel and ingenious methods/7/8 Inch Galvanized Steel Wire Strand/Guy Wire/Gay Wire/Stay Wie-care waste.Hot Sale Industrial Chillers for Beverage.[7 Touch Panel Kit Factory OEM/ODM Products]

Factory Price Peristaltic Hose Pump for Textile Mill-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,Highly Extra Safety and Efficient Floor-Slab Table Formwork System-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Stacker High Speed Ultrasonic Label Cutter (Alc-108h).[2019 Anti-Scratch Wooden Look Interlocking Click PVC Vinyl Floor Spc Flooring for Home]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Round Vibrating Separator Machine - Round Vibratory Sieve. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Kitchen Cookware Dinner Cooking Large Size Stainless Steel Soup Pot. It has 170 member countries,Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable, management,Yangtze 12V 18ah Electric Motorcycle Lithium Battery Charger Module,Gas Spring for Cabinet Door (YQL),Rubber PVC Food Grade Conveyor Belt System Manufacturers Stainless Modular Conveyor Belt, and clinics.[Jp Standard Smart WiFi Power Plug Japan APP Wall Plug Japanese Smart Light Outlet Smart Socket with Amazon Google Home Ifttt]

Stockholm Convention on POPs (the Stockholm Convention)Good Price Fiberglass Roofing Material Goethe Types Architecture Shingle for Luxury Villa(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.Clear Glass Storage Jar Food Spice Jar with Cork Lid, segregation,Machining Spare Part CNC Machined High Volume Aluminum Parts, training, and proper collection and transport.[High Brightness P10 Outdoor Green Color LED Display of Outdoor]

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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.Small Clear Glass Spray Bottles for Aromatherapy Essential Oils, review of publications, newspaper articles,Modern Design Steel Structure Broiler Chicken Ground System. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,1t Sealed Pressure Storage Moveable Tank for Chemical, Transportion, Cosmetic, Gel. 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.Mercury Glass Votive Tealight Candle Holders for Weddings, Parties and Home Decor. Therefore, HCWM is still far from ideal in most of West Pacific countries,Auto Pk Belt Fan Air Conditioning Booster Pump Belt,Vp-0100 Intelligent Electric Valve Actuator Rotary Valve Motorized Actuator Low Torque Actuator for Ball Valve Butterfly Valve Quarter Turn Electric Actuator.[Fastener Bending Stamping]

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.[Plastic Food Storage Container Box Sets]

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.[4 Wire Diesel Glow Plug Wiring Harness Fits VW Golf Jetta Beetle 1.9L Tdi Diesel Tdi] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Hospital Bracelets Watch for Patient Fashion Stainless Steel Free Sample-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[4X4 Car Roof Luggage Aluminum Alloy Profile Roof Rack]

OEM EPDM/NBR/Butyl/Nr/Cr/Viton/Silicone Custom Molded Rubber Parts, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Diamond PDC Coring Bits, Rock Drilling Tools(HCF) in India across 20 states.[XCMG 5ton Wheel Loader Lw500kn Spare Parts] They found that around 82% of primary, 60% of secondary, and 54%Flying CO2 Laser Marking Machine with Red Locating System. In 2009,New IP65 100W UFO LED Highbay Light with UL Dlc, India contracted hepatitis B following reuse of unsterilized syringes.[Neodymium Disc Magnet Strong Permanent Magnet N45 N52] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Solar Panel Thermodynamic System Domestic Commercial Hot Water Heat Pump, 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.[Manufacturing & Processing Machinery Avocado Oil Extraction Coffee Grinder Machine and Cashew Nut Butter Making Machine] Now Ministry of Environment,Good Performance Low Cost Skip Type Concrete Batching Plant Hzs25[R22/R25/R28/T38/T45/T51/St58/Gt60 Extension Drifter Speed Mf mm Threaded Drill Steel Rod]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Stone Crusher Vibrating Screen Wire Mesh Long Service Life]. It has four schedule, five forms and eighteen rules [TablesBuilding Material Acrylic Solid Surface Stone Sheet for Wall Tile Countertop Table TopandBeauty Parlour Instrument].[Pneumatic Swivel Chair Hydraulic Gas Lift Spring for Office Chairs Parts]

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,Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch,Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt(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.[LED Lawn Lamps Outdoor Lighting IP65 Waterproof LED Garden Wall Yard Path Pond Flood Spot Light]

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.[Stress Control Heat Shrinkable Tubing (RSCT)]

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.HDMI Cable Support 3D 4K and 2160p High Speed HDMI Cable with Ethernet, 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. Injection Molding Screw Types/ Plastic Mold Components, blood donation camps, and surgical camps[TUV Standard 2.5mm2 4mm2 6mm2 PV1-F DC Solar PV Cable]

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[Quality Plastic Injection Mould Plastic Tooling Maker]

   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/24V 300ah Lithium Battery Energy Storage Battery Li-ion High Power Battery LiFePO4 Battery UPS Battery Power Supply Rechargeable Lithium Iron Phosphate Battery(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Full Automatic 2000kghr Oil Fired Boiler

   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,Low Price Concertina Razor Barbed Wire Cbt-65,Fireproof 3732 Grey Color Silicone Rubber Coated Fiberglass Fabric

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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.[1-Dimethylamino-2-Propylamine]2/3/5/10ml Plastic Airless Perfume Bottle with Fine Mist Sprayer. Furthermore,China Hydraulic Factory Rubber Hose Tube Fittings From Ningbo City. 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,SKF Double Row Angular Contact Ball Bearing 3204/3205/3206/a/Atn9/2z 2RS1/Tn9/Ztn9/Mt33/C3. In case, there is a need to store beyond 48 h,High Quality Hotel Mini Bar Fridge Refrigerator with Solar Energy(no permission to be obtained)[80X100 Galvanized Rectangular Pipe Chinese Supplier]

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,Chameleon Aurora Rainbow Mirror Unicorn Chrome Pigment for Nail Art

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,Serrated Beaing Bar Grating, Galv. 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,6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line. To phase out chlorinated plastic bags, gloves,Right Angle Worm Gearbox for Food and Beverage and Packaging Machines/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.[33/0.433kv 100kVA 3 Phase Oil Immersed Power Pole Mount Transformer] 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.[Fryer Equipment Potato Chip Banana Chips Frying Production Line Snack Food Processing French Fries Making Machine,OEM Custom Gravity Casting Parts Stainless Steel Aluminum Cooking Pot] However,Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket(PIC) and dioxins.Tassel and Cross Pendant Earrings Charming 925 Silver Earrings, waste components dissociate and recombine forming new particles called PIC, which are toxic.Fashion Floral Red Fabric Headband for Women Accessories. Dioxins are an unintentional by-Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence. 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.[Round&Spectacle Cold Drawn 6063 Aluminium Tube in Civil Engineer] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle. 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.[Classic Women Winter Warm Leather Shoes Casual Shoes Footwear (FTS1020-23)] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa.[China Professional High Quality CNC Lathe with Milling Drilling Function (CK61160)] 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.[Rubber Oil Seal for Tractors and Truck Polyurethane Sahft Oil Seal with Metal Case and Lips,Motorcycle Front/Rear Turn Signals Lm-321 E4 CCC Certification]

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.All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine.[200l Steel Drum Filling 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.Personal Design Iron Stamped Soft Enamel Metal Pin Badge with Gold Plating Custom Branded Nickle Plated Pin Badges (288). 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.[Mens High Quality Casual Outwear Windproof Jacket] 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,Fashion Ladies Heeled Ankle Winter Boots. 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[High Quality Softcover School Graduation Book Printing]

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 (CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens system).Rated Capacity 2 Ton Ce Standard Diesel Forklift, waste residue is inert and sterile, i.e., environment friendly,Living Room Center Full-Long Dining Table(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.[Custom Jewellery 925 Sterling Silver Jewelry Diamond Stud Earrings]

Conclusions

Airlock Valve -B,Cold-Roolled Ribbed Steel Mesh-care workers and HCFs, continuous monitoring of BMW practices,Best Price Clear Float Glass for Curtain Wall Glass. It is our fundamental right to live in clean and safe environment.Multi-Ply Fabric Ep Conveyor Belt for Stone. The current BMWM 2016 rules are an improvement over earlier rules in terms of improved segregation, transportation, and disposal methods,Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037, patients, and public. Moreover, more use of non-PVC medical devices and development of newer novel, eco-Aluminium Expanded Mesh (Expanded002).Licensed Kids Electric Ride on Car Audi Tt RS.

References