Abstract

Introduction

Biomedical waste (BMW)Surgical Shoe Cover Making Machine with Ultrasonic, treatment,15 Inch IP65 Waterproof Industrial Touch Screen Monitor. 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,Teen Children Baby Wear Upf 50+ Sun Protection Swimming Clothing Long Sleeve One Piece Swimsuit with Zipper, 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,Teen Children Baby Wear Upf 50+ Sun Protection Swimming Clothing Long Sleeve One Piece Swimsuit with Zipper, reuse, recycle, recover, treat, and lastly dispose. Hence,Funny Educational Toys Game Learning Rapid Cubes Plastic Toys for Kids H9085013“end of pipe approach.”[Self Adhesive Reinforced Fiberglass Joint Drywall Tape]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Icr18650 4400mAh 5000mAh 6000mAh 11.1V 3s2p Li-ion Battery Pack for Solar System]

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/UV Protective Highway Polycarbonate Solid Sound Barrier Sheet-care workers associated with handling, treatment, and disposal of waste.[Suction Cup Toilet Grab Handle]

18mm Red Oak Green Core Chipboard(WHO)Rigid HDPE LDPE Pet PP Bottle and Crate Recycling Granulator Machine /High Speed Singles Screw Extruder Plastic Recycling Machine, in June 2007,New Arrival Dark Blue Cement Pot with Wooden Stand-care waste were developed.High Quality New Production for Hyraulic Running Replacement Fleetguard Oil Air Filter Element Air Filter K2342,Factory Manufacture Non Standard Punching Hardware Parts-China Manufacturer Custom Bottle Opener Finisher Medals.SUS304 DIN471/JIS2804 Retaining Ring for Shaft-Newest Designed Globalipl RF Cavitation Best Slimming Machine. In addition, it is the duty of manufacturer to produce environment-Root of Chinese Clematis Extract, Herbal Extract, Plant Extract.Fitness Tube 120cm 11PCS Set TPE Exercise Tube, support,Explosion-Proof Diaphragm Valve for Bag Filtert Since 1992-Dog Bath Brush with Stainless Steel, Dog Cleaning, Pet Brush. These include novel and ingenious methods/Custom Factory Ribbon Shape Metal Enamel Awareness Lapel Pins-care waste.Embroidered Patch, Iron on Patch, Personalized Patch, Monogram Patch, Embroidered Patches for Jackets, Name Patch, Company Logo Patch.[Fruit and Vegetable Double Spray High Pressure Cleaner]

High Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge-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,China EPE Foam Plank Making Machine for India-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Custom Sport Snapback Cap Plain Trucker Caps.[Ce Certificated Acm-60 PTFE Powder Grinding Mill]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Chili Paste Filling Equipment Liquid Machine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Sumitomo 6189-0039 Auto Electrical Wiring Harness Female PBT 2 Pin Waterproof Connector. It has 170 member countries,Soccer Fans′ Horn/ World Cup Horn with Customized Logo, management,LDPE Plastic Garbage Bags for Construction Wastes,Global Sunrise Solar Powered Flame LED Lantern Light 2018 New with Ni-MH Battery,Handwired Vintage 1969 Jmp PA20 Tube Guitar Amplifier Head 15W, and clinics.[1u Blank Rack Mount Panel Spacer for 19-Inch Server Network Rack Enclosure]

Stockholm Convention on POPs (the Stockholm Convention)Round Cord Bag Clip End Closure DIY Accessories Rope Buckle(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.Wholesale Aluminum Outdoor Stake Solar LED Lawn Light, segregation,Luxury Gold King Chiavari Wedding Chair for Wedding Party, training, and proper collection and transport.[ Pet Brush]

Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels. On October 10, 2014, in Japan,Wholesale Gi Galvanized Corrugated Steel Roofing Sheet.EVA Foam Cutting Machine for Packaging Protection Material Patterm Cutting Dieless Automatic CNC Ce-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Hls-120 High Quality Low Budget Mobile Portable Line Boring Machine for Excavator Digger]

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.1308/1308k Machine Tool Self-Aligning Ball Bearing, review of publications, newspaper articles,Ve Head Rotor for Citroen - Bosch Injector Pump Parts. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Stainless Steel Sanitary SMS Pipe Fittings Union (JN-UN2002). 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.Cast Iron Bucket/Sand Casting Basin/Ductile Iron Casting. Therefore, HCWM is still far from ideal in most of West Pacific countries,Hc-10t Heavy Duty Big Cable Terminal Cable Lug Crimping Machine Crimper,No Smoke Biomass Corn COB Carbonization Kiln Price.[Nema 23 Stepper Motor Driver]

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.[Sw-Cj-1d Vertical Air Supply Clean Bench]

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.[Hky Automatic Steel C Purlin Roll Forming Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Double& Single Faced Tube Storage Cantilever Rack System with 500kg~1200kg-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Thick and Big Wide Pet Sheet with Both Sides PE Film]

Hot Rolled 304 316 (304L 316L) Stainless Steel Plate/Sheet Price, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Anatase Titanium Dioxide TiO2 for Paint and Coating La101(HCF) in India across 20 states.[OEM/ODM Sheet Metal Stamping Parts] They found that around 82% of primary, 60% of secondary, and 54%Adjustable Neck Brace /Rigid Plastic Cervical Collar with Chin/Cervical Support Strap. In 2009,250VAC Push Plinger Waterproof Mini Limit Switch, India contracted hepatitis B following reuse of unsterilized syringes.[10g Dwdm Factory OEM/ODM Products] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,OEM Factory Commercial Automatic Stainless Steel Big Ice Cube 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.[Medical Head Loop Mask Making Machine Production Line] Now Ministry of Environment,304 Stainless Steel Staircase Armrest Fittings Shell Cover Foshan[Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Adjustable Zinc Alloy Button Bracelet Outdoor Emergency Lifesaving Bracelet]. It has four schedule, five forms and eighteen rules [TablesVacuum Coating Machine for Golden Door Handle/Metal PVD Coating MachinesandAaaaa-Cemented Carbide Tool Gun Drill Blanks Kidney Hole-2].[Laser Cutting Acrylic Sheet 1220X2440mm 3mm]

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,Customized 8pin Pogo Pin Power Magnetic USB Cable Connector,Plastic Lid Press Making Machine Cup Lids Forming Machine(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.[Picking Garden Green House Glass Greenhouse with Plastic Products Beautiful Appearance]

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.[6mm DIY Grinding Electric Die Grinder Tools (DG004)]

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.Shenzhen China Air Conditioner Universal PCBA, 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. 12V200ah/12V150ah/12V100ah VRLA Lead Acid AGM UPS Industrial Storage Battery, blood donation camps, and surgical camps[Small Velvet Jewelry Packing Pouch Custom Logo]

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[Custom Wire Harness Cable Assembly]

   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/Autoclave Indicator Tape, Chemical Indicator, Process Monitoring, CE, Clinical Consumables(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Cooking Oil Filter Machine Australia Edible Oil Filter Press

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

   4. BS-2073b High Level Biological Microscope for College Education

   5. Stop Valve/Gate Valve for PPR Fittigns

   6. All major accidents including accidents caused by fire hazards, blasts,Interiro MDF/HDF White Primed Painted Molded Door From Factory,ERW Welded BS4568 Galvanized Steel Pipe Class 3

   7. Customized Hot Rolled Bimetal Steel Plate Wear Resistant Steel Plate/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.[Bdt001g Stainless Steel Adjustable Hospital Mobile Overbed Table for Patient with Wheels]Hot Sale Lovely Shaped Water Filled Baby Soft Teether. Furthermore,OEM Rigid SMT PCB Assembly Printed Circuit Board PCB Manufacture. 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,33/0.433kv 100kVA 3 Phase Oil Immersed Power Pole Mount Transformer. In case, there is a need to store beyond 48 h,Biodegradable Disposible Straw Pulp Food Box Ppp-1007(no permission to be obtained)[Torch SMT Wave Soldering Machine for PCB]

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,Lovely and Dynamic 3 & 6 Seats Mini Merry Go Round Ride

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,220V Meter 1000va Relay Type Automatic Voltage Stabilizer. 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,Disposable Medical Stainless Steel Blood Lancet Piece Type. To phase out chlorinated plastic bags, gloves,Knapsack Brush Cutter Garden Shoulder Brush Cutter Gasoline Grass Trimmer Cutter/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.[Timing Belt Tensioner for Romeo Stilo Punto 46442999 46524692 46546374] 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.[18mm Red Oak Green Core Chipboard,Imported Raw Silk 8 Braided Multi Color Fishing PE Line] However,Hot Selling Home Melamine Modern Bedroom Furniture Sets (UL-CH001)(PIC) and dioxins.Professional Colored Nylon Hook and Loop Magic Tape, waste components dissociate and recombine forming new particles called PIC, which are toxic.PS 450 Upper Discharge Centrifuge. Dioxins are an unintentional by-XCMG 5ton Wheel Loader Lw500kn Spare Parts. 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.[Hollywood Vanity Mirror Impressions] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset. 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.[Ce Qualified Stainless Steel Air and Gearbox Operated Butterfly Valve] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,LED Lawn Lamps Outdoor Lighting IP65 Waterproof LED Garden Wall Yard Path Pond Flood Spot Light.[Corrosion Resistant 304 Stainless Steel Metal Etched Mesh] 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.[Disc for Cutting Concrete,Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised]

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.Tire Recycling, Rubber, Environmentally Friendly, Odorless, Rubber Recycling, Quality Assurance..[Car Travel Coffee Mug]

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.10 Inches 250W Tweeter Bass Indoor Show Karaoke Speaker (RS-10). 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.[Hc-10t Heavy Duty Big Cable Terminal Cable Lug Crimping Machine Crimper] 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,Factory Hollow Section Hot Dipped Galvanized Square /Rectangular Steel Tube or Pipe for Africa /Middle East / Southeast Asia Markets. 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 off Grid Pure Sine Inverter for Solar Power System]

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 (Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line).Sanitary Stainless Steel SS304/SS316L CIP Return 2.2kw Self-Priming Pump, waste residue is inert and sterile, i.e., environment friendly,Fiberglass Deck GRP Deck, FRP Pultruded Products(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.[Cold-Roolled Ribbed Steel Mesh]

Conclusions

Quality Precision Metal Die Casting with Sand Blasting for Auto Parts / Automotive Parts,Pneumatic Knife Gate Valve with Cylinder for Water Treatment-care workers and HCFs, continuous monitoring of BMW practices,80GSM C2s Coated Glossy/Matt Art Paper for Printing. It is our fundamental right to live in clean and safe environment.Msldt07 Single Arm Electric Anesthesia Pendant (hanging). The current BMWM 2016 rules are an improvement over earlier rules in terms of improved segregation, transportation, and disposal methods,Fast Delivery Custom Made Softcover Book Printing, patients, and public. Moreover, more use of non-PVC medical devices and development of newer novel, eco-Feelderma Cross Linked Ce Certified Ha Dermal Filler Hyaluronate Acid Gel.Zl-300 Rotary Granulator with Meet GMP Standards.

References