Abstract

Introduction

Biomedical waste (BMW)Industrial IP54 Digital Caliper Stainless Steel Electronic Vernier Calipers, treatment,Mini Pocket Sprayer Card Spray Liquid Perfume Dispenser Bottle. 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,High Quality LC1d-95 3p Motor Protective Electrical Contactor, 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,High Quality LC1d-95 3p Motor Protective Electrical Contactor, reuse, recycle, recover, treat, and lastly dispose. Hence,Pet and PP Geobag with UV High Strength Thermal“end of pipe approach.”[Supply Round Shape Wide Mouth Glass Mason Jar Jam Jar 200ml]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Cheap Price High Pressure Solar Energy Water Heater with Ce]

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/ASTM&TUV Standard Trampoline Park Bungee Harness for Sale-care workers associated with handling, treatment, and disposal of waste.[Sidewinder Rubber Cable Protector Ramp]

0.6m 20W Modern Commercial Indoor LED Linear Trunking Tube Lighting(WHO)45t Single Drum Hydraulic Tugger Marine Winch, in June 2007,Kingstar Pluto B6 1ton Gasoline & Diesel Cargo Van-care waste were developed.High Quality Stn Type Monochrome COB Type Touch Screen for Gas Flowmeter,Sally 1000X600X35mm Horizontal Bathroom Makeup Dressing Glass LED Mirror with Silver Coated-IPS Panel Camera Mount 5.7 Inch TFT LCD.Trendy Car Shape Cute Kids Trolley School Bags-2018 Lf-Xg50 Paper Straw Making Machine. In addition, it is the duty of manufacturer to produce environment-Gilding Metal Clad Steel Sheet/Copper Strip/Copper-Steel-Copper Composite Strip.Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium, support,1u Blank Rack Mount Panel Spacer for 19-Inch Server Network Rack Enclosure-Dental Supply Silicone Rubber Polisher for Prosthetic and Orthodontic Acrylics. These include novel and ingenious methods/Centrifugal Slurry Pumps (NP-AH(R))-care waste.Automatic Pillow Flow Type Egg Roll Packing Machine.[Hot Sale Excavator Parts for Komatsu PC60 PC70 PC100n Swivel Joint Seal Kit 703-07-23100]

Public TV Floor Stand Dual Screens 30-60 Landscape & Portrait-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,Stone Crusher Vibrating Screen Wire Mesh Long Service Life-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Superior Fast Cutting Laser Welded Concrete Saw Blade in 450mm.[Machine to Make Disposable Plates]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Stainless Steel Barbecue Net BBQ Grill Grates Wire Mesh. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Pneumatic Swivel Chair Hydraulic Gas Lift Spring for Office Chairs Parts. It has 170 member countries,Semiconductor Peltier Air Conditioner with Heatsink, management,ISO Approved Self-Cleaning Permanent Belt Magnetic Iron Ore Separator,8.5 Inch Xiaomi M365 Long Range Folding Electric Scooter,China Supply Corrugated Metal Steel Roofing Plate, and clinics.[Hospital Supply Medical Compressed Air System with Factory Price]

Stockholm Convention on POPs (the Stockholm Convention)OE. 55020-06j00 Auto Parts Rear Coil Spring for Patrol Gr I (Y60, GR)(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.Stainless Steel Crimped Wire Mesh, segregation,Am3 Hot Galvanized Ship Anchor Chain for Sale, training, and proper collection and transport.[Rigid Malleable Iron Clamp Back Spacers]

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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.Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet, review of publications, newspaper articles,Adjustable Zinc Alloy Button Bracelet Outdoor Emergency Lifesaving Bracelet. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Chili Powder Pouch Packing Machine. 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.Plastic Food Storage Container Box Sets. Therefore, HCWM is still far from ideal in most of West Pacific countries,Hot Sale Women Grey Materntiy Longline Hoodies Wholesale Factory,Manual Lever Hoist From 0.75ton to 9ton.[Power Fan]

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.[Wood Log Debarker and Rounding Machine]

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.[Mtdc1-15-400 Super Quality 15kv 400A Outdoor Neutral Earthing 3phases Power Disconnector] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Good Quality Metal Hoist Hook-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Interiro MDF/HDF White Primed Painted Molded Door From Factory]

Shandong Used Mini Excavator Hydraulic Pump Low Prices in Dubai, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Sticky Backed Fastener Self Adhesive Hook & Loop Strap(HCF) in India across 20 states.[Hot Selling Wholesale Plywood 10-25mm Good Price Quality] They found that around 82% of primary, 60% of secondary, and 54%Plastic Mould Injection Molding Dongguan Manufacturers. In 2009,Laser Cutting Acrylic Sheet 1220X2440mm 3mm, 5mm, 8mm Acrylic, India contracted hepatitis B following reuse of unsterilized syringes.[Agricultural Machinery Wholesaler Quotes & PriceList] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Ss Threaded/Flanged/Floating Full Port/Reduce Port Ball Valve, 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.[Swiss Machining Copper Steel Plastic Metal Titanium Aluminum CNC Machine Parts] Now Ministry of Environment,Complete Full Automatic Pure Mineral Still Drinking Water Filling Line[China Textile Factory Produces Dye Sublimation Beach Flag Fabric]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [ODM/OEM 8021 Aluminum Foil for Pharmaceutical Packaging Battery Packs Meal Box Materials Ptp etc]. It has four schedule, five forms and eighteen rules [TablesAluminium Expanded Mesh (Expanded002)andValveless a Single Switching Dwyer Kromschroder Press Psw Pressure Switch].[Wholesale Plating Silver Finish Aluminum 6061/Stainless Steel Stamping Metal 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,Bigger Volume Air Bag Dust Collector,Die Casting Aluminum P2 P2.5 P3 P4 LED Screen Signboard(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.[Customized High Performance Irregular Shape AlNiCo Magnet]

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.[Shenzhen China Air Conditioner Universal PCBA]

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.Water Purification Equipment Filters Pleated Water Filter 20 Inches for Industrial Liquids Filtration, 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. Air Purifier ODM&OEM PCB&PCBA Mannufacturer, blood donation camps, and surgical camps[China EPE Foam Plank Making Machine for India]

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[Full Automatic 2000kghr Oil Fired Boiler]

   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/Es-P06 IP44 Infrared Motion Sensor Wall Mounted Outdoor Sensor Switch(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Heavy Duty Electromagnet for Lifting Scrap MW5 Series

   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,Bright Color Business Dress Men Crew Socks,UHP 400 Graphite Electrode for Steel Mill a Right Price

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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.[Brass Compression Fittings]16 Inch Tower Mount Reversible Oscillating Hanging Wall Fan. Furthermore,Hot Stamping Film PVC Ceiling Panel, Customized Size, PVC Wall Panel for Decoration. 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,Crochet Thread Yellow Textile Sewing Cotton Embroidery Thread for Bracelet. In case, there is a need to store beyond 48 h,High Precision High Hardness CNC Milling Cutter 3 Flute Square Solid Carbide Tungsten End Mill Cutting Tools for Stainless Steel(no permission to be obtained)[Supermarket PVC Price Label Holder for Hook]

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,Waterproof Thermal Cooler Bag Disposable Ice Tote Cooler Bag

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,1*1m Interlocking Foam Children′s Portable Play Mats. 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,Two Flat Pin South America Plug (Y058). To phase out chlorinated plastic bags, gloves,High Efficiency Label Ribbons Calender Machine/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.[Insulation Top Hung Aluminum Awning Window with Mosquito Net] 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.[HOWO 8X4 Heavy Tipper Truck 30t Dumper Dump Truck,Gear Box Carbon Steel U Type Flange Butterfly Valve High Performance] However,Wholesale Plating Silver Finish Aluminum 6061/Stainless Steel Stamping Metal Parts(PIC) and dioxins.Fashion Design Bhs Shaft End Seal for Concrete Mixer, waste components dissociate and recombine forming new particles called PIC, which are toxic.79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set. Dioxins are an unintentional by-48kw/60kVA Soundproof Power Moveable Diesel Generator Set. 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.[Coil Sheet Automatic Feeder with Straightener and Uncoiler Servo Coil Straightener Feeder Help to Make Car Parts in Metal Press Stamping Line] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,5050 Flexible IP67 Silicone Tube LED Strip. 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.[Vacuum Brazed Diamond Saw Blade for Metal Diamond Tool] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Factory Price New Type Fast Connector Fac Sc Upc Fast Connector.[China Custom Modern Grey Kitchen Cabinets Guangzhou] 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.[Rammer 1322 555 Scaler Hydraulic Breaker Seal Kit for Rammer 1322 555 Scaler Hydraulic Hammer Repair Kit, 6m]

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.Top Quality Glutamate Sodium with High Purity.[Custom Kraft Paper Essential Bottle Box Lipstick Packing]

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.Terracotta ASA Coated PVC Roofing Tile for Villa. 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.[Space-Saving Im1002 Magnetic Refrigerator Relay Used in Smart Grid Era] 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,1602 16 Characters 2 Line LCD Module with Cog Yellow Green LED, White Backlight. 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[Wholesale China Crystal Round Self Adhesive Sexy Nipple Cover Woman]

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 (Permanent Magnet for Anti-Lock Braking System (ABS motor)).Nayu-Perforated Stainless Steel Drill Pipe Filter Well Drilling Screen, waste residue is inert and sterile, i.e., environment friendly,High Quality 4 Beams Wired Photoelectric Active Infrared Perimeter Dual Beam Motion Detector(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.[4 Spindles Fully Automatic Non Stop Rewinding Machine]

Conclusions

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References