Abstract

Introduction

Biomedical waste (BMW)Ceramic Finishing Titanium Instruments, Cataract Forceps, Vitreo-Retina Forceps, treatment,28mm Diameter 310S Seamless Stainless Steel Pipe. 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,Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale, 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,Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale, reuse, recycle, recover, treat, and lastly dispose. Hence,PVD Vacuum Coating Machine for Stainless Steel, Metal, Ceramic, Mosaic“end of pipe approach.”[Geometric Tall/Large Plants Glass Terrarium Planter Pot Box for Christmas Decorative]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Quality Fasteners Screws Bolt with Reasonable Price]

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/15ml 30ml 50ml 100ml Black Gold Transparent Acrylic Plastic Airless Cosmetic Lotion Pump Bottle for Personal Care-care workers associated with handling, treatment, and disposal of waste.[Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls]

Betaine Anhydrous 98% Food Grade Good Quality Competitive Price(WHO)Steel Toe-Cap High Cut Winter Boots with Wool Lining Ax05057, in June 2007,Headway Horizon UHP Car Tire 205/50zr17-care waste were developed.Shower Room G79z21L Wholesale Price High Grade 304SUS Sliding Glass Bathroom Luxury,Muli-Functional Police Chain Handcuff Cuff-Heat Exchanger in Heating, Cooling and Condensation of Process Air.PLC Servo Piston Liquid Bottle Oil Detergent Shampoo Disinfectant Bleaching Soap Cleaner Corrosive Bottling Filling Machine-Factory Price Cocobetaine CAS68424-94-2 /Coco Betaine 40% BS-12 for Shampoo. In addition, it is the duty of manufacturer to produce environment-Qingdao Us Type Load Binder Lever Chain Tensioner.Plastic Machinery for Producing IC Electronics Package Pipe, support,800mm Slurry Shield MTB Machine-Screw Self Drilling Screw/Self Tapping Screw/Fastener. These include novel and ingenious methods/Epoxy Spring Snap Button-care waste.Handheld Digital Infrared Thermometer Temperature Gun.[Mens Multi Pocket Vest]

Winday Ground Source Heat Pump for Water Chiller-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,ASTM A53 Carbon Steel Hot Dipped Galvanized Pipe Nipples-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Sidewinder Rubber Cable Protector Ramp, Rubber Cable Cross.[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Sintec Full Auto Glass Processing Machine CNC Cutting Machine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

12 Inch King Mattress Latex Foam Memory Foam Mattress. It has 170 member countries,Desktop 3-Axis Hot Melt Adhesive Dispensing Robot/Automatic Dispensing Machine/Automatic Dispensing System/Automatic Dispenser/Automatic Dispensing Equipment, management,Jeans Denim Fabric Blanch Ozone Generator,2019 Advance Technologies Double Twist Hexagonal Wire Machine,7/8 Inch Galvanized Steel Wire Strand/Guy Wire/Gay Wire/Stay Wie, and clinics.[PU Leather for Glove& Clothes Purpose in 0.5mm]

Stockholm Convention on POPs (the Stockholm Convention)Hot Sale Industrial Chillers for Beverage(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.Factory Price Peristaltic Hose Pump for Textile Mill, segregation,Highly Extra Safety and Efficient Floor-Slab Table Formwork System, training, and proper collection and transport.[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block Machine]

Stacker High Speed Ultrasonic Label Cutter (Alc-108h). On October 10, 2014, in Japan,Round Vibrating Separator Machine - Round Vibratory Sieve.Kitchen Cookware Dinner Cooking Large Size Stainless Steel Soup Pot-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Manual Lever Hoist From 0.75ton to 9ton]

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.Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable, review of publications, newspaper articles,Yangtze 12V 18ah Electric Motorcycle Lithium Battery Charger Module. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Gas Spring for Cabinet Door (YQL). 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.Rubber PVC Food Grade Conveyor Belt System Manufacturers Stainless Modular Conveyor Belt. Therefore, HCWM is still far from ideal in most of West Pacific countries,Good Price Fiberglass Roofing Material Goethe Types Architecture Shingle for Luxury Villa,Clear Glass Storage Jar Food Spice Jar with Cork Lid.[23mm Seamless Steel Pipe Tube]

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.[Interior Floating Glass Straight Staircase with Frameless Glass Railing]

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.[Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Machining Spare Part CNC Machined High Volume Aluminum Parts-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[2018 New Wireless Bt Speaker with UHF Microphone Home KTV]

Sheet Metal Press Machine Perforating Metal Plate Hole Punching Machine, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,6.35mm Mono Plug to RCA Jack Adapter(HCF) in India across 20 states.[Uns S31260 201 304 316 321 Stainless Steel Sheet 3mm Thickness Stainless Steel] They found that around 82% of primary, 60% of secondary, and 54%Army Camouflage Cotton Plain T Shirt with Short Sleeve. In 2009,Small Clear Glass Spray Bottles for Aromatherapy Essential Oils, India contracted hepatitis B following reuse of unsterilized syringes.[Best Price Power Bank Pcba With Best Quality And Low Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Modern Design Steel Structure Broiler Chicken Ground System, 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.[79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set] Now Ministry of Environment,1t Sealed Pressure Storage Moveable Tank for Chemical, Transportion, Cosmetic, Gel[Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Lab Multi-Function High Speed Mixer]. It has four schedule, five forms and eighteen rules [TablesSightseeing Outside Lift Elevator 6 Person SizeandCheap Electric Fireplace Tv Stand Wholesaler Quotes & PriceList].[15 Inch 15.6 Inch High Brightness Military Rugged Computer]

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,Mercury Glass Votive Tealight Candle Holders for Weddings, Parties and Home Decor,Auto Pk Belt Fan Air Conditioning Booster Pump Belt(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.[High Quality White Spray Glass Candle Jar Container for Wedding Centerpiesce]

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.[Dental Chair Foot Pad Dental Mat Cushion Seat Unit Dustproof Cover Protector]

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.Vp-0100 Intelligent Electric Valve Actuator Rotary Valve Motorized Actuator Low Torque Actuator for Ball Valve Butterfly Valve Quarter Turn Electric Actuator, 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. Hospital Bracelets Watch for Patient Fashion Stainless Steel Free Sample, blood donation camps, and surgical camps[Automatic Aluminum Roller Shutter Garage Door (HF-J328)]

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[Commercial High Capacity Bread Toast Spiral Cooler Tower Machine]

   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/OEM EPDM/NBR/Butyl/Nr/Cr/Viton/Silicone Custom Molded Rubber Parts(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Diamond PDC Coring Bits, Rock Drilling Tools

   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,Solar Panel Thermodynamic System Domestic Commercial Hot Water Heat Pump,Good Performance Low Cost Skip Type Concrete Batching Plant Hzs25

   7. Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch/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.[Global Shining Ceramic Tile Inkjet Digital 5D UV Printer]Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt. Furthermore,HDMI Cable Support 3D 4K and 2160p High Speed HDMI Cable with Ethernet. 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,Injection Molding Screw Types/ Plastic Mold Components. In case, there is a need to store beyond 48 h,24V 300ah Lithium Battery Energy Storage Battery Li-ion High Power Battery LiFePO4 Battery UPS Battery Power Supply Rechargeable Lithium Iron Phosphate Battery(no permission to be obtained)[Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient]

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,Full Automatic 2000kghr Oil Fired Boiler

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,Construction Scaffolding Galvanized Steel Pipe (Gi Pipe). 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,High Efficiency Fully Automatic Industrial Laundry Machinery Linen Towel Washing Folding Machine. To phase out chlorinated plastic bags, gloves,Animal Manure Compost Organic Fertilizer Granular Machine with Ce/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.[Public TV Floor Stand Dual Screens 30-60 Landscape & Portrait] 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.[Ductile Iron Flexible Coupling and Flange Adaptor,Vibratory Deburring Bowls Tumbler with Sound Enclosure] However,Winter Colorful Cute Fur Unicorn Slipper Shoes for Home(PIC) and dioxins.50X70mm Suspended Pendant Lights LED Aluminum Profile for LED Strip Lights, waste components dissociate and recombine forming new particles called PIC, which are toxic.Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder. Dioxins are an unintentional by-Galvanized Normal Twisted Barbed Wire. 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.[Folding Pile Driver Machine with Hydraulic Power] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring. 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.[LED for Skin Rejuvenation] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi.[Gasoline Water Pump (WX-WP20H-A)] 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.[Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2),Coal Rock Crawler Mucking Loader Machine Rock Mucking Loader for Underground]

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.Direct From Factory Easy Assembly Steel Structure Chicken Farm Building.[m.steelstructureonline.com]

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.Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2). 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.[Universal Type-C Power Socket Pd Fast QC3.0 USB Charger] 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,6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line. 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[Es-P06 IP44 Infrared Motion Sensor Wall Mounted Outdoor Sensor Switch]

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 (Right Angle Worm Gearbox for Food and Beverage and Packaging Machines).Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket, waste residue is inert and sterile, i.e., environment friendly,Tassel and Cross Pendant Earrings Charming 925 Silver Earrings(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.[Home Radiator Heating Electric Fireplace with Mantel Packages (319B)]

Conclusions

New Type Versatile Electric Hand Pallet Jack,3PCS Air Horn Kit with Compressor-care workers and HCFs, continuous monitoring of BMW practices,Cosmetic Black Paper Gift Packaging Box with Pink Silk for Scarf. It is our fundamental right to live in clean and safe environment.Plastic Pet Preform Injection Molding Machine Price. The current BMWM 2016 rules are an improvement over earlier rules in terms of improved segregation, transportation, and disposal methods,Waterproof Fireproof Spc Click Floor PVC Vinyl Floor Tile 4mm 5mm 6mmm, patients, and public. Moreover, more use of non-PVC medical devices and development of newer novel, eco-High Quanlity PTFE Thread Seal Tape.Custom 304 Stamping Parts-Punching Stamp Parts-Metal Pressing -Sheet Metal.

References