Abstract

Introduction

Biomedical waste (BMW)Precision CNC Machining Turning Anodized Aluminum Washers Spacers, treatment,Medical Disposable Oxygen Mask Nebulizer Mask. 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,Quality Fasteners Screws Bolt with Reasonable Price, 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,Quality Fasteners Screws Bolt with Reasonable Price, reuse, recycle, recover, treat, and lastly dispose. Hence,Small Size Liquid Container with Cheap Price“end of pipe approach.”[2 Gang 5pin Multi Socket with Neon Electrical Power Socket]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Anti-Slip TPU or PVC Tactile Indicator Paving Tile]

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/Promotional Garment Embroidery Patch with Scotland Logo-care workers associated with handling, treatment, and disposal of waste.[Bwm Blue Convex Mirror Glass R1200 R1400 R1800]

Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete(WHO)2~3 Cm Natural Long Lasting Decorative Flower Roses for Christmas Gifts & Crafts, in June 2007,Cummins Diesel Engine Electric Silent Power Generation 16kw -1100kw-care waste were developed.High Quality Prepayment Energy Meter 12 Volt DC Latching Relays 24V DC Magnetic Contactor Relays,High Quality Electronic Circuit Boards PCBA / PCB Assembly-2018 New Wireless Bt Speaker with UHF Microphone Home KTV.Drum / Roll Permanent Magnetic Particle Separator Equipment for Mining-Pipe Production Line for PE Shell Pipe Casing Thin Wall Pipe with Thermal Insulation with Polyurethane Foam (PPU). In addition, it is the duty of manufacturer to produce environment-High-Tech Platen Vulcanizing Press Rubber Machine / Automatic Plate Vulcanizing Press.Breathable PU Coated Ripstop Taffeta 190t Polyester Fabric with Printed, support,2.2um Al/Zn Metallized Film for Capacitor Use-Preseasoned Cast Iron Mini Serving Cocotte Casserole. These include novel and ingenious methods/Fast Change Cassette Corrugated Carton Paperboard Single Facer Machine-care waste.Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair.[Compression Nitinol Spring]

Auto Parts Alloy 3000 Series Reflective Rolled Aluminium Plate Sheet-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,Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Bytcnc High Efficiency Aluminum Profile Bending Machine Auto.[SKF Double Row Angular Contact Ball Bearing 3204/3205/3206/a/Atn9/2z 2RS1/Tn9/Ztn9/Mt33/C3]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

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Stockholm Convention on POPs (the Stockholm Convention)Women Fashion Winter V Neck Long Sleeve Clothes(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.Building Material Acrylic Solid Surface Stone Sheet for Wall Tile Countertop Table Top, segregation,Electronic Parts Plastic Injection Product Prototype for Heater, training, and proper collection and transport.[10-120mm2 Cable Terminal Applicator for Crimping Machine Hydraulic Terminal Machine]

Farm Storage Steel Structure Building. On October 10, 2014, in Japan,Mini Metal Cheap CNC Plasma Cutting Machine.China 94V0 Electronic Printed Circuit Board PCB Assembly PCBA Board Supplier-care services, including mercury-containing medical items such as thermometers and blood pressure device.[3D PVC Free Peel and Stick Non Woven Printable Wallpaper Material]

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.Mtdc1-15-400 Super Quality 15kv 400A Outdoor Neutral Earthing 3phases Power Disconnector, review of publications, newspaper articles,Long Sleeve Sleeve Unisex Gender 100% Merino Wool Baby Clothes. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Artificial Plant Phalaenopsis Lovely Flowers Orchid Real Electroplating Succulent Pot Lovely Round Decorative Ceramic Glass Box Pot. 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.China Manufacturer Promotional Custom Made Stainless Steel Air Shaft. Therefore, HCWM is still far from ideal in most of West Pacific countries,Cast Iron Plumbing Pipes Manufacturer Hematite Malleable Iron Pipe Fitting,Opgw Cable Mentel Joint Box 24 Fibers.[Sublimation Phone Case Xiaomi 6/6x /6 Plus]

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.[Customized Arrow Wooden Timber Acoustic Wall Panels with Cheep Price]

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.[Excellent Quality 3-Strand PE Blue Color Fishing and Mooring Ropes] In India, BMW problem was further compounded by the presence of scavengers who sort out open,500ton Plywood Hot Press Using in Plywood Base Panel-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[1.6m Hydraulic Small Home Lift for Disabled]

SBPP Hygienic Non Woven Disposable Briefs, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,1/4 6.35mm Plug Connector Phone Jack Mono Stereo Audio Chrome(HCF) in India across 20 states.[Good Price 200 Ton Double Action Deep Drawing Hydraulic Press] They found that around 82% of primary, 60% of secondary, and 54%Flexible Temperature Chemical SAE 100r14/Teflon Hose. In 2009,Automatic Aluminum Roller Shutter Garage Door (HF-J328), India contracted hepatitis B following reuse of unsterilized syringes.[Plastic Granulator] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005, 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 Device Orthopedic Surgical Instruments Bone Reamer Drill] Now Ministry of Environment,Fiber Optic DWDM 100g Mux/Demux Module[Aluminum Profiles L Shape Tile Edge Trim with Champagne Color]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [High Quality Wool Felt Porkpie Fedora Trilby Hat]. It has four schedule, five forms and eighteen rules [TablesGood Performance Low Cost Skip Type Concrete Batching Plant Hzs25andStraight Salon Razor Replaceable Barber Razor Blade].[Right Angle Worm Gearbox for Food and Beverage and Packaging Machines]

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,High Efficiency Multi-Function Disposable Plastic Cutlery for Napkin Knife Fork Spoon Pepper Salt Packing Machine,Vibratory Deburring Bowls Tumbler with Sound Enclosure(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.[LDPE Plastic Garbage Bags for Construction Wastes]

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.[MC4 Connector Male and Female]

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.5kVA Air Cooled Silent Diesel Portable Generator, 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. High Quality Custom Logo Leather Hardcover A5 Notebook New 2018 Personal Journals Wholesale Diary Paper notebook, blood donation camps, and surgical camps[Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser]

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[500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire]

   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/Girls Bling Mini Travel Backpack Kids Children School Bag Satchel Purses(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Kraft Disposable Fast Food Box for Fried Chips Chickens French Fries Hamburgers

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

   4. Bwm Blue Convex Mirror Glass R1200 R1400 R1800

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   6. All major accidents including accidents caused by fire hazards, blasts,New Product Kinetic Lights, LED Kinetic Tube, Guangzhou Lighting for Club Disco DJ Bar Stage,Auto Tool Changer CNC Router Machine (XE1325/1530/2030/2040)

   7. China Manufacturer Supply Cassava Flour Machine in Tanzania/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.[Anti-Climb Security Protected Razor Barbed Wire]High Quality Fruit Lemon H20 Water Bottle Drinking Bottle Infusion Sports Bottle BPA Free. Furthermore,Picking Garden Green House Glass Greenhouse with Plastic Products Beautiful Appearance. 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,High Quality Factory Price Sterile Picc Puncture Start Kits. In case, there is a need to store beyond 48 h,80X100 Galvanized Rectangular Pipe Chinese Supplier(no permission to be obtained)[Fashion Design Bhs Shaft End Seal for Concrete Mixer]

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,PC Different Colors Resin Chiavari Chair for Wedding

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,High Quality off Grid Pure Sine Inverter for Solar Power System. 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,Personalized Stainless Steel Spade Shape Blank Smooth Dog Tag Pendant. To phase out chlorinated plastic bags, gloves,Anti Corrosive Remote Type Electromagnetic Flow Meter/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.[Anti-Bacterial Hospital Waterproof Fireproof PVC Vinyl Flooring] 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.[Semiconductor Peltier Air Conditioner with Heatsink,OEM Colored Replacement Silicone Rubber O Ring for Tap and Faucet Fitting] However,Blue PVC Dotted Gloves Used in The Work(PIC) and dioxins.Dustpans Metal Dustpans Galvanic Dustpan Brooms and Dustpans, waste components dissociate and recombine forming new particles called PIC, which are toxic.Soosan Excavator Hydraulic Hammer for Construction Demolition. Dioxins are an unintentional by-Redel Pag Male Plug Connector for Medical Finger Oximeter Equipment. 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.[210kg/24h Commercial Instant Cube Ice Maker Ice Machine] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,2016 OEM 2ml 9-425 HPLC Vial with Screw Cap and PTFE Septa Used for Lab Analysis Chromatography Sample Vial 100PCS/Pack. 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.[Farm Storage Steel Structure Building] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,1500W 2000W 3000W CNC Fiber Metal Pipe Laser Cutting Engraving Machine.[Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch] 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.[PLC Servo Piston Liquid Bottle Oil Detergent Shampoo Disinfectant Bleaching Soap Cleaner Corrosive Bottling Filling Machine,Fiber Optic DWDM 100g Mux/Demux Module]

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.Office Workstation Desk Grommet Aluminum Furniture Wire Socket Box (HC-XH003-1).[Wholesale Cheap Recycled Plastic Baby Bowls Set Kids Soup Bowl]

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.High Precision Low Tolerance Stainless Steel Die Casting Parts. 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.[Auto Tool Changer CNC Router Machine (XE1325/1530/2030/2040)] 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,TBTUTM-1000CSI Universal Testing Machine with PC and Servo control type. 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[Chinese Supplier Anti Slip Lvt Vinyl Flooring Spc Floor]

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 (1260 Heat Resistant Fireproof Ceramic Fiber Paper).Stationary Type Rock Breaker Boom System, waste residue is inert and sterile, i.e., environment friendly,15 Inch 15.6 Inch High Brightness Military Rugged Computer(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.[Medical Hospital Equipment Hydraulic Electric Hoist Lifts]

Conclusions

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References