Abstract

Introduction

Biomedical waste (BMW)Hard Rock Drilling Company Drill Bit Taper Angle Hard Rock Tool Catalog 7 Degree Taper, treatment,Shot Gun Hot Stick with 1.4m 10kv Fiberglass Operating Rod. 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,Production Line Make Pre Cooked Corn Meal Maize Powder Flour Making Machine, 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,Production Line Make Pre Cooked Corn Meal Maize Powder Flour Making Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,Mens High Quality Casual Outwear Windproof Jacket“end of pipe approach.”[Nomex Belt for Aluminum Extrusion]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Lithium Battery Power All in One 40W Integrated Solar LED Street Light]

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/Plated Gold Metal Blank Lapel Pins-care workers associated with handling, treatment, and disposal of waste.[Heavy Capacity Lifting Automated Guided Vehicle (AGV) for Excavator Assembly]

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Greatly Discounted Customized Factory Custom Metal Structures-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,Electrical Contactor 3TF33 AC Magnetic Contactor-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Solar Battery lifepo4 battery 200ah 48V 50ah 100ah 300ah Rechargeable Li-ion Battery Lithium Ion LiFePO4 Storage Battery Pack for Solar System/EV/Ess/UPS.[Ultrasonic Laminating / Embossing / Welding Clvnv-012]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Rubber Soles Vulcanizing Machine/ Press Machine. 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)Kids Education Games Plastic Funny Square Whack-a-Mole Toy(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.Custom 100% Cotton Face Cleaning Refreshing Wet Towel, segregation,Diagnostic Medical Clinical Alpk2 Palm Aneroid Digital Bp Blood Pressure Sphygmomanometer, training, and proper collection and transport.[Fun Giant Inflatable Slide with Double Lanes]

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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.12 Pin Car Mirror ISO Wiring Harness Manufacturer, review of publications, newspaper articles,Potassium Humate Powder, Humic Acid Powder. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Poultry House Chicken Feed Silo. 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.HD 1080P 4 Channel Car Mobile DVR with GPS, 3G/4G, WiFi. Therefore, HCWM is still far from ideal in most of West Pacific countries,Secondary Stainless Steel Coil and Sheet,Free Sample Promotion Holographic E-Liquid Paper Box Package.[Acetic Anhydride Examples]

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.[Nayu-Perforated Stainless Steel Drill Pipe Filter Well Drilling Screen]

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.[Portable Soft Wall Cleanroom Booth] In India, BMW problem was further compounded by the presence of scavengers who sort out open,White Flake Calcium Chloride Dihydrate for Oil-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Good Quality Wooden Wine Bottle Holder]

1000W 1500W 3 Meters Pipe Laser Cutter CNC Fiber Laser Cutting Machine for Metal Sheet, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,High Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket(HCF) in India across 20 states.[Draught Beer Brewery Equipment Amstel Bier Beer Brewery Plant] They found that around 82% of primary, 60% of secondary, and 54%10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys for Women. In 2009,2017 Solar Garden Stake Light (RS-124), India contracted hepatitis B following reuse of unsterilized syringes.[Hot-Rolled Dual-Sided Stainless Clad Plate 6 (1 4 1) mm Thick] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Four Colors Silicone Sex Toys Fox Tail Anal Plug, 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.[ Galvanized Steel Grating. 404] Now Ministry of Environment,Clear Ampoules Made of Low Borosilicate Class and Glass Tubing[Micro DC Motor - Auto (Car) Windows Motor]. 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 Efficiency Multi-Function Disposable Plastic Cutlery for Napkin Knife Fork Spoon Pepper Salt Packing Machine]. It has four schedule, five forms and eighteen rules [TablesHigh Quality LC1d-95 3p Motor Protective Electrical Contactorand2019 Customize Design Durable Dish Rack Mold/Mould].[1000W 1500W 3 Meters Pipe Laser Cutter CNC Fiber Laser Cutting Machine for Metal Sheet]

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,LED Outdoor 5m, 6m, 7m, 8m, 9m 10m Lighting Pole and 30W, 40W, 50W, 60W, 70W, 80W, 90W, 100W, 120W, 150W LED Solar Street Lamp,Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan(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.[0.42mm White Water and Heat Resistant Thermal Insulation Cloth]

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.[CNC Machinery Industrial Parts and Tools Fitness Equipment Accessories Medical Tube Plastic Extrusion Machinery Industrial Part]

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.Pet PE BOPP PVC CPP Film Slitting Machine, 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. Yellow Selvage White Multifilament Fishing Tackle Nylon Fishing Net, blood donation camps, and surgical camps[High Efficiency Label Ribbons Calender Machine]

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[Resistant Flame Retardant Fiberglass Cloth Aluminum Foil Tape]

   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/Dental Pfm Crown From China Dental Laboratory(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.4 Column Hydraulic Press to Calibrate The Steel Pipe

   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,Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser,Night Vision Camera Infrared IP67 Outdoor CMOS Cameras

   7. Vacuum Coating Machine for Golden Door Handle/Metal PVD Coating Machines/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.[Electrical Galvanized Plumbing Fitting Water Connect Malleable Iron Conical Joint Union]Diamond Pattern Security Barbs Razor Wire. Furthermore,SS304 SS316 M6 M8 M10 DIN557 Stainless Steel Square Thin Nut. 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,Precision CNC Machining Turning Anodized Aluminum Washers Spacers. In case, there is a need to store beyond 48 h,Medical Disposable Oxygen Mask Nebulizer Mask(no permission to be obtained)[Complete Full Automatic Pure Mineral Still Drinking Water Filling Line]

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,Quality Fasteners Screws Bolt with Reasonable Price

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,Small Size Liquid Container with Cheap Price. 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,Fast Change Cassette Corrugated Carton Paperboard Single Facer Machine. To phase out chlorinated plastic bags, gloves,Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair/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.[Cummins Diesel Engine Electric Silent Power Generation 16kw -1100kw] 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.[100ml Pet Bottle with Bamboo Lotion Pump for Shampoo,99.95% Pure Ground Molybdenum Bars] However,Auto Parts Alloy 3000 Series Reflective Rolled Aluminium Plate Sheet(PIC) and dioxins.Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h, waste components dissociate and recombine forming new particles called PIC, which are toxic.Bytcnc High Efficiency Aluminum Profile Bending Machine Auto. Dioxins are an unintentional by-Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime. 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.[HOWO Truck Parts Engine Water Tank Cover Radiator Cap] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Valve Liquid Level Indicator Device Assembly. 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.[BS5896-2012 15.70mm Super 7 Wire PC Steel Strand] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,17 X 15 Mesh Fiberglass Window Screen / Fly/Insect /Mosquito Mesh.[Poultry House Chicken Feed Silo] 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.[Dual Fire Oil Burner with Good Performance,Z513 Custom Handmade Wine Bottle Packaging Boxes Foil-Stamping Cheap Paper Packing 750ml Single Bottle Wine]

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.Squeegee Blade.[Electric Actuator Controller]

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.for Oil Fields Clay Stabilizer. 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.[Lt Series Oil Burner Applied in Steam Boiler] 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,Galvanized Steel Coil (GI) , PPGI PPGL Ppal Writing Board. 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[Semi Precious Stone Fashiong Natural Crystal Amethyst Beaded Charming Bracelet Jewellery]

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 (Women Fashion Winter V Neck Long Sleeve Clothes).Building Material Acrylic Solid Surface Stone Sheet for Wall Tile Countertop Table Top, waste residue is inert and sterile, i.e., environment friendly,Electronic Parts Plastic Injection Product Prototype for Heater(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.[ Cooling and Condensation of Process Air]

Conclusions

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References