Abstract

Introduction

Biomedical waste (BMW)Aluminum Alloy Die Casting for Window/Door Hardware/Hinge (STK-ADC-167), treatment,500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire. 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,Dual Head Medical Aluminum Stethoscope for Child, 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,Dual Head Medical Aluminum Stethoscope for Child, reuse, recycle, recover, treat, and lastly dispose. Hence,Best Price Food Grade Citric Acid Monohydrate“end of pipe approach.”[2017 New Design Business Multifunction Zipper Bag Notebook]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Directly Modulated 1550nm Optical Transmitter with AGC]

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/Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors-care workers associated with handling, treatment, and disposal of waste.[Cheap White Pastry Packaging Box with Window]

Ultrasonic Laminating / Embossing / Welding Clvnv-012(WHO)High Quality Softcover School Graduation Book Printing, in June 2007,Disposable Plastic 28g Twist Blood Lancet-care waste were developed.Digital Printing Light Weight UV Resistant Air Drone Race Gate,First-Class DIP Soldering Machine for PCBA Production Line-Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch.Rubber Compound Two Roll Mill, Two Roll Mixing Mill-Good Quality Wall-Mounted Ozone Generator with 10g/H Ozone. In addition, it is the duty of manufacturer to produce environment-Wholesale Outdoor Sport Light Weight Waterproof Backpack for Camping Hiking.Stainless Steel Automatic Commercial Coffee Machine for Sale with CE Approved, support,Wood Log Debarker and Rounding Machine-Ultrasonic Fabric Underwear Spot Welding Bonding Cutting Machine. These include novel and ingenious methods/Micro DC Motor - Auto (Car) Windows Motor-care waste.5/16 Rubber Twin Welding Hose W. P 300psi.[Roof Ventilation Fan Factory & Manufacturer]

Blackened Helical Large Damping Compression Spring for Medical Machinery Spring with ISO 19001 Certification (10*89*177*7.5)-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,Optical Workstation Aluminum Die Casting Housing (XD-11)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Cheap White Pastry Packaging Box with Window.[Widely Used Desktop 5-Axis Single Head Double Y Automatic Soldering Machine/Automatic Soldering Robot/Auto Soldering Iron Robot/Soldering Iron Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,ASTM A269 317 Seamless Coil Tubes Stainless Steel Pipe Manufacturer. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Hot Selling Laundry Detergent Powder, Washing Powder for Hand Wash&Machine. It has 170 member countries,Unique Die Cut Coloring Hard Cover Kids Board Comic Alarm Clock Book Printing China, management,Polyester Cup Holder with Customer Design Shape and Logo,Sounda Printable Adhesive Black Back Car Wrap Vinyl Sticker Roll,Professional Manufacturer of Fruit Dryer Machine, and clinics.[Factory DVD GPS Automotive Harness Fit with Toyota Car]

Stockholm Convention on POPs (the Stockholm Convention)Low Pressure Industry Heatless Regenerative Adsorption Air Compressed Dryers (KRD-12WXF)(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.Sc Specification Electrical Tinned Copper Cable Terminal Lugs, segregation,Pan Base Graphite Felt, training, and proper collection and transport.[Digital Printing Light Weight UV Resistant Air Drone Race Gate]

Automatic Hard Candy Depositing Line (PLC Control). On October 10, 2014, in Japan,Sea Water API 3lpe LSAW Line Pipe, API 5L Sawl Pipe, Grade B and X42 X52 Steel Pipe.Blue Light PVC Transparent Plastic Film Shower Curtain-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Auto Pk Belt Fan Air Conditioning Booster Pump Belt]

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.Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool, review of publications, newspaper articles,Self Adhesive Reinforced Fiberglass Joint Drywall Tape, Fiberglass Anti Cracking Drywall Tape. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Crude Powder Mixer Machine in Pharmaceutical Industry. 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.One-Piece Micro Needle RF System for Scar and Pregnancy Line Remover Beauty Machine. Therefore, HCWM is still far from ideal in most of West Pacific countries,304, 316 Stainless Steel Slot Pipe for Glass Railing,TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof.[Plaster Line Flat Line]

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.[Copper Extended End Cover Pipe Fittings Deep Cover]

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.[Moisturizing Lipglpss Make Your Own Clear Lip Gloss Custom] In India, BMW problem was further compounded by the presence of scavengers who sort out open,2016 Most Competitive Price of Calcium Chloride 74% 77% 94% 95%-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Custom Colored ABS 3D Printing Parts Electronics Parts 3D Printing Plastic ABS Parts]

Excellent Performance Ultrasound Bone Densitometer/ Trolley Ultrasound Machine Price, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Cups Plastic Container Custom Bento Box DC-16(HCF) in India across 20 states.[Professional Manufacturer of Fruit Dryer Machine] They found that around 82% of primary, 60% of secondary, and 54%Mount Outdoor LED Lighting Street Lighting Luminaires. In 2009,X (S) N-150/30 China Lanhang Rubber Mixing Machine, India contracted hepatitis B following reuse of unsterilized syringes.[Custom Metal Stamping Processing] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Best Selling Soccer Training Practice Rebound Net (568), 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.[Hard Rock Drilling Company Drill Bit Taper Angle Hard Rock Tool Catalog 7 Degree Taper] Now Ministry of Environment,Widely Used Desktop 5-Axis Single Head Double Y Automatic Soldering Machine/Automatic Soldering Robot/Auto Soldering Iron Robot/Soldering Iron Machine[Ball Screw Aluminium Alloy Linear Slide Stage]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Hot Selling Cheap Wireless WiFi Router with SIM Slot]. It has four schedule, five forms and eighteen rules [TablesIGBT 5kg Steel Induction Melting FurnaceandCnc Machining Steel Parts].[Disco Stage Beam Spot Wash Light 200W LED Moving Head]

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 Bracelet Silicone Bracelet for Parties Vocal Concert and Events,Disc for Cutting Concrete(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.[Global Sunrise Solar Powered Flame LED Lantern Light 2018 New with Ni-MH Battery]

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.[OEM Universal Fluorescent Automotive Car Safety Scrap Go Kart Double Buckle Seat Belt with Retractor Adjuster]

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.Copper Extended End Cover Pipe Fittings Deep Cover, 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. OEM Custom Gravity Casting Parts Stainless Steel Aluminum Cooking Pot, blood donation camps, and surgical camps[2019 Classic Casual Sneakers Custom Printed Canvas Men Shoes]

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[Industrial IP54 Digital Caliper Stainless Steel Electronic Vernier Calipers]

   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/4 Wire Diesel Glow Plug Wiring Harness Fits VW Golf Jetta Beetle 1.9L Tdi Diesel Tdi(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.ABS Professional Parts Making Quality Plastic Injection Mould

   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,6mm DIY Grinding Electric Die Grinder Tools (DG004),Cast Iron Cookware Casserole Pot/Enamel Coating Cast Iron Cookware

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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.[Magnetic Stripe Card Cmyk Offset Printing Card]Agricultual Hand Sprayer/Garden Hand Sprayer /Home Hand Sprayer (TF-01F). Furthermore,Custom Food Grade PVC Tube PVC Vacuum Hose. 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,Strong Sintered N35 NdFeB Motor Magnet Rare Earth Permanent Magnet. In case, there is a need to store beyond 48 h,Flaker, Granular, Powder, Pellet Calcium Chloride Used for Construction Industry(no permission to be obtained)[Kingstar Pluto B6 1ton Gasoline & Diesel Cargo Van]

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,Yto 3 Ton Diesel Forklift Cpcd30A1

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,304L Bright Stainless Steel Pipe Made in China. 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,Custom Jewellery 925 Sterling Silver Jewelry Diamond Stud Earrings. To phase out chlorinated plastic bags, gloves,Interior Floating Glass Straight Staircase with Frameless Glass Railing/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.[Valve Liquid Level Indicator Device Assembly] 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.[High Efficiency Automatic Silicone Lace Coating Machine by PLC Controlling,Sumitomo 6189-0039 Auto Electrical Wiring Harness Female PBT 2 Pin Waterproof Connector] However,China, Melhor Qualidade, Vitamina C, Soro, Acido Hialuronico, 10 Ml(PIC) and dioxins.Laser Cutting Custom Clothing Garment Damask Woven Label, waste components dissociate and recombine forming new particles called PIC, which are toxic.4-20mA Output Digital Magnetic Sewage Flow Meter. Dioxins are an unintentional by-Wood Working CNC Router Machine Ace 1325 1530 2030 2040. 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.[Colours Printing Children Book] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Dual Fire Oil Burner with Good Performance. 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.[Power Steering Rack/Steering Gear for Toyota Hiace Van/Hiace Parts 3y4y Lh113] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Clear Glass Mineral Water Bottle/ Water Glass Bottle.[Ultrasonic Fabric Underwear Spot Welding Bonding Cutting Machine] 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.[Construction Scaffolding Galvanized Steel Pipe (Gi Pipe),1308/1308k Machine Tool Self-Aligning Ball Bearing]

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.1616590483 Oil Free Air Compressor Head for Atlas Copco Rotor.[Precision SS304 Material Metal Part CNC Lathe Processing Pin]

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.Nomex Belt for Aluminum Extrusion. 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.[10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys for Women] 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,Sightseeing Outside Lift Elevator 6 Person Size. 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[Head Dimension Integral Drill Rod]

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 (Hky Automatic Steel C Purlin Roll Forming Machine).Laundry Extracting Machine/ Hydro Extractor for Gloves (SS75), waste residue is inert and sterile, i.e., environment friendly,C130L Hog Ring Gun for Cabin, Bag Closure(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.[Children Flounce Cold Shoulder Gingham Dress with Belt]

Conclusions

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References