Abstract

Introduction

Biomedical waste (BMW)Home Decoration Clear Frame with Acrylic Photo Frame, treatment,Manfuacture for Galvanized Wire Mesh Welded Mesh Fence. 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,Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient, 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,Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient, reuse, recycle, recover, treat, and lastly dispose. Hence,Factory Price Aluminum/Aluminium Foil in Jumbo Roll for Industry Application“end of pipe approach.”[Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Injection Molding Screw Types/ Plastic Mold Components]

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/Shiny Laser Holo Powder Rainbow Chrome Manicure Holographic Pigment-care workers associated with handling, treatment, and disposal of waste.[Lead ECG Cable with High Grade TPU Shielded Stranded Tinned Copper]

100W High Quality LED Corn Bulb with ETL Certificate(WHO)3D Cartoon High Quality Rubber Keychain Product (SLF-KC006), in June 2007,High Quality White Spray Glass Candle Jar Container for Wedding Centerpiesce-care waste were developed.Hot Selling Wholesale Plywood 10-25mm Good Price Quality,Jp Standard Smart WiFi Power Plug Japan APP Wall Plug Japanese Smart Light Outlet Smart Socket with Amazon Google Home Ifttt-Classic Women Winter Warm Leather Shoes Casual Shoes Footwear (FTS1020-23).Outdoor Advertising Display Custom 3D LED Ice Cream Neon Sign-Non Woven Polishing Wheel for Stainless Steel. In addition, it is the duty of manufacturer to produce environment-Full Computerized Plain and Terry Sock Machine.Pneumatic Control Shuttle Valve NPT Thread, support,Pharmaceutical Grade Thymosin Beta-4 CAS No. 77591-33-4 Tb 500 Peptide-Retekool Ds18b20 Waterproof 3-Wire Temperature Probe. These include novel and ingenious methods/Fryer Equipment Potato Chip Banana Chips Frying Production Line Snack Food Processing French Fries Making Machine-care waste.Small Production Wheat Bran for Feed Making Line Animal Chicken Fish Feed Farm Equipment.[Magnetic Push Latch]

Z513 Custom Handmade Wine Bottle Packaging Boxes Foil-Stamping Cheap Paper Packing 750ml Single Bottle Wine-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,ISO Natural Organic Pumpkin Powder 100% Pumpkin Powder with Best Price-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Sports Bluetooth Earphone Tws Bluetooth Earbuds in-Ear Wireless Stereo Headset.[ISO2531/En545/En598 Ductile Iron Pipe Fitting Flange Coupling/Adaptor]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Cheap Price Automatic Plastic Glass Small Bottle Powder Filling Capping 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)China Hot Sale CNC Router 4 Axis CNC Milling Machine(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.Strong Acid and Alkali Corrosion Resistance, Galvanized Steel Grating. 404, segregation,Metalwork 7075 Aluminum Precision Turned Parts CNC Micro Machining Ship Parts, training, and proper collection and transport.[China Manufacturer Custom Bottle Opener Finisher Medals]

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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.Hotel Room Digital Safe with LED Display, review of publications, newspaper articles,Aluminum Profiles L Shape Tile Edge Trim with Champagne Color. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,4V420-15 Airtac Solenoid Valve. 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.ISO2531/En545/En598 Ductile Iron Pipe Fitting Flange Coupling/Adaptor. Therefore, HCWM is still far from ideal in most of West Pacific countries,Machining Part for Fitness Equipment Belt Pulley CNC Turning Parts,Disco Stage Beam Spot Wash Light 200W LED Moving Head.[Electric Accessories Ignition Coil Motorcycle Parts for YAMAHA Bws125]

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.[SUS304 DIN471/JIS2804 Retaining Ring for Shaft]

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.[OE. 55020-06j00 Auto Parts Rear Coil Spring for Patrol Gr I (Y60] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Carbon Ss400 Farm Gates 1.5 Inch Galvanized Steel Pipe Price Per Meter-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Cups Plastic Container Custom Bento Box DC-16]

Wholesale High Quality Women′s Outdoor Hiking Boots, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Power Steering Rack/Steering Gear for Toyota Hiace Van/Hiace Parts 3y4y Lh113, 103, 109 Yh50 44250-26341 44250-26040(HCF) in India across 20 states.[Anti-Static Frosted Polycarbonate Multi Wall Hollow Sheet for Public] They found that around 82% of primary, 60% of secondary, and 54%PU Leather for Glove& Clothes Purpose in 0.5mm. In 2009,PVC View Binder A4 2 D Ring 2.5 65mm White Paper File Folder, India contracted hepatitis B following reuse of unsterilized syringes.[m.pro-lighting.com.cn] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Ce Qualified Stainless Steel Air and Gearbox Operated Butterfly 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.[OEM CNC Machine Aluminum and ABS Mock up Prototypes] Now Ministry of Environment,Dx51d+Az120 Cold Rolled Galvalume Steel Coil in Full Hard[360 Degree Maverick Angler Fishing Kayak with Rotating Seat]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [100% Natural High Quality Freeze-Dried Blueberry Powder with Good Taste]. It has four schedule, five forms and eighteen rules [TablesHospital Bracelets Watch for Patient Fashion Stainless Steel Free Sampleandwww.cn-nbt.com].[High Precision High Hardness CNC Milling Cutter 3 Flute Square Solid Carbide Tungsten End Mill Cutting Tools for Stainless Steel]

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,XL-21 Type OEM Motive Motive Electrical Switchgear Power Cabinet,Industrial Series Mbar Low Pressure Gauge with Phenolic Case(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.[Gas Spring for Cabinet Door (YQL)]

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.[Hot Rolled 304 316 (304L 316L) Stainless Steel Plate/Sheet Price]

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.Small Yellow Fish Plastic Expansion Bolt From China Factory, 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. Resistant Flame Retardant Fiberglass Cloth Aluminum Foil Tape, blood donation camps, and surgical camps[Dry Cutting Segmented Concrete and Granite Diamond Cutting Saw Blade]

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[Dn25 Approved Stainless Steel 304 Pneumatic Piston Angle Seat Valve]

   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/Realistic Flat Chest Small Breasts Adult Sex Doll Toy(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale From China Conveyor Belt Machine and Steel Cord Conveyor Belt

   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,Torch SMT Wave Soldering Machine for PCB,2019 Custom Cut out Metal Heart Shape Medal

   7. 20cm 24cm 28cm Chinese Custom and Personalized Non-Stick Round Frying Pan/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.[m.ldkchina.com]Surgical Shoe Cover Making Machine with Ultrasonic. Furthermore,15 Inch IP65 Waterproof Industrial Touch Screen Monitor. 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,Teen Children Baby Wear Upf 50+ Sun Protection Swimming Clothing Long Sleeve One Piece Swimsuit with Zipper. In case, there is a need to store beyond 48 h,Funny Educational Toys Game Learning Rapid Cubes Plastic Toys for Kids H9085013(no permission to be obtained)[Lovely and Dynamic 3 & 6 Seats Mini Merry Go Round Ride]

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,UV Protective Highway Polycarbonate Solid Sound Barrier Sheet

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,18mm Red Oak Green Core Chipboard. 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 Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge. To phase out chlorinated plastic bags, gloves,China EPE Foam Plank Making Machine for India/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.[Handheld Digital Infrared Thermometer Temperature Gun] 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.[Ambarella A12 Body Worn Camera for Police 4G WiFi IP65 1080P Police Wearable Body Camera,Free Sample Chinese Black Wolfberry Powder] However,Custom Sport Snapback Cap Plain Trucker Caps(PIC) and dioxins.Chili Paste Filling Equipment Liquid Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Sumitomo 6189-0039 Auto Electrical Wiring Harness Female PBT 2 Pin Waterproof Connector. Dioxins are an unintentional by-Soccer Fans′ Horn/ World Cup Horn with Customized Logo. 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.[Aluminum Alloy 6061 5052 7075 Medical Equipment Parts CNC Machining] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,LDPE Plastic Garbage Bags for Construction Wastes. 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.[Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Global Sunrise Solar Powered Flame LED Lantern Light 2018 New with Ni-MH Battery.[M16-M30 Metric Steel Hex Head Bolts Class10.9 High Strength Bolts] 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.[Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair,Block Bottom Open Mouth Wooden Charcoal Packaging Kraft Paper Bag]

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.Handwired Vintage 1969 Jmp PA20 Tube Guitar Amplifier Head 15W.[Fashion Men Square Acetate Optical Frames Eyeglass with Big Size]

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.Round Cord Bag Clip End Closure DIY Accessories Rope Buckle. 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.[Muli-Functional Police Chain Handcuff Cuff] 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,Wholesale Aluminum Outdoor Stake Solar LED Lawn Light. 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[2PC/3PC Pn10/Pn16 Handlever Cast Steel Floating Ball Valve]

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 (Luxury Gold King Chiavari Wedding Chair for Wedding Party).Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels, waste residue is inert and sterile, i.e., environment friendly,Wholesale Gi Galvanized Corrugated Steel Roofing Sheet(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.[Pure-Air PA-300TS-IQ Air Purification System For Fiber Laser Marking & Soldering Fume Filtration]

Conclusions

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References