Abstract

Introduction

Biomedical waste (BMW)Stacker High Speed Ultrasonic Label Cutter (Alc-108h), treatment,Round Vibrating Separator Machine - Round Vibratory Sieve. 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,Kitchen Cookware Dinner Cooking Large Size Stainless Steel Soup Pot, 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,Kitchen Cookware Dinner Cooking Large Size Stainless Steel Soup Pot, reuse, recycle, recover, treat, and lastly dispose. Hence,Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable“end of pipe approach.”[Kids Sneakers School Shoes for Girls with Design Wholesale High-Quality Custom Dropshipping Running Shoes]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[2017 Solar Garden Stake Light (RS-124)]

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/Yangtze 12V 18ah Electric Motorcycle Lithium Battery Charger Module-care workers associated with handling, treatment, and disposal of waste.[Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring]

Gas Spring for Cabinet Door (YQL)(WHO)Rubber PVC Food Grade Conveyor Belt System Manufacturers Stainless Modular Conveyor Belt, in June 2007,Good Price Fiberglass Roofing Material Goethe Types Architecture Shingle for Luxury Villa-care waste were developed.Clear Glass Storage Jar Food Spice Jar with Cork Lid,Machining Spare Part CNC Machined High Volume Aluminum Parts-Sheet Metal Press Machine Perforating Metal Plate Hole Punching Machine.6.35mm Mono Plug to RCA Jack Adapter-Army Camouflage Cotton Plain T Shirt with Short Sleeve. In addition, it is the duty of manufacturer to produce environment-Small Clear Glass Spray Bottles for Aromatherapy Essential Oils.Modern Design Steel Structure Broiler Chicken Ground System, support,1t Sealed Pressure Storage Moveable Tank for Chemical, Transportion, Cosmetic, Gel-Mercury Glass Votive Tealight Candle Holders for Weddings, Parties and Home Decor. These include novel and ingenious methods/Auto Pk Belt Fan Air Conditioning Booster Pump Belt-care waste.Vp-0100 Intelligent Electric Valve Actuator Rotary Valve Motorized Actuator Low Torque Actuator for Ball Valve Butterfly Valve Quarter Turn Electric Actuator.[m.frontop.com]

Hospital Bracelets Watch for Patient Fashion Stainless Steel Free Sample-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,OEM EPDM/NBR/Butyl/Nr/Cr/Viton/Silicone Custom Molded Rubber Parts-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Diamond PDC Coring Bits, Rock Drilling Tools.[Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Flying CO2 Laser Marking Machine with Red Locating System. 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)HDMI Cable Support 3D 4K and 2160p High Speed HDMI Cable with Ethernet(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.Injection Molding Screw Types/ Plastic Mold Components, segregation,24V 300ah Lithium Battery Energy Storage Battery Li-ion High Power Battery LiFePO4 Battery UPS Battery Power Supply Rechargeable Lithium Iron Phosphate Battery, training, and proper collection and transport.[Industrial Series Mbar Low Pressure Gauge with Phenolic Case]

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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.Low Price Concertina Razor Barbed Wire Cbt-65, review of publications, newspaper articles,Fireproof 3732 Grey Color Silicone Rubber Coated Fiberglass Fabric. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,2019 Anti-Scratch Wooden Look Interlocking Click PVC Vinyl Floor Spc Flooring for Home. 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.2/3/5/10ml Plastic Airless Perfume Bottle with Fine Mist Sprayer. Therefore, HCWM is still far from ideal in most of West Pacific countries,China Hydraulic Factory Rubber Hose Tube Fittings From Ningbo City,SKF Double Row Angular Contact Ball Bearing 3204/3205/3206/a/Atn9/2z 2RS1/Tn9/Ztn9/Mt33/C3.[Open Die Forgings Suppliers]

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.[HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage]

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.[Hot Sale Cement/Concrete Electric Pole Making Machines in China] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Hotel Mini Bar Fridge Refrigerator with Solar Energy-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[New Products Fishing Bags Fishing Tackle Outdoor Bags]

Chameleon Aurora Rainbow Mirror Unicorn Chrome Pigment for Nail Art, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Serrated Beaing Bar Grating, Galv(HCF) in India across 20 states.[White HPL 600*600mm Coffee Table] They found that around 82% of primary, 60% of secondary, and 54%Industrial Steel Structural Warehouse From China. In 2009,Factory Directly Pasta Maker with More Mould Shapes, India contracted hepatitis B following reuse of unsterilized syringes.[Carbon Steel 3pcs Ball Valve] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Quality Wool Felt Porkpie Fedora Trilby Hat, 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.[Horizontal Aluminium Iron Wrought Decorative Metal Used Fencing and Garden Fence] Now Ministry of Environment,High Efficiency Fully Automatic Industrial Laundry Machinery Linen Towel Washing Folding Machine[Mini Metal Cheap CNC Plasma Cutting Machine]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Metal Nameplate Laser Etching Machine Fibre Laser Marking]. It has four schedule, five forms and eighteen rules [TablesSmall Production Wheat Bran for Feed Making Line Animal Chicken Fish Feed Farm EquipmentandAs Material Coffee Mug].[7/8 Inch Galvanized Steel Wire Strand/Guy Wire/Gay Wire/Stay Wie]

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,Animal Manure Compost Organic Fertilizer Granular Machine with Ce,Winter Colorful Cute Fur Unicorn Slipper Shoes for Home(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.[Dental Supplier Lithium Disilicate Glass Ceramic]

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.[Shiny Laser Holo Powder Rainbow Chrome Manicure Holographic Pigment]

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.50X70mm Suspended Pendant Lights LED Aluminum Profile for LED Strip Lights, 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. Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder, blood donation camps, and surgical camps[LCD Display Bzc-220V-150A PWM Solar Charge Cntroller]

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[9′′ 6CH 1080 HD Mobile Car DVR with Touch Screen]

   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/Galvanized Normal Twisted Barbed Wire(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring

   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,Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2),6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line

   7. Right Angle Worm Gearbox for Food and Beverage and Packaging 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.[14X14 Aluminium Window Screen/Insect Aluminum Alloy Wire Netting]Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket. Furthermore,Tassel and Cross Pendant Earrings Charming 925 Silver Earrings. 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,Fashion Floral Red Fabric Headband for Women Accessories. In case, there is a need to store beyond 48 h,Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence(no permission to be obtained)[Die Casting Aluminum P2 P2.5 P3 P4 LED Screen Signboard]

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,2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle

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,Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa. 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,Waterproof Fireproof Spc Click Floor PVC Vinyl Floor Tile 4mm 5mm 6mmm. To phase out chlorinated plastic bags, gloves,High Quanlity PTFE Thread Seal Tape/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.[High Quality Hotel Mini Bar Fridge Refrigerator with Solar Energy] 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 Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket,HDMI VGA DVI AV Input 55inch electronic whiteboard white board] However,Custom 304 Stamping Parts-Punching Stamp Parts-Metal Pressing -Sheet Metal(PIC) and dioxins.Wholesale Biodegradable Christmas Gift Goodies Packaging Customized Kraft Paper Bags for Kids, waste components dissociate and recombine forming new particles called PIC, which are toxic.Corrosion Resistant 304 Stainless Steel Metal Etched Mesh. Dioxins are an unintentional by-Turn Key Prefabricated Industrial Steel Structure for Workshop. 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.[High Quality CNC Shaft Hardened Linear Transmission Drive Spline Motor Shaft] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Airlock Valve -B. 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 RGB Stage Effect Light Vision Curtain for Indoor Show] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Cold-Roolled Ribbed Steel Mesh.[6.35mm Mono Plug to RCA Jack Adapter] 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.[4 Column Hydraulic Press to Calibrate The Steel Pipe,Wonderful Tinted Stained Colour Film Laminated Glass Decoration Glass]

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.Best Price Clear Float Glass for Curtain Wall Glass.[www.bestcontactor.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.Multi-Ply Fabric Ep Conveyor Belt for Stone. 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.[Good Insulated Real Estate Well Designed Labor Camp/Warehouse Prefab House] 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,Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037. 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[Adjustable Neck Brace /Rigid Plastic Cervical Collar with Chin/Cervical Support Strap]

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 (Aluminium Expanded Mesh (Expanded002)).Licensed Kids Electric Ride on Car Audi Tt RS, waste residue is inert and sterile, i.e., environment friendly,100ml Pet Bottle with Bamboo Lotion Pump for Shampoo(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.[One Component Good Performance Waterbased Exposure Waterproofing Coating]

Conclusions

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References