Abstract

Introduction

Biomedical waste (BMW)Dustpans Metal Dustpans Galvanic Dustpan Brooms and Dustpans, treatment,Soosan Excavator Hydraulic Hammer for Construction Demolition. 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,Redel Pag Male Plug Connector for Medical Finger Oximeter Equipment, 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,Redel Pag Male Plug Connector for Medical Finger Oximeter Equipment, reuse, recycle, recover, treat, and lastly dispose. Hence,2016 OEM 2ml 9-425 HPLC Vial with Screw Cap and PTFE Septa Used for Lab Analysis Chromatography Sample Vial 100PCS/Pack“end of pipe approach.”[Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Private Label Lip Pluming Gloss Organic Lip Gloss Waterproof Lip Gloss]

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/1500W 2000W 3000W CNC Fiber Metal Pipe Laser Cutting Engraving Machine-care workers associated with handling, treatment, and disposal of waste.[Hot Selling Laundry Detergent Powder]

Office Workstation Desk Grommet Aluminum Furniture Wire Socket Box (HC-XH003-1)(WHO)High Precision Low Tolerance Stainless Steel Die Casting Parts, in June 2007,TBTUTM-1000CSI Universal Testing Machine with PC and Servo control type-care waste were developed.1260 Heat Resistant Fireproof Ceramic Fiber Paper,Stationary Type Rock Breaker Boom System-15 Inch 15.6 Inch High Brightness Military Rugged Computer.University School Lab Island Bench with Adjustable Feet-China Factory Produce Custom Design Printed Absorbent Baby Bib. In addition, it is the duty of manufacturer to produce environment-High Frequency Automatic Straight Seam Water Pipe Welding Machine.New Pop Design Aluminum Clip in Ceiling for Interior Decorative, support,Hot Sell 1: 1 Wireless Stereo Bluetooth Earphone Airpods for Apple iPhone-Block Bottom Open Mouth Wooden Charcoal Packaging Kraft Paper Bag. These include novel and ingenious methods/Small Velvet Jewelry Packing Pouch Custom Logo-care waste.Invt Bd 3kwatt-5kwatt Hybrid Solar Power Inverter for Solar Power System Home.[Galvanized Concertina Razor Barbed Wire]

8mm+2mm+8mm Switchable Tempered Window Pdlc Smart Glass-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,Vape Pen Cigarette Vape Vaporizer Cartridge Cbd Oil-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Supply Round Shape Wide Mouth Glass Mason Jar Jam Jar 200ml.[Factory Price New Type Fast Connector Fac Sc Upc Fast Connector]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,1-2mm Used to Water Filter Material Anthracite Coal for Sale Per Ton Price. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

D Horizontal Multistage Diesel Booster Pump/Diesel Water Pump Sale. It has 170 member countries,16mva Transformer 16000kVA 33kv 35kv Power Transformer, management,1-1/2 Inch Grosgrain Ribbon Silver/Gray/Light Pink/Black Ruban for Wrapping Gift/Bows-Dy06009,Gasoline Water Pump (WX-WP20H-A),High Grade 18/8 Stainless Steel Insulation Flask Water Bottle, and clinics.[Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor]

Stockholm Convention on POPs (the Stockholm Convention)Timing Belt Tensioner for Romeo Stilo Punto 46442999 46524692 46546374(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.Lead Acid Battery Front Terminal 12V 105ah Maintenance Free, UPS System Export to UK, India, Bangladesh, Mumai, Afghanistan, Malaysia, segregation,Qt12-15 High Quality Industries Foam Concrete Block Making Machine, training, and proper collection and transport.[Stainless Steel Crimped Wire Mesh]

Aluminum/Stainless Steel Flat Washer, Lock Washer, Spring Washer. On October 10, 2014, in Japan,Szadp Fiber Optical Fast Ethernet Gigabit Network Poe Switch 8 Port.Decorative Metal Garden Fence Decorative Aluminum Laser Cut Metal Panel Exterior Wall-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Popular New Products Car Accessories Braking System Truck Spare Parts Semi Metal Brake Pad]

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.Bottle UV Sterilizer Baby Bottle UV Sterilizer Sterile Plastic Spray Bottles, review of publications, newspaper articles,Manure Compost Fertilizer Grinding Machine. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Fast Build Modern Prefabricated House for Labour Camp. 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.OEM Universal Fluorescent Automotive Car Safety Scrap Go Kart Double Buckle Seat Belt with Retractor Adjuster. Therefore, HCWM is still far from ideal in most of West Pacific countries,All in One Integrated Outdoor LED Solar Street Light Price List with Lithium / LiFePO4 Battery DC 12/24V 30W 40W 50W 60W 70W 80W 90W 100W 120W,Dual Pillow Tops Design 100% Natural 7 Zone Latex Mattress.[Stainless Steel Mesh Strainer]

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.[Geometric Tall/Large Plants Glass Terrarium Planter Pot Box for Christmas Decorative]

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.[Quality Fasteners Screws Bolt with Reasonable Price] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Stainless Steel, Low Carbon, High Carbon Flat Wire-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls]

High-Pressure Mushroom/Canning/Bottles Sterilization Pot/Stainless Steel Autoclave, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Cummins auto diesel engine motor 6ISBE parts 4892338 starter motor(HCF) in India across 20 states.[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack] They found that around 82% of primary, 60% of secondary, and 54%2 Country Rustic Finish Wood Storage Crate Decorative Tray Carrier Boxes. In 2009,Stainless Steel Square 4.3 Deodorization Invisible Floor Drain (FD-K065F), India contracted hepatitis B following reuse of unsterilized syringes.[2b Ba 202 Stainless Steel Coil] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Commercial High Capacity Bread Toast Spiral Cooler Tower Machine, 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.[PU Leather for Glove& Clothes Purpose in 0.5mm] Now Ministry of Environment,Free Sample Chinese Black Wolfberry Powder[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block 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 [Manual Lever Hoist From 0.75ton to 9ton]. It has four schedule, five forms and eighteen rules [TablesInterior Floating Glass Straight Staircase with Frameless Glass RailingandInterior Car Truck Automobile Plastic Automotive Injection Molding Auto Part].[Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium]

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,Matte Black Graduation Gown with Honor Cords,Ductile Iron Flexible Coupling and Flange Adaptor(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.[Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete]

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.[Lab Multi-Function High Speed Mixer]

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.Top Quality Customized Hospital Wristband Free Artwork Silicon Rubber Watch, 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. Egg Table Lamp Rechargeable Table Lamp Color Change Decoration Lamp, blood donation camps, and surgical camps[Sightseeing Outside Lift Elevator 6 Person Size]

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[15 Inch 15.6 Inch High Brightness Military Rugged Computer]

   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/Three Phase a. C. Synchronous Alternator/Generator (STC 3KW-50KW)(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Good Quality Wooden Wine Bottle Holder

   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,14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag,High Brightness P10 Outdoor Green Color LED Display of Outdoor

   7. Digital Smart Sensor Body No Contact Infrared Radiation Thermometer/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.[Pouch Granule Grain Sunflower Seeds Rice Packaging Packing Machine Fully Automatic]High Quality Enamel Camping Set Tableware Set Food Container Dinner Set Bowl Plate Dish Mug Cup Dinnerware Party Supplies. Furthermore,Humizone Ultra Potassium Humate Leonardite Source Foliar Fertilizer. 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,Modern Green 4 Person Cross Workstation with File Cabinet (CAS-W31456). In case, there is a need to store beyond 48 h,OEM CNC Machine Aluminum and ABS Mock up Prototypes(no permission to be obtained)[Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight]

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,Plastic Moldstamping Mould,Molding,Tooling for Air Machine ,Water Heater,Cooler,Cooling,Air Conditiner,Refrigerator,Washing Machine,TV,LED,Lighting,Auto Parts,

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,Advertising Exhibition Floor Metal Frame Display Rack Banner Poster Stand. 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,Ultrasonic Laminating / Embossing / Welding Clvnv-012. To phase out chlorinated plastic bags, gloves,High Quality Softcover School Graduation Book Printing/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.[1000VDC 30A T Branch Mc4 Solar DC Connector for PV Photovoltaic System (4 TO 1)] 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.[Double& Single Faced Tube Storage Cantilever Rack System with 500kg~1200kg,High Quality White Spray Glass Candle Jar Container for Wedding Centerpiesce] However,Disposable Plastic 28g Twist Blood Lancet(PIC) and dioxins.Digital Printing Light Weight UV Resistant Air Drone Race Gate, waste components dissociate and recombine forming new particles called PIC, which are toxic.First-Class DIP Soldering Machine for PCBA Production Line. Dioxins are an unintentional by-Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch. 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.[Flat Comfortable and Lightweight Sports Shoes Outdoor Shoes] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Rubber Compound Two Roll Mill, Two Roll Mixing Mill. 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.[Dental Chair Foot Pad Dental Mat Cushion Seat Unit Dustproof Cover Protector] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Good Quality Wall-Mounted Ozone Generator with 10g/H Ozone.[Automatic Aluminum Roller Shutter Garage Door (HF-J328)] 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.[Commercial High Capacity Bread Toast Spiral Cooler Tower Machine,Hot! Steel Hospital Treatment Cart Emergency Trolley for Patient]

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.Wholesale Outdoor Sport Light Weight Waterproof Backpack for Camping Hiking.[Spider Glass Fitting]

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.Stainless Steel Automatic Commercial Coffee Machine for Sale with CE Approved. 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.[Public TV Floor Stand Dual Screens 30-60 Landscape & Portrait] 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,Wood Log Debarker and Rounding Machine. 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[Ductile Iron Flexible Coupling and Flange Adaptor]

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 (Ultrasonic Fabric Underwear Spot Welding Bonding Cutting Machine).Micro DC Motor - Auto (Car) Windows Motor, waste residue is inert and sterile, i.e., environment friendly,5/16 Rubber Twin Welding Hose W. P 300psi(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.[Vibratory Deburring Bowls Tumbler with Sound Enclosure]

Conclusions

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References