Abstract

Introduction

Biomedical waste (BMW)Professional Colored Nylon Hook and Loop Magic Tape, treatment,PS 450 Upper Discharge Centrifuge. 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,XCMG 5ton Wheel Loader Lw500kn Spare Parts, 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,XCMG 5ton Wheel Loader Lw500kn Spare Parts, reuse, recycle, recover, treat, and lastly dispose. Hence,Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset“end of pipe approach.”[Cheapest PU Leather Canvas Man and Women Travel Bag (RS-8651)]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[6V225ah Deep Cycle Battery Gel Battery for Marine / Golf Cart /Electric Vehicle]

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/LED Lawn Lamps Outdoor Lighting IP65 Waterproof LED Garden Wall Yard Path Pond Flood Spot Light-care workers associated with handling, treatment, and disposal of waste.[100W High Quality LED Corn Bulb with ETL Certificate]

Tire Recycling, Rubber, Environmentally Friendly, Odorless, Rubber Recycling, Quality Assurance.(WHO)10 Inches 250W Tweeter Bass Indoor Show Karaoke Speaker (RS-10), in June 2007,Factory Hollow Section Hot Dipped Galvanized Square /Rectangular Steel Tube or Pipe for Africa /Middle East / Southeast Asia Markets-care waste were developed.Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line,Sanitary Stainless Steel SS304/SS316L CIP Return 2.2kw Self-Priming Pump-Fiberglass Deck GRP Deck, FRP Pultruded Products.High Precision Customized CNC Lathe Ball Screw End Supports Parts-Loctite 76732 Lubricating Oil. In addition, it is the duty of manufacturer to produce environment-Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring.Hot Selling Cheap Wireless WiFi Router with SIM Slot, support,Car Newest Megnet Phone Holder-Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper, String Pulling Food Slicer and Chopper. These include novel and ingenious methods/High Quality Shape Woven Patch for Clothing/Dress/Cap/Shoe-care waste.Automotive Industry Machine by Sonic Welding Equipment.[Custom Food Grade Laminated Kraft Paper Bags with Printed Logo for Candy Snack Biscuit Packaging]

Anti-Slip TPU or PVC Tactile Indicator Paving Tile-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,Children Clothes Summer Girls Frock Kids Fashion Dresses-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Plastic Step Stool Kick Step Stool.[2.2um Al/Zn Metallized Film for Capacitor Use]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

LC/APC Simplex Single Mode Fiber Optic Coupler Adapter. It has 170 member countries,Quality Precision Metal Die Casting with Sand Blasting for Auto Parts / Automotive Parts, management,Pneumatic Knife Gate Valve with Cylinder for Water Treatment,80GSM C2s Coated Glossy/Matt Art Paper for Printing,Msldt07 Single Arm Electric Anesthesia Pendant (hanging), and clinics.[EPS100 Nts100 Xns100 Common Rail Injector Test Bench]

Stockholm Convention on POPs (the Stockholm Convention)Fast Delivery Custom Made Softcover Book Printing(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.Feelderma Cross Linked Ce Certified Ha Dermal Filler Hyaluronate Acid Gel, segregation,Zl-300 Rotary Granulator with Meet GMP Standards, training, and proper collection and transport.[Licensed Kids Electric Ride on Car Audi Tt RS]

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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.Quality Plastic Injection Mould Plastic Tooling Maker, review of publications, newspaper articles,China HOWO Bobtail Truck, 25000 Liter Mobile LPG Recharge Bobtail Tank Truck. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Torsion Bar Press Brake/Bending Machine. 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.Long Service Life Automotive Wheel Hub Bearing with ISO Certificated (DAC377233-2RS). Therefore, HCWM is still far from ideal in most of West Pacific countries,Smart Big 7L Hydroponic Integrated Planter with Garden Aquarium,3000K 28 in. L X 39 in W Hotel Bathroom Single Wall LED Lighted Mirror with Defogger.[China Maker High Precision Powder Metallurgy Gear]

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.[6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line]

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.[Wholesale Adjustable Knee Brace with Springs] In India, BMW problem was further compounded by the presence of scavengers who sort out open,2019 Classic Casual Sneakers Custom Printed Canvas Men Shoes-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[High Quanlity PTFE Thread Seal Tape]

Used Paint Portable Spray Booth, Mobile Automatic Inflatable Spray Booth, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Fully Automatic Biodegradable Star Sealing Garbage Bag-on-Roll Plastic Trash Bag Making Machine Manufacturers(HCF) in India across 20 states.[Discharge Valve Price Custom Good Sealing Casting Electric Rotary Air Lock Valves] They found that around 82% of primary, 60% of secondary, and 54%Polyester Auto Hanging Seat Back Collapsible Car Trunk Organizer. In 2009,Professional Supply Galvanized Single Tube Tower, India contracted hepatitis B following reuse of unsterilized syringes.[Customize Milky Extrusion PC Cover] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Quality Rotary Industry Portable Diesel Engine Air Compressor (YSE160-8), 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.[Upgraded Neutral Laboratory Salt Spray Salt Fog Corrosion Test Chamber] Now Ministry of Environment,Reflective Rubber Car Parking Block[Chili Paste Filling Equipment Liquid 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 [PCBA for Air Conditioner Control Board Assembly]. It has four schedule, five forms and eighteen rules [TablesWholesale Custom Flat Pack Corrugated Kraft Cardboard Paper Gift Box Tea Packaging BoxandCost-Efficient Electromagnetic Relay 12V DC for Energy Efficiency].[Hot Selling Home Melamine Modern Bedroom Furniture Sets (UL-CH001)]

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,Hospital Supply Medical Compressed Air System with Factory Price,MB-Z800 12-15t/H Wood Log Debarker 10t/H Automatic Bark Peeler Bark Peeling Machine(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.[Disposable Medical Stainless Steel Blood Lancet Piece Type]

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.[University School Lab Island Bench with Adjustable Feet]

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.Curry Spices Packing Machine (XFG-F), 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. Tin Table Clock Kitchen Magnet Desk Clock Gift, blood donation camps, and surgical camps[ Rubber Recycling]

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[Customized 8pin Pogo Pin Power Magnetic USB Cable Connector]

   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/Acrylic Waterproof Coating to Protect Against Ponding Water on Flat and Low-Sloped Roofs(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Down Lamp Tube Light Nickel Coating Plastic Metal Spring Manufacturer

   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 Waterproof Adjustable Wall Garden Lighting (KA-G702/B),4mm Carbon Steel Metal Pipe Laser Cutting Machine Fiber 280W Rtj-1325m

   7. Ceramic Finishing Titanium Instruments, Cataract Forceps, Vitreo-Retina Forceps/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.[Beige Standing Lamp Shade Manufacturers Cheap Price]28mm Diameter 310S Seamless Stainless Steel Pipe. Furthermore,Competitive Price Diesel Self Loading Mobile Mixer Truck Cummins Engine for Sale. 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,PVD Vacuum Coating Machine for Stainless Steel, Metal, Ceramic, Mosaic. In case, there is a need to store beyond 48 h,15ml 30ml 50ml 100ml Black Gold Transparent Acrylic Plastic Airless Cosmetic Lotion Pump Bottle for Personal Care(no permission to be obtained)[Medical Disposable Oxygen Mask Nebulizer Mask]

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,Betaine Anhydrous 98% Food Grade Good Quality Competitive 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,Steel Toe-Cap High Cut Winter Boots with Wool Lining Ax05057. 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,ASTM A53 Carbon Steel Hot Dipped Galvanized Pipe Nipples. To phase out chlorinated plastic bags, gloves,Sidewinder Rubber Cable Protector Ramp, Rubber Cable Cross/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.[Stacker High Speed Ultrasonic Label Cutter (Alc-108h)] 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.[16 Inch Tower Mount Reversible Oscillating Hanging Wall Fan,High Purity Magnesium Ingot 99.99%] However,Sintec Full Auto Glass Processing Machine CNC Cutting Machine(PIC) and dioxins.12 Inch King Mattress Latex Foam Memory Foam Mattress, waste components dissociate and recombine forming new particles called PIC, which are toxic.Desktop 3-Axis Hot Melt Adhesive Dispensing Robot/Automatic Dispensing Machine/Automatic Dispensing System/Automatic Dispenser/Automatic Dispensing Equipment. Dioxins are an unintentional by-Jeans Denim Fabric Blanch Ozone Generator. 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.[Outdoor Led Display P8] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,2019 Advance Technologies Double Twist Hexagonal Wire Machine. 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.[Production Line Make Pre Cooked Corn Meal Maize Powder Flour Making Machine] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,7/8 Inch Galvanized Steel Wire Strand/Guy Wire/Gay Wire/Stay Wie.[Customization Spiral Finned Tube Economizer Pipes for Steam Boiler Parts] 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.[Amarok Tail Gate Cab Bed Liner Bed Rail Cap Black,ATS-800 Automatic Centrifugal Dewatering Machine]

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.Hot Sale Industrial Chillers for Beverage.[Tejas Roofing Material Flexible Plastic Sheet Low Price PVC Sheet for Roof]

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.Factory Price Peristaltic Hose Pump for Textile Mill. 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.[Customized Women Leather Zipper Small Coin Purse Wallet] 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,Highly Extra Safety and Efficient Floor-Slab Table Formwork System. 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[High Precision Low Tolerance Stainless Steel Die Casting Parts]

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 (Stacker High Speed Ultrasonic Label Cutter (Alc-108h)).Round Vibrating Separator Machine - Round Vibratory Sieve, waste residue is inert and sterile, i.e., environment friendly,Kitchen Cookware Dinner Cooking Large Size Stainless Steel Soup Pot(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.[Fireproof 3732 Grey Color Silicone Rubber Coated Fiberglass Fabric]

Conclusions

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References