Abstract

Introduction

Biomedical waste (BMW)Handwired Vintage 1969 Jmp PA20 Tube Guitar Amplifier Head 15W, treatment,Round Cord Bag Clip End Closure DIY Accessories Rope Buckle. 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,Wholesale Aluminum Outdoor Stake Solar LED Lawn Light, 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,Wholesale Aluminum Outdoor Stake Solar LED Lawn Light, reuse, recycle, recover, treat, and lastly dispose. Hence,Luxury Gold King Chiavari Wedding Chair for Wedding Party“end of pipe approach.”[Non Woven Polishing Wheel for Stainless Steel]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Optical Workstation Aluminum Die Casting Housing (XD-11)]

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/Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels-care workers associated with handling, treatment, and disposal of waste.[2017 New Quick Charge QC3.0 Power Bank Mobile Charger]

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304 Stainless Steel Staircase Armrest Fittings Shell Cover Foshan-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,Customized 8pin Pogo Pin Power Magnetic USB Cable Connector-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Plastic Lid Press Making Machine Cup Lids Forming Machine.[Best Selling High Quality Automatic Palletizing Robot Machine Manipulator]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Shenzhen China Air Conditioner Universal PCBA. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

12V200ah/12V150ah/12V100ah VRLA Lead Acid AGM UPS Industrial Storage Battery. It has 170 member countries,Autoclave Indicator Tape, Chemical Indicator, Process Monitoring, CE, Clinical Consumables, management,Cooking Oil Filter Machine Australia Edible Oil Filter Press,BS-2073b High Level Biological Microscope for College Education,Stop Valve/Gate Valve for PPR Fittigns, and clinics.[New Design 100kVA 6 Cylinder Jet Power Low Noise Generator Price]

Stockholm Convention on POPs (the Stockholm Convention)Interiro MDF/HDF White Primed Painted Molded Door From Factory(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.ERW Welded BS4568 Galvanized Steel Pipe Class 3, segregation,Customized Hot Rolled Bimetal Steel Plate Wear Resistant Steel Plate, training, and proper collection and transport.[Melamine Particle Board for Outdoor Usage/White Melamine Faced Veneer Chipboard]

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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.Biodegradable Disposible Straw Pulp Food Box Ppp-1007, review of publications, newspaper articles,Lovely and Dynamic 3 & 6 Seats Mini Merry Go Round Ride. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,220V Meter 1000va Relay Type Automatic Voltage Stabilizer. 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.China Custom Modern Grey Kitchen Cabinets Guangzhou. Therefore, HCWM is still far from ideal in most of West Pacific countries,Anti-Theft Ss Wire Rope Mesh Bag Hand Woven Stainless Steel Bags,2.13 E- Ink Screen with Black&White and 250*122 Resolution for Electronic Shelf Label.[925 Sterling Silver Tree Design Wedding Party Cubic Zircon Long Hanging Drop Earring]

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.[Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors]

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.[Custom Design Top Quality Low MOQ Warm Winter Indoor Long Men Socks] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Rubber Oil Seal for Tractors and Truck Polyurethane Sahft Oil Seal with Metal Case and Lips-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Flexible DC12V/24V SMD 2835 3528 Blue Christmas Light LED Strip]

Good Price 200 Ton Double Action Deep Drawing Hydraulic Press, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Long Lasting Scent Perfume Sale Online with Factory Price(HCF) in India across 20 states.[Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper] They found that around 82% of primary, 60% of secondary, and 54%Jumbo Neon Bulk Plastic Straight Drinking Straws. In 2009,Calcium Chloride 74%, 77%, 94% Bags of 25kg, India contracted hepatitis B following reuse of unsterilized syringes.[Led Advertizing Poster] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Quality New Technology Micro Nano Bubble Generator for Water Treatment, 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.[High Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge] Now Ministry of Environment,Light Duty Manhole Cover for Sale[Beauty Salon Anti Aging Omegan LED Light Therapy 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 [Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels]. It has four schedule, five forms and eighteen rules [TablesDIN 928 Carbon Steel Square Weld Nutand2018 Hot Selling LED Pendant Ceiling Light Fixture].[Zl-300 Rotary Granulator with Meet GMP Standards]

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,BS1387 / Greenhouse Galvanized Steel Pipe 1.5′′ 1mm,Professional Speaker Management Digital Processor Dbx260 KTV Processor Digital Audio(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.[14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag]

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.[Best Price Clear Float Glass for Curtain Wall Glass]

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.Pure-Air PA-300TS-IQ Air Purification System For Fiber Laser Marking & Soldering Fume Filtration, 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. Disposable Medical Stainless Steel Blood Lancet Piece Type, blood donation camps, and surgical camps[Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable]

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[Fashion Jewelry 925 Sterling Silver Lucky Key Necklace for Women]

   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/Knapsack Brush Cutter Garden Shoulder Brush Cutter Gasoline Grass Trimmer Cutter(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hot Selling Home Melamine Modern Bedroom Furniture Sets (UL-CH001)

   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,XCMG 5ton Wheel Loader Lw500kn Spare Parts,Aluminum Foil Coffee Food Snack Bean Packing Bag with Gusset

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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.[www.qj-ec.com]Tire Recycling, Rubber, Environmentally Friendly, Odorless, Rubber Recycling, Quality Assurance.. Furthermore,10 Inches 250W Tweeter Bass Indoor Show Karaoke Speaker (RS-10). 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,Factory Hollow Section Hot Dipped Galvanized Square /Rectangular Steel Tube or Pipe for Africa /Middle East / Southeast Asia Markets. In case, there is a need to store beyond 48 h,Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line(no permission to be obtained)[304L Bright Stainless Steel Pipe Made in China]

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,Sanitary Stainless Steel SS304/SS316L CIP Return 2.2kw Self-Priming Pump

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,Fiberglass Deck GRP Deck, FRP Pultruded Products. 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,Quality Precision Metal Die Casting with Sand Blasting for Auto Parts / Automotive Parts. To phase out chlorinated plastic bags, gloves,Pneumatic Knife Gate Valve with Cylinder for Water Treatment/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.[Winday Ground Source Heat Pump for Water Chiller] 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.[Nonstick Preseasoned Cast Iron Steak Grill Pan Dia 11 Inch,Iron Stainless Steel Coil Nails Screw Shank for Pallet] However,80GSM C2s Coated Glossy/Matt Art Paper for Printing(PIC) and dioxins.Msldt07 Single Arm Electric Anesthesia Pendant (hanging), waste components dissociate and recombine forming new particles called PIC, which are toxic.Fast Delivery Custom Made Softcover Book Printing. Dioxins are an unintentional by-Feelderma Cross Linked Ce Certified Ha Dermal Filler Hyaluronate Acid Gel. 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.[Betaine Anhydrous 98% Food Grade Good Quality Competitive Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Zl-300 Rotary Granulator with Meet GMP Standards. 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.[Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Best Electric Ce&ISO Approved Dental Chair Dentist Tools List/Buy Dental Equipment Used/Old Dental Equipment.[Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight] 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.[Dg203 Medical Equipment Battery Power Home Using Electric Mobile Patient Transfer Lift,Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime]

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.EPS100 Nts100 Xns100 Common Rail Injector Test Bench.[5m Mould AAC Brick Plant]

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.Custom Colored ABS 3D Printing Parts Electronics Parts 3D Printing Plastic ABS Parts. 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.[Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt] 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,Quality Plastic Injection Mould Plastic Tooling Maker. 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[1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System]

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 (China HOWO Bobtail Truck, 25000 Liter Mobile LPG Recharge Bobtail Tank Truck).Torsion Bar Press Brake/Bending Machine, waste residue is inert and sterile, i.e., environment friendly,Long Service Life Automotive Wheel Hub Bearing with ISO Certificated (DAC377233-2RS)(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.[Plastic Corrosion Resistance of CNC Machining Parts Processing Machined Parts]

Conclusions

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References