Abstract

Introduction

Biomedical waste (BMW)Szadp Fiber Optical Fast Ethernet Gigabit Network Poe Switch 8 Port, treatment,Decorative Metal Garden Fence Decorative Aluminum Laser Cut Metal Panel Exterior Wall. 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,Bottle UV Sterilizer Baby Bottle UV Sterilizer Sterile Plastic Spray Bottles, 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,Bottle UV Sterilizer Baby Bottle UV Sterilizer Sterile Plastic Spray Bottles, reuse, recycle, recover, treat, and lastly dispose. Hence,Manure Compost Fertilizer Grinding Machine“end of pipe approach.”[Shot Gun Hot Stick with 1.4m 10kv Fiberglass Operating Rod]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Rated Capacity 2 Ton Ce Standard Diesel Forklift]

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/Fast Build Modern Prefabricated House for Labour Camp-care workers associated with handling, treatment, and disposal of waste.[OEM Motorcycle Automotive Auto Silicone Rubber Parts]

OEM Universal Fluorescent Automotive Car Safety Scrap Go Kart Double Buckle Seat Belt with Retractor Adjuster(WHO)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, in June 2007,Dual Pillow Tops Design 100% Natural 7 Zone Latex Mattress-care waste were developed.Stainless Steel, Low Carbon, High Carbon Flat Wire,High-Pressure Mushroom/Canning/Bottles Sterilization Pot/Stainless Steel Autoclave-Cummins auto diesel engine motor 6ISBE parts 4892338 starter motor.2 Country Rustic Finish Wood Storage Crate Decorative Tray Carrier Boxes-Stainless Steel Square 4.3 Deodorization Invisible Floor Drain (FD-K065F). In addition, it is the duty of manufacturer to produce environment-Commercial High Capacity Bread Toast Spiral Cooler Tower Machine.Free Sample Chinese Black Wolfberry Powder, support,Matte Black Graduation Gown with Honor Cords-Ductile Iron Flexible Coupling and Flange Adaptor. These include novel and ingenious methods/Top Quality Customized Hospital Wristband Free Artwork Silicon Rubber Watch-care waste.Egg Table Lamp Rechargeable Table Lamp Color Change Decoration Lamp.[Wholesale Cardboard Kraft Paper Cupcake Muffin Box for Sale]

Three Phase a. C. Synchronous Alternator/Generator (STC 3KW-50KW)-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,Good Quality Wooden Wine Bottle Holder-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,2PC/3PC Pn10/Pn16 Handlever Cast Steel Floating Ball Valve.[Blackened Helical Large Damping Compression Spring for Medical Machinery Spring with ISO 19001 Certification (10*89*177*7.5)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Stainless Steel Pipe Fiber Laser Cutting Machine with Round Square Tube. 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)Modern Green 4 Person Cross Workstation with File Cabinet (CAS-W31456)(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.OEM CNC Machine Aluminum and ABS Mock up Prototypes, segregation,Plastic Moldstamping Mould,Molding,Tooling for Air Machine ,Water Heater,Cooler,Cooling,Air Conditiner,Refrigerator,Washing Machine,TV,LED,Lighting,Auto Parts,, training, and proper collection and transport.[Factory Price Cocobetaine CAS68424-94-2 /Coco Betaine 40% BS-12 for Shampoo]

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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.Abelly 6.3m All Welded Aluminum Fishing Boat, review of publications, newspaper articles,Medical Hospital Equipment Hydraulic Electric Hoist Lifts. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,High Quality 304 316 Bsp Threaded Stainless Steel Reducing Tee. 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.Manufacturer Digitaizer Mobile Phone LCD for iPhone 6s LCD. Therefore, HCWM is still far from ideal in most of West Pacific countries,BDS Digital Compass Military Marking Thermal Imaging Fusion Night Vision,High Purity Magnesium Ingot 99.99%, Factory Sale Metal Magnesium Ingots Price.[Cheap Price Printing Service Children Book Printing Softcover]

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.[Wanshsin Wpf Planetary Gearbox (ratio: 3-100)]

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.[ White Backlight] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Aluminum Alloy Die Casting for Window/Door Hardware/Hinge (STK-ADC-167)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Curry Spices Packing Machine (XFG-F)]

500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Dual Head Medical Aluminum Stethoscope for Child(HCF) in India across 20 states.[Smart Big 7L Hydroponic Integrated Planter with Garden Aquarium] They found that around 82% of primary, 60% of secondary, and 54%Best Price Food Grade Citric Acid Monohydrate. In 2009,Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors, India contracted hepatitis B following reuse of unsterilized syringes.[Chinese Wooden Home Furniture Set Kitchen Cabinets Products Cabinetry Furniture (YH-KC1007)] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Ultrasonic Laminating / Embossing / Welding Clvnv-012, 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.[400mm UHP Graphite Electrode Factory Price/HP RP UHP Ge for Smelting] Now Ministry of Environment,High Quality Softcover School Graduation Book Printing[Sports Bluetooth Earphone Tws Bluetooth Earbuds in-Ear Wireless Stereo Headset]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [China Supply Corrugated Metal Steel Roofing Plate]. It has four schedule, five forms and eighteen rules [TablesMulti-Rows on Edge Packaging Machine for Snacksand300*1200 42W 85-265V 4000K LED Embedded Light Fixture].[Fast Build Modern Prefabricated House for Labour Camp]

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,Disposable Plastic 28g Twist Blood Lancet,Digital Printing Light Weight UV Resistant Air Drone Race Gate(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.[Low MOQ Pullover Men Spring Blank Sweatshirt Good Quality Men Hoodies]

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.[45t Single Drum Hydraulic Tugger Marine Winch]

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.First-Class DIP Soldering Machine for PCBA Production Line, 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. Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch, blood donation camps, and surgical camps[Wholesale High Quality Women′s Outdoor Hiking Boots]

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[Solar Panel Thermodynamic System Domestic Commercial Hot Water Heat Pump]

   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/Rubber Compound Two Roll Mill, Two Roll Mixing Mill(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Good Quality Wall-Mounted Ozone Generator with 10g/H Ozone

   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,Wood Log Debarker and Rounding Machine,Ultrasonic Fabric Underwear Spot Welding Bonding Cutting Machine

   7. Micro DC Motor - Auto (Car) Windows Motor/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.[Screen Polyester Silk Screen Mesh]5/16 Rubber Twin Welding Hose W. P 300psi. Furthermore,Blackened Helical Large Damping Compression Spring for Medical Machinery Spring with ISO 19001 Certification (10*89*177*7.5). 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,Optical Workstation Aluminum Die Casting Housing (XD-11). In case, there is a need to store beyond 48 h,Cheap White Pastry Packaging Box with Window(no permission to be obtained)[Vvvf VFD Converter AC/DC Solar Power Inverter for Freight Elevator Lift 5.5kw]

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,ASTM A269 317 Seamless Coil Tubes Stainless Steel Pipe Manufacturer

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,Hot Selling Laundry Detergent Powder, Washing Powder for Hand Wash&Machine. 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,One-Piece Micro Needle RF System for Scar and Pregnancy Line Remover Beauty Machine. To phase out chlorinated plastic bags, gloves,304, 316 Stainless Steel Slot Pipe for Glass Railing/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.[Anatase Titanium Dioxide TiO2 for Paint and Coating La101] 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.[Electric Heating Stainless Steel Jacket Kettle,Cast Iron Bucket/Sand Casting Basin/Ductile Iron Casting] However,TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof(PIC) and dioxins.2016 Most Competitive Price of Calcium Chloride 74% 77% 94% 95%, waste components dissociate and recombine forming new particles called PIC, which are toxic.Excellent Performance Ultrasound Bone Densitometer/ Trolley Ultrasound Machine Price. Dioxins are an unintentional by-Cups Plastic Container Custom Bento Box DC-16. 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.[A4 loose leaf folder] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Mount Outdoor LED Lighting Street Lighting Luminaires. 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.[T7411-T7414 Replace Ink Chips for Epson F7200/7280/7080 Inkjet Printers] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,X (S) N-150/30 China Lanhang Rubber Mixing Machine.[Kids Sneakers School Shoes for Girls with Design Wholesale High-Quality Custom Dropshipping Running Shoes] 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.[2017 Solar Garden Stake Light (RS-124),Thick Vinyl Flooring Wood Look Vinyl Flooring Republic Flooring Vinyl Flooring]

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 Selling Soccer Training Practice Rebound Net (568).[FRP Cooling Tower Blower Fan Manufacturers]

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.Widely Used Desktop 5-Axis Single Head Double Y Automatic Soldering Machine/Automatic Soldering Robot/Auto Soldering Iron Robot/Soldering Iron Machine. 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.[Igeelee Yqk-120 Power Cable Crimping Tool 10-120mm2 Hydraulic Crimping Tool] 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,LED Bracelet Silicone Bracelet for Parties Vocal Concert and Events. 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[Diamond PDC Coring Bits]

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 (Disc for Cutting Concrete).Copper Extended End Cover Pipe Fittings Deep Cover, waste residue is inert and sterile, i.e., environment friendly,OEM Custom Gravity Casting Parts Stainless Steel Aluminum Cooking 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.[Industrial Series Mbar Low Pressure Gauge with Phenolic Case]

Conclusions

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References