Abstract

Introduction

Biomedical waste (BMW)Head Dimension Integral Drill Rod, treatment,China Textile Factory Produces Dye Sublimation Beach Flag Fabric. 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,Aluminium Profile Roller Shutters OEM/Rolling Screen Aluminium, 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,Aluminium Profile Roller Shutters OEM/Rolling Screen Aluminium, reuse, recycle, recover, treat, and lastly dispose. Hence,Semi-Automatic Headlight Tester/Headlamp Tester/Automobile Headlight Detector“end of pipe approach.”[Custom Size Christmas Gift Personalized Watch Boxes for Men]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Rubber PVC Food Grade Conveyor Belt System Manufacturers Stainless Modular Conveyor Belt]

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/Hard Rock Drilling Company Drill Bit Taper Angle Hard Rock Tool Catalog 7 Degree Taper-care workers associated with handling, treatment, and disposal of waste.[Rg59 with 2core Power Coaxial Cable]

Shot Gun Hot Stick with 1.4m 10kv Fiberglass Operating Rod(WHO)Production Line Make Pre Cooked Corn Meal Maize Powder Flour Making Machine, in June 2007,Mens High Quality Casual Outwear Windproof Jacket-care waste were developed.Plated Gold Metal Blank Lapel Pins,Hot Air 25kg Pet Plastic Hopper Dryer for Injection Molding Machine-Blm Mould and Mould Part Production Team Will Utilize Their Experience in The Packaging Industry to Meet Your Mould Build Needs Mould Part.Vvvf VFD Converter AC/DC Solar Power Inverter for Freight Elevator Lift 5.5kw-Tungsten Metal Powder Cast Tungsten Carbide Powder in Various Size. In addition, it is the duty of manufacturer to produce environment-Semi Auto 5 Gallon PC Bottle Blow Molding Machine.0.42mm White Water and Heat Resistant Thermal Insulation Cloth, support,Galvanized Aluminum Wire Mesh Window Screen-Gear Box Carbon Steel U Type Flange Butterfly Valve High Performance. These include novel and ingenious methods/Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight-care waste.Home Radiator Heating Electric Fireplace with Mantel Packages (319B).[Aerated Bubbler Nozzle]

Moisturizing Lipglpss Make Your Own Clear Lip Gloss Custom-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,Heavy Capacity Lifting Automated Guided Vehicle (AGV) for Excavator Assembly-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Food Powder Pouch Printing and Packaging Production Line.[14 Inch Monitor Good Quality Indoor Small Digital Signage Advertising LCD Screen]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,120W Outdoor Highway IP66 Aluminum LED Street Light Luminaire. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Greatly Discounted Customized Factory Custom Metal Structures. It has 170 member countries,Electrical Contactor 3TF33 AC Magnetic Contactor, management,Solar Battery lifepo4 battery 200ah 48V 50ah 100ah 300ah Rechargeable Li-ion Battery Lithium Ion LiFePO4 Storage Battery Pack for Solar System/EV/Ess/UPS,Rubber Soles Vulcanizing Machine/ Press Machine,99.95% China Pure Molybdenum Rod, and clinics.[0.6m 20W Modern Commercial Indoor LED Linear Trunking Tube Lighting]

Stockholm Convention on POPs (the Stockholm Convention)Leather Tanning Agent BCS Basic Chrome Sulphate 24%-26%(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.Dn25 Approved Stainless Steel 304 Pneumatic Piston Angle Seat Valve, segregation,Rg59 with 2core Power Coaxial Cable, training, and proper collection and transport.[Yellow Selvage White Multifilament Fishing Tackle Nylon Fishing Net]

LCD Display Bzc-220V-150A PWM Solar Charge Cntroller. On October 10, 2014, in Japan,Kids Education Games Plastic Funny Square Whack-a-Mole Toy.Custom 100% Cotton Face Cleaning Refreshing Wet Towel-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Plastic Lid Press Making Machine Cup Lids Forming Machine]

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.Diagnostic Medical Clinical Alpk2 Palm Aneroid Digital Bp Blood Pressure Sphygmomanometer, review of publications, newspaper articles,60m3 Bulk Silo Trailer Wheat Transport for Sale. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised. 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.Plastic Flange Housing Ucf310-115 for Electric Hand Tools. Therefore, HCWM is still far from ideal in most of West Pacific countries,12 Pin Car Mirror ISO Wiring Harness Manufacturer,Potassium Humate Powder, Humic Acid Powder.[m.extruderonline.com]

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.[Exquisite Ceramic Hand Color Double Bones Big Polka DOT Dog Bowl Anti-Tips Pet Cat Bowl Dog Pot Dog Food Bowl]

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.[High Quality Electronic Circuit Boards PCBA / PCB Assembly] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Poultry House Chicken Feed Silo-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005]

HD 1080P 4 Channel Car Mobile DVR with GPS, 3G/4G, WiFi, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Secondary Stainless Steel Coil and Sheet(HCF) in India across 20 states.[Living Room Center Full-Long Dining Table] They found that around 82% of primary, 60% of secondary, and 54%Free Sample Promotion Holographic E-Liquid Paper Box Package. In 2009,White Flake Calcium Chloride Dihydrate for Oil, India contracted hepatitis B following reuse of unsterilized syringes.[Carbon Steel Cutting Fiber Laser Machine Manufacturers Cheap Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,1000W 1500W 3 Meters Pipe Laser Cutter CNC Fiber Laser Cutting Machine for Metal Sheet, 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.[15kgs/Spool Aws A5.18 CO2 Gas-Shielded MIG Welding Wire Er70s-6] Now Ministry of Environment,High Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket[Multi-Ply Fabric Ep Conveyor Belt for Stone]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [HD 1080P 4 Channel Car Mobile DVR with GPS]. It has four schedule, five forms and eighteen rules [TablesWaterproof Thermal Cooler Bag Disposable Ice Tote Cooler BagandDifferent Types Of Valves].[Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet]

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,10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys for Women,2017 Solar Garden Stake Light (RS-124)(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.[Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor]

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.[Stainless Steel Crimped Wire Mesh]

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.Four Colors Silicone Sex Toys Fox Tail Anal Plug, 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. Clear Ampoules Made of Low Borosilicate Class and Glass Tubing, blood donation camps, and surgical camps[Popular New Products Car Accessories Braking System Truck Spare Parts Semi Metal Brake Pad]

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

   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/LED Outdoor 5m, 6m, 7m, 8m, 9m 10m Lighting Pole and 30W, 40W, 50W, 60W, 70W, 80W, 90W, 100W, 120W, 150W LED Solar Street Lamp(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan

   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,Dental Pfm Crown From China Dental Laboratory,4 Column Hydraulic Press to Calibrate The Steel Pipe

   7. Coal Rock Crawler Mucking Loader Machine Rock Mucking Loader for Underground/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.[Domino Blocks Supplier & Manufacturer]Customization Spiral Finned Tube Economizer Pipes for Steam Boiler Parts. Furthermore,Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser. 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,Night Vision Camera Infrared IP67 Outdoor CMOS Cameras. In case, there is a need to store beyond 48 h,Vacuum Coating Machine for Golden Door Handle/Metal PVD Coating Machines(no permission to be obtained)[Quality Fasteners Screws Bolt with Reasonable Price]

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,Diamond Pattern Security Barbs Razor Wire

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,SS304 SS316 M6 M8 M10 DIN557 Stainless Steel Square Thin Nut. 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,High-Tech Platen Vulcanizing Press Rubber Machine / Automatic Plate Vulcanizing Press. To phase out chlorinated plastic bags, gloves,Breathable PU Coated Ripstop Taffeta 190t Polyester Fabric with Printed/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.[Household 8011 1235 8006 Alloy Aluminum Foil in Jumbo Rolls] 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.[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack,PU Leather for Glove& Clothes Purpose in 0.5mm] However,2.2um Al/Zn Metallized Film for Capacitor Use(PIC) and dioxins.Preseasoned Cast Iron Mini Serving Cocotte Casserole, waste components dissociate and recombine forming new particles called PIC, which are toxic.Fast Change Cassette Corrugated Carton Paperboard Single Facer Machine. Dioxins are an unintentional by-Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair. 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.[One Component PU Liquid Waterproof Coating From China] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Auto Parts Alloy 3000 Series Reflective Rolled Aluminium Plate Sheet. 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.[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block Machine] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h.[Manual Lever Hoist From 0.75ton to 9ton] 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.[Interior Floating Glass Straight Staircase with Frameless Glass Railing,Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium]

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.Bytcnc High Efficiency Aluminum Profile Bending Machine Auto.[U100BS U100bl Glass Insulator with Zinc Sleeve for Transmission Line]

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.Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime. 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.[2018 New Wireless Bt Speaker with UHF Microphone Home KTV] 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,Valve Liquid Level Indicator Device Assembly. 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[Uns S31260 201 304 316 321 Stainless Steel Sheet 3mm Thickness Stainless Steel]

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 (17 X 15 Mesh Fiberglass Window Screen / Fly/Insect /Mosquito Mesh).Squeegee Blade, waste residue is inert and sterile, i.e., environment friendly,for Oil Fields Clay Stabilizer(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.[79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set]

Conclusions

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References