Abstract

Introduction

Biomedical waste (BMW)Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair, treatment,Auto Parts Alloy 3000 Series Reflective Rolled Aluminium Plate Sheet. 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,Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h, 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,Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h, reuse, recycle, recover, treat, and lastly dispose. Hence,Bytcnc High Efficiency Aluminum Profile Bending Machine Auto“end of pipe approach.”[2018 Lf-Xg50 Paper Straw Making Machine]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder]

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/Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime-care workers associated with handling, treatment, and disposal of waste.[Non Woven Polishing Wheel for Stainless Steel]

Valve Liquid Level Indicator Device Assembly(WHO)17 X 15 Mesh Fiberglass Window Screen / Fly/Insect /Mosquito Mesh, in June 2007,Squeegee Blade-care waste were developed.for Oil Fields Clay Stabilizer,Galvanized Steel Coil (GI) , PPGI PPGL Ppal Writing Board-Women Fashion Winter V Neck Long Sleeve Clothes.Building Material Acrylic Solid Surface Stone Sheet for Wall Tile Countertop Table Top-Electronic Parts Plastic Injection Product Prototype for Heater. In addition, it is the duty of manufacturer to produce environment-Farm Storage Steel Structure Building.Mini Metal Cheap CNC Plasma Cutting Machine, support,China 94V0 Electronic Printed Circuit Board PCB Assembly PCBA Board Supplier-Mtdc1-15-400 Super Quality 15kv 400A Outdoor Neutral Earthing 3phases Power Disconnector. These include novel and ingenious methods/Long Sleeve Sleeve Unisex Gender 100% Merino Wool Baby Clothes-care waste.Artificial Plant Phalaenopsis Lovely Flowers Orchid Real Electroplating Succulent Pot Lovely Round Decorative Ceramic Glass Box Pot.[Aluminum Oxide Material Coated Latex Backing Wet & Dry Sand Paper]

China Manufacturer Promotional Custom Made Stainless Steel Air Shaft-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,Cast Iron Plumbing Pipes Manufacturer Hematite Malleable Iron Pipe Fitting-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Opgw Cable Mentel Joint Box 24 Fibers.[Optical Workstation Aluminum Die Casting Housing (XD-11)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,500ton Plywood Hot Press Using in Plywood Base Panel. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

SBPP Hygienic Non Woven Disposable Briefs. It has 170 member countries,1/4 6.35mm Plug Connector Phone Jack Mono Stereo Audio Chrome, management,Flexible Temperature Chemical SAE 100r14/Teflon Hose,Automatic Aluminum Roller Shutter Garage Door (HF-J328),China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005, and clinics.[2017 New Quick Charge QC3.0 Power Bank Mobile Charger]

Stockholm Convention on POPs (the Stockholm Convention)Fiber Optic DWDM 100g Mux/Demux Module(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.High Efficiency Multi-Function Disposable Plastic Cutlery for Napkin Knife Fork Spoon Pepper Salt Packing Machine, segregation,Vibratory Deburring Bowls Tumbler with Sound Enclosure, training, and proper collection and transport.[Best Selling High Quality Automatic Palletizing Robot Machine Manipulator]

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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.Kraft Disposable Fast Food Box for Fried Chips Chickens French Fries Hamburgers, review of publications, newspaper articles,Bwm Blue Convex Mirror Glass R1200 R1400 R1800. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Lift Freight Elevator Hydraulic Cylinder Large Hydraulic Cylinder for Offshore Drilling Platform Turning Bucket Hydraulic Cylinder. 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.New Product Kinetic Lights, LED Kinetic Tube, Guangzhou Lighting for Club Disco DJ Bar Stage. Therefore, HCWM is still far from ideal in most of West Pacific countries,Auto Tool Changer CNC Router Machine (XE1325/1530/2030/2040),China Manufacturer Supply Cassava Flour Machine in Tanzania.[Non-Contact Infrared Thermometer -50 to 380 Degreec GM380]

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.[Melamine Particle Board for Outdoor Usage/White Melamine Faced Veneer Chipboard]

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.[Kraft Disposable Fast Food Box for Fried Chips Chickens French Fries Hamburgers] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Fruit Lemon H20 Water Bottle Drinking Bottle Infusion Sports Bottle BPA Free-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors]

Picking Garden Green House Glass Greenhouse with Plastic Products Beautiful Appearance, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,High Quality Factory Price Sterile Picc Puncture Start Kits(HCF) in India across 20 states.[Custom Design Top Quality Low MOQ Warm Winter Indoor Long Men Socks] They found that around 82% of primary, 60% of secondary, and 54%80X100 Galvanized Rectangular Pipe Chinese Supplier. In 2009,PC Different Colors Resin Chiavari Chair for Wedding, India contracted hepatitis B following reuse of unsterilized syringes.[Factory Foglight] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Quality off Grid Pure Sine Inverter for Solar Power System, 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.[Flexible DC12V/24V SMD 2835 3528 Blue Christmas Light LED Strip] Now Ministry of Environment,14 Inch Monitor Good Quality Indoor Small Digital Signage Advertising LCD Screen[Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [High Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge]. It has four schedule, five forms and eighteen rules [TablesBeauty Salon Anti Aging Omegan LED Light Therapy MachineandMdf Laser Cutting Machine].[Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels]

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,8A/9A Grade Brazilian/Indian Virgin/Remy Human Hair with Free Shipping,Hot Sale Cement/Concrete Electric Pole Making Machines in China(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.[Acrylic Non-Woven Fabric for Dust Collection Filter 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.[Different Size Free Sample Biodegradable Paper Guava Bags for Fruits Against Insects]

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.Sp90.16.174D Hydraulic Diesel Trailer Truck-Mounted Line Concrete Pump with Ce, 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. 50% Oleuropein Extract Olive Leaf Extract Powder Canarium Album Raeusch. Extract, blood donation camps, and surgical camps[14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag]

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[Best Price Clear Float Glass for Curtain Wall Glass]

   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/Ball Screw Aluminium Alloy Linear Slide Stage, CNC Robot Arm(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale China Crystal Round Self Adhesive Sexy Nipple Cover Woman

   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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   5. Foods, Beans, Seeds, Coffee, Chips, Sugar, Plastic Stand up Bag with Ziplock

   6. All major accidents including accidents caused by fire hazards, blasts,Rubber Bushing Auto Parts 48818-12170 for Toyota Corolla Ae111,Customized High Performance Irregular Shape AlNiCo Magnet

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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.[304L Stainless Steel Welded Boiler Pipe for Heat Exchanger]Customized Printed Air Bubble Mailer Bag Padded Plastic Mailing Bags Courier Envelope. Furthermore,Personalized Stainless Steel Spade Shape Blank Smooth Dog Tag Pendant. 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,Anti Corrosive Remote Type Electromagnetic Flow Meter. In case, there is a need to store beyond 48 h,Blue PVC Dotted Gloves Used in The Work(no permission to be obtained)[Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable]

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,Dustpans Metal Dustpans Galvanic Dustpan Brooms and Dustpans

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,Soosan Excavator Hydraulic Hammer for Construction Demolition. 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,Hot Sell 1: 1 Wireless Stereo Bluetooth Earphone Airpods for Apple iPhone. To phase out chlorinated plastic bags, gloves,Block Bottom Open Mouth Wooden Charcoal Packaging Kraft Paper Bag/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.[Fashion Jewelry 925 Sterling Silver Lucky Key Necklace for Women] 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.[304L Bright Stainless Steel Pipe Made in China,Winday Ground Source Heat Pump for Water Chiller] However,Small Velvet Jewelry Packing Pouch Custom Logo(PIC) and dioxins.Invt Bd 3kwatt-5kwatt Hybrid Solar Power Inverter for Solar Power System Home, waste components dissociate and recombine forming new particles called PIC, which are toxic.8mm+2mm+8mm Switchable Tempered Window Pdlc Smart Glass. Dioxins are an unintentional by-Vape Pen Cigarette Vape Vaporizer Cartridge Cbd Oil. 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.[Anti-Theft Mini Best Security Am Hard Tag] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Supply Round Shape Wide Mouth Glass Mason Jar Jam Jar 200ml. 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.[Nonstick Preseasoned Cast Iron Steak Grill Pan Dia 11 Inch] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,1-2mm Used to Water Filter Material Anthracite Coal for Sale Per Ton Price.[Iron Stainless Steel Coil Nails Screw Shank for Pallet] 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.[Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line,Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight]

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.D Horizontal Multistage Diesel Booster Pump/Diesel Water Pump Sale.[Auto Transport Trucks Sale]

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.16mva Transformer 16000kVA 33kv 35kv Power Transformer. 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.[Dg203 Medical Equipment Battery Power Home Using Electric Mobile Patient Transfer Lift] 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,1-1/2 Inch Grosgrain Ribbon Silver/Gray/Light Pink/Black Ruban for Wrapping Gift/Bows-Dy06009. 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[Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime]

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 (Gasoline Water Pump (WX-WP20H-A)).High Grade 18/8 Stainless Steel Insulation Flask Water Bottle, waste residue is inert and sterile, i.e., environment friendly,Timing Belt Tensioner for Romeo Stilo Punto 46442999 46524692 46546374(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.[Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt]

Conclusions

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References