Abstract

Introduction

Biomedical waste (BMW)Bottle UV Sterilizer Baby Bottle UV Sterilizer Sterile Plastic Spray Bottles, treatment,Manure Compost Fertilizer Grinding Machine. 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,Fast Build Modern Prefabricated House for Labour Camp, 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,Fast Build Modern Prefabricated House for Labour Camp, reuse, recycle, recover, treat, and lastly dispose. Hence,OEM Universal Fluorescent Automotive Car Safety Scrap Go Kart Double Buckle Seat Belt with Retractor Adjuster“end of pipe approach.”[Custom Design Top Quality Low MOQ Warm Winter Indoor Long Men Socks]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Flexible DC12V/24V SMD 2835 3528 Blue Christmas Light LED Strip]

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/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-care workers associated with handling, treatment, and disposal of waste.[Vegetable Cutter Kitchen Gadget 330ml Mini Size Handy Pull Chopper]

Dual Pillow Tops Design 100% Natural 7 Zone Latex Mattress(WHO)Stainless Steel, Low Carbon, High Carbon Flat Wire, in June 2007,High-Pressure Mushroom/Canning/Bottles Sterilization Pot/Stainless Steel Autoclave-care waste were developed.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).Commercial High Capacity Bread Toast Spiral Cooler Tower Machine-Free Sample Chinese Black Wolfberry Powder. In addition, it is the duty of manufacturer to produce environment-Matte Black Graduation Gown with Honor Cords.Ductile Iron Flexible Coupling and Flange Adaptor, support,Top Quality Customized Hospital Wristband Free Artwork Silicon Rubber Watch-Egg Table Lamp Rechargeable Table Lamp Color Change Decoration Lamp. These include novel and ingenious methods/Three Phase a. C. Synchronous Alternator/Generator (STC 3KW-50KW)-care waste.Good Quality Wooden Wine Bottle Holder.[Silver Plated Copper House Wire]

2PC/3PC Pn10/Pn16 Handlever Cast Steel Floating Ball Valve-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,Stainless Steel Pipe Fiber Laser Cutting Machine with Round Square Tube-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag.[High Effecient Mini Ozone Fridge Sterilizer for Cleaning Fridge]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Brightness P10 Outdoor Green Color LED Display of Outdoor. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Digital Smart Sensor Body No Contact Infrared Radiation Thermometer. It has 170 member countries,High Quality Enamel Camping Set Tableware Set Food Container Dinner Set Bowl Plate Dish Mug Cup Dinnerware Party Supplies, management,Humizone Ultra Potassium Humate Leonardite Source Foliar Fertilizer,Modern Green 4 Person Cross Workstation with File Cabinet (CAS-W31456),OEM CNC Machine Aluminum and ABS Mock up Prototypes, and clinics.[Beauty Salon Anti Aging Omegan LED Light Therapy Machine]

Stockholm Convention on POPs (the Stockholm Convention)Plastic Moldstamping Mould,Molding,Tooling for Air Machine ,Water Heater,Cooler,Cooling,Air Conditiner,Refrigerator,Washing Machine,TV,LED,Lighting,Auto Parts,(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.Advertising Exhibition Floor Metal Frame Display Rack Banner Poster Stand, segregation,Hot Sale Supermarket Chiller Supermarket Cooler with Ce Certificate, training, and proper collection and transport.[Stage Light Copy Robe Pointe 10r 280W Beam Spot Wash Moving Head Light 16 and 24 DMX Channels]

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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.High Quality 304 316 Bsp Threaded Stainless Steel Reducing Tee, review of publications, newspaper articles,Manufacturer Digitaizer Mobile Phone LCD for iPhone 6s LCD. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,BDS Digital Compass Military Marking Thermal Imaging Fusion Night Vision. 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.High Purity Magnesium Ingot 99.99%, Factory Sale Metal Magnesium Ingots Price. Therefore, HCWM is still far from ideal in most of West Pacific countries,Aluminum Alloy Die Casting for Window/Door Hardware/Hinge (STK-ADC-167),500mm Coil Diameter Hot-Dipped Galvanized Concertina Flat Wrap Razor Wire.[Board Cnc Engraving Machine]

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.[Zl-300 Rotary Granulator with Meet GMP Standards]

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 Flake Calcium Chloride Dihydrate for Oil] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Dual Head Medical Aluminum Stethoscope for Child-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Acrylic Non-Woven Fabric for Dust Collection Filter Bag]

Best Price Food Grade Citric Acid Monohydrate, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Finks 41 Inch Spruce Sapele Folk & Acoustic Guitar Many Colors(HCF) in India across 20 states.[Different Size Free Sample Biodegradable Paper Guava Bags for Fruits Against Insects] They found that around 82% of primary, 60% of secondary, and 54%Ultrasonic Laminating / Embossing / Welding Clvnv-012. In 2009,High Quality Softcover School Graduation Book Printing, India contracted hepatitis B following reuse of unsterilized syringes.[2mm Fiber Lens for Laser Cutting Machine] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Disposable Plastic 28g Twist Blood Lancet, 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.[14 Colors Tactical Military Backpack Molle Camo Camping Hiking Bag] Now Ministry of Environment,Digital Printing Light Weight UV Resistant Air Drone Race Gate[Best Price Clear Float Glass for Curtain Wall Glass]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Downlight IP65 8W CCT Changeable Fire Rated LED Down Light with Bezel Changeable]. It has four schedule, five forms and eighteen rules [TablesFashion Jewelry 925 Sterling Silver Lucky Key Necklace for WomenandApi Standerd Drill Pipe].[304L Bright Stainless Steel Pipe Made in China]

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,First-Class DIP Soldering Machine for PCBA Production Line,Outdoor Portable Insulated Thermal Tote Cooler Bag for Lunch(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.[Plastic Extruder Machine 16mm-800mm Water Conduit Drainage PVC Pipe Extrusion Line]

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.[Dimmable White Silver Shell Shouing Ceiling Lamp 15W LED Downlight]

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.Rubber Compound Two Roll Mill, Two Roll Mixing Mill, 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

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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[Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime]

   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/Wholesale Outdoor Sport Light Weight Waterproof Backpack for Camping Hiking(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Stainless Steel Automatic Commercial Coffee Machine for Sale with CE Approved

   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,Micro DC Motor - Auto (Car) Windows Motor,5/16 Rubber Twin Welding Hose W. P 300psi

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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.[m.neodermalfiller.com]Optical Workstation Aluminum Die Casting Housing (XD-11). Furthermore,Cheap White Pastry Packaging Box with Window. 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,ASTM A269 317 Seamless Coil Tubes Stainless Steel Pipe Manufacturer. In case, there is a need to store beyond 48 h,Hot Selling Laundry Detergent Powder, Washing Powder for Hand Wash&Machine(no permission to be obtained)[Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt]

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,Unique Die Cut Coloring Hard Cover Kids Board Comic Alarm Clock Book Printing China

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,Polyester Cup Holder with Customer Design Shape and Logo. 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,TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof. To phase out chlorinated plastic bags, gloves,2016 Most Competitive Price of Calcium Chloride 74% 77% 94% 95%/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.[1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System] 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.[Plastic Corrosion Resistance of CNC Machining Parts Processing Machined Parts,Flex Rigid PCB Printed Circuit Board with High Technology] However,Excellent Performance Ultrasound Bone Densitometer/ Trolley Ultrasound Machine Price(PIC) and dioxins.Cups Plastic Container Custom Bento Box DC-16, waste components dissociate and recombine forming new particles called PIC, which are toxic.Mount Outdoor LED Lighting Street Lighting Luminaires. Dioxins are an unintentional by-X (S) N-150/30 China Lanhang Rubber Mixing Machine. 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.[Desk Cutting Plotter] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Best Selling Soccer Training Practice Rebound Net (568). 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.[Outdoor Full Printed Folding Gazebo Canopy Tent for Promotion Event] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Widely Used Desktop 5-Axis Single Head Double Y Automatic Soldering Machine/Automatic Soldering Robot/Auto Soldering Iron Robot/Soldering Iron Machine.[Automotive Industry Machine by Sonic Welding Equipment] 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.[Diamond Circular Granite Saw Blades for Masonry Cutting,HDMI Cable Support 3D 4K and 2160p High Speed HDMI Cable with Ethernet]

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.LED Bracelet Silicone Bracelet for Parties Vocal Concert and Events.[cnmirant]

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.Disc for Cutting Concrete. 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.[One-Piece Micro Needle RF System for Scar and Pregnancy Line Remover Beauty Machine] 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,Copper Extended End Cover Pipe Fittings Deep Cover. 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[Biodegradable Disposible Straw Pulp Food Box Ppp-1007]

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 (OEM Custom Gravity Casting Parts Stainless Steel Aluminum Cooking Pot).4 Wire Diesel Glow Plug Wiring Harness Fits VW Golf Jetta Beetle 1.9L Tdi Diesel Tdi, waste residue is inert and sterile, i.e., environment friendly,ABS Professional Parts Making Quality Plastic Injection Mould(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.[Multi Functional Professional Long Nose Plier]

Conclusions

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References