Abstract

Introduction

Biomedical waste (BMW)Vp-0100 Intelligent Electric Valve Actuator Rotary Valve Motorized Actuator Low Torque Actuator for Ball Valve Butterfly Valve Quarter Turn Electric Actuator, treatment,Hospital Bracelets Watch for Patient Fashion Stainless Steel Free Sample. 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,OEM EPDM/NBR/Butyl/Nr/Cr/Viton/Silicone Custom Molded Rubber Parts, 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,OEM EPDM/NBR/Butyl/Nr/Cr/Viton/Silicone Custom Molded Rubber Parts, reuse, recycle, recover, treat, and lastly dispose. Hence,Diamond PDC Coring Bits, Rock Drilling Tools“end of pipe approach.”[Plastic Lid Press Making Machine Cup Lids Forming 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.[Exquisite Ceramic Hand Color Double Bones Big Polka DOT Dog Bowl Anti-Tips Pet Cat Bowl Dog Pot Dog Food Bowl]

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/Flying CO2 Laser Marking Machine with Red Locating System-care workers associated with handling, treatment, and disposal of waste.[High Quality Electronic Circuit Boards PCBA / PCB Assembly]

New IP65 100W UFO LED Highbay Light with UL Dlc(WHO)Solar Panel Thermodynamic System Domestic Commercial Hot Water Heat Pump, in June 2007,Good Performance Low Cost Skip Type Concrete Batching Plant Hzs25-care waste were developed.Pre-Galvanized Steel Pipe / Threaded Conduit Gi Pipe 1 1/4 Inch,Sequin Appliques Rainbow 5mm Adhesive Sticker Felt Shapes Circles Felt-HDMI Cable Support 3D 4K and 2160p High Speed HDMI Cable with Ethernet.Injection Molding Screw Types/ Plastic Mold Components-24V 300ah Lithium Battery Energy Storage Battery Li-ion High Power Battery LiFePO4 Battery UPS Battery Power Supply Rechargeable Lithium Iron Phosphate Battery. In addition, it is the duty of manufacturer to produce environment-Full Automatic 2000kghr Oil Fired Boiler.Construction Scaffolding Galvanized Steel Pipe (Gi Pipe), support,Cast Iron Wafer Butterfly Valve with Two Holes-Low Price Concertina Razor Barbed Wire Cbt-65. These include novel and ingenious methods/Fireproof 3732 Grey Color Silicone Rubber Coated Fiberglass Fabric-care waste.2019 Anti-Scratch Wooden Look Interlocking Click PVC Vinyl Floor Spc Flooring for Home.[Endoscopy Ceiling Pendant]

2/3/5/10ml Plastic Airless Perfume Bottle with Fine Mist Sprayer-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,China Hydraulic Factory Rubber Hose Tube Fittings From Ningbo City-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,SKF Double Row Angular Contact Ball Bearing 3204/3205/3206/a/Atn9/2z 2RS1/Tn9/Ztn9/Mt33/C3.[China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Quality Hotel Mini Bar Fridge Refrigerator with Solar Energy. 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)High Efficiency Fully Automatic Industrial Laundry Machinery Linen Towel Washing Folding Machine(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.Animal Manure Compost Organic Fertilizer Granular Machine with Ce, segregation,Winter Colorful Cute Fur Unicorn Slipper Shoes for Home, training, and proper collection and transport.[15kgs/Spool Aws A5.18 CO2 Gas-Shielded MIG Welding Wire Er70s-6]

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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.Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring, review of publications, newspaper articles,Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Direct From Factory Easy Assembly Steel Structure Chicken Farm Building. 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.Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2). Therefore, HCWM is still far from ideal in most of West Pacific countries,6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line,Right Angle Worm Gearbox for Food and Beverage and Packaging Machines.[Side Entry 6p Rj11 Connector]

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.[HD 1080P 4 Channel Car Mobile DVR with GPS]

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.[Waterproof Thermal Cooler Bag Disposable Ice Tote Cooler Bag] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Climatic Cycling Stability Testing Chamber Temperature Humidity Cabinet]

Tassel and Cross Pendant Earrings Charming 925 Silver Earrings, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Fashion Floral Red Fabric Headband for Women Accessories(HCF) in India across 20 states.[Private Label Lip Pluming Gloss Organic Lip Gloss Waterproof Lip Gloss] They found that around 82% of primary, 60% of secondary, and 54%Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence. In 2009,2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle, India contracted hepatitis B following reuse of unsterilized syringes.[Thermocouples For Sale] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa, 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.[Hot Selling Laundry Detergent Powder] Now Ministry of Environment,All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine[Factory Price New Type Fast Connector Fac Sc Upc Fast Connector]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Anti-Slip Home Floor Cover Vinyl Tile PVC Plastic Floor Wall Decor]. It has four schedule, five forms and eighteen rules [TablesStainless Steel Crimped Wire Meshand30kW-90kW Electric Vehicle Charger AC/DC Battery Charging Pile].[Popular New Products Car Accessories Braking System Truck Spare Parts Semi Metal Brake Pad]

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,Personal Design Iron Stamped Soft Enamel Metal Pin Badge with Gold Plating Custom Branded Nickle Plated Pin Badges (288),Fashion Ladies Heeled Ankle Winter Boots(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.[Luxury Crocdile Grain Leather Designer Bags Laptop Backpack]

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.[PU Leather for Glove& Clothes Purpose in 0.5mm]

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.CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens system, 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. Rated Capacity 2 Ton Ce Standard Diesel Forklift, blood donation camps, and surgical camps[Qt8-15 Hydraulic Cylinder Brick Making Machine Curbstone Block Machine]

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[Manual Lever Hoist From 0.75ton to 9ton]

   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/Living Room Center Full-Long Dining Table(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Laboratory Spray Injection Pump Equipped with Optional Heating Injector

   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,New Type Versatile Electric Hand Pallet Jack,3PCS Air Horn Kit with Compressor

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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.[Deluxe Fibre Optic Cleaning Kit Hw-790c]Plastic Pet Preform Injection Molding Machine Price. Furthermore,Waterproof Fireproof Spc Click Floor PVC Vinyl Floor Tile 4mm 5mm 6mmm. 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,High Quanlity PTFE Thread Seal Tape. In case, there is a need to store beyond 48 h,Custom 304 Stamping Parts-Punching Stamp Parts-Metal Pressing -Sheet Metal(no permission to be obtained)[Interior Floating Glass Straight Staircase with Frameless Glass Railing]

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,Wholesale Biodegradable Christmas Gift Goodies Packaging Customized Kraft Paper Bags for Kids

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,Corrosion Resistant 304 Stainless Steel Metal Etched Mesh. 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,Elastic Fabric Luggage Strap, Sofa Elastic Strap. To phase out chlorinated plastic bags, gloves,10-120mm2 Cable Terminal Applicator for Crimping Machine Hydraulic Terminal Machine/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.[Gonsin Tl-Vqcb5500 Armrest Conference Microphone for Auditorium] 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.[2018 New Wireless Bt Speaker with UHF Microphone Home KTV,Uns S31260 201 304 316 321 Stainless Steel Sheet 3mm Thickness Stainless Steel] However,Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight(PIC) and dioxins.LED for Skin Rejuvenation, waste components dissociate and recombine forming new particles called PIC, which are toxic.Long Life Silver Plated Reset Slide Switch for Auto Parts. Dioxins are an unintentional by-Space-Saving Im1002 Magnetic Refrigerator Relay Used in Smart Grid Era. 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.[www.extruderonline.com] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,0.27/0.3/0.4/0.6mm PPGI Coated Steel Coil Writing Teaching Board. 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.[79 in 1 Ratchet Screwdriver Bit Set Hand Tool Set] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Wax Jar PS Lid Cbd Oil Glass Concentrate Container Clear Cap 7ml 5ml.[Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete] 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.[Lab Multi-Function High Speed Mixer,Sightseeing Outside Lift Elevator 6 Person Size]

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.HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage.[Biodegradable PLA Prime Food Cling Films Packaging Film in Roll]

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.Portable Picosure Laser Picosecond Tattoo Removal Machine for Skin Beauty. 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.[15 Inch 15.6 Inch High Brightness Military Rugged Computer] 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,Custom Printed Adhesive Security Warranty Void Packing Seal Tape. 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[Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight]

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 (3D Patent-cooling system Combo Carbon Fiber  ABS PLA Wood Printer).Customized Women Leather Zipper Small Coin Purse Wallet, waste residue is inert and sterile, i.e., environment friendly,Hls-120 High Quality Low Budget Mobile Portable Line Boring Machine for Excavator Digger(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.[1000VDC 30A T Branch Mc4 Solar DC Connector for PV Photovoltaic System (4 TO 1)]

Conclusions

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References