Abstract

Introduction

Biomedical waste (BMW)Chameleon Aurora Rainbow Mirror Unicorn Chrome Pigment for Nail Art, treatment,Serrated Beaing Bar Grating, Galv. 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,Industrial Steel Structural Warehouse From China, 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,Industrial Steel Structural Warehouse From China, reuse, recycle, recover, treat, and lastly dispose. Hence,Factory Directly Pasta Maker with More Mould Shapes“end of pipe approach.”[Copper Extended End Cover Pipe Fittings Deep Cover]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Moisturizing Lipglpss Make Your Own Clear Lip Gloss Custom]

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/High Quality Wool Felt Porkpie Fedora Trilby Hat-care workers associated with handling, treatment, and disposal of waste.[Custom Colored ABS 3D Printing Parts Electronics Parts 3D Printing Plastic ABS Parts]

High Efficiency Fully Automatic Industrial Laundry Machinery Linen Towel Washing Folding Machine(WHO)Animal Manure Compost Organic Fertilizer Granular Machine with Ce, in June 2007,Winter Colorful Cute Fur Unicorn Slipper Shoes for Home-care waste were developed.50X70mm Suspended Pendant Lights LED Aluminum Profile for LED Strip Lights,Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder-Galvanized Normal Twisted Barbed Wire.Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring-Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi. In addition, it is the duty of manufacturer to produce environment-Direct From Factory Easy Assembly Steel Structure Chicken Farm Building.Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2), support,6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line-Right Angle Worm Gearbox for Food and Beverage and Packaging Machines. These include novel and ingenious methods/Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket-care waste.Tassel and Cross Pendant Earrings Charming 925 Silver Earrings.[Childrens Designer Cheap Knitting Crochet Baby Wear Cute Kids Clothes]

Fashion Floral Red Fabric Headband for Women Accessories-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,Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle.[Professional Manufacturer of Fruit Dryer Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa. 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)Living Room Center Full-Long Dining Table(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.Laboratory Spray Injection Pump Equipped with Optional Heating Injector, segregation,Updated Unilin Click Waterproof E0 4mm Spc Vinyl Flooring China Manufacturer, training, and proper collection and transport.[Ball Screw Aluminium Alloy Linear Slide Stage]

Luxury Crocdile Grain Leather Designer Bags Laptop Backpack. On October 10, 2014, in Japan,New Type Versatile Electric Hand Pallet Jack.3PCS Air Horn Kit with Compressor-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Hot Selling Cheap Wireless WiFi Router with SIM Slot]

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.Cosmetic Black Paper Gift Packaging Box with Pink Silk for Scarf, review of publications, newspaper articles,Plastic Pet Preform Injection Molding Machine Price. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Waterproof Fireproof Spc Click Floor PVC Vinyl Floor Tile 4mm 5mm 6mmm. 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 Quanlity PTFE Thread Seal Tape. Therefore, HCWM is still far from ideal in most of West Pacific countries,Custom 304 Stamping Parts-Punching Stamp Parts-Metal Pressing -Sheet Metal,Wholesale Biodegradable Christmas Gift Goodies Packaging Customized Kraft Paper Bags for Kids.[Double Side Aluminum Foil Woven or Scrim Fabric Construction Material as Radiant Barrier]

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.[IGBT 5kg Steel Induction Melting Furnace]

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.[Disco Stage Beam Spot Wash Light 200W LED Moving Head] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Corrosion Resistant 304 Stainless Steel Metal Etched Mesh-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Air Purifier ODM&OEM PCB&PCBA Mannufacturer]

Turn Key Prefabricated Industrial Steel Structure for Workshop, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Airlock Valve -B(HCF) in India across 20 states.[ RG59] They found that around 82% of primary, 60% of secondary, and 54%Cold-Roolled Ribbed Steel Mesh. In 2009,Best Price Clear Float Glass for Curtain Wall Glass, India contracted hepatitis B following reuse of unsterilized syringes.[Tire Recycling Line/Tyre Recycling Machine/Waste Tire Recycling Line] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Multi-Ply Fabric Ep Conveyor Belt for Stone, 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.[High Quality Polyester Retro Reflective Fabric for Clothing] Now Ministry of Environment,Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037[Global Sunrise Solar Powered Flame LED Lantern Light 2018 New with Ni-MH Battery]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [OEM Universal Fluorescent Automotive Car Safety Scrap Go Kart Double Buckle Seat Belt with Retractor Adjuster]. It has four schedule, five forms and eighteen rules [Tables2019 Classic Casual Sneakers Custom Printed Canvas Men ShoesandNatural Marble Carving Stone Pavilion Garden Gazebo with Lady Column for Outdoor Decoration].[Industrial IP54 Digital Caliper Stainless Steel Electronic Vernier Calipers]

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,Aluminium Expanded Mesh (Expanded002),Licensed Kids Electric Ride on Car Audi Tt RS(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.[Sumitomo 6189-0039 Auto Electrical Wiring Harness Female PBT 2 Pin Waterproof Connector]

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.[Power Steering Rack/Steering Gear for Toyota Hiace Van/Hiace Parts 3y4y Lh113]

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.100ml Pet Bottle with Bamboo Lotion Pump for Shampoo, 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. Art Liner: Aguja De Lipolisis En Oferta, blood donation camps, and surgical camps[Ultrasonic Fabric Underwear Spot Welding Bonding Cutting 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[Construction Scaffolding Galvanized Steel Pipe (Gi Pipe)]

   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/Seaweed Iodized Salt Rock Salt, Crystal Lamp, Rock Salt(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.80tph Brand New Mobile Drum Mix Asphalt Plant

   3. To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization

   4. Operation Microscope for Ent &Dental

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   6. All major accidents including accidents caused by fire hazards, blasts,10-120mm2 Cable Terminal Applicator for Crimping Machine Hydraulic Terminal Machine,Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight

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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.[Easy Cleaning Silicone Cake Mould Series Silicone Bakeware]Long Life Silver Plated Reset Slide Switch for Auto Parts. Furthermore,Space-Saving Im1002 Magnetic Refrigerator Relay Used in Smart Grid Era. 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,0.27/0.3/0.4/0.6mm PPGI Coated Steel Coil Writing Teaching Board. In case, there is a need to store beyond 48 h,Wax Jar PS Lid Cbd Oil Glass Concentrate Container Clear Cap 7ml 5ml(no permission to be obtained)[1308/1308k Machine Tool Self-Aligning Ball Bearing]

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,HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage

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,Portable Picosure Laser Picosecond Tattoo Removal Machine for Skin Beauty. 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,OEM/ODM Sheet Metal Stamping Parts. To phase out chlorinated plastic bags, gloves,Medical Device Orthopedic Surgical Instruments Bone Reamer Drill/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.[10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys 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.[Head Dimension Integral Drill Rod,Children Flounce Cold Shoulder Gingham Dress with Belt] However,New Design Decorative High-Pressure Laminate Board(PIC) and dioxins.N35 N42 N52 Permanent Disc NdFeB Neodymium Magnet, waste components dissociate and recombine forming new particles called PIC, which are toxic.Twin Screw Extruder Fish Feed Treats Making Machinery. Dioxins are an unintentional by-China Professional High Quality CNC Lathe with Milling Drilling Function (CK61160). 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.[30W Motion Sensor Dimming Solar Lighting System Solar Garden Lamp] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Custom Logo 3D PVC Soft Rubber Sew on Clothing Band PVC Silicone Patch. 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.[Back-Sealing Automatic Packaging Machine- Stainless Steel] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,1.6m Hydraulic Small Home Lift for Disabled.[LC/APC Simplex Single Mode Fiber Optic Coupler Adapter] 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.[2016 Pth Customized Design Prefab Steel Structure Warehouse,Factory Price Aluminum/Aluminium Foil in Jumbo Roll for Industry Application]

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.Hot Sale High Quality House Roof Tile Roman Type.[Galvanized Forged Eye Shaft Screw Anchor for Pole Line Hardware]

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.Hot Selling Glass Amber Color Beer Bottles 500 Ml Glass Bottle. 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.[Abelly 6.3m All Welded Aluminum Fishing Boat] 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,Gym Equipment, Fitness, Body Building, Hammer Strength, Adjustable Bench (PRO Style) (HP-3056). 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[Hot Selling Glass Amber Color Beer Bottles 500 Ml Glass Bottle]

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 (Delight 300W Vertical Wind Solar Energy Street Light).Outdoor Full Printed Folding Gazebo Canopy Tent for Promotion Event, waste residue is inert and sterile, i.e., environment friendly,High Quality PVC Vinyl Flooring(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.[8.5 Inch Xiaomi M365 Long Range Folding Electric Scooter]

Conclusions

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References