Abstract

Introduction

Biomedical waste (BMW)Rubber Soles Vulcanizing Machine/ Press Machine, treatment,99.95% China Pure Molybdenum Rod. 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,Leather Tanning Agent BCS Basic Chrome Sulphate 24%-26%, 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,Leather Tanning Agent BCS Basic Chrome Sulphate 24%-26%, reuse, recycle, recover, treat, and lastly dispose. Hence,Dn25 Approved Stainless Steel 304 Pneumatic Piston Angle Seat Valve“end of pipe approach.”[TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Two Flat Pin South America Plug (Y058)]

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/Rg59 with 2core Power Coaxial Cable-care workers associated with handling, treatment, and disposal of waste.[1325 3 Heads Wood Kitchen Cabinet Door CNC Router]

LCD Display Bzc-220V-150A PWM Solar Charge Cntroller(WHO)Kids Education Games Plastic Funny Square Whack-a-Mole Toy, in June 2007,Custom 100% Cotton Face Cleaning Refreshing Wet Towel-care waste were developed.Diagnostic Medical Clinical Alpk2 Palm Aneroid Digital Bp Blood Pressure Sphygmomanometer,60m3 Bulk Silo Trailer Wheat Transport for Sale-Stainless Steel Screw DIN912 Hexagon Socket Head Cap Screws Customised.Plastic Flange Housing Ucf310-115 for Electric Hand Tools-12 Pin Car Mirror ISO Wiring Harness Manufacturer. In addition, it is the duty of manufacturer to produce environment-Potassium Humate Powder, Humic Acid Powder.Poultry House Chicken Feed Silo, support,HD 1080P 4 Channel Car Mobile DVR with GPS, 3G/4G, WiFi-Secondary Stainless Steel Coil and Sheet. These include novel and ingenious methods/Free Sample Promotion Holographic E-Liquid Paper Box Package-care waste.White Flake Calcium Chloride Dihydrate for Oil.[House Cleaning Products Single Roller Magic Sponge PVA Mop]

1000W 1500W 3 Meters Pipe Laser Cutter CNC Fiber Laser Cutting Machine for Metal Sheet-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,High Quality Cleaning Microfiber Magic Spin Mop with Mop Bucket-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,10 Mode Remote Control Single Egg Vibrators 100% Waterproof Speed Jump Egg Love Ball Clitoris Stimulator Sex Toys for Women.[Hala Certified Chinese Supplier Instant Black Tea Extract]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,2017 Solar Garden Stake Light (RS-124). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Four Colors Silicone Sex Toys Fox Tail Anal Plug. It has 170 member countries,Clear Ampoules Made of Low Borosilicate Class and Glass Tubing, management,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,Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan,Pet PE BOPP PVC CPP Film Slitting Machine, and clinics.[ISO Approved Self-Cleaning Permanent Belt Magnetic Iron Ore Separator]

Stockholm Convention on POPs (the Stockholm Convention)Yellow Selvage White Multifilament Fishing Tackle Nylon Fishing Net(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.Dental Pfm Crown From China Dental Laboratory, segregation,4 Column Hydraulic Press to Calibrate The Steel Pipe, training, and proper collection and transport.[Small Clear Glass Spray Bottles for Aromatherapy Essential Oils]

Coal Rock Crawler Mucking Loader Machine Rock Mucking Loader for Underground. On October 10, 2014, in Japan,Customization Spiral Finned Tube Economizer Pipes for Steam Boiler Parts.Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser-care services, including mercury-containing medical items such as thermometers and blood pressure device.[500ton Plywood Hot Press Using in Plywood Base Panel]

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.Night Vision Camera Infrared IP67 Outdoor CMOS Cameras, review of publications, newspaper articles,Vacuum Coating Machine for Golden Door Handle/Metal PVD Coating Machines. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Diamond Pattern Security Barbs Razor Wire. 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.SS304 SS316 M6 M8 M10 DIN557 Stainless Steel Square Thin Nut. Therefore, HCWM is still far from ideal in most of West Pacific countries,Precision CNC Machining Turning Anodized Aluminum Washers Spacers,Medical Disposable Oxygen Mask Nebulizer Mask.[Double Sided Card Holder]

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.[Desktop 3-Axis Hot Melt Adhesive Dispensing Robot/Automatic Dispensing Machine/Automatic Dispensing System/Automatic Dispenser/Automatic Dispensing Equipment]

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.[Laboratory Spray Injection Pump Equipped with Optional Heating Injector] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Quality Fasteners Screws Bolt with Reasonable Price-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens system]

Small Size Liquid Container with Cheap Price, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Promotional Garment Embroidery Patch with Scotland Logo(HCF) in India across 20 states.[Custom Embroidered Socks christmas Cute Thermal Funky Cotton Socks] They found that around 82% of primary, 60% of secondary, and 54%Polycarboxylate Super Plasticizer PCE Flakes Crude Powder for Concrete. In 2009,2~3 Cm Natural Long Lasting Decorative Flower Roses for Christmas Gifts & Crafts, India contracted hepatitis B following reuse of unsterilized syringes.[1000W Low Price Solar Power System Generation for Home System.] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Cummins Diesel Engine Electric Silent Power Generation 16kw -1100kw, 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.[Soosan Excavator Hydraulic Hammer for Construction Demolition] Now Ministry of Environment,High Quality Prepayment Energy Meter 12 Volt DC Latching Relays 24V DC Magnetic Contactor Relays[220V Meter 1000va Relay Type Automatic Voltage Stabilizer]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [ASTM&TUV Standard Trampoline Park Bungee Harness for Sale]. It has four schedule, five forms and eighteen rules [TablesAluminum/Stainless Steel Flat WasherandCutlery Polishing Machine].[Dual Pillow Tops Design 100% Natural 7 Zone Latex Mattress]

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,High Quality Electronic Circuit Boards PCBA / PCB Assembly,2018 New Wireless Bt Speaker with UHF Microphone Home KTV(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.[Folding Ebike Fat Tyre]

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.[Jiayu Jrr Series Heat Regenerated Adsorption Air Dryer]

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.Drum / Roll Permanent Magnetic Particle Separator Equipment for Mining, 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. Pipe Production Line for PE Shell Pipe Casing Thin Wall Pipe with Thermal Insulation with Polyurethane Foam (PPU), blood donation camps, and surgical camps[DIY Plastic Window Insect Screen for Various of Windows]

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[Steel Toe-Cap High Cut Winter Boots with Wool Lining Ax05057]

   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/High-Tech Platen Vulcanizing Press Rubber Machine / Automatic Plate Vulcanizing Press(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Breathable PU Coated Ripstop Taffeta 190t Polyester Fabric with Printed

   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,Fast Change Cassette Corrugated Carton Paperboard Single Facer Machine,Antique Stainless Steel Arc Backrest Party Banquet Garden Dining Chair

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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.[Aviation Aluminium Coffee Table]Xgma 3 Ton Earth Moving Machine Small Wheel Loader Xg935h. Furthermore,Bytcnc High Efficiency Aluminum Profile Bending Machine Auto. 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,Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime. In case, there is a need to store beyond 48 h,Valve Liquid Level Indicator Device Assembly(no permission to be obtained)[Swivel Chair Parts Adjustable Hydraulic Lift Gas Spring for Chair]

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,17 X 15 Mesh Fiberglass Window Screen / Fly/Insect /Mosquito Mesh

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,Squeegee Blade. 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,Opgw Cable Mentel Joint Box 24 Fibers. To phase out chlorinated plastic bags, gloves,500ton Plywood Hot Press Using in Plywood Base Panel/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.[Electric Heavy Duty Rail Guided Vehicle for Transportation] 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.[Wholesale Gi Galvanized Corrugated Steel Roofing Sheet,Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring] However,SBPP Hygienic Non Woven Disposable Briefs(PIC) and dioxins.1/4 6.35mm Plug Connector Phone Jack Mono Stereo Audio Chrome, waste components dissociate and recombine forming new particles called PIC, which are toxic.Flexible Temperature Chemical SAE 100r14/Teflon Hose. Dioxins are an unintentional by-Automatic Aluminum Roller Shutter Garage Door (HF-J328). 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.[Venlo Hollow Double Tempered Glass Greenhouse with Hydroponics Growing System for Vegetables/ Flowers/ Tomato/ Farm/ Garden] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,China Deep Drawing Aluminium Disc/Circle Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005. 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.[Aluminum Height Adjustable Cane (SC-CR58-67)] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Fiber Optic DWDM 100g Mux/Demux Module.[M-02 Round Shape Green Plastic Sprayed Garden Spade] 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.[Rubber Mixer/Rubber Mixing Mill with Ce/Rubber Machine,Manufacturers Selling High-Quality Food Grade Sodium Sulfate Anhydrous for Food Additives]

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.High Efficiency Multi-Function Disposable Plastic Cutlery for Napkin Knife Fork Spoon Pepper Salt Packing Machine.[Commercial Led Track Lighting]

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.Vibratory Deburring Bowls Tumbler with Sound Enclosure. 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.[Ss Stainless Steel Female Thread Tee Gas Pipe Fitting] 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,5kVA Air Cooled Silent Diesel Portable Generator. 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[Building Wall 3D EPS Sandwich Panel Welding Machine]

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 (High Quality Custom Logo Leather Hardcover A5 Notebook New 2018 Personal Journals Wholesale Diary Paper notebook).Girls Bling Mini Travel Backpack Kids Children School Bag Satchel Purses, waste residue is inert and sterile, i.e., environment friendly,Kraft Disposable Fast Food Box for Fried Chips Chickens French Fries Hamburgers(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.[Funny Educational Toys Game Learning Rapid Cubes Plastic Toys for Kids H9085013]

Conclusions

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References