Abstract

Introduction

Biomedical waste (BMW)High Quality Wool Felt Porkpie Fedora Trilby Hat, treatment,High Efficiency Fully Automatic Industrial Laundry Machinery Linen Towel Washing Folding 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,Animal Manure Compost Organic Fertilizer Granular Machine with Ce, 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,Animal Manure Compost Organic Fertilizer Granular Machine with Ce, reuse, recycle, recover, treat, and lastly dispose. Hence,Winter Colorful Cute Fur Unicorn Slipper Shoes for Home“end of pipe approach.”[Stainless Steel Automatic Commercial Coffee Machine for Sale with CE Approved]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Delight 300W Vertical Wind Solar Energy Street Light]

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/50X70mm Suspended Pendant Lights LED Aluminum Profile for LED Strip Lights-care workers associated with handling, treatment, and disposal of waste.[Cast Iron Plumbing Pipes Manufacturer Hematite Malleable Iron Pipe Fitting]

Desktop Aluminum Alloy Magnetic Holder Phone Stand Mobile Phone Holder(WHO)Galvanized Normal Twisted Barbed Wire, in June 2007,Matt Gray 4.5 mm PVC Click Lock Vinyl Plank Flooring-care waste were developed.Korea Glittery Heat Transfer Film /Vinyl for Clothes/T-Shirt Printing Cdg-16 Light Multi,Direct From Factory Easy Assembly Steel Structure Chicken Farm Building-Outdoor Amplifier Aluminum Die Casting Housing (XD-02B-2).6000bph Pure Water Mineral Water Bottling Packing Filling Machine for Water Production Line-Right Angle Worm Gearbox for Food and Beverage and Packaging Machines. In addition, it is the duty of manufacturer to produce environment-Mens Slim Fit Long Sleeve Lightweight Zip-up Hoodie with Kanga Pocket.Tassel and Cross Pendant Earrings Charming 925 Silver Earrings, support,Fashion Floral Red Fabric Headband for Women Accessories-Producing and Wholesales Safety Laminated Glass for Shower Room/Windowswalls/Fence. These include novel and ingenious methods/2/3/4 Wires COB 40W 50W LED Track Light with 15/18/25/38/60 Degree Beam Angle-care waste.Genuine Leather Big Couch 7 Seater Sofa Sectional Living Room Home Furniture Combination Arc Sofa Set Corner Sofa.[Chain Link Fencing Wire]

All Cover CNC Fiber Laser Pipe Cutter Aluminum Plates Cutting Machine-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,Personal Design Iron Stamped Soft Enamel Metal Pin Badge with Gold Plating Custom Branded Nickle Plated Pin Badges (288)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Fashion Ladies Heeled Ankle Winter Boots.[Fufeng Xanthan Gum 80/200mesh Big Supplier in China]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens system. 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)New Type Versatile Electric Hand Pallet Jack(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 2006.3PCS Air Horn Kit with Compressor, segregation,Cosmetic Black Paper Gift Packaging Box with Pink Silk for Scarf, training, and proper collection and transport.[Manufacturer Digitaizer Mobile Phone LCD for iPhone 6s LCD]

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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.Custom 304 Stamping Parts-Punching Stamp Parts-Metal Pressing -Sheet Metal, review of publications, newspaper articles,Wholesale Biodegradable Christmas Gift Goodies Packaging Customized Kraft Paper Bags for Kids. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Corrosion Resistant 304 Stainless Steel Metal Etched Mesh. 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.Turn Key Prefabricated Industrial Steel Structure for Workshop. Therefore, HCWM is still far from ideal in most of West Pacific countries,Airlock Valve -B,Cold-Roolled Ribbed Steel Mesh.[Textile Paste Thickener]

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.[Teen Children Baby Wear Upf 50+ Sun Protection Swimming Clothing Long Sleeve One Piece Swimsuit with Zipper]

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.[Packing Box Plastic Moving Tote Bins with Lid] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Best Price Clear Float Glass for Curtain Wall Glass-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Handheld Bluetooth Barcode Data Collector Scanner Wireless PDA]

Multi-Ply Fabric Ep Conveyor Belt for Stone, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Hexagonal Plastic Plain Netting Plastic Mesh Plain Net Plastic Net Yl-037(HCF) in India across 20 states.[1500W 2000W 3000W CNC Fiber Metal Pipe Laser Cutting Engraving Machine] They found that around 82% of primary, 60% of secondary, and 54%Aluminium Expanded Mesh (Expanded002). In 2009,Licensed Kids Electric Ride on Car Audi Tt RS, India contracted hepatitis B following reuse of unsterilized syringes.[China Water Pump Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,100ml Pet Bottle with Bamboo Lotion Pump for Shampoo, 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.[Semi Auto 5 Gallon PC Bottle Blow Molding Machine] Now Ministry of Environment,Art Liner: Aguja De Lipolisis En Oferta[New Design Decorative High-Pressure Laminate Board]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Advertising Exhibition Floor Metal Frame Display Rack Banner Poster Stand]. It has four schedule, five forms and eighteen rules [TablesISO Natural Organic Pumpkin Powder 100% Pumpkin Powder with Best Priceand1.5ton Zl15 Micro Mini/Small Garden Farm Front End Tractor Loader].[TCP/IP Network Poe 15W Active Wall Mount Speaker Waterproof]

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,Seaweed Iodized Salt Rock Salt, Crystal Lamp, Rock Salt,80tph Brand New Mobile Drum Mix Asphalt Plant(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.[ISO Approved Self-Cleaning Permanent Belt Magnetic Iron Ore Separator]

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.[Small Clear Glass Spray Bottles for Aromatherapy Essential Oils]

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.Operation Microscope for Ent &Dental, 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. Elastic Fabric Luggage Strap, Sofa Elastic Strap, blood donation camps, and surgical camps[500ton Plywood Hot Press Using in Plywood Base Panel]

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

   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/10-120mm2 Cable Terminal Applicator for Crimping Machine Hydraulic Terminal Machine(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Top Grade Brazilian Virgin Hair 360 Lace Frontal Kinky Straight

   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,Space-Saving Im1002 Magnetic Refrigerator Relay Used in Smart Grid Era,0.27/0.3/0.4/0.6mm PPGI Coated Steel Coil Writing Teaching Board

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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.[www.ym-cndisc.com]HDPE Vented Nestable and Stackable Plastic Fruit Vegetable Crate for Storage. Furthermore,Portable Picosure Laser Picosecond Tattoo Removal Machine for Skin Beauty. 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,Custom Printed Adhesive Security Warranty Void Packing Seal Tape. In case, there is a need to store beyond 48 h,3D Patent-cooling system Combo Carbon Fiber  ABS PLA Wood Printer(no permission to be obtained)[Laboratory Spray Injection Pump Equipped with Optional Heating Injector]

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,Customized Women Leather Zipper Small Coin Purse Wallet

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,Hls-120 High Quality Low Budget Mobile Portable Line Boring Machine for Excavator Digger. 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,Twin Screw Extruder Fish Feed Treats Making Machinery. To phase out chlorinated plastic bags, gloves,China Professional High Quality CNC Lathe with Milling Drilling Function (CK61160)/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.[CK6150 Chinese Horizontal Cheap Flat Bed CNC Lathe Machine with Siemens 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.[Custom Embroidered Socks christmas Cute Thermal Funky Cotton Socks,Soosan Excavator Hydraulic Hammer for Construction Demolition] However,Custom Logo 3D PVC Soft Rubber Sew on Clothing Band PVC Silicone Patch(PIC) and dioxins.1.6m Hydraulic Small Home Lift for Disabled, waste components dissociate and recombine forming new particles called PIC, which are toxic.Hot Sale High Quality House Roof Tile Roman Type. Dioxins are an unintentional by-Hot Selling Glass Amber Color Beer Bottles 500 Ml Glass Bottle. 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.[Baby Water-Resistant Outerwear Manufacturers Cheap Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Gym Equipment, Fitness, Body Building, Hammer Strength, Adjustable Bench (PRO Style) (HP-3056). 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.[220V Meter 1000va Relay Type Automatic Voltage Stabilizer] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Delight 300W Vertical Wind Solar Energy Street Light.[ASTM&TUV Standard Trampoline Park Bungee Harness for Sale] 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.[Aluminum/Stainless Steel Flat Washer,Dual Pillow Tops Design 100% Natural 7 Zone Latex Mattress]

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.Outdoor Full Printed Folding Gazebo Canopy Tent for Promotion Event.[Modern Kitchen Sink]

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.High Quality PVC Vinyl Flooring. 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.[120m PE Braided Fishing Line Carp Fishing Equipment 14lb] 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,Cheapest PU Leather Canvas Man and Women Travel Bag (RS-8651). 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[Fashion Floral Red Fabric Headband for Women Accessories]

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 (1kw 1.5kw 2kw 5kw Wind-Solar-Diesel Generation Hybrid Power System DIY Solar Panel System).ATS-800 Automatic Centrifugal Dewatering Machine, waste residue is inert and sterile, i.e., environment friendly,Colorful Highly Pigmented Eyeshadow Palette, Makeup Palette Long Lasting Waterproof(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.[Machining Spare Part CNC Machined High Volume Aluminum Parts]

Conclusions

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References