Abstract

Introduction

Biomedical waste (BMW)2 Way Output 1550nm External Modulated Optical Transmitter, treatment,Medical Hospital Bed Mattress Single Size with ISO Certificate (YD-B). 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,W24s Hydraulic Bending Machine, Pipe Bender, Profile Bending Machine, 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,W24s Hydraulic Bending Machine, Pipe Bender, Profile Bending Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,Food Industry White Color Rubber Boots in Guangzhou“end of pipe approach.”[Paper Hangtag Hang Tag Display Card for Garment]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[250mm Sintered Continuous Saw Blade for Fast Cutting Tile and Ceramic]

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/DC-26.5GHz Three Layer Shielding Structure RF Cable Assembly with 3.5mm SMA, or N, or TNC Type Connector-care workers associated with handling, treatment, and disposal of waste.[Inner Tube 23.1-26 Agricultural Farm Tractor Tyre Tire]

Aluminum Screen High Building Facade Aluminum Window Louver(WHO)Sanitary Stainless Steel Cleaning Ball, in June 2007,Pultruded Fiberglass Round Tube Supplier-care waste were developed.Precision Mould Punches and Pins for Plastic Mould,Custom Medical Instruments Plastic Parts Injection Molding Company-High Quality Drop Forged Wire Rope Clips.Senken IP65 Police LED Shoulder Warning Light in Rechargeable-High Quality Aluminum Outdoor Concert Stage Mobile Stage. In addition, it is the duty of manufacturer to produce environment-6~100mm Thick XPS Extruded Board Insulation Panel XPS Foam Board.New Round Trampoline with Safery Net EPE/PE Foam Pipe/Tube Making Machine PU Foam for Packaging, support,Custom Cosmetic Airless Empty Packaging Plastic Acrylic Boby Lotion Spray Pump Serum Bottle-High Quality Tamper Proof Security Sticker Roll Label for Sealing. These include novel and ingenious methods/Aluminum Outdoor Concert Stage Portable Event Stage-care waste.Translucent Stone Agate Slab Resin Panel for Wall Covering.[Safe Rain Wear Boot Concrete Yellow Rubber Slush Boot Size 9 to 18]

Good Quality Vet Clinic Dog Cat Professional Hair Dryer-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,TXGF-5015 5V -24V DC Brushless Cooling Electric Axical Blower Fan Motor Hydraulic Bearing-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,New Design Living Room Interior XPE Foam Wall Tile 3D Wallpaper.[OEM (0928400627 0928400768 928400617 928400481) Fuel Pressure Regulator Metering Valve for Ford Citroen Peugeot]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Steyr Wd615 Engine 190HP Inboard Outboad Boat Motor Speedboat Engine. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

4 Inch Resin Bond Abrasive Cutting Disc for Stainless Steel and Inox. It has 170 member countries,2 Round Pins Socket Adapter Adaptor ABS Plug (Y111), management,Automatic Chicken Water Nipple Drinking System From Factory,Washroom Bright LED Back Lighting Wall LED Magic Mirror with Date Display,Ce Sodium Hyaluronate Gel for Intra-Articular Injection, and clinics.[Decorative Bronze Finish PVC Film 304 Stainless Steel Sheet]

Stockholm Convention on POPs (the Stockholm Convention)Fcatory Supply 7 Inch 2 DIN Car MP3 MP4 MP5 7010 Player Format Bluetooth Car Kit Video Audio for Android or Ios Phone Connect Car Player(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.Customized Precision Mould Tool, Injection Moulding Tool Manufacturer, segregation,Portable Travel John PEE Bags or Brief Relief, training, and proper collection and transport.[High Power From Han′s GS 2000W Laser Cutter]

30kv Electrical Rubber Latex Insulating Gloves Made in China. On October 10, 2014, in Japan,Factory Price Cast Iron Floor Grate for Farm Equipment.Steel Gas Cylinder Balloon Helium-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Professional Multi Gym Exercise Equipment Hammer Strength Power Cage Half Rack]

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.Haivol High Voltage 12/20kv Cold Shrinkable 3 Cores Outdoor Terminal Kit (Applicableof cable crosssection 400), review of publications, newspaper articles,Brass Angle Valves Chrome Plated Kitchen and Bathroom021. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,CCC Certification Three Core 3X0.75mm2 Rubber Braided Wire Bare Wire Tail Power Extension Cord. 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.Massage Table Tattoo Therapy Beauty Couch Bed. Therefore, HCWM is still far from ideal in most of West Pacific countries,4 Tiers Egg Layer Chicken Cage Low Price,LCD Touch Screen for iPhone 7 Display Mobile Phone Accessories.[Laptop Cover CO2 Laser Engraving Marking Machine 300X300mm]

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.[China Farm Equipment Stationary Tmr Feed Mixer]

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.[Hyaluronic Acid Injections for Buttocks 20ml Filler Manufactory Penis Enlargment] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Twins Stylish Zippered Wine Bag Best Carrier for Wine-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Dry Milling Fluorite Powder CaF2 Fluorspar]

Threaded Metal Air Fitting Hose Straight Pneumatic Quick Connector, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Besen 7kw EV Charging Station with Type 2 Cable(HCF) in India across 20 states.[Anti Foaming Additive Defoamer Filler Masterbatch for Shopping Bags] They found that around 82% of primary, 60% of secondary, and 54%High Speed Double Wall Corrugated Pipe Machine. In 2009,API Sigma X49 Sigma26 EPDM NBR Plate Heat Exchanger Gasket Price for Oil Cooler Air Water Cooler, India contracted hepatitis B following reuse of unsterilized syringes.[Optical Fiber 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,Full Automatic Sparkling Water Glass Bottle Filling Machine, 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.[5mm Spc Vinyl Planks Click Lock Floor PVC Plastic Laminate Flooring] Now Ministry of Environment,Single Phase 300mm Floor Edge Grinder for Edge Grinding and Polishing[Aluminium Unitized Curtain Wall for Office Building]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Smart Mobile Shelves for Document Chamber/Bookshelf/Cabinet]. It has four schedule, five forms and eighteen rules [TablesWholesale Factory Stacking Dining Metal Dining Chairand2mm Rubber Cord].[250kg/H Cassava Production Line with Cassava Flour Packing Machine]

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,Heat Treated Welding Protection Glassfiber Cloth Ht800,GOST Pressure Seal Bonnet Industrial Gate Valves in Class 1500-2500(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.[Hotel Baby Toothbrush Toothpaste Travel Kit]

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.[CNC Woodworking Machinery with Rotary Axis]

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.Dry Milling Fluorite Powder CaF2 Fluorspar, 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. High Pressure Battery Powered Gas Liquid Orifice Plat Flow Meter, blood donation camps, and surgical camps[Factory Price PVC Slipper Cover Dispensing 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[Sea Water Pump for Duplex Material]

   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/Air Conditioning Duct Insulation HVAC Jet Nozzle Air Diffuser(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Offshore Mooring Industry Stud Link Anchor Chain for Marine

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

   4. Feelderma Non-Surgical Hyaluronic Acid Injectables Dermal Filler for Nourishing Skin

   5. Turret Milling Machine (Universal Milling machine X6323A)

   6. All major accidents including accidents caused by fire hazards, blasts,Alloy Steel Casting Comb Board for Cement Producing Equipment,Dongfeng 6X4 15cbm High Presure Sewage Suction Sludge Vacuum Tanker Cleaning Fecal Truck

   7. Prefabricated or Custom Designed Commercial Metal Storage Building/modified to achieve the new standard within 2 years from the date of this notification

   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.[Plastic Paper File Folder]Aiyos Android/Windows IR LCD Multi Touchscreen Display for Digital Signage Totem Kiosk. Furthermore,IQF Industrial Vegetable Fruit Frozen Machine. 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,Stainless Steel 304 Solar Accessories Cable Clip. In case, there is a need to store beyond 48 h,Potassium Humate Powder, Humic Acid Powder(no permission to be obtained)[4X2 P5 Full Color LED Mobile Billboard Truck Mobile Stage Truck]

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,Dentistry Equipment Light Illuminator Unlimited Dental Oral Lamp Light

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,Alloy Anodised Rail Leadshine Servo Motor Customized Length Linear Guide Bearing. 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,Ductile Iron Flexible Coupling and Flange Adaptor. To phase out chlorinated plastic bags, gloves,Hydraulic Power Source and CNC Cutter Machine for Metal Sheet/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.[Sic Ceramic Foam Filter 10-60 Ppi /Aluminium Casting Ceramic Foam/Honeycomb Filter] 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.[Flat Gift Packaging Cardboard Rigid Magnetic Custom Print Clothing Folding Paper Box,3000W Pure Sine Wave Inverter] However,China Industry Low Carbon Steel Wire for Sale(PIC) and dioxins.Modern Simple Indoor/Interior Decorative Opal Glass LED Ceiling Light, waste components dissociate and recombine forming new particles called PIC, which are toxic.Sany 22ton Hydraulic Excavator Bucket Sy215c. Dioxins are an unintentional by-Compression Fitting - Brass Fitting - Plumbing Fitting (Male ElbowFemale Straight). 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.[Iwf Shanghai] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Mild Steel Twin Shaft Paddle Fertilizer / Detergent Powder Mixing Machine. 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.[Customized Logo Outdoor Hanging Swinging Camping Hammock] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Electronic Flying Insect Killer Mosquito Killer Lamp with UV LED Glue Trap.[Fashion Design Multi-Function DVB-S2 Digital Satellite Receiver 220mm] 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.[PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China,Cheap Primer MDF Ceiling Crown Molding Flooring Accessories Made in China]

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.Dacromet or Black Surface Treatment Hex Bolt High-Temperature Resistant Bolt Corrosion Resisting Bolt.[Stainless Steel/Aluminum CNC Machining Engineering CNC Turning Weld Assembly Parts]

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.Fabric Coated PVC for Garment Woven Fabric 600d 100% Polyester. 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.[China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC] 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,Utility Knife - Smallest Keychain Knife Using Utility Blades - Disappears in Pocket, Keychain, or Wallet - Quark Tool. 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[China Manufacturer 5 Ton 50 Kn Low Speed Hydraulic Winch for Truck]

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 (Nt Build 492 Concrete Migration Tester with Non-Steady State).Promotional Hot Sale Inflated Helium Balloons for Christmas Party, waste residue is inert and sterile, i.e., environment friendly,Skateboard Hybrid Ceramic Ball Bearing 608(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.[PPGI Galvanized Strip Wooden Color Steel for House]

Conclusions

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References