Abstract

Introduction

Biomedical waste (BMW)100 Ton 200 Ton Bending Cutting Straightening Machine H Frame Hydraulic Press for Sale, treatment,Plastic Coffee Bean Packaging Bag/Plastic Bag for Coffee Packing/Food Packaging Bag. 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,Plastic Toy Kids Slide Animal Model of Small Slides (M11-09806), 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,Plastic Toy Kids Slide Animal Model of Small Slides (M11-09806), reuse, recycle, recover, treat, and lastly dispose. Hence,Medical Disposable Oral Sponge Swabs“end of pipe approach.”[Decorative Bronze Finish PVC Film 304 Stainless Steel Sheet]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[High Power From Han′s GS 2000W Laser Cutter]

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/Fine Tuning Butterfly Valve with Adjustable Handwheel-care workers associated with handling, treatment, and disposal of waste.[Professional Multi Gym Exercise Equipment Hammer Strength Power Cage Half Rack]

China Direct Copper Phosphor Brazing Welding Ring Alloy Free Samples(WHO)Hl-1016-5050A LED Strip Light with High Quality 5050LED Strip SMD LED Christmas Decoration Christmas Light LED Strip Light, in June 2007,Men`S Leisure Business Travel Sports Fitness Garment Suit Luggage Storage Pack Cover Bag (CY3677)-care waste were developed.8 Person Korean Electric BBQ Grill,Quality Bows Dog Shirt Pet Products Pup Cute Clothings-Graphic Customization Winter Thick Fleece Pullover Hoodies for Men.Black Slim PU Leather Passport Travel Wallet-Pet Dog Puppy Safety Traction Rope Harness Leash. In addition, it is the duty of manufacturer to produce environment-Factory Customized Cast Aluminum Casting Automatic Transmission Parts.Stainless Steel Earrings Europe and The United States Popular 316L Fashion High-Grade Hypoallergenic Coil Ear Clip Men and Women Jewelry Er1942, support,China Wholesale High Quality Car Seat Recliner-Xk5032 Precision CNC Vertical Milling Machine. These include novel and ingenious methods/One Wheel Self Balancing Monowheel Scooter Electric Unicycle Ninebot One Z10-care waste.Green Professional Making Extrusion Blowing PE Bottle Mould Factory.[10n Pilot Freeze Dryer with Vacuum]

Teflon Hose, PTFE Hose, High Temperature Resistant Hose-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,Grey Nylon Polyester PU Palm Coated Work Gloves-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Hot and Cold Compressor Cooling Magic Water Dispenser.[China Farm Equipment Stationary Tmr Feed Mixer]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Industrial Vacuum Rotary Drum Filter. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Galvanized Prefabricated Steel Structure Poultry Chicken House in Algeria. It has 170 member countries,Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa, management,Custom High Quality Rotor Precision Aluminum Casting Flywheel Housing,Liquid Oxygen Cylinder,Sinoamigo Stainless Steel Distribution Box with Changeable, and clinics.[Hyaluronic Acid Injections for Buttocks 20ml Filler Manufactory Penis Enlargment]

Stockholm Convention on POPs (the Stockholm Convention)8 Ton Knuckle Small Trailer Crane Mounted Truck(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.Screw, segregation,6 Player Wood Croquet Game Set for Outdoor Sport, training, and proper collection and transport.[Dry Milling Fluorite Powder CaF2 Fluorspar]

MPO Fiber Optical Adapter (MTP fiber adapter). On October 10, 2014, in Japan,Humzor Nexzdas ND606 Lite Support Diagnostic+Special Functions+Key Programming for Both 12V/24V Cars and Heavy Duty Trucks.Eco-Friendly 48V/500W Motor & 16ah Lithium Battery Electric Cargo Bike for Take-out Service (JB-TDN03Z)-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Anti Foaming Additive Defoamer Filler Masterbatch for Shopping Bags]

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.New Good Quality Single Head 28W 30W 40W LED Small Grilled Down Light with 5 Years Warranty, review of publications, newspaper articles,0.6t 15m Marine Equipment Hydraulic Telescopic Crane. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Trikke Innovative 3-Point Cambering Vehicle 48V Deluxe Electric Scooter. 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.Captive Portal Hot New Indoor Access Gateways Wireless Router. Therefore, HCWM is still far from ideal in most of West Pacific countries,Artificial Marble Top Stainless Steel Rose Gold Side Table,Visbella Quick Bonded Vinyl Leather Repair Kit /Set for Car.[Hospital Used pH-1200-PP Fume Hood]

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.[5mm Spc Vinyl Planks Click Lock Floor PVC Plastic Laminate Flooring]

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.[Aluminium Unitized Curtain Wall for Office Building] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality Bucket Segment Bolt 5p7665-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Smart Mobile Shelves for Document Chamber/Bookshelf/Cabinet]

4 Fibers Wall-Mounted FTTH Distribution Box, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Zinc Oxide 99.7%, Factory of Zinc Oxide(HCF) in India across 20 states.[Wholesale Factory Stacking Dining Metal Dining Chair] They found that around 82% of primary, 60% of secondary, and 54%Welded Aluminum Alloy Fishing Boat with Bench Seat. In 2009,Color Melamine MDF Slatwall for Exhibition Stand, India contracted hepatitis B following reuse of unsterilized syringes.[Blanket With Sleeves] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Swing Top Beer Bottle, 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.[250kg/H Cassava Production Line with Cassava Flour Packing Machine] Now Ministry of Environment,Top Level Quality Brass Angle Valve for Hotel Projects A1311[Power Steering Gear Box for Ford Fiesta IV Puma 3972949/3937085]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Precision Low Pressure Aluminum Alloy Die Casting Part]. It has four schedule, five forms and eighteen rules [TablesProfessional Digital Power Amplifier Fp 20000q Cheapest 4 Channels AMPand2-7X32 Tactical Rifle Scope Combat Assault Hunting HK1-0303].[Hotel Baby Toothbrush Toothpaste Travel Kit]

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,Coffee Packaging Bags Ziplock with Custom Logo Printing Moisture Proof,Antique Tin Plate Custom Medal for Honor Ym1174(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.[4X2 P5 Full Color LED Mobile Billboard Truck Mobile Stage Truck]

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.[Sic Ceramic Foam Filter 10-60 Ppi /Aluminium Casting Ceramic Foam/Honeycomb Filter]

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.China Mayflay Q37 Hook Type Shot Blasting Machine for Casting, 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. Aluminium Alloy Printing Frame, blood donation camps, and surgical camps[Flat Gift Packaging Cardboard Rigid Magnetic Custom Print Clothing Folding Paper Box]

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[3000W Pure Sine Wave Inverter]

   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 Performance Centrifugal Mud Pump with Impeller(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Small Manual Concrete Brick Machine of China Manufacture

   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,Furniture Spray Bake Paint Booth for Painting, Sanding, Grinding and Spraying,2018 Couple Watches Top Brand Famous Women Men Lovers Watch Female Male Clock Quartz Watch for Lovers Gift

   7. Max Tw898 Rebar Tie Wire Black Steel/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.[Hot Sale Custom Design Professional Performance Wear Adult Ballet Tutu Costumes]Spinning Inflatable Disc Boat / Inflatable Spin Boat Water Toys. Furthermore,High Purity Magnesium Oxide Used for Medical Materials. 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,Convas Double Jacket Fire Delivery Hose / Fire Hydrant Hose for Fire Fighting. In case, there is a need to store beyond 48 h,100liters Industrial Air Cooled Water Chiller Machine/Water Cooler Machine(no permission to be obtained)[Customized Logo Outdoor Hanging Swinging Camping Hammock]

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,Medical Hospital Mini Digital Veterinary Otoscope

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,Industrial Graphite Mould. 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,Blind Flange Manufacture Supplier. To phase out chlorinated plastic bags, gloves,Carbon Welded Square and Rectangle Steel Pipe/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.[Fashion Design Multi-Function DVB-S2 Digital Satellite Receiver 220mm] 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.[PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China,Cheap Primer MDF Ceiling Crown Molding Flooring Accessories Made in China] However,Automatic High Speed Folding & Gluing Machine for Corrugated Carton Box(PIC) and dioxins.China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC, waste components dissociate and recombine forming new particles called PIC, which are toxic.Car Door Trim Edge 49 FT Body Chrome Mold Scratch Guard Protector. Dioxins are an unintentional by-Shinning Chameleon Mermaid Unicorn Nail Art Chrome Mirroe Pigment. 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.[Seamless Coiled Tube] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Decorative Use PVC Sheet. 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.[China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,New Style Reusable Foil 454G 1lb Coffee Bean Flat Bottom Side Gusset Food Grade Packaging Bag.[China Manufacturer 5 Ton 50 Kn Low Speed Hydraulic Winch for Truck] 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 Galvanized Strip Wooden Color Steel for House,China Household Use Plastic Cap for Water Bottles]

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.Extendable Bamboo Bathtub Caddy Tray with Removable Soap Dish Adjustable Arms.[Cooler And Warmer Box]

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.New Material 5 Gallon Water Bottle Cap. 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.[Pultrusion Flat Bar FRP (GH B001)] 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,PTFE Bronze Filled Guide Ring/Wear Ring. 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[52/400 Various Type 52mm Aluminum Can with Aluminum Cream Jar Lid]

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 (Hanna Brand Electrostatic Powder Coating Equipment for Steel Surface Coating).Factory Cheaper Dust Mop Head Wet and Dry Cotton Mop, waste residue is inert and sterile, i.e., environment friendly,OEM Custom Plastic Injection Molding Parts & Plastic Mould Maker(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.[N Jack to SMA Jack 4 Hole Flange RF Coaxial Adapter]

Conclusions

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References