Abstract

Introduction

Biomedical waste (BMW)Drop Forged Wire Rope Clip, treatment,Stainless Inox Escalator Decorative Panel 304 Grade Brushed Stainless Steel Sheet with 7 PVC Film. 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,Wide Mouth Mason Glass Jars with Lids & Straws Handle 16oz, 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,Wide Mouth Mason Glass Jars with Lids & Straws Handle 16oz, reuse, recycle, recover, treat, and lastly dispose. Hence,Sound Barrier Material with Fire Resistant Slot Acoustic Wall Panel“end of pipe approach.”[Convas Double Jacket Fire Delivery Hose / Fire Hydrant Hose for Fire Fighting]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Tab Terminal Waterproof Toggle Switch]

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/Natural Avocado Powder Extract-care workers associated with handling, treatment, and disposal of waste.[PF Series Hydraulic Impact Stone/Rock/Aggregate Breaker]

Disposable Infusion Set with Free Needle Blood Transfusion Device(WHO)Pneumatic Three Eccentric Wafer Butterfly Valve Center Line Worm Gear Wafer Lug Butterfly Valve, in June 2007,Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set-care waste were developed.High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen,High Quality OEM Plastic Automobile Parts Injection Molding-Fire Alarm Smoke Detector Addressable Audio/Visual Alarm (640-004).10mm Stainless Steel Sheet Metal Fiber Laser Cutting Machine Price-FTTH 4fe+CATV Gepon Epon ONU with 1 RF Port. In addition, it is the duty of manufacturer to produce environment-Side Sealing Plastic Carry Bag Making Machine Price.Computer Jacquard Lace Embroidery Machine, support,Ce Approval CO2 Aluminum Cylinder Steel Cylinder Argon Cylinder-Rema Male and Female Connector 320A 180A Electronic Relay. These include novel and ingenious methods/Qt40-1 Interlocking Concrete Hollow Block Machine with Mold for Sale in Philippines-care waste.Op-10 Price of Medical Direct Ophthalmoscope Set.[m.etonsmtauto.com]

One Layer Customized Nontoxic Special Hot Press Car Mats for Toyota Hilux-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,CE Auto Car Spray Paint Booth Wld-8200-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Hot Sale Rose Gold Round Decorative Diffuser Glass Bottle with Reed Stick.[Carbon Steel Sheet Metal Laser Cutter Fiber Laser CNC Cutting Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Electric Motor with 220V Air Compressor Motor. 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)Electric 3 Wheel Beer Bike for Sale with Water Sink(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.Wiring Terminal Stamping Part, Electrical Terminal Part, segregation,Fiberglass Mesh Filter for Castings, training, and proper collection and transport.[Cast Iron 1/2 Inch Lug Type Wafer Flange Butterfly Valve]

DVB-S2 Digital Satellite Receiver with WiFi and Youtobe Function. On October 10, 2014, in Japan,Small Tracked Transport Vehicle, Agricultural Machinery Garden Mini Crawler Loader.3/8Super Flexible Cable Low Smoke Halogen-Free Fire-Retardant RF Feeder Cable Coaxial Cable-care services, including mercury-containing medical items such as thermometers and blood pressure device.[GOST Pressure Seal Bonnet Industrial Gate Valves in Class 1500-2500]

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.ISO 7241-a Bsp Hyaulic Quick Coupling Hose Connectors, review of publications, newspaper articles,Synthetic Grass Fake Turf Lawn for Public Green Field. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Wall Mount Interactive Touch Digital Dignage Display. 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.Customized Sponge Rubber Weatherstrips Seals Extrusion for Cabinet, Industry Equipment. Therefore, HCWM is still far from ideal in most of West Pacific countries,Dahu Fashinon New Product HD Fisheye IR CCTV IP Camera,High Quality Pre-Painted Galvanized Steel Coil/PPGI/PPGL.[8 Core Fiber Optic Termination Box Factory OEM/ODM Products]

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.[Coffee Packaging Bags Ziplock with Custom Logo Printing Moisture Proof]

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.[Ce RoHS Ozone Generator Fruit and Vegetable Washer] In India, BMW problem was further compounded by the presence of scavengers who sort out open,ASA and PMMA Co-Extrusion Plastic Red Film ASA Polyester Masterbatch for PVC Roof Tile-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Cheap Water Bottle PVC Heat Shrink Labels Label Sleeve Labels]

High Quality Pipe Flange / Blind Flange, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Manufacturer Supply Red 8 Strand Braided Fishing Line(HCF) in India across 20 states.[CNC Aluminum Machinery Parts Customized Aluminum Parts Blue Anodized Aluminum Mechanics Parts CNC Machining Factory] They found that around 82% of primary, 60% of secondary, and 54%400mm Masonry Saw Blade for Marble. In 2009,Size Customized Ceramic Fiber Tape for Furnace Pipe with Ss Wire Reinforced Fiberglass Wire, India contracted hepatitis B following reuse of unsterilized syringes.[Tea Cup Sets] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Lab Furniture Steel Frame Wall Bench, 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.[400mm Masonry Saw Blade for Marble] Now Ministry of Environment,4-8mm Wine Red/Blue/Yellow/White/Black Paint Glass/Backing Glass[Custom Size Data Strip for Supermarket Shelves]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Better Breathe Nasal Strips Nasal Stick]. It has four schedule, five forms and eighteen rules [TablesSize Customized Ceramic Fiber Tape for Furnace Pipe with Ss Wire Reinforced Fiberglass WireandPre-Impregnated DMD Film/Insulation Film for Dry Transformer].[100 Ton 200 Ton Bending Cutting Straightening Machine H Frame Hydraulic Press for Sale]

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 PE Pipe Production Line/PE Gas Water-Supply Pipe,Custom Made Precision CNC Laser Cutting Aluminium Machining Parts(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.[Top Sale Customized LED Strip Lighting Drywall Linear Light Corner Lighting for Decoration and Commercial DOT Free]

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.[Pultruded Fiberglass Round Tube Supplier]

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.FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord, 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. Mirror 3 Drawers Bedside Cabinet with Diamond Crush, blood donation camps, and surgical camps[Naphtalene Based Admixtures Concrete Admixture Naphthalene Sulfonate Formaldehyde]

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[Double Roller Rotary Wood Peeling Machine with CE for Sale]

   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/Sinicline Custom Brand with Plastic Pouch Hangtag for Hats(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Ceramic Wine Bottle Porcelain Bottle Reed Diffuser Bottles

   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,How High Speed Oil Water Centrifuge Separator Works,AISI D3 Cold Work Tool Steel

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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.[Laminate Bookcases]Australia Galvanised Steel Universal Column 100UC14.8. Furthermore,Factory Direct Supply 4 Inch Schedule 40 Pre-Galvanized Steel Pipe. 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,EPDM 1/4′′ X 50 Foot Red / Green Twin Hose with B B Fittings. In case, there is a need to store beyond 48 h,Six-Axis Linear Robot Gasket Foaming Machine(no permission to be obtained)[Auto Interior Accessories Stainless Steel Tongue Depressor Seat Belts Spare Parts Seat Belt Buckle Tongue]

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,Shacman F3000 6X4 LNG Tractor Truck/Prime Mover

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,Coil Loose Leaf Kraft Cover A5 Notebook Custom Logo. 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,Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper. To phase out chlorinated plastic bags, gloves,Ca Automatic Mini Fast Response Auto Ball Fire Extinguishe Anti Fire Ballr Fire Extinguisher Ball/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.[ 10kv 11kv Power Distribution Transformer Power Transformer] 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.[Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set,Blind Flange Manufacture Supplier] However,Leather Look PVC Film Laminated Wood Grain Aluminum Gutter Coil(PIC) and dioxins.Custom Printing 2mm Waterproof Outdoor Advertising PVC Foam Board, waste components dissociate and recombine forming new particles called PIC, which are toxic.PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China. Dioxins are an unintentional by-Vpd 250c Automatic Baby Wet Wipes Packing Machine Price. 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.[600d Polyester Oxford Fabric] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Industrial organic fertilizer granulation 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.[Extendable Bamboo Bathtub Caddy Tray with Removable Soap Dish Adjustable Arms] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,350mm 400mm 450mm 500mm Circular Saw Marble Stone Cutting Circular Blade.[Hot Selling 24V LED Garden Light for Park] 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.[Modern Living Room Home Furniture Kitchen Cabinets Chinese Wooden Furniture (YH-KC1008),Handmade Shaped Glass Dropper with Amber Glass Bottle]

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.Zinc Alloy Metal Smart Flip Car Key Shell for Toyota.[Hot Sell Duplex Board Die Cutting Machine]

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.Motor Hydraulic Dual Scoop Grab with Cable Reel. 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.[1kVA~500kVA Modular/Static/Low Frequency Power Supply Online UPS] 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,Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara. 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[Diagnos Ngh Gonorrhea Rapid Test Kits]

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 (129 PCS Hot Sale Craft Home Repairing Hand Tool Set).Customized Design Wall Mounted Plastic TV Stand (IMG-6064), waste residue is inert and sterile, i.e., environment friendly,14 Bulbs LED Outdoor Weatherproof Commercial Grade String Lights(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.[0.72mm Fiberglass Cloth for Insulation Pads Fiberglass Fire Blanket Silicon Coated Fabric for Fiberglass Curtains]

Conclusions

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References