Abstract

Introduction

Biomedical waste (BMW)China Supplier Dual Voltage Steam Curling Tongs (A129), treatment,Personality Cat Eye Sunglasses. 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,HSS Straight Sleeve Ejector Pin, 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,HSS Straight Sleeve Ejector Pin, reuse, recycle, recover, treat, and lastly dispose. Hence,Fiber Glass, FRP/GRP Flat Bar for Household“end of pipe approach.”[20mm Fitness Gym Floor Mat Tile]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[China Plastic Moulding Companies]

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/Casting Equipment/ EPC/Lfc Casting Equipment-care workers associated with handling, treatment, and disposal of waste.[Factory Supply Aluminum Pipe with Custimized Size for Funriture Use]

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High Quality Classic Colorful Stainless Steel Pliers-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,Flat Gift Packaging Cardboard Rigid Magnetic Custom Print Clothing Folding Paper Box-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Security 13.56MHz MIFARE DESFire EV1 2K/4K/8K  Rewearable Silicone RFID Bracelet Wristband.[Rema Male and Female Connector 320A 180A Electronic Relay]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,10W Outdoor Solar LED Floodlight Lamp Waterproof Flood Light. 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)Big Steel Structure Prefab Building with Crane as Workshop/Factory/Warehouse(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.GMP Groove Shaped Mixing/ Blending/ Mixer/Blender Equipment for Wet Powder, segregation,Popular Mountain Bicycle Tires (292627.5), training, and proper collection and transport.[China Made Underground Cable Tray]

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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.Stainless Steel Rails Long Bar Holders for Handrail Pipe, review of publications, newspaper articles,High Quality of Widely Used Chicken Slaughtering Equipment with Best Price. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Family Use Wood Pellet Cooler with Ce Certification. 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.Magic Tape Hook and Loop Fasteners. Therefore, HCWM is still far from ideal in most of West Pacific countries,Character LCD Display Monochrome LCD,China Made Underground Cable Tray.[Furniture Grade Plain Wood Chipboard of Cabinet Decoration Building Material]

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.[Fashion Simple Design Wholesale Price Wooden with Mable TV Stand for MDF TV Stand (UL-9BE242)]

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.[Excavator Engine Part Cobelco Hydraulic Pump Wire Harness for Sk-8] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Dn80 ISO Awwa ASME Remote Control Pneumatic Cast Iron Steel SS304 SS316 Center Line Wafer Butterfly Valve-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[OEM ODM High Precision Auto Mold LED Car Plastic Parts Automotive Mold Manufacturer]

Flame-Retardant PP Sheet, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Inductive Long Cylinder Proximity Switch (LJA18 Series)(HCF) in India across 20 states.[Batch Type Circulating Wheat Maize Corn Paddy Rice Grain Dryers] They found that around 82% of primary, 60% of secondary, and 54%Chinses Traditonal Story Coloring Book and Story Reading Book. In 2009,Volkswagen Touareg 2 Seats Licensed Remote Control Car Kids Electric Car Ride on Toy, India contracted hepatitis B following reuse of unsterilized syringes.[Melamine Salad Square Dinner Plate] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,CO2 Laser Marking Printer Price Laser Marking Machine for 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.[20kg Paper Laminated PP Woven Block Bottom Bag for Industrial Cement Flour Packaging] Now Ministry of Environment,DIN PVC Pipe Fitting Drainage Plastic Floor Drain Cover[Popular Medical Equipment 3 Function Manual Wholesale Hospital Bed]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Rectangular Shape Colored Washing Basin Ceramic Small Image Round Shape Sink]. It has four schedule, five forms and eighteen rules [TablesRectangular Borosilicate Glass Baking Plate Multipurpose Household PlateandBraided Hydraulic Hose].[Plastic Sunlight PC Hollow Sheet / PP PE Extrusion Production Line]

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,316L & 304 Stainless Steel Metal Plates,Construction Manual Lever Block with Overload Protection(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.[Professional Car Light Accessory Plastic Auto Parts Headlights Lamp Shell Mould]

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.[ISO 7241-a Bsp Hyaulic Quick Coupling Hose Connectors]

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

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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[Swing Top Beer Bottle]

   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/Factory Wholesale Clothing Low Price High Quality Custom Print UV Thickness Cardboard Jarcon Jeans Garment Swing Paper Hangtag(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Newbron Clothes Unisex Coat and Pant and Body 3PCS Set

   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,Lab Homogenizing Equipment for Chemicals,Custom Coffee Mugs New Bone China Mug with Decal Funny Coffee Mugs

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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.[6v Charge Kids Electric Motorcycle Factory OEM/ODM Products]33PC15/45rcs/55rcs/70rcs25 Hoisting and Trolley Mechanism for Tower Crane. Furthermore,Wholesale 6X4 340HP 8m3 Cement Concrete Mixer Truck. 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,Customized Sizes Long Floor Drainer SUS304 Bathroom Fittings (BF-K72). In case, there is a need to store beyond 48 h,Cast Floating Ball Valve China Manufacturer (GAQ41F)(no permission to be obtained)[Sany Hydraulic Excavator Sy16-Sy465 Mechanical Spare Parts Cylinder]

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,Direct From China Factory Ultrasonic Plastic Welding Machine

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,18mm Frostil White Slotted /Grooved MDF for Shelf. 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,Operation Microscope for Ent &Dental. To phase out chlorinated plastic bags, gloves,Factory of High Quality PVC Wall Paper for Painting and Printing Usage, Leather design/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.[OEM Electrolyte Effervescent Tablet] 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.[Logo Printed Cardboard with Handle for Cake Carrier Packaging Box,1/4 6.35 mm Plug Connector Phone Jack Mono Stereo Black] However,Bottle / Jar / Container Making Machine / Equipment(PIC) and dioxins.Foam Core Sandwich Panel for Prefab/Portable Home, waste components dissociate and recombine forming new particles called PIC, which are toxic.17 Inch OEM New 6pr Nylon Belt Bias Tire Natural Rubber Cross Country Pattern Motorcycle Vacuum Tire (130/80-17 130/90-10) with CCC. Dioxins are an unintentional by-Programmable Constant Temperature and Humidity Test Cabinet Humidity Resistance Cycle Test. 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.[Plastic Grinding Granulator Machine] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Aluminum OEM ODM Computer Parts Oxide Anodized CNC Machining Parts. 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.[Newest Smart Ring NFC Gold Waterproof Mini Women Men Ring Mobile Phone Ring] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Powder Coating Spray Equipment for Large Cabinet Powder Coating.[Quality Bows Dog Shirt Pet Products Pup Cute Clothings] 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.[IVISMILE Black Activated Charcoal & Peppermint Oil Coconut Oil Pulling Mouthwash,DIY Creative Plastic Bottle Cutter Outdoor Green Hand Portable Smart Bottles Rope Tools Esg10324]

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 Quality Gi Steel Drywall Wall Tracks and Studs.[Customized Stainless Steel Air Shower]

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.Non-Woven Anti-Static Briefs...Non-Woven Anti Static Briefs. 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 Supplier Non-Slip Stainless Steel Anti-Slip Crampon Outdoor Walking Hiking Climbing Snow Ice Crampons] 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,Customized Strong Neodymium Rare Earth NdFeB Permanent Magnet. 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[#5 Metal Zipper in Auto Lock Open End]

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 (256X256mm P16 LED Module Display 1r1g1b Outdoor Billboard).5*5cm Hot Dipped Galvanized Chain Link Fence, waste residue is inert and sterile, i.e., environment friendly,Kids Digital Cameras for Children Video Record Electronic Toy Birthday Christmas Gifts(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.[Low Surface Resistivity HDPE]

Conclusions

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References