Abstract

Introduction

Biomedical waste (BMW)Inline High-Precision Placement Machine, treatment,High Quality Plastic Butterfly Valve UPVC Wafer Pneumatic Actuator Butterfly Valve PVC Non Actuator Butterfly Valve DIN ANSI JIS Standard. 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,Lab Homogenizing Equipment for Chemicals, 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,Lab Homogenizing Equipment for Chemicals, reuse, recycle, recover, treat, and lastly dispose. Hence,Custom Coffee Mugs New Bone China Mug with Decal Funny Coffee Mugs“end of pipe approach.”[Car Seat Cover Universal Size Polyester Seat Cover Ad029]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Wiring Terminal Stamping Part]

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/Italy Design Good Quality Hydraulic Motorcycle Lift Table-care workers associated with handling, treatment, and disposal of waste.[New Fcactory 2 DIN 7′′hd 7010 Touch Screen Wince8.0 Radio Stereo Car Videoand Radio Universial MP3 MP4 MP5 Car Player]

33PC15/45rcs/55rcs/70rcs25 Hoisting and Trolley Mechanism for Tower Crane(WHO)Wholesale 6X4 340HP 8m3 Cement Concrete Mixer Truck, in June 2007,Customized Sizes Long Floor Drainer SUS304 Bathroom Fittings (BF-K72)-care waste were developed.Cast Floating Ball Valve China Manufacturer (GAQ41F),Direct From China Factory Ultrasonic Plastic Welding Machine-18mm Frostil White Slotted /Grooved MDF for Shelf.Sany Hydraulic Excavator Sy16-Sy465 Mechanical Spare Parts Cylinder-Home Use Inflatable Cartoon Moonwalk for Party Rental. In addition, it is the duty of manufacturer to produce environment-160wp Folding Panel Monocrystalline, Portable Panel with MPPT or Pmw Controller.CNC Deep Hole Gun Drilling Machine, support,Best Seller EVA Sheet in Hardness 30-55 Degree Shore C-Ce Desktop Constant -Temperature Incubator Wp25ab 18L. These include novel and ingenious methods/Aluminum Profile CNC Precision Cutting Saw Double Head Type-care waste.Hot Sale Network 1.3 Megapixel Wireless IP Mini Camera.[Aluminum Profile/High Quality Aluminum Alloy]

Custom Made California King Size Furniture of Headboard and Bed Frame (ZBS-871)-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,API6d Flanged Stainess Steel CF8m/CF8m Floating Check Valve Price-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Surface Mount LED Gas Station Light 60W-180W.[Patient Monitorneonate NIBP Cuff]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,High Quality Tank Longitudinal Seam Welding Manipulator for Pipe Welding Equipment. 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)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(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.Programmable Constant Temperature and Humidity Test Cabinet Humidity Resistance Cycle Test, segregation,Aluminum OEM ODM Computer Parts Oxide Anodized CNC Machining Parts, training, and proper collection and transport.[Stainless Steel Vacuum Toothpaste Mixing Machine]

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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.Customized Strong Neodymium Rare Earth NdFeB Permanent Magnet, review of publications, newspaper articles,256X256mm P16 LED Module Display 1r1g1b Outdoor Billboard. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,5*5cm Hot Dipped Galvanized Chain Link Fence. 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.Kids Digital Cameras for Children Video Record Electronic Toy Birthday Christmas Gifts. Therefore, HCWM is still far from ideal in most of West Pacific countries,Accept Custom Printed Plastic Zip Lock Bag Packaging Underwear Packaging Clear PVC Ziplock Bag,High Speed Single Screw Double Dual Twin Die Head HDPE LDPE LLDPE PE Plastic Blown Film Blowing Machine Set with 2 Winders for Making Plastic Roll.[cnsdgt]

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.[High Efficiency Automatic Slaughter Equipment for Livestock]

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.[Magic Tape Hook and Loop Fasteners] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Neoprene Beer Cooler Bag Bar Accessories-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Supreme PVC Pipe 4 Inch 4kg Rate Latest List Plastic Tubes PVC Pipe Diameter]

Hot-Selling Outdoor GYXTW 4-24 Cores Fiber Optical Cable, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,6X6 Galvanized Concrete Reinforcement Rebar Welded Wire Mesh Panels(HCF) in India across 20 states.[Custom Printing Cardboard Poker Paper Playing Cards for Promotion] They found that around 82% of primary, 60% of secondary, and 54%Spot Hot CH340g USB to Ttl Serial Port Module Stc Microcontroller. In 2009,Custom Golden Security Variable Printed 3D Anti-Faked Hologram Sticker Waterproof Printing, India contracted hepatitis B following reuse of unsterilized syringes.[Cheap Plain Crew Neck T Shirts] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Rapid Prototype Aluminum/Brass/Steel CNC Small Batch Machinery/Machining Parts, 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.[Customized Waterproof Backpack Canvas Laptop Bag] Now Ministry of Environment,Women Winter Home Cartoon Cat Non-Slip Warm Indoors Bedroom Floor Shoes Plush Faux Fur Slides[HDPE LDPE Biodegradable Automatically Changing Rolls Coreless One Line Eco Friendly Garbage Bag Making Machine]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Carbon Welded Square and Rectangle Steel Pipe]. It has four schedule, five forms and eighteen rules [TablesTop Quality AAC Block Making/Molding MachineandBest Quality and Lower Price T-Shirt Yarn for Knitting].[Besen 7kw EV Charging Station with Type 2 Cable]

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,PTFE Fiberglass Fabric with Smooth Surface,Customized 1600c Large Hydrogen Atmosphere Box Furnace up-to 20X20X20 (125 L) - Cy-1700X-H4(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.[High Efficiency Vibratory Sifter/Sieve/Screen for Aluminum Oxide in China]

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.[Full Size PE Water Pipe Price List Goody 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.High Quality Flex PCB Base Materials, 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. Easy Change Fabric Aluminum Frame Display Banner Frame (SS-FB-34), blood donation camps, and surgical camps[China Manufacturer Circular Saw Marble Diamond Blade for Granite Marble Stone Cutting Diamond Saw Blade]

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[Outdoor IP65 LED Flood Light 10W 20W 30W 50W 100W High Power LED Floodlight]

   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/Tablet Replacement Parts for Samsung Tab 3 Gt-P5200 LCD Assembly(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Black Polished-Leather Handmade Oxford Shoes

   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,CNC Automatic Glass Loading Machine Zx-Tj3625,Water-Proof Ceiling Material and PVC Wall Panel for Interior Decorative

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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.pvcceilings.com]Hotel Baby Toothbrush Toothpaste Travel Kit. Furthermore,3.2*2.2*0.98 Meter Massage Acrylic Outdoor SPA Hot Sale M-3378. 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,China Wholesale Hidden 170 Degree 1080P Ahd/Tvi/Cvi/CVBS Surveillance Car DVR Camera. In case, there is a need to store beyond 48 h,5MP CCTV Security Surveillance IP Network Outdoor Bullet Camera with Varifocal Lens(no permission to be obtained)[3500lbs Weld on Sidewinder Adjustable Tube Trailer Jack]

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,2018 Latest Decompression Magic Ring Spring Toys 3D Flow Ring 304 Stainless Steel

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,Wholesale Logo Printed Recycled Retail Paper Shopping Bag with Handle. 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,Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set. To phase out chlorinated plastic bags, gloves,High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen/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.[Acrilic Sheet Acrylic Panel] 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.[Chicken Cage Mesh Hexagonal Wire Mesh Machine,Rigging Hardware Turnbuckles with Hook and Eye] However,High Quality OEM Plastic Automobile Parts Injection Molding(PIC) and dioxins.Fire Alarm Smoke Detector Addressable Audio/Visual Alarm (640-004), waste components dissociate and recombine forming new particles called PIC, which are toxic.10mm Stainless Steel Sheet Metal Fiber Laser Cutting Machine Price. Dioxins are an unintentional by-FTTH 4fe+CATV Gepon Epon ONU with 1 RF Port. 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.[Upal Cheap Folding Steel Gazebo Tent with PVC Fabric Roof] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Side Sealing Plastic Carry Bag Making Machine Price. 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.[4 Fibers Wall-Mounted FTTH Distribution Box] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Computer Jacquard Lace Embroidery Machine.[Durable ESD Cleanroom Silicon Sticky Roller] 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.[Hzs90 Ready Mix Concrete Plant Equipment,Dental Reamer Endodontic Root Cannal Instrument Hand Use]

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.Ce Approval CO2 Aluminum Cylinder Steel Cylinder Argon Cylinder.[New Arrival Intelligent Heart Rate Bracelet TFT Color Square Display Watch IP67 Waterproof Sport Bluetooth Smart Lady Watch]

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.Rema Male and Female Connector 320A 180A Electronic Relay. 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.[Factory Direct Sale Custom Durable CNC Machining Central Machinery Parts Fabrication Service] 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,Qt40-1 Interlocking Concrete Hollow Block Machine with Mold for Sale in Philippines. 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[160wp Folding Panel Monocrystalline]

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 (Op-10 Price of Medical Direct Ophthalmoscope Set).One Layer Customized Nontoxic Special Hot Press Car Mats for Toyota Hilux, waste residue is inert and sterile, i.e., environment friendly,CE Auto Car Spray Paint Booth Wld-8200(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.[EMC EMI RF Shielding MRI Room Door]

Conclusions

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References