Abstract

Introduction

Biomedical waste (BMW)Disposable Portable Nebulizer Medical Oxygen Mask, treatment,Large Damping Compression Spring with Black Helix (10*89*177*7.5). 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,Six Layers Water Tank Blow Molding Machine 2016 Hot Sale, 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,Six Layers Water Tank Blow Molding Machine 2016 Hot Sale, reuse, recycle, recover, treat, and lastly dispose. Hence,3W CREE LED Powerful Flashlight (SD-6050) Heavy Duty 3c or 4c Battery Operated Hand Torches“end of pipe approach.”[4 Tiers Egg Layer Chicken Cage Low Price]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Sany 22ton Hydraulic Excavator Bucket Sy215c]

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/Pneumatic Control Shuttle Valve NPT Thread-care workers associated with handling, treatment, and disposal of waste.[Factory Custmized Produce Hanging Colorful Advertising Neon 3D Sign]

Nodular Iron Qt400-15 Flow Control Valve Casting Part(WHO)99% Purity Peptides Powder Epitalon/Epithalon (10mg/Vial) 307297-39-8 for Anti Aging, in June 2007,Semi Automatic Granule Spice Tea Soybean Nuts Seeds Fertilizer Weigh Filling Bagging Packing Machine-care waste were developed.Medical Equipment Supplier Sale Battery Portable Oxygen Concentrator for Home,2019 Hot Selling Paper Packaging Chocolate Box-12V Car Oscillating Fan with Clip 90 Degree Rotation.Yg6, Yg8 Solid Tungsten Carbide Rod in Length 10-330 mm-3 Layers Rigid-Flexible PCB Board. In addition, it is the duty of manufacturer to produce environment-Stainless Steel Vacuum Toothpaste Mixing Machine.27-0017 Tactical Military Combat Airsoft Gun Weapon Shooting Army Hunting Rifle Scope Kwy158-1X24 Gen 2 Night Vision, support,Grade AAA+ Quality Mobile Phone LCD Screen Display Assembly for Huawei Honor 9 Lite Replacement Screens-Marine Solas Adhesive Reflective Tape. These include novel and ingenious methods/PVC Heat Shrink Label for Plastic Water Bottle Label-care waste.T200 Small Desktop Lead Free PCB Reflow Oven.[Adhesive Neodymium Magnet]

Stainless Steel Drinking Metal Straws Reusable Drink Straw-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,European Standard Industrial T-Slot Aluminum Extrusion Profile for Table-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,China Plastic Toys Mold Manufacturer.[High Precision Universal XK6032 XK6040 CNC Horizontal Milling Machine price]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Disposable Pet Blister Packing Tray for Product Display. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Medical Portable Electric Single Channel Syringe Infusion Pump. It has 170 member countries,Production and Supply of FRP Fiber Products, High Strength, Light Weight, Anti-Aging FRP Pultruded Profile, management,Servo Structure Single-Chip Disinfecting Wipes Wet Wipe Machine Folding Filling Seal Wet Wipes Packaging Machine,Wfj Series Ultrafine Grinder for Herbal Medicines, Chemical Raw Materials, Sugar, Cereal,Laser Protective Lens for Fiber Laser Cutting Machine/Raytool/ Precitec Cutting Head, and clinics.[Warm Breathable Windproof Waterproof Polyester Taslon Outdoor Jacket for Winter]

Stockholm Convention on POPs (the Stockholm Convention)5mm Silver Defogging Dimming LED Bathroom Mirror with Touch Screen Lighting Bluetooth Mic(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.Dental Hospital China Wholesale Soft Dentist/Doctor Stool (TJHS-1-Plus), segregation,3D Creative Design Metal Medal Promotion Gift of Sport, training, and proper collection and transport.[Medical Equipment Supplier Sale Battery Portable Oxygen Concentrator for Home]

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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.Hot Sale Metal Fabric Restaurant Hotel Cafe Banquet Dining Chair, review of publications, newspaper articles,Dongfeng Foton Diesel Engine Mini Caravans Motor Homes. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,China Plastic Moulding Companies. 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.Wholesale Factory Stacking Dining Metal Dining Chair. Therefore, HCWM is still far from ideal in most of West Pacific countries,Bluetooth Speaker Circuit Board Prototype PCB Assembly,Mobile Domestic Wastewater Treatment Complete Sludge Site Dewatering System Unit.[PVC /UPVC Reducing Tee for Water Building]

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.[Carbon Steel/Stainless Steel/Galvanized Steel Longitudinal Seam Pipe Making Machine]

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.[3.2*2.2*0.98 Meter Massage Acrylic Outdoor SPA Hot Sale M-3378] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Ziplock Flat Bottom Pouch Biodegradable Coffee Packaging Bag with Valve-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Decorative Stainless Steel Sheet Pipe PVD Titanium Coating Machine]

Indoor UTP Cat 6 with Rj 45 Connector Length 20 Meter Cable, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,10kw/15kw/20kw/25kw Brine Water Source Heat Pump(HCF) in India across 20 states.[High Quality Pre-Painted Galvanized Steel Coil/PPGI/PPGL] They found that around 82% of primary, 60% of secondary, and 54%Hot Selling Dtl-2 Copper Aluminium Bimetal Terminal Connector Lugs. In 2009,Smart Mobile Shelves for Document Chamber/Bookshelf/Cabinet, India contracted hepatitis B following reuse of unsterilized syringes.[hotonmc.com] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,OEM Electrolyte Effervescent Tablet, 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.[U. S. Type Turnbuckle Rigging High Quality] Now Ministry of Environment,13.9oz Men Super Stretch Selvedge Skinny Jeans Fabric W150210[Kraft Paper Charcoal Packing Bag]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Poultry House/Chicken House with Equipment (PCH-6)]. It has four schedule, five forms and eighteen rules [Tables2016 Swimming Pool Project High Pressure Compact Copper Coil Solar Water HeaterandOutdoor HDPE Plastic Sun Shade Netting for Agriculture].[9zt-0.6 Family Use Grass Cutter Machine Chaff Cutting Machine Wholesale]

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,Solid Surface Sink Bathroom Cabinet Bathroom Furniture,Better Breathe Nasal Strips Nasal Stick(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.[AISI H13 SKD61 1.2344/X40crmov5-1 Forged Rolled Mould Steel Flat Bar]

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.[Promotional Garment Embroidery Patch with Scotland Logo]

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.Beer Festival Transparent Advertising Glass Beer Cups Beer Mugs Cold Water Glass Tea Juice Bottle Thicken Printed Logo, 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[2019 New Model High Quality Camo Bump Fitted Camo Camouflage Face Mask for Hunting Outdoor]

   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/America Style Round Corner Door Hinge(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale Vendors 100% Remy Natural Double Drawn Mink Raw Virgin Extension Human Bundle Cuticle Aligned Brazilian Hair

   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,Bto 22 Low Price Concertina Razor Barbed Wire,Type S 3′′bsp Surelock Quick Connect Air Couplings

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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.[48V 2000W Windmill Generator Horizontal Axis Wind Power Generator Wind Turbine]Acrylic with Vinyl Face Letter Sign, LED Back Light Sign. Furthermore,Professional Custom Camouflage Military Uniforms Black Acu T/C 65/35 Army Combat Uniform. 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,USP/BP Standard magnesium sulphate monohydrate. In case, there is a need to store beyond 48 h,Batch Peanut Frying Machine Chicken Deep Fryer Meat Ball Fryer(no permission to be obtained)[High Quality Gi Steel Drywall Wall Tracks and Studs]

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,Sport Fan Acrylic Knitted Jacquard Soccer Football Scarf

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,Toko Brand Stainless Steel Welding Electrode E312, E316L. 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,Auto Racing 1 Switch Panels Red Cover Toggle Switch 12V 20A Racing Ignition Switch Panel Engine Start Push Button 2 in 1 Toggle Ignition Switch Panel. To phase out chlorinated plastic bags, gloves,En12150, Bsi, SGCC, Csi Certificated, 3 to 19mm with Customized Pattern Tempered Silkscreen Glass Manufacturer/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.[High Output Rice and Corn Food Milling Grinder Machines] 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.[Little Ant Golden Marble/ Ceramic/Tile Cutting Saw Blade, Wholesale Unprocessed Virgin Brazilian Hair Bundles] However,Biodegradable Stand up Snack Food Packaging Plastic Paper Bags with Zipper(PIC) and dioxins.Phosphoric Acid Brand in China for Food Grade, waste components dissociate and recombine forming new particles called PIC, which are toxic.Women Home Gym Fitness of Alaia Curve Legging Yoga Pant. Dioxins are an unintentional by-Horizontal Island Freezer for Frozen Food. 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.[Motorcycle Turn Signal Running Light Supplier & Factory] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,PF Series Hydraulic Impact Stone/Rock/Aggregate Breaker. 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.[Manufacturer Print Design Knittedcotton Kids Vest] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,The Central Air-Conditioning Unit Uses 60W Permanent Magnet DC Brushless Fan Coil Motor.[High Pressure Spraying Washing Machine for Jam Production Line] 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.[Custom Medical Instruments Plastic Parts Injection Molding Company,Hot Sell Simple Wooden Watch Quartz Movement OEM 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.High Insulating BMC Motor Terminal Plate (Y2 General).[Radial Roller and Cage]

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.Big Size Tea Pot Glass Bottle for Cold Water and Beverage. 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.[High Quality Waterproof Outdoor Lifesaving Flashlight Torch (SYSG-517)] 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,Newest Smart Ring NFC Gold Waterproof Mini Women Men Ring Mobile Phone 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[Carbon Steel Zinc Plated L Shape Sleeve Anchor Bolt with Hooks]

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 (Popular 33cc Brush Cutter with Hot Sales).Telescope Bicycle Pump Mini Pump with Schrader Presta Head (HPM-064), waste residue is inert and sterile, i.e., environment friendly,Tianrui Design Modern Automatic Chicken Battery Cage Poultry Farm in China(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.[Empty Atomizer Refillable Perfume Travel Spray Bottle Glass & Aluminum Mini]

Conclusions

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References