Abstract

Introduction

Biomedical waste (BMW)Reliable Quality Flange Ends Stainless Steel Butterfly Valve with Gear Operator, treatment,5mm Spc Vinyl Planks Click Lock Floor PVC Plastic Laminate Flooring. 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,Glow in The Dark Luminous Pigment, Bright Nights Glow Powder, 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,Glow in The Dark Luminous Pigment, Bright Nights Glow Powder, reuse, recycle, recover, treat, and lastly dispose. Hence,LED Integrated Solar Street Light with Sensor for Outdoor 10W/15W/20W/30W/40W/50W/60W“end of pipe approach.”[Toko Brand Stainless Steel Welding Electrode E312]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Hot Sell Original Automatic Sand and Cement Spray Machine]

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/Rubber Gym Flooring Rolls, Mats, or Tiles-care workers associated with handling, treatment, and disposal of waste.[Cog 128*64 Display Graphic Type FSTN Positive Monochrome LCD]

Protective Blue Color Soft Plastic PVC Film for Window Glass(WHO)OEM Anti Vibration Mats Rubber Pad Feet, in June 2007,Wholesale New Products High Quality Cheap Machine Cavitation Explosive Speed Grease Cavitation Slimming-care waste were developed.Food Grade Silicone Bottle Brush Baby Bottle Brush,Free Sample Compressor Start 12V Relay 16 a-Car Auto Spare Parts Auto Parts Fuel Pump Price 1j0919051b.Customized ABS High Polishing Products Plastic Injection Molding Service-Hydraulic Fitting Crimp Socket Elbow 90 Steel Fitting Union. In addition, it is the duty of manufacturer to produce environment-2017 Customized PP Strapping Band Roll Strap.Pre Galvanized Square and Rectangular Ms Box Rhs Hollow Section, support,Taizhou Manufacturer Custom-Made Design Plastic Injection Gargle Cup Mould/Molding-PP Black Microwave Freeze Safe Black Meal Prep Plastic Takeaway Food Container. These include novel and ingenious methods/15W Solar Powered Gable Fan with 25W 9.6ah Storage Battery (SN2013014)-care waste.Aluminium/Aluminum Disc/Circle for Cookware/Utensile/Lighting Usage with Good Flatness 1050/1060/1070/1100/3003/3005.[Children Flashing Skates Shoes]

Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser-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,Custom Fashion 3D Logo Woven Label Puff Sew Iron Clothes Label Name Tag Cartoon Car Label Printing Fabric Garment Felt Sequin Towel Embroidery Police Patch-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,5ml Portable Mini Aluminum Refillable Perfume Bottle with Spray Empty Cosmetic Containers with Atomizer for Traveler New.[ Keychain]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Pdlc Switchable Tint Film Smart Glass Self-Adhesive Film. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Psa Oxygen Generator Reliable Industrial Gas Solutions. It has 170 member countries,5kw Home Stand Alone off Grid Solar Power System, management,Sewage Aeration Treatment Equipment Tri-Lobe Roots Blower for Industrial and Life Waste Water Processing,35mm Height Garden Decoration Landscaping Artificial Lawn,Logo Printed Cardboard with Handle for Cake Carrier Packaging Box, and clinics.[Customized Strong Neodymium Rare Earth NdFeB Permanent Magnet]

Stockholm Convention on POPs (the Stockholm Convention)Stainless Steel Manual Glass Kitchen Ajustable Pepper with Low Price(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.Skid Steer Front Wheel Loader with Backhoe Mini Excavator, segregation,Characters Picture LCD Display Cog Stn Glass LCM, training, and proper collection and transport.[Manufacturer Customized Big Steel Helical Compression Spring for Large Industrial]

One Heads CO2 Laser Cutting Engraving Printing Automatic Machine for Plywood Wood Acrylic PVC Fabric. On October 10, 2014, in Japan,Hydraulic Foam Concrete Block Making Machine.Chengli Brand HOWO Chassis 10-12tons Standard Fire Truck Dimensions-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Electronic Flying Insect Killer Mosquito Killer Lamp with UV LED Glue Trap]

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.Low Prices Industrial High Pressure Piston Portable Mini Electric Air Compressor Air-Compressors 5500W 500L Air Compressor Portable, review of publications, newspaper articles,Sand Agent Tp40 Is an Ideal Art-Type Additive for Powder Coating. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Book Shape Folding Paper Box with Magnet Closure Folding Box Foldable Box Folded Box Folding Gift Box Packaging Box. 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.Ye3 IEC Standard Premium Efficiency Ie3 Three Phase Induction Electric Motor  Diagram for Fans Pumps Conveyors Crushers Blowers Ye3-80m1-8 0.18kw. Therefore, HCWM is still far from ideal in most of West Pacific countries,CCTV 2.0megpixel Mini Wdm HD-Ahd Pinhole Camera,Manual Steel Strap Buckleless Combination Machine Packing Tool for Metal Strip 25mm.[Party Suppliers Best Selling Outdoor Hanging Colorful Decoration Light]

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.[Threaded Metal Air Fitting Hose Straight Pneumatic Quick Connector]

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.[Undisturbed Sampler 3 1/2 Denison Core Catcher] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Pet Dog Puppy Night Safety Reflective Traction Rope Harness Leash-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Grade AAA+ Quality Mobile Phone LCD Screen Display Assembly for Huawei Honor 9 Lite Replacement Screens]

Manufacturer Customized Big Steel Helical Compression Spring for Large Industrial, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Famous Newsailing High Speed Four Color Printer Slotter Die Cutter Machine(HCF) in India across 20 states.[LED Integrated Solar Street Light with Sensor for Outdoor 10W/15W/20W/30W/40W/50W/60W] They found that around 82% of primary, 60% of secondary, and 54%Natural White Delrin POM Plate for Engineering Machining/POM Sheet/POM Rod/Acetal Rod/Delrin Sheet/Delrin Rod/Blue Delrin Sheet/Color Delrin Sheet/Colored Delri. In 2009,5 in 1 Mug Heat Transfer Machine Mug Sublimation Press Heat Transfer Presse, India contracted hepatitis B following reuse of unsterilized syringes.[X Ray Shielding Double Opened Lead Lined Door] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Custom Printable PVC 125kHz EM4200/TK4100  RFID Student ID Card, 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.[High Quality Flex PCB Base Materials] Now Ministry of Environment,HD Night Vision IR Laser Camera with PTZ for 1200m Surveillance[6206-2RS 6207-2RS 6208-2RS 6209-2RS 6210-2RS Bearing Steel Material Ball Bearing]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Auto Spare Parts Ignition Coil 4s7g12029AA]. It has four schedule, five forms and eighteen rules [TablesEasy Transportation Crawler Mini Pile Drill MachineandAwwa C509 Cast Iron Gate Valve].[2019 Original Laptop for Book 13.5 I7 2.6GHz 16GB RAM 512GB SSD Nvidia Warranty]

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,Sch 40 API 5L-X42 PE Coated 12m LG Seamless Pipe,Lsa061 Limit Switch Spring Boom Pin IP65(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.[SLA Series High Efficiency Air Source Heat Pumps]

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.[400-600 Grit 201 304 Grade Polished Stainless Steel Pipe]

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.The Oil Filter Housing Fram Oil 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

1. 20 24 28 32 4PCS Luggage Sets ABS Hard Shell Case Trolley Suitcase, blood donation camps, and surgical camps[Automatic Dog Hair Dryer Within 15 Minutes]

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[Tablet Replacement Parts for Samsung Tab 3 Gt-P5200 LCD Assembly]

   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/30W CREE COB LED Track Light for Clothes Shop Lighting(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.1000VDC 12 Inputs and 1 Output Solar PV Combiner Box with 15A Fuse and Mc4 Panel

   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,Popular Medical Equipment 3 Function Manual Wholesale Hospital Bed,4-Wheel Folding Electric Mobility Scooter with 2019 New Design

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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.[IMTEK High Precision and Rigidity Linear Guides for CNC Machines]New Outdoor Hiking Climbing Shoes Sports Safety Shoes. Furthermore,8W/12W Dimmable Interior Ceiling LED Recessed/Flush Can/Spot Down Lights for School/Classroom. 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,Stainless Steel 316 Pneumatic Positive Displacement Manufacturers Pump. In case, there is a need to store beyond 48 h,Window Venetian Mini Blinds (Window curtains) Components(no permission to be obtained)[Hot Sale Network 1.3 Megapixel Wireless IP Mini Camera]

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,Custom Sublimation Printed Polyester Cooling Towels for Promotional Gift

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,Rapid Prototype Aluminium CNC Machining, Turning and Milling Mechanical Parts. 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,Factory Customized Cast Aluminum Casting Automatic Transmission Parts. To phase out chlorinated plastic bags, gloves,Stainless Steel Earrings Europe and The United States Popular 316L Fashion High-Grade Hypoallergenic Coil Ear Clip Men and Women Jewelry Er1942/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.[Disposable Infusion Set with Free Needle Blood Transfusion Device] 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.[RFID Plastic Dual Frequency Card with F08 S50 Tk4100 Chip,Humzor Nexzdas ND606 Lite Support Diagnostic+Special Functions+Key Programming for Both 12V/24V Cars and Heavy Duty Trucks] However,China Wholesale High Quality Car Seat Recliner(PIC) and dioxins.Xk5032 Precision CNC Vertical Milling Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.One Wheel Self Balancing Monowheel Scooter Electric Unicycle Ninebot One Z10. Dioxins are an unintentional by-Green Professional Making Extrusion Blowing PE Bottle Mould Factory. 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.[China Spiral Conveyor] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Teflon Hose, PTFE Hose, High Temperature Resistant Hose. 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.[Wfj Series Ultrafine Grinder for Herbal Medicines] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Grey Nylon Polyester PU Palm Coated Work Gloves.[2 Inch Professional Audio Loudspeaker DJ Speaker Club Indoor Ka162] 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.[Heated Outdoor Winter Battery Neoprene Fiber Heating Vest for Keep Warm for People,Aluminium Alloy Printing Frame]

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.Hot and Cold Compressor Cooling Magic Water Dispenser.[Steel Disabled People Use Rollator]

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.Industrial Vacuum Rotary Drum Filter. 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.[Natural Avocado Powder Extract] 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,Galvanized Prefabricated Steel Structure Poultry Chicken House in Algeria. 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[Max Tw898 Rebar Tie Wire Black Steel]

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 (Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa).Custom High Quality Rotor Precision Aluminum Casting Flywheel Housing, waste residue is inert and sterile, i.e., environment friendly,Liquid Oxygen Cylinder(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.[Fashion Trolley Luggage Case Bag Bags Travel Suitcase]

Conclusions

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References