Abstract

Introduction

Biomedical waste (BMW)Stage Performance Round Shape Graphic Digital Water Curtain Fountain, treatment,Epidural Filter Bacteria Filter 0.22 Micron Filter. 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,Elastomer Bellow Mechanical Seal Bmg9, 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,Elastomer Bellow Mechanical Seal Bmg9, reuse, recycle, recover, treat, and lastly dispose. Hence,Pet Plastic Wire Drawing Machine for Rope/Broom/Net/Brush Filament/Yarn/Bristle/Fiber Production“end of pipe approach.”[Laparoscopic Instruments Trocar Laparoscopy Endoscopy Spiral Thoracic]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[New Product 4X2 Road Rescue Truck 2t 3t Road Wrecker Truck]

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/2016 Swimming Pool Project High Pressure Compact Copper Coil Solar Water Heater-care workers associated with handling, treatment, and disposal of waste.[Medical Neonate Disposable Hme Filter]

Recording Studios Reduce Noise Pyramid Sound Absorption Sponge(WHO)LED Cocktail Bar Serving Station Portable Glowing Bar Counter, in June 2007,High Quality Automatic Hydraulic Steel Sheet Bending Crimping Curving Machine-care waste were developed.Professional Manufacturer Car/Automobile Quality Plastic Injection Mold/Mould,400 Ton Straight Side Double Point Punch Machine-High Efficiency Automatic Slaughter Equipment for Livestock.N Jack to SMA Jack 4 Hole Flange RF Coaxial Adapter-Eco-Friendly Customized Metal Drinking Straws in Multicolor. In addition, it is the duty of manufacturer to produce environment-Business Class Socks Fashion Airline Socks Socks Inflight.Custom Self Adhesive Aluminium Foil Matt Yellow Metallic Bubble Envelope Express Mailing Bag, support,10 in 1 Multifunctional Salon Facial Beauty Machine for Skin Care for Beauty Salon (Beauty Salon Equipment)-Bomco Mud Pumps/China Manufacturer/Bi-Metal Cylinder Liner. These include novel and ingenious methods/Wiibooxsweetin High Accuracy Touch Panel China Impresora 3D for DIY Chocolate Printing-care waste.Carbon Steel/Stainless Steel/Galvanized Steel Longitudinal Seam Pipe Making Machine.[Household Cleaning Products Magic Sponges Kitchen Wonder Sponge]

Motorcycle Parts 150cc C7hsa A7tc Motorcycle Spark Plugs-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,Best Price Wastewater Treatment STP Treat All Kinds of Sewage to Discharge Irrigation Reuse -care waste management in emergencies, emerging pandemics, drug-resistant bacteria,High Quality Thread Rolling Machine Rebar Threading Machine.[Drinking Mineral Water Filling Machine/Water Bottling Plant]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Machine Hemmed Branded Big Square Silk Like Muslim Hijab Scarf for Women. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Wholesale Dry Fit Plain Sport Suit Top and Pants Man′s Club T Shirt Team Shirt. It has 170 member countries,1.0mm*2 Wire Max Wire Tw1061t, management,Manufacturer High Quality P-Toluene Sulfonamide/Ptsa,Silver Embossed Aluminum Foil Paper,Pet Sleeve Shrinking Label /Hot Pet Shrink Label Heating Roll Label Film in China Factory, and clinics.[Fine Tuning Butterfly Valve with Adjustable Handwheel]

Stockholm Convention on POPs (the Stockholm Convention)PP Plastic Bucket, Custom Plastic Injection Bucket Mould Manufacturer(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.Shenzhen Bakeware Supplier Metal Cake Baking Molds, segregation,Rotary Granule Price Zipper Pouch Counting Packing Machine, training, and proper collection and transport.[Shacman F3000 6X4 LNG Tractor Truck/Prime Mover]

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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.Domestic Evaporative Air Cooler / Portable Floor Standing Air Conditioner (JH18AP-31Y2-2), review of publications, newspaper articles,Commercial Steam Jacketed Agitated Reaction Kettle with Stirrer. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Car Accessories D8tc High Performance 3-Electrode Motorcycle Spark Plug. 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.Supply Christmas Lace Gold Silver Offray Silk Ribbon. Therefore, HCWM is still far from ideal in most of West Pacific countries,HDPE Reducing Tee for Water Supply,Matt Finish Wooden Jewelry Display Storage Packaging Gift Box.[Canvas Painting Modern Artwork]

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.[Grade 201 304 316 316L 430 Decorative Stainless Steel Sheet]

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.[Portable Travel John PEE Bags or Brief Relief] In India, BMW problem was further compounded by the presence of scavengers who sort out open,13.56MHz ISO14443 NFC MIFARE Ultralight C Chip PVC Sheet Inlay-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Lifting Equipment Wire Rope Lever Hoist]

Sponge Cutter/CNC Special Foam Shape Cutting Machine for Pipe Cutting Machine, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Classic Low Cut Armholes Crop Tank Top Short Length Gym Workout Clothing(HCF) in India across 20 states.[Customized Design Wall Mounted Plastic TV Stand (IMG-6064)] They found that around 82% of primary, 60% of secondary, and 54%Chinese Silver Anodizing Ob 2525r Industrial Extrusion Aluminium Profile for Industrial Decoration. In 2009,Shenzhen Professional Rigd-Fr4 PCB Circuit Board Manufacturing PCB, India contracted hepatitis B following reuse of unsterilized syringes.[Aluminum Ceiling Ventilation Exhaust Jet Diffuser] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Factory Directly High Precision Best Locksmith Tool, 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.[Wholesale Dry Fit Plain Sport Suit Top and Pants Man′s Club T Shirt Team Shirt] Now Ministry of Environment,Naphtalene Based Admixtures Concrete Admixture Naphthalene Sulfonate Formaldehyde[Dn15-20 horizontal type piston R315 China water meter]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Fitness Equipment Commercial Treadmill Motorized Running Machine]. It has four schedule, five forms and eighteen rules [TablesHigh Purity Sodium Benzoate with Best PriceandAutomatic Hydraulic Press Machine Suppliers for Sale].[Mobile Hospital Truck Portable Shipping Container Clinic for Rescue]

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,YCOM HDMI Cable to USB Charger Cable for Lightning iPhone,BPW Wheel Hub Bolt M22X1.5/M22X2X118(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.[Light Gauge Stainless Steel Reducing Tee for Water System]

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.[Eco-Friendly 48V/500W Motor & 16ah Lithium Battery Electric Cargo Bike for Take-out Service (JB-TDN03Z)]

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.Woven Plaid Pure Cotton Fringed Picnic Throw, 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. High Capacity Single Wall Corrugated Pipe Plastic Extrusion Line, blood donation camps, and surgical camps[OEM Brand 400ml Aerosol Household Insecticide Spray Mosquito Repellent]

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[Car Accessories D8tc High Performance 3-Electrode Motorcycle Spark Plug]

   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/Flow Meter-Differential Pressure Air Flow Meter Flowmeter Water Flowmeter(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hot Sale Beauty Shadow Color Glass Container for Soy Candle

   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,Class One UV Laser Marking Machinery for PCB Glass Metal Logo Mark,Waterproof Fashion Footwear EVA Injection Casual Shoes for Women

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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.triround-inox.com]Stainless Steel Quick Release Exhaust V Band Clamp with Male Female Flange. Furthermore,Single Phase Household Irrigation 3.5HP Centrifugal Motor Electric Water Pumps. 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,Movable Axial Flow Blower. In case, there is a need to store beyond 48 h,Patient Monitorneonate NIBP Cuff(no permission to be obtained)[All Plastic 14 Electric Stand Fan with Safe Grill]

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,Economic Horizontal CNC Lathe for Tire Mold Machining (CK61200)

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,Modern White Living Room Furniture Chaise Lounge for Sale. 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,Ripstop Cotton Fabric with Flame-Retardant Finish 280GSM. To phase out chlorinated plastic bags, gloves,Dia350mm 400mm 450mm Arix Diamond Saw Blade/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.[Cast Floating Ball Valve China Manufacturer (GAQ41F)] 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.[Building Materials Slotted Unistrut C Section Stainless Steel Channel,Woman Fitness Long Sleeve Sweatshirt Gym Wear Yoga Sports Clothing] However,Automatic Chicken Leg Deboner/Deboning Machine(PIC) and dioxins.Factory Price of Industrial Hydrochloric Acid 32%, waste components dissociate and recombine forming new particles called PIC, which are toxic.Decorative Stainless Steel Sheet Pipe PVD Titanium Coating Machine. Dioxins are an unintentional by-Military Using Bomb Signal Jammer Blocking GSM/2g/3G/4glte/GPS Signal Cover Radius 50-100m. 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.[Custom Plastic Mould] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Sf6, Sulfur Hexafluoride Gas, 99.9-99.999%, High Purity. 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.[Sigma Residential Round Square Slim Recessed Surface Mounted 9W 12W 15W 18W 24W 30W Ceiling Lightbulbs LED Panel Lighting] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Wholesale Durable Student Kids Cute Insulated Tote Cooler Lunch Bag.[Electronic Keypad Smart Digital Gym Locker Lock] 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.[Hard Cover Laser Cut Paper Greeting Cards Custom New Design Invitation Cards,Car Seat Cover Universal Size Polyester Seat Cover Ad029]

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.Small Injection Molding Machine Price.[Cob Downlight Housing]

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.11kw EV Charger Station Charging Point with Type 2 Cable 20 Feet. 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.[Wiring Terminal Stamping Part] 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,Mc4 Solar Compatible Connector IP67 TUV for Solar Power System. 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[New Fcactory 2 DIN 7′′hd 7010 Touch Screen Wince8.0 Radio Stereo Car Videoand Radio Universial MP3 MP4 MP5 Car Player]

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 (6.5m Aluminum Cuddy Cabin Cruiser Fishing Boat).Mobile Hospital Truck Portable Shipping Container Clinic for Rescue, waste residue is inert and sterile, i.e., environment friendly,Retro Gold Rose Earrings (fresh rose)(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.[Patient Monitorneonate NIBP Cuff]

Conclusions

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References