Abstract

Introduction

Biomedical waste (BMW)Medical Hospital Mini Digital Veterinary Otoscope, treatment,Industrial Graphite Mould. 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,Chuangke Washing Detergent Spray Drying Machine, 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,Chuangke Washing Detergent Spray Drying Machine, reuse, recycle, recover, treat, and lastly dispose. Hence,Leite All Kinds of Customized Anodized Aluminum Color Screw“end of pipe approach.”[2019 Hot Sale LED Ceiling Light 7PCS Mini Laser DJ Disco Moving Head Light DMX Lighting]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Weilang Used 4-Hi Rolling Mills]

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/250mm Sintered Continuous Saw Blade for Fast Cutting Tile and Ceramic-care workers associated with handling, treatment, and disposal of waste.[4FT Plywood Spindless Veneer Peeling Machine/Plywood Production Line]

Fitness Equipment Commercial Treadmill Motorized Running Machine(WHO)Plastic Waste PE Film Recycling Grinding Washing Equipment, in June 2007,36*18W 6in1 Rgbaw UV Stage LED Moving Head Wash Light-care waste were developed.2 Bedroom Low Cost Portable Prefabricated Modular Mobile Steel Prefab Container Tiny House Sales in Philippines,Duraflame Fireplace Heater Electric Stove Home Heaters-Hot Sale 3D Glass Printing Machine.Hyaluronic Acid Injections for Buttocks 20ml Filler Manufactory Penis Enlargment-20mm Fitness Gym Floor Mat Tile. In addition, it is the duty of manufacturer to produce environment-Soft Start Brushless DC Motor 3kw3000rpm48V Eif-Bl3348.Australia Two Pins Power Cord with SAA Certification, support,Blind Flange Manufacture Supplier-Carbon Welded Square and Rectangle Steel Pipe. These include novel and ingenious methods/Automatic High Speed Folding & Gluing Machine for Corrugated Carton Box-care waste.China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC.[Fruit / Vegetable High Pressure Cleaner for Industrial / Commercial Use]

Car Door Trim Edge 49 FT Body Chrome Mold Scratch Guard Protector-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,Shinning Chameleon Mermaid Unicorn Nail Art Chrome Mirroe Pigment-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Decorative Use PVC Sheet.[Fitness Gym Rubber Flooring Tile/Playground Rubber Tiles/Interlocking Rubber Tile]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,New Style Reusable Foil 454G 1lb Coffee Bean Flat Bottom Side Gusset Food Grade Packaging Bag. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Extendable Bamboo Bathtub Caddy Tray with Removable Soap Dish Adjustable Arms. It has 170 member countries,New Material 5 Gallon Water Bottle Cap, management,PTFE Bronze Filled Guide Ring/Wear Ring,Hanna Brand Electrostatic Powder Coating Equipment for Steel Surface Coating,Factory Cheaper Dust Mop Head Wet and Dry Cotton Mop, and clinics.[Aluminum Profile CNC Precision Cutting Saw Double Head Type]

Stockholm Convention on POPs (the Stockholm Convention)OEM Custom Plastic Injection Molding Parts & Plastic Mould Maker(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.CO2 Laser Marking Machine for Jeans/Cloth, segregation,Fashion Design Multi-Function DVB-S2 Digital Satellite Receiver 220mm, training, and proper collection and transport.[Beer Cans Sealing Machine Food Canning Sealing 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.6A/4c Transmission Chain Conveyor Chain for Agricultural Machinery, review of publications, newspaper articles,Capacitive Touch Screen Monitor with 21.5 Inch LCD Display. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Modern Outdoor Garden Hotel Resort Home Furniture Deep Seating Arm Chair Fabric Lounge Leisure Modular Sofa Set. 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.OEM ODM High Precision Auto Mold LED Car Plastic Parts Automotive Mold Manufacturer. Therefore, HCWM is still far from ideal in most of West Pacific countries,Ce RoHS Ozone Generator Fruit and Vegetable Washer,Formwork Accessories Galvanized Wing Nut for Construction.[Fair Price Newly High Precision Three Phase Power Quality Analyzer]

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.[6A/4c Transmission Chain Conveyor Chain for Agricultural Machinery]

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.[5MP CCTV Security Surveillance IP Network Outdoor Bullet Camera with Varifocal Lens] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Tab Terminal Waterproof Toggle Switch-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[HDPE Reducing Tee for Water Supply]

Factory Custmized Produce Hanging Colorful Advertising Neon 3D Sign, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Disposable Underwear Beauty Salon Special Bath Sweat Sauna Travel Paper Underwear Men and Women Non-Woven Briefs (jt-016)(HCF) in India across 20 states.[High Quality 42 Inches Smart HD Color 4k LED TV] They found that around 82% of primary, 60% of secondary, and 54%Cheap Primer MDF Ceiling Crown Molding Flooring Accessories Made in China. In 2009,Customized Plastic Beer Crate Mould with 24 Bottles, India contracted hepatitis B following reuse of unsterilized syringes.[Coal Fired Steam Boiler Design] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,CNC Turned Plastic Delrin POM Parts Machining, 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.[ Profile Bending Machine] Now Ministry of Environment,P4.81 500mm*1000mm Cabinet Indoor Professional High Resolution LED Display Screen[Industrial Machine Dry Cleaning Shop Disinfect Cabinet]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Sanitary Stainless Steel Cleaning Ball]. It has four schedule, five forms and eighteen rules [TablesCustom Foam Inserts for White Cardboard Slide Jewelry Packing BoxandFactory Supplier FKM Colored Rubber O Ring].[Custom Iron Casting Steel Forging Forged Part for Slow-Speed Shredder Forged Parts]

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,Household Home Appliances Parts Cheap Wholesale Used Plastic Injection Mould Molding Mold,2019 Hot Sales Duplicator Garage Door Opener Keychain(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.[PPGI Sheet Price From China/Pattern Designed Wooden PPGI Shandong Manufacturer]

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.[Manual Electric Winch Small Winch 220V Winch]

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.Precision Low Pressure Aluminum Alloy Die Casting Part, 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. 1kVA~500kVA Modular/Static/Low Frequency Power Supply Online UPS, blood donation camps, and surgical camps[Nonwoven Thermal Bonding Production Line for Making Stiff Polyester Padding]

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[Solid Flex-Drain Pipe Length 40′]

   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/Small Size Laser Engraving Machine, High Speed Laser Cutting Machine(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Favorites Compare Ts16949 High Quality Automotive Rubber Parts

   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,Double Flanged Type Double Disc Swing Check Valve,2019 New Servo Four Pillar Double Action Deep Drawing Hydraulic Press Machine

   7. Carbon Steel Zinc Plated L Shape Sleeve Anchor Bolt with Hooks/modified to achieve the new standard within 2 years from the date of this notification

   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.[Cheap Price Large Wooden Jewelry Display Showcase for Shop]Laundry Extracting Machine/ Hydro Extractor for Gloves (SS75). Furthermore,Stainless Steel Sanitary Threaded Pipe Hanger/ Tube Hanger. 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,Manufacturer Print Design Knittedcotton Kids Vest. In case, there is a need to store beyond 48 h,Sic Ceramic Silicon Carbide Ceramic(no permission to be obtained)[Honeycomb Plate for FPC]

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,High Power Lipo Battery Cell 3.7V 9600mAh 126899

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,Aluminium Profile Curtain Wall with Home Interior Decoration. 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,LED Cocktail Bar Serving Station Portable Glowing Bar Counter. To phase out chlorinated plastic bags, gloves,High Quality Automatic Hydraulic Steel Sheet Bending Crimping Curving Machine/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.[Operation Microscope for Ent &Dental] 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.[Nihon MEK7222K Hemolyse 3 MEK Lyse for Hematology Analyzer,High Efficient Disinfection with Low Price N-Alkyl Dimethyl Benzyl Ammonium Chloride] However,Professional Manufacturer Car/Automobile Quality Plastic Injection Mold/Mould(PIC) and dioxins.400 Ton Straight Side Double Point Punch Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.High Efficiency Automatic Slaughter Equipment for Livestock. Dioxins are an unintentional by-N Jack to SMA Jack 4 Hole Flange RF Coaxial Adapter. 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.[Moisturizing Face Mask Natural Plant Essence Facial Mask Whitening Oil Control Depth Replenishment Wrapped Mask Beauty Skin Care] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Eco-Friendly Customized Metal Drinking Straws in Multicolor. 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.[Lab Furniture Steel Frame Wall Bench] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Business Class Socks Fashion Airline Socks Socks Inflight.[Manufacturer Supply Na2co3 Soda Ash Dense/Sodium Carbonate with Low Price] 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.[4 Tiers Egg Layer Chicken Cage Low Price,Sany 22ton Hydraulic Excavator Bucket Sy215c]

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.Custom Self Adhesive Aluminium Foil Matt Yellow Metallic Bubble Envelope Express Mailing Bag.[Best Portable Stereo Speakers]

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.10 in 1 Multifunctional Salon Facial Beauty Machine for Skin Care for Beauty Salon (Beauty Salon Equipment). 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 Custmized Produce Hanging Colorful Advertising Neon 3D Sign] 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,Bomco Mud Pumps/China Manufacturer/Bi-Metal Cylinder Liner. 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[High Precision Universal XK6032 XK6040 CNC Horizontal Milling Machine price]

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 (Wiibooxsweetin High Accuracy Touch Panel China Impresora 3D for DIY Chocolate Printing).Carbon Steel/Stainless Steel/Galvanized Steel Longitudinal Seam Pipe Making Machine, waste residue is inert and sterile, i.e., environment friendly,Motorcycle Parts 150cc C7hsa A7tc Motorcycle Spark Plugs(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.[Warm Breathable Windproof Waterproof Polyester Taslon Outdoor Jacket for Winter]

Conclusions

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References