Abstract

Introduction

Biomedical waste (BMW)Teflon Seal/Seals Spring Energized, PTFE Spring Energized Seal, treatment,Bending Press Mining Machine Hydraulic Cylinder. 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,CL2T-CS24 Comlom Ergonomic Knife Sharpener with Ceramic Rod, 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,CL2T-CS24 Comlom Ergonomic Knife Sharpener with Ceramic Rod, reuse, recycle, recover, treat, and lastly dispose. Hence,Batch Type Circulating Wheat Maize Corn Paddy Rice Grain Dryers“end of pipe approach.”[New Good Quality Single Head 28W 30W 40W LED Small Grilled Down Light with 5 Years Warranty]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Australia Galvanised Steel Universal Column 100UC14.8]

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/Power Steering Gear Box for Ford Fiesta IV Puma 3972949/3937085-care workers associated with handling, treatment, and disposal of waste.[Automatic Fire Ball Extinguisher Ty-0800 0.8kg]

Cannabidiol Powder Cbd 13956-29-1 Nootropics Anti-Cancer Drugs(WHO)China Manufacturer 5 Ton 50 Kn Low Speed Hydraulic Winch for Truck, in June 2007,Chicken Paw/Wing/Leg/Meat Weight Sorter with Low Price-care waste were developed.18V New Power Tool Lithium Battery Cordless Drill for Sale,Small Mini Wire Rope Lever Manual Hoist Block with Hand Lifting-High Brightness P3/P4/P5/P6/P8/P10 Full Color Outdoor LED Display.Heat Transfer Films/Heat Press Films-China High Quality Adhesive Dispensing Machines Manufacturers for Electronics. In addition, it is the duty of manufacturer to produce environment-Simple Modern Small Apartment Leather Sofa Living Room First Layer Cowhide Three-Family Furniture Hotelhb01-92.High End Fancy Sequins Embroidery Lace Fabric, support,America 12V 4pin Blade Trailer Plug-Smooth Surface Stainless Steel Banding Strap for Binding Cables. These include novel and ingenious methods/New fashion Kids Warm Winter Boots-care waste.Best Seller Laser Machine Reci CO2 Laser Tube Price.[PCB /PCBA Design Gerber Files HDI Multilayer Aluminum PCB Prototype PCB]

Six Colors Custom Logo Schoolbag Child Breathable 1-3-6 Primary Students Boys Girls Korean Cartoon Pack-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 Small Biomass Fireplace Pellet Stove (CR-10)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,High Quality Sintered Diamond Circular Saw Blade for Granite Cutting.[Professional Custom Camouflage Military Uniforms Black Acu T/C 65/35 Army Combat Uniform]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,10, 13.3 Inch Tablet PC Analog Frameless LED Flat Screen TV. 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)45# Steel Folding Wrench Hex Wrench 14 Inch Cross Socket Wrench Hardware Auto Repair Tools(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.Wholesale Men′s Polycotton Customized Orange Bucket Hat with Cigarette Holder, segregation,No. 1062 20PCS Tools, training, and proper collection and transport.[Black Polished-Leather Handmade Oxford Shoes]

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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.Diesel Engine Lubricating Oil Dky176, review of publications, newspaper articles,Good Price Double Door Drying Dewatering Machine in Stock. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Handwheel Ductile Iron Wafer Knife Gate Valve. 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.BPA Free Octopus Design Silicone Baby Teethers Chewing Toys. Therefore, HCWM is still far from ideal in most of West Pacific countries,China Supplier Non-Slip Stainless Steel Anti-Slip Crampon Outdoor Walking Hiking Climbing Snow Ice Crampons,Reliable Quality Flange Ends Stainless Steel Butterfly Valve with Gear Operator.[Milk Powder Bag]

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.[Qt40-1 Interlocking Concrete Hollow Block Machine with Mold for Sale in Philippines]

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.[ASA and PMMA Co-Extrusion Plastic Red Film ASA Polyester Masterbatch for PVC Roof Tile] In India, BMW problem was further compounded by the presence of scavengers who sort out open,5mm Spc Vinyl Planks Click Lock Floor PVC Plastic Laminate Flooring-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[ Camping Leisure Tent]

Glow in The Dark Luminous Pigment, Bright Nights Glow Powder, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,LED Integrated Solar Street Light with Sensor for Outdoor 10W/15W/20W/30W/40W/50W/60W(HCF) in India across 20 states.[Fiber Laser Tube Cutting Machine with Stable Optical Transition] They found that around 82% of primary, 60% of secondary, and 54%Rubber Gym Flooring Rolls, Mats, or Tiles. In 2009,Protective Blue Color Soft Plastic PVC Film for Window Glass, India contracted hepatitis B following reuse of unsterilized syringes.[Sinotruk HOWO Trucks Auto Parts of Js180-1601021-4 Wg1642430385] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,OEM Anti Vibration Mats Rubber Pad Feet, 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.[ Large Capacity Baby Bag Backpack Stylish Maternity Multi-Function Travel Back Pack for Mom Daddy] Now Ministry of Environment,Wholesale New Products High Quality Cheap Machine Cavitation Explosive Speed Grease Cavitation Slimming[SBR Round DOT Horse Stall Mat]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Coil Loose Leaf Kraft Cover A5 Notebook Custom Logo]. It has four schedule, five forms and eighteen rules [TablesSmall Tracked Transport VehicleandZinc Handle].[Yellow / Black Barricade Warning Tape]

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,Food Grade Silicone Bottle Brush Baby Bottle Brush,Free Sample Compressor Start 12V Relay 16 a(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.[Family Use Wood Pellet Cooler with Ce Certification]

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.[Performance Hand Tool Cr-V Steel Shaft PP+TPR Handle Screwdriver]

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.Car Auto Spare Parts Auto Parts Fuel Pump Price 1j0919051b, 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[HPL Ship Hull Wall Rock Wool Sandwich Panels]

   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/Hydraulic Fitting Crimp Socket Elbow 90 Steel Fitting Union(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.2017 Customized PP Strapping Band Roll Strap

   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,PP Black Microwave Freeze Safe Black Meal Prep Plastic Takeaway Food Container,15W Solar Powered Gable Fan with 25W 9.6ah Storage Battery (SN2013014)

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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.[Xvm Series Three Phase Asynchronous Electric Vibrator Motor]Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser. Furthermore,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. 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,5ml Portable Mini Aluminum Refillable Perfume Bottle with Spray Empty Cosmetic Containers with Atomizer for Traveler New. In case, there is a need to store beyond 48 h,Pdlc Switchable Tint Film Smart Glass Self-Adhesive Film(no permission to be obtained)[ CNC Prototype]

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,Psa Oxygen Generator Reliable Industrial Gas Solutions

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,5kw Home Stand Alone off Grid Solar Power System. 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,CCTV 2.0megpixel Mini Wdm HD-Ahd Pinhole Camera. To phase out chlorinated plastic bags, gloves,Manual Steel Strap Buckleless Combination Machine Packing Tool for Metal Strip 25mm/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.[China Industry Low Carbon Steel Wire for Sale] 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.[Best Small Biomass Fireplace Pellet Stove (CR-10),4-12X50eg Illuminated Hunting Rifle Scope for Airgun HK1-0318] However,Pet Dog Puppy Night Safety Reflective Traction Rope Harness Leash(PIC) and dioxins.Manufacturer Customized Big Steel Helical Compression Spring for Large Industrial, waste components dissociate and recombine forming new particles called PIC, which are toxic.Famous Newsailing High Speed Four Color Printer Slotter Die Cutter Machine. Dioxins are an unintentional by-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. 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.[USA Standard Chain on Both End with Grab Hooks] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,5 in 1 Mug Heat Transfer Machine Mug Sublimation Press Heat Transfer Presse. 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.[18mm Frostil White Slotted /Grooved MDF for Shelf] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Custom Printable PVC 125kHz EM4200/TK4100  RFID Student ID Card.[Six Colors Custom Logo Schoolbag Child Breathable 1-3-6 Primary Students Boys Girls Korean Cartoon Pack] 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.[Unbonded Low Relaxation 7 Wire PC Steel Strand Wire,Halogen Double Dome Medical Supply Shadowless Operting Lamp]

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.HD Night Vision IR Laser Camera with PTZ for 1200m Surveillance.[hongraygloves]

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.Sch 40 API 5L-X42 PE Coated 12m LG Seamless Pipe. 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.[Party Supplies School Gift Kid Toy Education Wholesale Yiwu Market Agent (P4081)] 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,Lsa061 Limit Switch Spring Boom Pin IP65. 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 Quality PE Pipe Production Line/PE Gas Water-Supply Pipe]

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 (The Oil Filter Housing Fram Oil Filter).20 24 28 32 4PCS Luggage Sets ABS Hard Shell Case Trolley Suitcase, waste residue is inert and sterile, i.e., environment friendly,30W CREE COB LED Track Light for Clothes Shop Lighting(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.[Large Damping Compression Spring with Black Helix (10*89*177*7.5)]

Conclusions

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References