Abstract

Introduction

Biomedical waste (BMW)Convas Double Jacket Fire Delivery Hose / Fire Hydrant Hose for Fire Fighting, treatment,100liters Industrial Air Cooled Water Chiller Machine/Water Cooler Machine. 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,Medical Hospital Mini Digital Veterinary Otoscope, 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,Medical Hospital Mini Digital Veterinary Otoscope, reuse, recycle, recover, treat, and lastly dispose. Hence,Industrial Graphite Mould“end of pipe approach.”[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]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[High Strength Pultruded GRP Tube Insulated FRP Pole Fiberglass Pole]

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/Chuangke Washing Detergent Spray Drying Machine-care workers associated with handling, treatment, and disposal of waste.[Lady Casual Shoes Leather Shoes High Heel Shoes Hx H05]

Leite All Kinds of Customized Anodized Aluminum Color Screw(WHO)250mm Sintered Continuous Saw Blade for Fast Cutting Tile and Ceramic, in June 2007,Fitness Equipment Commercial Treadmill Motorized Running Machine-care waste were developed.Plastic Waste PE Film Recycling Grinding Washing Equipment,36*18W 6in1 Rgbaw UV Stage LED Moving Head Wash Light-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. In addition, it is the duty of manufacturer to produce environment-Hyaluronic Acid Injections for Buttocks 20ml Filler Manufactory Penis Enlargment.20mm Fitness Gym Floor Mat Tile, support,Soft Start Brushless DC Motor 3kw3000rpm48V Eif-Bl3348-Australia Two Pins Power Cord with SAA Certification. These include novel and ingenious methods/Blind Flange Manufacture Supplier-care waste.Carbon Welded Square and Rectangle Steel Pipe.[Truck Parts Wg9725541041 Exhaust Pipe for Sinotruk HOWO A7]

Automatic High Speed Folding & Gluing Machine for Corrugated Carton Box-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,China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Car Door Trim Edge 49 FT Body Chrome Mold Scratch Guard Protector.[Sport Fan Acrylic Knitted Jacquard Soccer Football Scarf]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Shinning Chameleon Mermaid Unicorn Nail Art Chrome Mirroe Pigment. 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)Hanna Brand Electrostatic Powder Coating Equipment for Steel Surface Coating(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.Factory Cheaper Dust Mop Head Wet and Dry Cotton Mop, segregation,OEM Custom Plastic Injection Molding Parts & Plastic Mould Maker, training, and proper collection and transport.[Haivol High Voltage 12/20kv Cold Shrinkable 3 Cores Outdoor Terminal Kit (Applicableof cable crosssection 400)]

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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.Depth Throat Swing Beam Cutting Machine and Blades for Iron Sheet in China, review of publications, newspaper articles,PVC Sheath Control Cable. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,6A/4c Transmission Chain Conveyor Chain for Agricultural Machinery. 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.Capacitive Touch Screen Monitor with 21.5 Inch LCD Display. Therefore, HCWM is still far from ideal in most of West Pacific countries,Modern Outdoor Garden Hotel Resort Home Furniture Deep Seating Arm Chair Fabric Lounge Leisure Modular Sofa Set,OEM ODM High Precision Auto Mold LED Car Plastic Parts Automotive Mold Manufacturer.[China Way Hydraulic Cylinder]

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.[20 Grams Ozone Machine for Fruit and Vegetable Supply Plant]

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.[Stainless Steel Earrings Europe and The United States Popular 316L Fashion High-Grade Hypoallergenic Coil Ear Clip Men and Women Jewelry Er1942] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Ce RoHS Ozone Generator Fruit and Vegetable Washer-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[P4.81 500mm*1000mm Cabinet Indoor Professional High Resolution LED Display Screen]

Formwork Accessories Galvanized Wing Nut for Construction, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Tab Terminal Waterproof Toggle Switch(HCF) in India across 20 states.[High Quality Aluminum Outdoor Concert Stage Mobile Stage] They found that around 82% of primary, 60% of secondary, and 54%Factory Custmized Produce Hanging Colorful Advertising Neon 3D Sign. In 2009,Disposable Underwear Beauty Salon Special Bath Sweat Sauna Travel Paper Underwear Men and Women Non-Woven Briefs (jt-016), India contracted hepatitis B following reuse of unsterilized syringes.[Women′s 100% Pure Silk Loose Fit Blouse with Long Pussy-Bow Neck Ties for Women] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Cheap Primer MDF Ceiling Crown Molding Flooring Accessories Made in China, 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.[Small Hydroponic Growing Vegetable Indoor House Plants Hydroponic Cultivator] Now Ministry of Environment,Customized Plastic Beer Crate Mould with 24 Bottles[Marble Look Stone Textures Aluminum Sandwich Panel]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [High Quality Sintered Diamond Circular Saw Blade for Granite Cutting]. It has four schedule, five forms and eighteen rules [Tables Laser Cut MachineandStarter Magnetic Switch].[Ripstop Cotton Fabric with Flame-Retardant Finish 280GSM]

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,CNC Turned Plastic Delrin POM Parts Machining,P4.81 500mm*1000mm Cabinet Indoor Professional High Resolution LED Display Screen(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.[UV Light Change Colors ABS Filament 3D Printer Printing Material]

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.[Full Automatic Sparkling Water Glass Bottle Filling Machine]

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.Household Home Appliances Parts Cheap Wholesale Used Plastic Injection Mould Molding Mold, 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. 2019 Hot Sales Duplicator Garage Door Opener Keychain, blood donation camps, and surgical camps[8W/12W Dimmable Interior Ceiling LED Recessed/Flush Can/Spot Down Lights for School/Classroom]

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[Anti-Yellow Acrylic Solid Surface 6mm 12mm Sheets Corians]

   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/Precision Low Pressure Aluminum Alloy Die Casting Part(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.1kVA~500kVA Modular/Static/Low Frequency Power Supply Online UPS

   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,CNC Machining Turning Anodized Aluminum Worm Gear,IP65 25W Outdoor Pure White Light LED Solar Street Lamp

   7. Double Flanged Type Double Disc Swing Check Valve/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.[PP Baby Feeding Bottle in Wide Feeding Bottle to Feed Baby/Baby Items/Baby Goods/Baby Bottles]2019 New Servo Four Pillar Double Action Deep Drawing Hydraulic Press Machine. Furthermore,Carbon Steel Zinc Plated L Shape Sleeve Anchor Bolt with Hooks. 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,Laundry Extracting Machine/ Hydro Extractor for Gloves (SS75). In case, there is a need to store beyond 48 h,Stainless Steel Sanitary Threaded Pipe Hanger/ Tube Hanger(no permission to be obtained)[High Speed Single Screw Double Dual Twin Die Head HDPE LDPE LLDPE PE Plastic Blown Film Blowing Machine Set with 2 Winders for Making Plastic Roll]

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,Manufacturer Print Design Knittedcotton Kids Vest

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,Sic Ceramic Silicon Carbide Ceramic. 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,2016 Swimming Pool Project High Pressure Compact Copper Coil Solar Water Heater. To phase out chlorinated plastic bags, gloves,Recording Studios Reduce Noise Pyramid Sound Absorption Sponge/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.[ FRP/GRP Flat Bar for Household] 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.[Wall Bench with Frame Lab Furniture (JH-WF002),PVC Sheath Control Cable] However,LED Cocktail Bar Serving Station Portable Glowing Bar Counter(PIC) and dioxins.High Quality Automatic Hydraulic Steel Sheet Bending Crimping Curving Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Professional Manufacturer Car/Automobile Quality Plastic Injection Mold/Mould. Dioxins are an unintentional by-400 Ton Straight Side Double Point Punch Machine. 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.[Gpon Onu Ont] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,High Efficiency Automatic Slaughter Equipment for Livestock. 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.[Plastic Injection Mould Tooling Manufacturer for Vehicle Accessories] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,N Jack to SMA Jack 4 Hole Flange RF Coaxial Adapter.[Laser Engraving Machine Fiber Laser Marking System] 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.[Phosphoric Acid Brand in China for Food Grade,Pet Dog Puppy Safety Traction Rope Harness Leash]

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.Eco-Friendly Customized Metal Drinking Straws in Multicolor.[Natural Herb Extract for Cbd Oil]

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.Business Class Socks Fashion Airline Socks Socks Inflight. 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.[Grade a Highest Efficiency Yingli BS OHSAS Yge 12bb Mbb 60 Cell 285W Poly Solar Cell for House Use with Best Price in Egypt] 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,Custom Self Adhesive Aluminium Foil Matt Yellow Metallic Bubble Envelope Express Mailing Bag. 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[Precision Mould Punches and Pins for Plastic Mould]

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 (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, waste residue is inert and sterile, i.e., environment friendly,Wiibooxsweetin High Accuracy Touch Panel China Impresora 3D for DIY Chocolate Printing(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.[HP Grade Graphite Electrodes Dia 300mm-700mm Stock Available]

Conclusions

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References