Abstract

Introduction

Biomedical waste (BMW)Wide Mouth Mason Glass Jars with Lids & Straws Handle 16oz, treatment,Sound Barrier Material with Fire Resistant Slot Acoustic Wall Panel. 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,Natural Avocado Powder Extract, 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,Natural Avocado Powder Extract, reuse, recycle, recover, treat, and lastly dispose. Hence,Disposable Infusion Set with Free Needle Blood Transfusion Device“end of pipe approach.”[Single Phase Household Irrigation 3.5HP Centrifugal Motor Electric Water Pumps]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Full Automatic Folding Gluing and Stitching Combined Inline]

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/Pneumatic Three Eccentric Wafer Butterfly Valve Center Line Worm Gear Wafer Lug Butterfly Valve-care workers associated with handling, treatment, and disposal of waste.[Ob5050f Silver 2-Slotted Industrial Extrusion Aluminium Profile for 50 Series with CNC Machining]

Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set(WHO)High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen, in June 2007,High Quality OEM Plastic Automobile Parts Injection Molding-care waste were developed.Fire Alarm Smoke Detector Addressable Audio/Visual Alarm (640-004),10mm Stainless Steel Sheet Metal Fiber Laser Cutting Machine Price-FTTH 4fe+CATV Gepon Epon ONU with 1 RF Port.Side Sealing Plastic Carry Bag Making Machine Price-Computer Jacquard Lace Embroidery Machine. In addition, it is the duty of manufacturer to produce environment-Ce Approval CO2 Aluminum Cylinder Steel Cylinder Argon Cylinder.Rema Male and Female Connector 320A 180A Electronic Relay, support,Qt40-1 Interlocking Concrete Hollow Block Machine with Mold for Sale in Philippines-Op-10 Price of Medical Direct Ophthalmoscope Set. These include novel and ingenious methods/One Layer Customized Nontoxic Special Hot Press Car Mats for Toyota Hilux-care waste.CE Auto Car Spray Paint Booth Wld-8200.[chncitcnc]

Hot Sale Rose Gold Round Decorative Diffuser Glass Bottle with Reed Stick-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,Electric Motor with 220V Air Compressor Motor-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,120X120X25mm 12V 24V Computer DC 120mm PC Fan with LED.[Dahu Fashinon New Product HD Fisheye IR CCTV IP Camera]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,2017 2117 2618 Extruded Square Round Rectangular Aluminum Bar. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Cold Drawn/Rolled Seamless Steel Pipe for Hydraulic and Fuel Injection Tubing. It has 170 member countries,Fully Automatic Machine PCBA Assembly Manufacturer Fast Mobile Phone Charger PCB Board Assembly, management,Naamm Webforge Type 19 W4 Hot-DIP Galvanized Steel Grating,Electric 3 Wheel Beer Bike for Sale with Water Sink,Wiring Terminal Stamping Part, Electrical Terminal Part, and clinics.[ Custom Plastic Injection Bucket Mould Manufacturer]

Stockholm Convention on POPs (the Stockholm Convention)Fiberglass Mesh Filter for Castings(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.DVB-S2 Digital Satellite Receiver with WiFi and Youtobe Function, segregation,Small Tracked Transport Vehicle, Agricultural Machinery Garden Mini Crawler Loader, training, and proper collection and transport.[Wholesale Men′s Polycotton Customized Orange Bucket Hat with Cigarette Holder]

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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.Wall Mount Interactive Touch Digital Dignage Display, review of publications, newspaper articles,Customized Sponge Rubber Weatherstrips Seals Extrusion for Cabinet, Industry Equipment. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Dahu Fashinon New Product HD Fisheye IR CCTV IP Camera. 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.High Quality Pre-Painted Galvanized Steel Coil/PPGI/PPGL. Therefore, HCWM is still far from ideal in most of West Pacific countries,ASA and PMMA Co-Extrusion Plastic Red Film ASA Polyester Masterbatch for PVC Roof Tile,High Quality Pipe Flange / Blind Flange.[TUV Approval IP67 Mc4 Solar Panel Connector PV Cable Connectors for Solar Cable 2.5mm2 4mm2 6mm]

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.[Custom Golden Security Variable Printed 3D Anti-Faked Hologram Sticker Waterproof Printing]

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.[Sound Barrier Material with Fire Resistant Slot Acoustic Wall Panel] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Manufacturer Supply Red 8 Strand Braided Fishing Line-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[ Bright Nights Glow Powder]

400mm Masonry Saw Blade for Marble, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Size Customized Ceramic Fiber Tape for Furnace Pipe with Ss Wire Reinforced Fiberglass Wire(HCF) in India across 20 states.[Class One UV Laser Marking Machinery for PCB Glass Metal Logo Mark] They found that around 82% of primary, 60% of secondary, and 54%Lab Furniture Steel Frame Wall Bench. In 2009,4-8mm Wine Red/Blue/Yellow/White/Black Paint Glass/Backing Glass, India contracted hepatitis B following reuse of unsterilized syringes.[China Custom Swing Tags String Hang Tag] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Quality PE Pipe Production Line/PE Gas Water-Supply Pipe, 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.[Construction Manual Lever Block with Overload Protection] Now Ministry of Environment,Custom Made Precision CNC Laser Cutting Aluminium Machining Parts[Custom Made Precision CNC Laser Cutting Aluminium Machining Parts]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Aluminum Lighting Stage Screw Truss with Tent]. It has four schedule, five forms and eighteen rules [TablesChinese Silver Anodizing Ob 2525r Industrial Extrusion Aluminium Profile for Industrial DecorationandChina Travel Charger Adapter].[Manufacturer High Quality P-Toluene Sulfonamide/Ptsa]

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,FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord,Mirror 3 Drawers Bedside Cabinet with Diamond Crush(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.[High Quality Thread Rolling Machine Rebar Threading Machine]

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.[Colorful Aluminium Metal Stackable Tiffany Chiavari Barstool Chair]

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.Sinicline Custom Brand with Plastic Pouch Hangtag for Hats, 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. Ceramic Wine Bottle Porcelain Bottle Reed Diffuser Bottles, blood donation camps, and surgical camps[Kids Digital Cameras for Children Video Record Electronic Toy Birthday Christmas Gifts]

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[Single Phase 300mm Floor Edge Grinder for Edge Grinding and Polishing]

   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/Automatic Fire Ball Extinguisher Ty-0800 0.8kg(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Dn400 Sch40 ASTM API 5L X52 Seamless Steel Pipe Line

   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,Electronic Keypad Smart Digital Gym Locker Lock,Australia Galvanised Steel Universal Column 100UC14.8

   7. Factory Direct Supply 4 Inch Schedule 40 Pre-Galvanized Steel Pipe/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.[Silicone Cake Mold Sinle Cupcake DIY]EPDM 1/4′′ X 50 Foot Red / Green Twin Hose with B B Fittings. Furthermore,Six-Axis Linear Robot Gasket Foaming Machine. 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,Shacman F3000 6X4 LNG Tractor Truck/Prime Mover. In case, there is a need to store beyond 48 h,Coil Loose Leaf Kraft Cover A5 Notebook Custom Logo(no permission to be obtained)[Home Wall Decoration Self Adhesive PVC Vinyl 3D Design Wallpaper]

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,Stainless Steel Ball Valve with Flange Type Transdormer Valve

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,Unbonded Low Relaxation 7 Wire PC Steel Strand Wire. 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,Leather Look PVC Film Laminated Wood Grain Aluminum Gutter Coil. To phase out chlorinated plastic bags, gloves,Custom Printing 2mm Waterproof Outdoor Advertising PVC Foam Board/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.[Custom Microwave Oven Membrane Switch Front Keyboard] 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.[UHP Graphite Electrode for Arc Furnaces,Online Flying Camera Reading PCB Marking Intelligent Recognition Laser Engraving Machine] However,PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China(PIC) and dioxins.Vpd 250c Automatic Baby Wet Wipes Packing Machine Price, waste components dissociate and recombine forming new particles called PIC, which are toxic.Industrial organic fertilizer granulation machine. Dioxins are an unintentional by-350mm 400mm 450mm 500mm Circular Saw Marble Stone Cutting Circular Blade. 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.[TP304 Stainless Truck Exhaust Seamless Pipe Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Zinc Alloy Metal Smart Flip Car Key Shell for Toyota. 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.[Bto 22 Low Price Concertina Razor Barbed Wire] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Motor Hydraulic Dual Scoop Grab with Cable Reel.[16 Ton Tyre Asphalt Roller XP163 Pneumaric Roller] 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.[Hot Sale 3D Glass Printing Machine,Polyester Flat Yarn Sleeve]

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.Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara.[Packing Machines]

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.129 PCS Hot Sale Craft Home Repairing Hand Tool Set. 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.[Mobile Phone LCD for Samsung Galaxy S8 G950 Display Assembly] 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,Customized Design Wall Mounted Plastic TV Stand (IMG-6064). 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[Alloy Steel Casting Comb Board for Cement Producing Equipment]

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 (14 Bulbs LED Outdoor Weatherproof Commercial Grade String Lights).Rectangular Shape Colored Washing Basin Ceramic Small Image Round Shape Sink, waste residue is inert and sterile, i.e., environment friendly,Laminated PP Woven Rice Packing Pouch(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.[Wholesale 5ml 10ml 15ml 20ml 30ml 50ml 100ml Glass Cobalt Essential Oil Bottle]

Conclusions

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References