Abstract

Introduction

Biomedical waste (BMW)Grey Nylon Polyester PU Palm Coated Work Gloves, treatment,Hot and Cold Compressor Cooling Magic Water Dispenser. 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,Industrial Vacuum Rotary Drum Filter, 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,Industrial Vacuum Rotary Drum Filter, reuse, recycle, recover, treat, and lastly dispose. Hence,Galvanized Prefabricated Steel Structure Poultry Chicken House in Algeria“end of pipe approach.”[Wholesale Cheap Lab PU Injection Outsole Safety Shoes]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Tct Round Saw Blade for Grass]

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/Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa-care workers associated with handling, treatment, and disposal of waste.[Factory of High Quality PVC Wall Paper for Painting and Printing Usage]

Custom High Quality Rotor Precision Aluminum Casting Flywheel Housing(WHO)Liquid Oxygen Cylinder, in June 2007,Sinoamigo Stainless Steel Distribution Box with Changeable-care waste were developed.8 Ton Knuckle Small Trailer Crane Mounted Truck,Screw-6 Player Wood Croquet Game Set for Outdoor Sport.MPO Fiber Optical Adapter (MTP fiber adapter)-Humzor Nexzdas ND606 Lite Support Diagnostic+Special Functions+Key Programming for Both 12V/24V Cars and Heavy Duty Trucks. In addition, it is the duty of manufacturer to produce environment-Eco-Friendly 48V/500W Motor & 16ah Lithium Battery Electric Cargo Bike for Take-out Service (JB-TDN03Z).New Good Quality Single Head 28W 30W 40W LED Small Grilled Down Light with 5 Years Warranty, support,0.6t 15m Marine Equipment Hydraulic Telescopic Crane-Trikke Innovative 3-Point Cambering Vehicle 48V Deluxe Electric Scooter. These include novel and ingenious methods/Captive Portal Hot New Indoor Access Gateways Wireless Router-care waste.Artificial Marble Top Stainless Steel Rose Gold Side Table.[Metal Medal Hanger Wholesaler Quotes & PriceList]

Visbella Quick Bonded Vinyl Leather Repair Kit /Set for Car-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,High Quality Bucket Segment Bolt 5p7665-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,4 Fibers Wall-Mounted FTTH Distribution Box.[100liters Industrial Air Cooled Water Chiller Machine/Water Cooler Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Zinc Oxide 99.7%, Factory of Zinc Oxide. 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)Antique Tin Plate Custom Medal for Honor Ym1174(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.China Mayflay Q37 Hook Type Shot Blasting Machine for Casting, segregation,Aluminium Alloy Printing Frame, training, and proper collection and transport.[Pneumatic Stainless Steel Tri-Clamp End Angle Seat Valve]

High Performance Centrifugal Mud Pump with Impeller. On October 10, 2014, in Japan,Small Manual Concrete Brick Machine of China Manufacture.Indoor Amusement Empty Arcade Cabinet Machine-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Outdoor Zero Signal Zone Emergency Video Audio Transmission]

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.Hard Cover Laser Cut Paper Greeting Cards Custom New Design Invitation Cards, review of publications, newspaper articles,Furniture Spray Bake Paint Booth for Painting, Sanding, Grinding and Spraying. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,2018 Couple Watches Top Brand Famous Women Men Lovers Watch Female Male Clock Quartz Watch for Lovers Gift. 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.Max Tw898 Rebar Tie Wire Black Steel. Therefore, HCWM is still far from ideal in most of West Pacific countries,Spinning Inflatable Disc Boat / Inflatable Spin Boat Water Toys,High Purity Magnesium Oxide Used for Medical Materials.[www.hybonsecurity-eas.com]

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.[OEM Anti Vibration Mats Rubber Pad Feet]

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.[80 Watt IP65 SMD Module Split Type Solar LED Street Light] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Convas Double Jacket Fire Delivery Hose / Fire Hydrant Hose for Fire Fighting-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Heavy Duty Cargo Transport Lashing Chain with Hooks]

100liters Industrial Air Cooled Water Chiller Machine/Water Cooler Machine, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Medical Hospital Mini Digital Veterinary Otoscope(HCF) in India across 20 states.[Welded Aluminum Alloy Fishing Boat with Bench Seat] They found that around 82% of primary, 60% of secondary, and 54%Industrial Graphite Mould. In 2009,Chuangke Washing Detergent Spray Drying Machine, India contracted hepatitis B following reuse of unsterilized syringes.[Universal Automatic PCB Cutter Machine Manufacturers with Competitive Price] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Leite All Kinds of Customized Anodized Aluminum Color Screw, 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.[Custome Promotional Sport Event Thunder Noise Maker Sticks for Cheering] Now Ministry of Environment,250mm Sintered Continuous Saw Blade for Fast Cutting Tile and Ceramic[ Injection Moulding Tool Manufacturer]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Economic Horizontal CNC Lathe for Tire Mold Machining (CK61200)]. It has four schedule, five forms and eighteen rules [TablesBrand New Camion Tractors Weichai Diesel 380HP 420HP International FAW 4X2 Tractor Trailer Head Truckanddmgstainless].[Senken IP65 Police LED Shoulder Warning Light in Rechargeable]

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,Fitness Equipment Commercial Treadmill Motorized Running Machine,Plastic Waste PE Film Recycling Grinding Washing Equipment(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.[Roll up High Quality Luxury Comfort Spring Mattress]

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.[60t/H Asphalt Mixing Equipment]

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.36*18W 6in1 Rgbaw UV Stage LED Moving Head Wash Light, 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[Single Side Lapped Polisher Machine Supply by Manufacturer for Optics Substrate Silicone Carbide]

   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/Duraflame Fireplace Heater Electric Stove Home Heaters(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Hot Sale 3D Glass Printing Machine

   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,Soft Start Brushless DC Motor 3kw3000rpm48V Eif-Bl3348,Australia Two Pins Power Cord with SAA Certification

   7. Blind Flange Manufacture Supplier/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.[m.etonsmtauto.com]Carbon Welded Square and Rectangle Steel Pipe. Furthermore,Automatic High Speed Folding & Gluing Machine for Corrugated Carton Box. 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,China Factory and Manufacturers Industrial Grade Cellulose Ethers HPMC. In case, there is a need to store beyond 48 h,Car Door Trim Edge 49 FT Body Chrome Mold Scratch Guard Protector(no permission to be obtained)[Custom Injection Molding Oil Casing Thread Protectors]

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,Shinning Chameleon Mermaid Unicorn Nail Art Chrome Mirroe Pigment

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,Decorative Use PVC Sheet. 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,Capacitive Touch Screen Monitor with 21.5 Inch LCD Display. To phase out chlorinated plastic bags, gloves,Modern Outdoor Garden Hotel Resort Home Furniture Deep Seating Arm Chair Fabric Lounge Leisure Modular Sofa Set/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.[Reliable Quality Flange Ends Stainless Steel Butterfly Valve with Gear Operator] 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.[Laminated PP Woven Rice Packing Pouch,Stainless Steel Rails Long Bar Holders for Handrail Pipe] However,OEM ODM High Precision Auto Mold LED Car Plastic Parts Automotive Mold Manufacturer(PIC) and dioxins.Ce RoHS Ozone Generator Fruit and Vegetable Washer, waste components dissociate and recombine forming new particles called PIC, which are toxic.Formwork Accessories Galvanized Wing Nut for Construction. Dioxins are an unintentional by-Tab Terminal Waterproof Toggle Switch. 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.[Metal Stamping Die Mold Mould Cemented Tungsten Carbide] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Factory Custmized Produce Hanging Colorful Advertising Neon 3D Sign. 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.[925 Sterling Silver Tree Design Wedding Party Cubic Zircon Long Hanging Drop Earring] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Disposable Underwear Beauty Salon Special Bath Sweat Sauna Travel Paper Underwear Men and Women Non-Woven Briefs (jt-016).[High Quality Plastic Butterfly Valve UPVC Wafer Pneumatic Actuator Butterfly Valve PVC Non Actuator Butterfly Valve DIN ANSI JIS Standard] 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.[Double Jacketed Cooking Kettle Electric Jacket Boiler,Spun Concrete Transmission Pole Making Welding Machine]

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.Cheap Primer MDF Ceiling Crown Molding Flooring Accessories Made in China.[Empaistic Living Room Designer 3D Wall Paper]

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.Customized Plastic Beer Crate Mould with 24 Bottles. 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.[Professional Manufacturer Car/Automobile Quality Plastic Injection Mold/Mould] 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,CNC Turned Plastic Delrin POM Parts Machining. 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[Pleated Water Filter Cartridge Filter Water for Water Filter Housing]

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 (P4.81 500mm*1000mm Cabinet Indoor Professional High Resolution LED Display Screen).Household Home Appliances Parts Cheap Wholesale Used Plastic Injection Mould Molding Mold, waste residue is inert and sterile, i.e., environment friendly,2019 Hot Sales Duplicator Garage Door Opener Keychain(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.[High Bright Anti-Glare 8 Inch 60W COB LED Ceiling Downlight]

Conclusions

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References