Abstract

Introduction

Biomedical waste (BMW)Refined Pure Metal High Purity 99.99% Lead Ingot, treatment,All Seasons Outdoor Protector 210d Oxford with Rope. 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,Jt701 Lock GPS Satelital Lock, 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,Jt701 Lock GPS Satelital Lock, reuse, recycle, recover, treat, and lastly dispose. Hence,Inner Tube Making Machine / Motorcycle Inner Making Equipment“end of pipe approach.”[Bnh Cheap Price Triple Wall Polycarbonate Hollow Sheet Polycarbonate Roofing 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.[KW5701 Ultrasonic Rainbow Night Light Humidifier Aroma Diffuser]

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/4ton Medium Flake Ice Making Machine for Meat Processing/Supermarket-care workers associated with handling, treatment, and disposal of waste.[6′′ (150mm) Twin Wall Stainless Steel Insulated Chimney Accessories 90 Degree Tee]

U. S. Type Turnbuckle Rigging High Quality(WHO)Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper, in June 2007,Ca Automatic Mini Fast Response Auto Ball Fire Extinguishe Anti Fire Ballr Fire Extinguisher Ball-care waste were developed.Leather Look PVC Film Laminated Wood Grain Aluminum Gutter Coil,Custom Printing 2mm Waterproof Outdoor Advertising PVC Foam Board-PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China.Vpd 250c Automatic Baby Wet Wipes Packing Machine Price-Industrial organic fertilizer granulation machine. In addition, it is the duty of manufacturer to produce environment-350mm 400mm 450mm 500mm Circular Saw Marble Stone Cutting Circular Blade.Zinc Alloy Metal Smart Flip Car Key Shell for Toyota, support,Motor Hydraulic Dual Scoop Grab with Cable Reel-Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara. These include novel and ingenious methods/129 PCS Hot Sale Craft Home Repairing Hand Tool Set-care waste.Customized Design Wall Mounted Plastic TV Stand (IMG-6064).[Ups Battery Jamaica]

14 Bulbs LED Outdoor Weatherproof Commercial Grade String Lights-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,Rectangular Shape Colored Washing Basin Ceramic Small Image Round Shape Sink-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Laminated PP Woven Rice Packing Pouch.[Agricultural Machinery Manure and Urine Solid-Liquid Separator Manure Dewatering Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Cocoon Bobbin Winding Machine (FX-WB610). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

20 Grams Ozone Machine for Fruit and Vegetable Supply Plant. It has 170 member countries,Top Quality AAC Block Making/Molding Machine, management,Acrylic Laser Engraving Cutting Machine Price 1325 1530,Cycjet High Speed Laser Marking Machine for 150m/Minute Cable,Commercial 15W 20W 30W COB LED Track Light for Shop Supermarket Gallary Museum, and clinics.[110t Jh25 Series Double Crank Sheet Metal Stamping Press with Balance Cylinder]

Stockholm Convention on POPs (the Stockholm Convention)250kg/H Cassava Production Line with Cassava Flour Packing Machine(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.LCD Display Digital Temperature Controller Stc-1000, segregation,Lint Free Industrial Cleaning Cleanroom Foam Swab Stick, training, and proper collection and transport.[Horizontal Island Freezer for Frozen Food]

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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.Top Sale Customized LED Strip Lighting Drywall Linear Light Corner Lighting for Decoration and Commercial DOT Free, review of publications, newspaper articles,2019 New Commercial Treadmill Gym Equipment for Sale. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,0.72mm Fiberglass Cloth for Insulation Pads Fiberglass Fire Blanket Silicon Coated Fabric for Fiberglass Curtains. 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.HPMC (Hydroxypropyl Methyl Cellulose) Pharmaceutical Grade Hypromellose. Therefore, HCWM is still far from ideal in most of West Pacific countries,9zt-0.6 Family Use Grass Cutter Machine Chaff Cutting Machine Wholesale,Powder Filling Machine with Ce Certificate for Measuring Flour/Pepper/Spice/Coffee Powder/Salt (JA-15LB-B).[m.guoweiseals.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.[Bomco Mud Pumps/China Manufacturer/Bi-Metal Cylinder Liner]

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.[ Pet Bottle Automatic Shrink Sleeve Label Wrapping Labeling Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Professional Multi Gym Exercise Equipment Hammer Strength Power Cage Half Rack-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[216 PCS Nicuni Plated Cube N52 Permanent Speaker Magnet Square]

Glass Double Layer Water 320ml Bottle with Stainless Steel Lids, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Sigma Residential Round Square Slim Recessed Surface Mounted 9W 12W 15W 18W 24W 30W Ceiling Lightbulbs LED Panel Lighting(HCF) in India across 20 states.[33PC15/45rcs/55rcs/70rcs25 Hoisting and Trolley Mechanism for Tower Crane] They found that around 82% of primary, 60% of secondary, and 54%Party Supplies School Gift Kid Toy Education Wholesale Yiwu Market Agent (P4081). In 2009,Biogas Scrubber/Pre-Treatment System/Desulphurization System, India contracted hepatitis B following reuse of unsterilized syringes.[Metal Aluminium Pot Press Tool Stamping Drawing Mould] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,G06p21L Newly Design Hanging Wheel 304 Stainless Steel Sliding Glass Frameless Shower Screen, 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.[Anti Wrinkle and Moisturizing 24K Gold Lip Mask Good Selling 8g Collagen] Now Ministry of Environment,Bathroom Steam Shower Cabin Wet Room[ or TNC Type Connector]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Mini Inflatable PVC Sofa for Kids]. It has four schedule, five forms and eighteen rules [TablesFactory 200 Ml Cosmetic Shampoo Perfume Plastic Pet BottleandMultipole Strip Magnet].[5*5cm Hot Dipped Galvanized Chain Link Fence]

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,Maize Starch Making Machine Corn Flour Processing Line Centrifugal Sieve Machine Starch,Light Gauge Stainless Steel Reducing Tee for Water System(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.[Amazon Best Selling Sports Ankle Support Sleeves Compression]

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.[Comfort Home Indoor Scent Aroma Machine Silent Essential Oil Diffuser]

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.Fashion Anti Silver Handmade Round and Natural Turquoise Stone Pendant Necklace, 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. 13oz Printable Banner/PVC Flex Banner/Advertising Material, blood donation camps, and surgical camps[Alloy Anodised Rail Leadshine Servo Motor Customized Length Linear Guide Bearing]

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[400 Ton Straight Side Double Point Punch Machine]

   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/RFID Plastic Dual Frequency Card with F08 S50 Tk4100 Chip(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Desheng Industrial High Speed Precision 3 Axis Linear Way Vertical CNC Milling Machining Center

   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,21FT Aluminium Cuddy Cabin Fishing Boat,Sc-Sc Simplex Multi-Mode Fiber Optic Adapter

   7. 4X2 P5 Full Color LED Mobile Billboard Truck Mobile Stage Truck/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.[3 Arms Glass Curtain Wall Fittings]High-Tenacity Conveyor Belt/ Steel Cord Conveyor Belt. Furthermore,Solid Flex-Drain Pipe Length 40′. 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,Plane UV Coating Curing Machine UV Dryer for Plastic and Paper Drying. In case, there is a need to store beyond 48 h,Hot Sale 316L Steel Necklace Owl Shape Pendant Necklace Fashion Jewelry(no permission to be obtained)[Sinicline Custom Brand with Plastic Pouch Hangtag for Hats]

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,Machine Manufacturers & Suppliers Sales Standard Pneumatic Used Sandblaster for Plain Carbon and Low Alloy Precise Steel Casting Pumps Cleaning with Control

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,UHP Graphite Electrode for Arc Furnaces. 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,Kraft Paper Charcoal Packing Bag. To phase out chlorinated plastic bags, gloves,Reflective Materials Fabric with High Tensity/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.[En12150] 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.[Carbon Steel Pipe Fitting Sch20 Steel Elbow,Washroom Bright LED Back Lighting Wall LED Magic Mirror with Date Display] However,Roll up High Quality Luxury Comfort Spring Mattress(PIC) and dioxins.Pn10/Pn16 Cast Ductile Iron Automatic Single/Double Ball Air Release Valve, waste components dissociate and recombine forming new particles called PIC, which are toxic.Hot Sale Ball Screw Sfu8010 with Best Quality and Good Price for CNC Machine From China Shac. Dioxins are an unintentional by-Piggery Accessory/Farm Pig/Sow/Piglet Accessories for Poultry Farm. 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.[Egg Tray Forming Machine] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,CNC New Design/Drawing Rapid Prototyping Model, CNC Prototype, Prototype Machining. 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.[Mgn12 300mm Miniature Linear Guide Rail with Bearing Steel Rail Block] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,6206-2RS 6207-2RS 6208-2RS 6209-2RS 6210-2RS Bearing Steel Material Ball Bearing.[New Design Sports Gym Cheap Custom Logo Stainless Steel Protein Shaker Bottle] 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.[Waste Engine Oil Filtration Equipment Oil Cleaning Machine,8 Person Korean Electric BBQ Grill]

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.Indoor Rental LED Display for Stage Show.[120W Bench Top Ultrasonic Cleaner with Degas Function and Two Transducer]

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 Waterproof Backpack Canvas Laptop Bag. 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.[Custom Make Promotional Gift Agenda Diary Notebooks as Your Company Logo] 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,Bar Chair New Design Bar Stool Bar Chair Bar Talbe Bar Stools. 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[Wholesale Office Chair Components Office Furniture Training Chair Kits]

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 (Italian Wafer Type Flange Ball Valve).Tactical Military Flashlight Waterproof Ipx7 Multi-Function Ultra Lightweight Flashlight HK15-0127, waste residue is inert and sterile, i.e., environment friendly,Wire Coated by Rare-Earth Zn-Al Alloy/Rare Earth Zinc Aluminum Alloy Coated Steel Wire Strand(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.[America Style Round Corner Door Hinge]

Conclusions

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References