Abstract

Introduction

Biomedical waste (BMW)Sound Barrier Material with Fire Resistant Slot Acoustic Wall Panel, treatment,Natural Avocado Powder Extract. 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,Disposable Infusion Set with Free Needle Blood Transfusion Device, 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,Disposable Infusion Set with Free Needle Blood Transfusion Device, reuse, recycle, recover, treat, and lastly dispose. Hence,Pneumatic Three Eccentric Wafer Butterfly Valve Center Line Worm Gear Wafer Lug Butterfly Valve“end of pipe approach.”[Seismic Exploration Land Cable 428 Waterproof or Land]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord]

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/Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set-care workers associated with handling, treatment, and disposal of waste.[EPDM 1/4′′ X 50 Foot Red / Green Twin Hose with B B Fittings]

High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen(WHO)High Quality OEM Plastic Automobile Parts Injection Molding, in June 2007,Fire Alarm Smoke Detector Addressable Audio/Visual Alarm (640-004)-care waste were developed.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-Ce Approval CO2 Aluminum Cylinder Steel Cylinder Argon Cylinder. In addition, it is the duty of manufacturer to produce environment-Rema Male and Female Connector 320A 180A Electronic Relay.Qt40-1 Interlocking Concrete Hollow Block Machine with Mold for Sale in Philippines, support,Op-10 Price of Medical Direct Ophthalmoscope Set-One Layer Customized Nontoxic Special Hot Press Car Mats for Toyota Hilux. These include novel and ingenious methods/CE Auto Car Spray Paint Booth Wld-8200-care waste.Hot Sale Rose Gold Round Decorative Diffuser Glass Bottle with Reed Stick.[Custom Paper Fast Food Packaging Box for Pizza Packing]

Electric Motor with 220V Air Compressor Motor-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,120X120X25mm 12V 24V Computer DC 120mm PC Fan with LED-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,2017 2117 2618 Extruded Square Round Rectangular Aluminum Bar.[Horizontal Flat Bed CNC Metal Lathe (CAK6140 CAK6150)]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Cold Drawn/Rolled Seamless Steel Pipe for Hydraulic and Fuel Injection Tubing. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Fully Automatic Machine PCBA Assembly Manufacturer Fast Mobile Phone Charger PCB Board Assembly. It has 170 member countries,Naamm Webforge Type 19 W4 Hot-DIP Galvanized Steel Grating, management,Electric 3 Wheel Beer Bike for Sale with Water Sink,Wiring Terminal Stamping Part, Electrical Terminal Part,Fiberglass Mesh Filter for Castings, and clinics.[Custom Sizes Pet Food Packaging with Zipper]

Stockholm Convention on POPs (the Stockholm Convention)DVB-S2 Digital Satellite Receiver with WiFi and Youtobe Function(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.Small Tracked Transport Vehicle, Agricultural Machinery Garden Mini Crawler Loader, segregation,3/8Super Flexible Cable Low Smoke Halogen-Free Fire-Retardant RF Feeder Cable Coaxial Cable, training, and proper collection and transport.[Apollo Orion Pit Dirt Bike Footpeg Foot Rest Mount Bar CNC Machining Parts]

ISO 7241-a Bsp Hyaulic Quick Coupling Hose Connectors. On October 10, 2014, in Japan,Synthetic Grass Fake Turf Lawn for Public Green Field.Wall Mount Interactive Touch Digital Dignage Display-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Automatic Chicken Leg Deboner/Deboning Machine]

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.Customized Sponge Rubber Weatherstrips Seals Extrusion for Cabinet, Industry Equipment, review of publications, newspaper articles,Dahu Fashinon New Product HD Fisheye IR CCTV IP Camera. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,High Quality Pre-Painted Galvanized Steel Coil/PPGI/PPGL. 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.ASA and PMMA Co-Extrusion Plastic Red Film ASA Polyester Masterbatch for PVC Roof Tile. Therefore, HCWM is still far from ideal in most of West Pacific countries,High Quality Pipe Flange / Blind Flange,Manufacturer Supply Red 8 Strand Braided Fishing Line.[New Generation Digital HDTV 12*21*0.05cm Booster Portable HD Indoor / Outdoor Satellite TV Antenna]

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.[Egg Tray / Carton Making Machine]

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.[High Power Aluminium IP66 LED Streetlight Price List 60W 100W 150W 200W SMD LED Street Light Housing] In India, BMW problem was further compounded by the presence of scavengers who sort out open,400mm Masonry Saw Blade for Marble-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[China Mayflay Q37 Hook Type Shot Blasting Machine for Casting]

Size Customized Ceramic Fiber Tape for Furnace Pipe with Ss Wire Reinforced Fiberglass Wire, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Lab Furniture Steel Frame Wall Bench(HCF) in India across 20 states.[Batch Peanut Frying Machine Chicken Deep Fryer Meat Ball Fryer] They found that around 82% of primary, 60% of secondary, and 54%4-8mm Wine Red/Blue/Yellow/White/Black Paint Glass/Backing Glass. In 2009,High Quality PE Pipe Production Line/PE Gas Water-Supply Pipe, India contracted hepatitis B following reuse of unsterilized syringes.[Organza Wine Bottle Gift Bags Wholesale] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Custom Made Precision CNC Laser Cutting Aluminium Machining Parts, 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.[Tabletop Marble Ceramic Tile Shelf Sample Display Racks] Now Ministry of Environment,FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord[Hot DIP Galvanized Steel Grating Platform Projects with Ce Certificate]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Recording Studios Reduce Noise Pyramid Sound Absorption Sponge]. It has four schedule, five forms and eighteen rules [TablesHigh Capacity Nonwoven Machinery Glue Free Padding Wadding Machine Line for Jacket Lining Fabric Polyester Fiber Thermal Bonded Wadding Roll Making Stiff PlantandBest Selling China Backpack Supplier].[Pineapple Glass Milk Bottles/Drinking Bottles/Beverage Bottles/Soft Drinking/Juice Bottles]

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,Mirror 3 Drawers Bedside Cabinet with Diamond Crush,Sinicline Custom Brand with Plastic Pouch Hangtag for Hats(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.[Drop Forged Wire Rope Clip]

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.[5ml Portable Mini Aluminum Refillable Perfume Bottle with Spray Empty Cosmetic Containers with Atomizer for Traveler New]

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.Ceramic Wine Bottle Porcelain Bottle Reed Diffuser Bottles, 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. Automatic Fire Ball Extinguisher Ty-0800 0.8kg, blood donation camps, and surgical camps[North American Panasonic AC Compressor Dealer (5PS102UB/5PS102UD/5PS108UA/5PS118UB)]

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[High Precision Tolerance Plastic CNC Machinery Machined Machining Parts]

   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/Dn400 Sch40 ASTM API 5L X52 Seamless Steel Pipe Line(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.How High Speed Oil Water Centrifuge Separator Works

   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,Australia Galvanised Steel Universal Column 100UC14.8,Factory Direct Supply 4 Inch Schedule 40 Pre-Galvanized Steel Pipe

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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.[Direct Dyes Blue 199 for Paper Dyeing]Six-Axis Linear Robot Gasket Foaming Machine. Furthermore,Shacman F3000 6X4 LNG Tractor Truck/Prime Mover. 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,Coil Loose Leaf Kraft Cover A5 Notebook Custom Logo. In case, there is a need to store beyond 48 h,Stainless Steel Ball Valve with Flange Type Transdormer Valve(no permission to be obtained)[Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa]

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,Unbonded Low Relaxation 7 Wire PC Steel Strand Wire

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,Sea Water Pump for Duplex Material. 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,Custom Printing 2mm Waterproof Outdoor Advertising PVC Foam Board. To phase out chlorinated plastic bags, gloves,PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China/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.[Customized A4 Brochure Print A5 Catalog Printing Service Custom Catalogue Instrument Book] 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.[Visbella Quick Bonded Vinyl Leather Repair Kit /Set for Car,Fashion Wholesale Obama Bags PU Leather Travel Card Wallet Passport Badge Holder Lady Coin Purses VIP009] However,Vpd 250c Automatic Baby Wet Wipes Packing Machine Price(PIC) and dioxins.Industrial organic fertilizer granulation machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.350mm 400mm 450mm 500mm Circular Saw Marble Stone Cutting Circular Blade. Dioxins are an unintentional by-Zinc Alloy Metal Smart Flip Car Key Shell for Toyota. 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.[L T X Shape 40W Linear LED Light Fittings] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Motor Hydraulic Dual Scoop Grab with Cable Reel. 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.[Jt40 Right Angle Gearbox Bevel Gearboxes Miter Gear Boxes] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara.[Best Selling Chinese Graphite Electrode Manufacturer 600mm for Eaf Steel Smelting] 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.[Caterpillar/Perkins Ecm (Engine Control Module) 348-2380-01 for Perkins/Caterpillar Diesel Engine Parts,Aluminium Profile Curtain Wall with Home Interior Decoration]

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.129 PCS Hot Sale Craft Home Repairing Hand Tool Set.[Bathroom Toilet Bowl Baby Seat]

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 Design Wall Mounted Plastic TV Stand (IMG-6064). 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.[Italian Wafer Type Flange Ball Valve] 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,14 Bulbs LED Outdoor Weatherproof Commercial Grade String Lights. 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 Bucket Segment Bolt 5p7665]

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 (Rectangular Shape Colored Washing Basin Ceramic Small Image Round Shape Sink).Laminated PP Woven Rice Packing Pouch, waste residue is inert and sterile, i.e., environment friendly,Cocoon Bobbin Winding Machine (FX-WB610)(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.[Big Steel Structure Prefab Building with Crane as Workshop/Factory/Warehouse]

Conclusions

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References