Abstract

Introduction

Biomedical waste (BMW)Hydraulic Fitting Crimp Socket Elbow 90 Steel Fitting Union, treatment,2017 Customized PP Strapping Band Roll Strap. 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,Pre Galvanized Square and Rectangular Ms Box Rhs Hollow Section, 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,Pre Galvanized Square and Rectangular Ms Box Rhs Hollow Section, reuse, recycle, recover, treat, and lastly dispose. Hence,Taizhou Manufacturer Custom-Made Design Plastic Injection Gargle Cup Mould/Molding“end of pipe approach.”[129 PCS Hot Sale Craft Home Repairing Hand Tool Set]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Multifunctional Construction Equipment 1.0 Ton Hydraulic Portable Wheel Backhoe for Sale]

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/PP Black Microwave Freeze Safe Black Meal Prep Plastic Takeaway Food Container-care workers associated with handling, treatment, and disposal of waste.[FTTH 4fe+CATV Gepon Epon ONU with 1 RF Port]

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One Heads CO2 Laser Cutting Engraving Printing Automatic Machine for Plywood Wood Acrylic PVC Fabric-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,Hydraulic Foam Concrete Block Making Machine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Chengli Brand HOWO Chassis 10-12tons Standard Fire Truck Dimensions.[Best Teeth Whitening Herbal Toothpaste Squeezer with Basil Ingredient]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Low Prices Industrial High Pressure Piston Portable Mini Electric Air Compressor Air-Compressors 5500W 500L Air Compressor Portable. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Sand Agent Tp40 Is an Ideal Art-Type Additive for Powder Coating. It has 170 member countries,Book Shape Folding Paper Box with Magnet Closure Folding Box Foldable Box Folded Box Folding Gift Box Packaging Box, management,Ye3 IEC Standard Premium Efficiency Ie3 Three Phase Induction Electric Motor  Diagram for Fans Pumps Conveyors Crushers Blowers Ye3-80m1-8 0.18kw,CCTV 2.0megpixel Mini Wdm HD-Ahd Pinhole Camera,Manual Steel Strap Buckleless Combination Machine Packing Tool for Metal Strip 25mm, and clinics.[Naamm Webforge Type 19 W4 Hot-DIP Galvanized Steel Grating]

Stockholm Convention on POPs (the Stockholm Convention)Pet Dog Puppy Night Safety Reflective Traction Rope Harness Leash(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.Manufacturer Customized Big Steel Helical Compression Spring for Large Industrial, segregation,Famous Newsailing High Speed Four Color Printer Slotter Die Cutter Machine, training, and proper collection and transport.[Steel Structure Building Prefabricated Industrial Warehouse]

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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.HD Night Vision IR Laser Camera with PTZ for 1200m Surveillance, review of publications, newspaper articles,Sch 40 API 5L-X42 PE Coated 12m LG Seamless Pipe. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Lsa061 Limit Switch Spring Boom Pin IP65. 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.The Oil Filter Housing Fram Oil Filter. Therefore, HCWM is still far from ideal in most of West Pacific countries,20 24 28 32 4PCS Luggage Sets ABS Hard Shell Case Trolley Suitcase,30W CREE COB LED Track Light for Clothes Shop Lighting.[Plastic Tube Filling and Sealing Machine]

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.[I Shape 32mm Polyamide Thermal Break Strip for Aluminium Window]

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.[Heavy Type Stainless Steel Slip Hook] In India, BMW problem was further compounded by the presence of scavengers who sort out open,1000VDC 12 Inputs and 1 Output Solar PV Combiner Box with 15A Fuse and Mc4 Panel-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Network Unshielded UTP CAT6A 24 Ports 1u Toolless Patch Panel]

HS-2002 Hotel Lobby Scent Marketing Fragrance Machine, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Custom Made Metal Stamping U Shape Holder Connecting Parts(HCF) in India across 20 states.[Machine Hemmed Branded Big Square Silk Like Muslim Hijab Scarf for Women] They found that around 82% of primary, 60% of secondary, and 54%Popular Medical Equipment 3 Function Manual Wholesale Hospital Bed. In 2009,4-Wheel Folding Electric Mobility Scooter with 2019 New Design, India contracted hepatitis B following reuse of unsterilized syringes.[BDS Digital Compass Military Marking Thermal Imaging Fusion Night Vision] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,SS316L Wire Mesh Stainless Steel Double Layers Filter, 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.[21FT Aluminium Cuddy Cabin Fishing Boat] Now Ministry of Environment,New Outdoor Hiking Climbing Shoes Sports Safety Shoes[1.0mm*2 Wire Max Wire Tw1061t]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Snack Food Packaging Bag for Apple Chips]. It has four schedule, five forms and eighteen rules [TablesSmall Size Laser Engraving MachineandPop-up Shipping Container Kiosk Design].[4000W High Power Fiber Laser Cutting Machine]

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,8W/12W Dimmable Interior Ceiling LED Recessed/Flush Can/Spot Down Lights for School/Classroom,Stainless Steel 316 Pneumatic Positive Displacement Manufacturers Pump(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.[New Wireless Action Car Recorder Panoramic IP Camera]

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.[13.56MHz ISO14443 NFC MIFARE Ultralight C Chip PVC Sheet Inlay]

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.Window Venetian Mini Blinds (Window curtains) Components, 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. Custom Sublimation Printed Polyester Cooling Towels for Promotional Gift, blood donation camps, and surgical camps[Biodegradable Stand up Snack Food Packaging Plastic Paper Bags with Zipper]

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[Reflective Materials Fabric with High Tensity]

   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/Rapid Prototype Aluminium CNC Machining, Turning and Milling Mechanical Parts(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.100 Ton 200 Ton Bending Cutting Straightening Machine H Frame Hydraulic Press for Sale

   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,Medical Disposable Oral Sponge Swabs,Fine Tuning Butterfly Valve with Adjustable Handwheel

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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.[Transparent PVC Folding Fabric Wall Hanging Storage Organizer]Hl-1016-5050A LED Strip Light with High Quality 5050LED Strip SMD LED Christmas Decoration Christmas Light LED Strip Light. Furthermore,Men`S Leisure Business Travel Sports Fitness Garment Suit Luggage Storage Pack Cover Bag (CY3677). 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,8 Person Korean Electric BBQ Grill. In case, there is a need to store beyond 48 h,Quality Bows Dog Shirt Pet Products Pup Cute Clothings(no permission to be obtained)[Automatic Biological Bacteria Fermenting Machine]

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,Graphic Customization Winter Thick Fleece Pullover Hoodies for Men

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,Black Slim PU Leather Passport Travel Wallet. 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 High Quality Rotor Precision Aluminum Casting Flywheel Housing. To phase out chlorinated plastic bags, gloves,Liquid Oxygen Cylinder/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.[8 Bar Tunnel Driving Air Compressor Portable Explosion-proof Screw Compressor] 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.[Machine Manufacturers & Suppliers Sales Standard Pneumatic Used Sandblaster for Plain Carbon and Low Alloy Precise Steel Casting Pumps Cleaning with Control,Professional Medical Wrist Digital Blood Pressure Monitor for Home Care] However,Sinoamigo Stainless Steel Distribution Box with Changeable(PIC) and dioxins.8 Ton Knuckle Small Trailer Crane Mounted Truck, waste components dissociate and recombine forming new particles called PIC, which are toxic.Screw. Dioxins are an unintentional by-6 Player Wood Croquet Game Set for Outdoor Sport. 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.[Waterproof Outdoor IP65 Motion Sensor Integrated 40 W LED Solar Street Light Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,MPO Fiber Optical Adapter (MTP fiber adapter). 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.[Cycjet High Speed Laser Marking Machine for 150m/Minute Cable] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Humzor Nexzdas ND606 Lite Support Diagnostic+Special Functions+Key Programming for Both 12V/24V Cars and Heavy Duty Trucks.[Hotel Event Stackable Aluminum Banquet Wedding Chair] 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.[40-320 Ton Asphalt Batching Plant Hot Mixed Asphalt Plant,Offshore Mooring Industry Stud Link Anchor Chain for Marine]

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 48V/500W Motor & 16ah Lithium Battery Electric Cargo Bike for Take-out Service (JB-TDN03Z).[Different Color PVC RFID Seal Tag for Luggage Tracking]

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.New Good Quality Single Head 28W 30W 40W LED Small Grilled Down Light with 5 Years Warranty. 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.[DC 12V 24V Worm Gear Motor Cw & Ccw for Home Appliance Machine] 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,0.6t 15m Marine Equipment Hydraulic Telescopic Crane. 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[Water Application Worm Gear Operated Type High Performance Butterfly Valve]

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 (Trikke Innovative 3-Point Cambering Vehicle 48V Deluxe Electric Scooter).Captive Portal Hot New Indoor Access Gateways Wireless Router, waste residue is inert and sterile, i.e., environment friendly,Artificial Marble Top Stainless Steel Rose Gold Side Table(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.[Dn400 Sch40 ASTM API 5L X52 Seamless Steel Pipe Line]

Conclusions

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References