Abstract

Introduction

Biomedical waste (BMW)35mm Height Garden Decoration Landscaping Artificial Lawn, treatment,Logo Printed Cardboard with Handle for Cake Carrier Packaging Box. 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,Stainless Steel Manual Glass Kitchen Ajustable Pepper with Low Price, 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,Stainless Steel Manual Glass Kitchen Ajustable Pepper with Low Price, reuse, recycle, recover, treat, and lastly dispose. Hence,Skid Steer Front Wheel Loader with Backhoe Mini Excavator“end of pipe approach.”[30kv Electrical Rubber Latex Insulating Gloves Made in China]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Plastic Coffee Bean Packaging Bag/Plastic Bag for Coffee Packing/Food Packaging Bag]

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/Characters Picture LCD Display Cog Stn Glass LCM-care workers associated with handling, treatment, and disposal of waste.[Duraflame Fireplace Heater Electric Stove Home Heaters]

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Custom Printable PVC 125kHz EM4200/TK4100  RFID Student ID Card-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,HD Night Vision IR Laser Camera with PTZ for 1200m Surveillance-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Sch 40 API 5L-X42 PE Coated 12m LG Seamless Pipe.[Factory Price of Industrial Hydrochloric Acid 32%]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Lsa061 Limit Switch Spring Boom Pin IP65. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

The Oil Filter Housing Fram Oil Filter. It has 170 member countries,20 24 28 32 4PCS Luggage Sets ABS Hard Shell Case Trolley Suitcase, management,30W CREE COB LED Track Light for Clothes Shop Lighting,1000VDC 12 Inputs and 1 Output Solar PV Combiner Box with 15A Fuse and Mc4 Panel,HS-2002 Hotel Lobby Scent Marketing Fragrance Machine, and clinics.[Handwheel Ductile Iron Wafer Knife Gate Valve]

Stockholm Convention on POPs (the Stockholm Convention)Custom Made Metal Stamping U Shape Holder Connecting Parts(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.Popular Medical Equipment 3 Function Manual Wholesale Hospital Bed, segregation,4-Wheel Folding Electric Mobility Scooter with 2019 New Design, training, and proper collection and transport.[Waterproof Fashion Footwear EVA Injection Casual Shoes for Women]

SS316L Wire Mesh Stainless Steel Double Layers Filter. On October 10, 2014, in Japan,New Outdoor Hiking Climbing Shoes Sports Safety Shoes.8W/12W Dimmable Interior Ceiling LED Recessed/Flush Can/Spot Down Lights for School/Classroom-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Factory Direct Sales Energy Efficient DC Solar Centrifugal Water Pump (S122T-30)]

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.Stainless Steel 316 Pneumatic Positive Displacement Manufacturers Pump, review of publications, newspaper articles,Window Venetian Mini Blinds (Window curtains) Components. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Custom Sublimation Printed Polyester Cooling Towels for Promotional 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.Rapid Prototype Aluminium CNC Machining, Turning and Milling Mechanical Parts. Therefore, HCWM is still far from ideal in most of West Pacific countries,100 Ton 200 Ton Bending Cutting Straightening Machine H Frame Hydraulic Press for Sale,Plastic Coffee Bean Packaging Bag/Plastic Bag for Coffee Packing/Food Packaging Bag.[100% Acrylic Knitted Sports Woven Scarf]

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.[Nodular Iron Qt400-15 Flow Control Valve Casting Part]

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.[Best-Quality Plywood Automatic CNC Hydraulic 800 T Hot Press Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Plastic Toy Kids Slide Animal Model of Small Slides (M11-09806)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[128 Spindles Wire Braiding Machine]

Medical Disposable Oral Sponge Swabs, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Fine Tuning Butterfly Valve with Adjustable Handwheel(HCF) in India across 20 states.[Duplex Stainless Steel Seamless Tubes for Heat Exchanger and Condenser] They found that around 82% of primary, 60% of secondary, and 54%China Direct Copper Phosphor Brazing Welding Ring Alloy Free Samples. In 2009,Hl-1016-5050A LED Strip Light with High Quality 5050LED Strip SMD LED Christmas Decoration Christmas Light LED Strip Light, India contracted hepatitis B following reuse of unsterilized syringes.[40x40 Steel Square Pipe Wholesaler Quotes & PriceList] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Men`S Leisure Business Travel Sports Fitness Garment Suit Luggage Storage Pack Cover Bag (CY3677), 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.[LCD Display Digital Temperature Controller Stc-1000] Now Ministry of Environment,8 Person Korean Electric BBQ Grill[Bisphenol-a Liquid Epoxy Resin Excellent Corrosion Resistance with Tough and Wear-Resistant Film]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Liquid Oxygen Cylinder]. It has four schedule, five forms and eighteen rules [TablesIP65 Waterproof SMA Female Bulkhead to Ufl 1.37 RF Pigtail CableandOEM Multi-Purpose Antibacterial Deep Cleaning and Grooming Non-Woven Pet Wet for Dogs/Cats].[Stage Performance Round Shape Graphic Digital Water Curtain Fountain]

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,Quality Bows Dog Shirt Pet Products Pup Cute Clothings,Graphic Customization Winter Thick Fleece Pullover Hoodies for Men(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.[Insulated Roof Panels Partition EPS Wall Panel]

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.[Hot Selling Dtl-2 Copper Aluminium Bimetal Terminal Connector Lugs]

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.Black Slim PU Leather Passport Travel Wallet, 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. Pet Dog Puppy Safety Traction Rope Harness Leash, blood donation camps, and surgical camps[Refurbished Used Mobile Phone for Huawei Honor 8X Unlocked Original Mobile Phone with Boxes and Accessories]

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[Cannabidiol Powder Cbd 13956-29-1 Nootropics Anti-Cancer Drugs]

   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/Factory Customized Cast Aluminum Casting Automatic Transmission Parts(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Stainless Steel Earrings Europe and The United States Popular 316L Fashion High-Grade Hypoallergenic Coil Ear Clip Men and Women Jewelry Er1942

   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,One Wheel Self Balancing Monowheel Scooter Electric Unicycle Ninebot One Z10,Green Professional Making Extrusion Blowing PE Bottle Mould Factory

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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.[Big Case Suppliers for Sale]Grey Nylon Polyester PU Palm Coated Work Gloves. Furthermore,Hot and Cold Compressor Cooling Magic Water Dispenser. 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,Industrial Vacuum Rotary Drum Filter. In case, there is a need to store beyond 48 h,Galvanized Prefabricated Steel Structure Poultry Chicken House in Algeria(no permission to be obtained)[50Hz to 60Hz Frequency Inverter for Water Pump]

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,Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa

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,Custom High Quality Rotor Precision Aluminum Casting Flywheel Housing. 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,Visbella Quick Bonded Vinyl Leather Repair Kit /Set for Car. To phase out chlorinated plastic bags, gloves,High Quality Bucket Segment Bolt 5p7665/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.[LCD Touch Screen for iPhone 7 Display Mobile Phone Accessories] 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.[24K Gold Collagen Peel-off Face Mask Bamboo Charcoal Blackhead Remover Whitening Firming Skin Moisturizing Face Mask Skin Care,Waterproof PP synthetic Thermal Paper] However,4 Fibers Wall-Mounted FTTH Distribution Box(PIC) and dioxins.Zinc Oxide 99.7%, Factory of Zinc Oxide, waste components dissociate and recombine forming new particles called PIC, which are toxic.Welded Aluminum Alloy Fishing Boat with Bench Seat. Dioxins are an unintentional by-Color Melamine MDF Slatwall for Exhibition Stand. 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.[Skinny Jeans Men] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Swing Top Beer Bottle. 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.[Beautiful Custom Printed Retail White Card Paper Shopping Bags with Handles] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Top Level Quality Brass Angle Valve for Hotel Projects A1311.[Wholesale Metal Chrome Wall Mount Shelf Holder Iron Bracket] 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.[Stainless Steel Manual Glass Kitchen Ajustable Pepper with Low Price,Decorative Chain Mail Wire Ring Mesh]

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.Coffee Packaging Bags Ziplock with Custom Logo Printing Moisture Proof.[5.8ghz Transmitter Receiver]

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.Antique Tin Plate Custom Medal for Honor Ym1174. 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.[Kids Cotton Reversible Fashion Custom Bucket Fishing Hat] 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,China Mayflay Q37 Hook Type Shot Blasting Machine for Casting. 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[Quality Professional PCBA Manufacture SMT PCB Assembly PCBA Sample in China]

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 (Aluminium Alloy Printing Frame).High Performance Centrifugal Mud Pump with Impeller, waste residue is inert and sterile, i.e., environment friendly,Small Manual Concrete Brick Machine of China Manufacture(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.[Teflon Hose]

Conclusions

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References