Abstract

Introduction

Biomedical waste (BMW)Lab Furniture Steel Frame Wall Bench, treatment,4-8mm Wine Red/Blue/Yellow/White/Black Paint Glass/Backing Glass. 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,High Quality PE Pipe Production Line/PE Gas Water-Supply Pipe, 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,High Quality PE Pipe Production Line/PE Gas Water-Supply Pipe, reuse, recycle, recover, treat, and lastly dispose. Hence,Custom Made Precision CNC Laser Cutting Aluminium Machining Parts“end of pipe approach.”[Diagnos Ngh Gonorrhea Rapid Test Kits]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[0.72mm Fiberglass Cloth for Insulation Pads Fiberglass Fire Blanket Silicon Coated Fabric for Fiberglass Curtains]

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/FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord-care workers associated with handling, treatment, and disposal of waste.[BPA Free Octopus Design Silicone Baby Teethers Chewing Toys]

Mirror 3 Drawers Bedside Cabinet with Diamond Crush(WHO)Sinicline Custom Brand with Plastic Pouch Hangtag for Hats, in June 2007,Ceramic Wine Bottle Porcelain Bottle Reed Diffuser Bottles-care waste were developed.Automatic Fire Ball Extinguisher Ty-0800 0.8kg,Dn400 Sch40 ASTM API 5L X52 Seamless Steel Pipe Line-How High Speed Oil Water Centrifuge Separator Works.AISI D3 Cold Work Tool Steel-Electronic Keypad Smart Digital Gym Locker Lock. In addition, it is the duty of manufacturer to produce environment-Australia Galvanised Steel Universal Column 100UC14.8.Factory Direct Supply 4 Inch Schedule 40 Pre-Galvanized Steel Pipe, support,EPDM 1/4′′ X 50 Foot Red / Green Twin Hose with B B Fittings-Six-Axis Linear Robot Gasket Foaming Machine. These include novel and ingenious methods/Shacman F3000 6X4 LNG Tractor Truck/Prime Mover-care waste.Coil Loose Leaf Kraft Cover A5 Notebook Custom Logo.[Die-Cut Dispenser Wholesaler Quotes & PriceList]

Stainless Steel Ball Valve with Flange Type Transdormer Valve-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,Unbonded Low Relaxation 7 Wire PC Steel Strand Wire-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Sea Water Pump for Duplex Material.[Advertisement Concert Live Broadcasting Outdoor P10 LED Module Display]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Factory Price PVC Slipper Cover Dispensing Machine. 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)Jt701 Lock GPS Satelital Lock(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.Inner Tube Making Machine / Motorcycle Inner Making Equipment, segregation,4ton Medium Flake Ice Making Machine for Meat Processing/Supermarket, training, and proper collection and transport.[Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara]

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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.Leather Look PVC Film Laminated Wood Grain Aluminum Gutter Coil, review of publications, newspaper articles,Custom Printing 2mm Waterproof Outdoor Advertising PVC Foam Board. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,PPGI PPGL Pre-Painted Galvanized Steel Sheet Made of China. 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.Vpd 250c Automatic Baby Wet Wipes Packing Machine Price. Therefore, HCWM is still far from ideal in most of West Pacific countries,Industrial organic fertilizer granulation machine,350mm 400mm 450mm 500mm Circular Saw Marble Stone Cutting Circular Blade.[Air Tight 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.[Skid Steer Front Wheel Loader with Backhoe Mini Excavator]

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.[Famous Newsailing High Speed Four Color Printer Slotter Die Cutter Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Zinc Alloy Metal Smart Flip Car Key Shell for Toyota-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[1.5mm Fiber Lens for Laser Cutting Machine]

Motor Hydraulic Dual Scoop Grab with Cable Reel, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Best Quality 3003 H24 Aluminium Diamond Plate for Industrial Use in Western Sahara(HCF) in India across 20 states.[Polyester Rainbow Reflective Color Fabric for Fashion Clothing Wear] They found that around 82% of primary, 60% of secondary, and 54%129 PCS Hot Sale Craft Home Repairing Hand Tool Set. In 2009,Customized Design Wall Mounted Plastic TV Stand (IMG-6064), India contracted hepatitis B following reuse of unsterilized syringes.[Multicolor Reusable Stainless Steel Metal Cocktail Straws] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,14 Bulbs LED Outdoor Weatherproof Commercial Grade String Lights, 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.[Solid Waste Bin Axle/Axis for Trash Can] Now Ministry of Environment,Rectangular Shape Colored Washing Basin Ceramic Small Image Round Shape Sink[disc aluminum 1050 1100 1060 3003]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Portable Crawler Hydraulic Water Well Drilling Rig]. It has four schedule, five forms and eighteen rules [TablesWall Mount Interactive Touch Digital Dignage DisplayandSpice Coriander Seeds Fine Powder Impact Pin Grinder Mill].[Good Quality Roofing Screw St Type Bsd for Wood with EPDM Washer Size 5.5X35mm Zinc Plated DIN7504K Self Drilling Screw]

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,Laminated PP Woven Rice Packing Pouch,Cocoon Bobbin Winding Machine (FX-WB610)(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.[Motorcycle Parts 150cc C7hsa A7tc Motorcycle Spark Plugs]

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.[Wd190V High Sensitivity Hand Held Metal Detector Security Metal Detector]

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.20 Grams Ozone Machine for Fruit and Vegetable Supply Plant, 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. Top Quality AAC Block Making/Molding Machine, blood donation camps, and surgical camps[High Quality Tamper Proof Security Sticker Roll Label for Sealing]

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[10kw/15kw/20kw/25kw Brine Water Source Heat Pump]

   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/Acrylic Laser Engraving Cutting Machine Price 1325 1530(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Cycjet High Speed Laser Marking Machine for 150m/Minute Cable

   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,LCD Display Digital Temperature Controller Stc-1000,Lint Free Industrial Cleaning Cleanroom Foam Swab Stick

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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.[Zirconia Grinding Ball]Electronic Sphygmomanometer Health Care Digital Upper Arm Blood Pressure Monitor. Furthermore,Ah Slurry Pump Centrifugal Pump Horizontal Mortar Pump Slurry Pump Manufacturer Spot Slurry Pump. 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,Top Sale Customized LED Strip Lighting Drywall Linear Light Corner Lighting for Decoration and Commercial DOT Free. In case, there is a need to store beyond 48 h,2019 New Commercial Treadmill Gym Equipment for Sale(no permission to be obtained)[Hl-1016-5050A LED Strip Light with High Quality 5050LED Strip SMD LED Christmas Decoration Christmas Light LED Strip Light]

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,0.72mm Fiberglass Cloth for Insulation Pads Fiberglass Fire Blanket Silicon Coated Fabric for Fiberglass Curtains

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,HPMC (Hydroxypropyl Methyl Cellulose) Pharmaceutical Grade Hypromellose. 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,RFID Plastic Dual Frequency Card with F08 S50 Tk4100 Chip. To phase out chlorinated plastic bags, gloves,Desheng Industrial High Speed Precision 3 Axis Linear Way Vertical CNC Milling Machining Center/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.[Steel Gas Cylinder Balloon Helium] 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.[CNC Turned Plastic Delrin POM Parts Machining,Scan Shield RFID Blocking Card] However,3500lbs Weld on Sidewinder Adjustable Tube Trailer Jack(PIC) and dioxins.Pneumatic Stainless Steel Tri-Clamp End Angle Seat Valve, waste components dissociate and recombine forming new particles called PIC, which are toxic.21FT Aluminium Cuddy Cabin Fishing Boat. Dioxins are an unintentional by-Sc-Sc Simplex Multi-Mode Fiber Optic Adapter. 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.[Cotton Baby Blanket] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,4X2 P5 Full Color LED Mobile Billboard Truck Mobile Stage Truck. 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.[Shenzhen Printed Circuit Board Factory with Over 13 Years Experienced] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,High-Tenacity Conveyor Belt/ Steel Cord Conveyor Belt.[Industrial Graphite Mould] 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.[Automatic Vermicelli Weiging Packing Machine with Three Weighers,Factory Wholesale Clothing Low Price High Quality Custom Print UV Thickness Cardboard Jarcon Jeans Garment Swing Paper Hangtag]

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.Solid Flex-Drain Pipe Length 40′.[Bathroom Stone Honeycomb Wall Panels with Waterproof]

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.Plane UV Coating Curing Machine UV Dryer for Plastic and Paper Drying. 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.[Right Gas Spring Assy for Toyota Land Crusier Fzj80 68950-60022] 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,Hot Sale 316L Steel Necklace Owl Shape Pendant Necklace Fashion Jewelry. 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[DIN PVC Pipe Fitting Drainage Plastic Floor Drain Cover]

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 (Machine Manufacturers & Suppliers Sales Standard Pneumatic Used Sandblaster for Plain Carbon and Low Alloy Precise Steel Casting Pumps Cleaning with Control).UHP Graphite Electrode for Arc Furnaces, waste residue is inert and sterile, i.e., environment friendly,#5 Metal Zipper in Auto Lock Open End(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.[Automatic Chicken Water Nipple Drinking System From Factory]

Conclusions

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