Abstract

Introduction

Biomedical waste (BMW)Woven Plaid Pure Cotton Fringed Picnic Throw, treatment,High Capacity Single Wall Corrugated Pipe Plastic Extrusion Line. 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,Flow Meter-Differential Pressure Air Flow Meter Flowmeter Water Flowmeter, 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,Flow Meter-Differential Pressure Air Flow Meter Flowmeter Water Flowmeter, reuse, recycle, recover, treat, and lastly dispose. Hence,Hot Sale Beauty Shadow Color Glass Container for Soy Candle“end of pipe approach.”[Hot DIP Galvanized Steel Grating Platform Projects with Ce Certificate]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Recording Studios Reduce Noise Pyramid Sound Absorption Sponge]

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/PVC, Pet Bottle Automatic Shrink Sleeve Label Wrapping Labeling Machine-care workers associated with handling, treatment, and disposal of waste.[High Capacity Nonwoven Machinery Glue Free Padding Wadding Machine Line for Jacket Lining Fabric Polyester Fiber Thermal Bonded Wadding Roll Making Stiff Plant]

Mini Inflatable PVC Sofa for Kids(WHO)Class One UV Laser Marking Machinery for PCB Glass Metal Logo Mark, in June 2007,Waterproof Fashion Footwear EVA Injection Casual Shoes for Women-care waste were developed.Full-Auto Rubber Flooring Mat Making Machine / Non-Slip Mat Vulcanizing Press Machine,Stainless Steel Quick Release Exhaust V Band Clamp with Male Female Flange-Single Phase Household Irrigation 3.5HP Centrifugal Motor Electric Water Pumps.Movable Axial Flow Blower-Patient Monitorneonate NIBP Cuff. In addition, it is the duty of manufacturer to produce environment-Economic Horizontal CNC Lathe for Tire Mold Machining (CK61200).Modern White Living Room Furniture Chaise Lounge for Sale, support,Polyester Rainbow Reflective Color Fabric for Fashion Clothing Wear-Acrilic Sheet Acrylic Panel. These include novel and ingenious methods/Puffed Animal Food Pet Food Pellet Extrusion Production Line Machine-care waste.EMC EMI RF Shielding MRI Room Door.[Model 1.6LG3 Big Capacity Stainless Steel Commercial 3 Doors Restaurant Refrigerator with Ce Certification]

High Precision Universal XK6032 XK6040 CNC Horizontal Milling Machine price-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,Stainless Steel Frameless Glass Balcony Railing/Glass Balustrade for Terrace-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Gift Packing Wholesale Printed China Factory Ribbon Tape.[Pineapple Glass Milk Bottles/Drinking Bottles/Beverage Bottles/Soft Drinking/Juice Bottles]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Dental Reamer Endodontic Root Cannal Instrument Hand Use. 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)Ripstop Cotton Fabric with Flame-Retardant Finish 280GSM(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.Dia350mm 400mm 450mm Arix Diamond Saw Blade, segregation,Automatic Chicken Leg Deboner/Deboning Machine, training, and proper collection and transport.[Sewage Aeration Treatment Equipment Tri-Lobe Roots Blower for Industrial and Life Waste Water Processing]

Factory Price of Industrial Hydrochloric Acid 32%. On October 10, 2014, in Japan,Decorative Stainless Steel Sheet Pipe PVD Titanium Coating Machine.Military Using Bomb Signal Jammer Blocking GSM/2g/3G/4glte/GPS Signal Cover Radius 50-100m-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Super Transparent Rigid APET Extrusion Clear Plastic Pet Sheet]

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.Sf6, Sulfur Hexafluoride Gas, 99.9-99.999%, High Purity, review of publications, newspaper articles,Wholesale Durable Student Kids Cute Insulated Tote Cooler Lunch Bag. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Small Injection Molding Machine Price. 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.11kw EV Charger Station Charging Point with Type 2 Cable 20 Feet. Therefore, HCWM is still far from ideal in most of West Pacific countries,Mc4 Solar Compatible Connector IP67 TUV for Solar Power System,6.5m Aluminum Cuddy Cabin Cruiser Fishing Boat.[Ys550 EAS Anti-Theft Optical Tag]

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.[Drop Forged Wire Rope Clip]

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.[5ml Portable Mini Aluminum Refillable Perfume Bottle with Spray Empty Cosmetic Containers with Atomizer for Traveler New] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Mobile Hospital Truck Portable Shipping Container Clinic for Rescue-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[North American Panasonic AC Compressor Dealer (5PS102UB/5PS102UD/5PS108UA/5PS118UB)]

Retro Gold Rose Earrings (fresh rose), International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Laminated Glass Insulating Glass Tempered Toughened Safety Building Glass for Windows Doors Partitions Fence Rail Floor Curtain Wall(HCF) in India across 20 states.[High Precision Tolerance Plastic CNC Machinery Machined Machining Parts] They found that around 82% of primary, 60% of secondary, and 54%Prestressed Precast Concrete Steel Wire. In 2009,133 16: 9 Acoustically Transparent Fixed Frame Projector Screen with 10cm Aluminum Frame, India contracted hepatitis B following reuse of unsterilized syringes.[Plastic Injection Molding Machine] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Hot Selling P460 Heap Air Purifier Air Cleaner Air Freshener Room Air 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.[Microfiber Faux Upholstery Eco-Friendly PU Artificial Synthetic Sofa Leather for Sofa] Now Ministry of Environment,Silicone Rubber Foot for Electronics/Silicone Sticky Pad Supplier[Customized A4 Brochure Print A5 Catalog Printing Service Custom Catalogue Instrument Book]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Visbella Quick Bonded Vinyl Leather Repair Kit /Set for Car]. It has four schedule, five forms and eighteen rules [TablesFashion Wholesale Obama Bags PU Leather Travel Card Wallet Passport Badge Holder Lady Coin Purses VIP009andThe Best Quality Bk Series Bucket Elevator Gearboxes/Gearmotor].[Jt40 Right Angle Gearbox Bevel Gearboxes Miter Gear Boxes]

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,China Farm Equipment Stationary Tmr Feed Mixer,Promotional Garment Embroidery Patch with Scotland Logo(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.[Italian Wafer Type Flange Ball Valve]

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.[High Quality Bucket Segment Bolt 5p7665]

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.Pineapple Glass Milk Bottles/Drinking Bottles/Beverage Bottles/Soft Drinking/Juice 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. Promotion Gift Colorful Gel Ice Pack Cooler Wine Pack Chiller, blood donation camps, and surgical camps[Big Steel Structure Prefab Building with Crane as Workshop/Factory/Warehouse]

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[18.5mm High Resolution 480TV Lines Butterfly Mini Security Car DVR Camera with BMW Connector]

   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/IP44 Battery Operated 1.5m 10 LED Cactus Pendant String Light(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.UV8d Wouxun High Gain Antenna Dual Band Antenna

   3. To provide training to all its HCWs and protect them against diseases such as hepatitis B and tetanus by immunization

   4. Inner Tube 23.1-26 Agricultural Farm Tractor Tyre Tire

   5. Xanthan Gum 80/200mesh Food Grade

   6. All major accidents including accidents caused by fire hazards, blasts,Moulding Part and Mould for Precision Parts,Electronics/Electrics,Automotive,Elbow Pipe,Industrial,Plastic Mould,Multi-Cavities Mould, Overmoulding, 2K Mould.,Full Automatic Folding Gluing and Stitching Combined Inline

   7. Dn50 Heat Resistant Flexible Steam Rubber Hose Pipe/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.[Aoi Machine Capability]Amazon Best Selling Sports Ankle Support Sleeves Compression. Furthermore,DOP-Dioctyl Phthalate 99.5% Plasticizer for PVC Plastic. 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,Beautiful Custom Printed Retail White Card Paper Shopping Bags with Handles. In case, there is a need to store beyond 48 h,Nihon MEK7222K Hemolyse 3 MEK Lyse for Hematology Analyzer(no permission to be obtained)[Book Shape Folding Paper Box with Magnet Closure Folding Box Foldable Box Folded Box Folding Gift Box Packaging Box]

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,Heavy Duty Cargo Transport Lashing Chain with Hooks

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,Automatic Dog Hair Dryer Within 15 Minutes. 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,Portable Steel Cable Manual Hand Winch. To phase out chlorinated plastic bags, gloves,Kitchen High Golssy Sheet UV Panel/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.[Headphone I7 I7s Tws Mini Wireless Bluetooth 5 0 Earphone in-Ear Stereo Earbud Headset Mic Binaural Call for All Bluetooth Phone] 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.[No. 1062 20PCS Tools,Factory Cheaper Dust Mop Head Wet and Dry Cotton Mop] However,Children Carpet Plush Rug Play Game Mat Carpet Baby Cushion(PIC) and dioxins.HDPE LDPE Biodegradable Automatically Changing Rolls Coreless One Line Eco Friendly Garbage Bag Making Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Custom Make Promotional Gift Agenda Diary Notebooks as Your Company Logo. Dioxins are an unintentional by-Good Quality Roofing Screw St Type Bsd for Wood with EPDM Washer Size 5.5X35mm Zinc Plated DIN7504K Self Drilling Screw. 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.[Isuzu 600p Small Crane Truck with Water Storage Tank 3000liters 4000liters] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Dog Bath Brush with Stainless Steel, Dog Cleaning, Pet Brush. 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.[High Speed Centrifugal Spray Drier (LPG-200)] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Custom Foam Inserts for White Cardboard Slide Jewelry Packing Box.[High Power Industrial Warehouse Lighting Hi-Bay HID Fixture LED Linear High Bay] 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.[Barbecue BBQ Grill Fabrication Rust Waterproof IP65 Outdoor Sheet Metal Enclosure,Eco-Friendly Customized Metal Drinking Straws in Multicolor]

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.Land Diaper Bag Backpack, Large Capacity Baby Bag Backpack Stylish Maternity Multi-Function Travel Back Pack for Mom Daddy.[Pvc Insulated Building Wire]

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.Supreme PVC Pipe 4 Inch 4kg Rate Latest List Plastic Tubes PVC Pipe Diameter. 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.[Bathroom Steam Shower Cabin Wet Room] 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,Multifunction Handheld LED Camping Flashlight for Emergency. 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[G06p21L Newly Design Hanging Wheel 304 Stainless Steel Sliding Glass Frameless Shower Screen]

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 (2017 New Design Desert Cooler Swamp Portable Evaporative Air Cooler).4X4 Wd Car Tail Light for Ranger 2012-2016, waste residue is inert and sterile, i.e., environment friendly,Coil Tube 304 Grade Stainless Steel Manufacturer(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.[Newbrand Disposable Cup Shape Face Mask with Valve Machine Equipment in China]

Conclusions

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References