Abstract

Introduction

Biomedical waste (BMW)4000W High Power Fiber Laser Cutting Machine, treatment,Paper Hangtag Hang Tag Display Card for Garment. 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,Brand New Camion Tractors Weichai Diesel 380HP 420HP International FAW 4X2 Tractor Trailer Head Truck, 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,Brand New Camion Tractors Weichai Diesel 380HP 420HP International FAW 4X2 Tractor Trailer Head Truck, reuse, recycle, recover, treat, and lastly dispose. Hence,Automatic Soak Tea Bag Packing Machine“end of pipe approach.”[256X256mm P16 LED Module Display 1r1g1b Outdoor Billboard]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[12 Bottles Portable Home Ues Thermoelectric Wine Chiller]

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/Hotel Bedsheet Dry Ironing Equipment/Ironer Equipment /Laundry Roller Equipment-care workers associated with handling, treatment, and disposal of waste.[UV Light Change Colors ABS Filament 3D Printer Printing Material]

Disposable Waterproof Dustproof Nonwoven Shoe Cover Making Machine(WHO)PVC Cornice for Interior Ceiling Decoration, in June 2007,Honeycomb Plate for FPC-care waste were developed.AU-300S Digital Electronic Tyre Portable Densitometer, Density Meter, Density Tester, Density Measurement Device,Hot Sell Square Transparent Glass Candle Holders Cup-Modern Building Materials Hospital Interior MGO Decorative Wall Panel.Heated Outdoor Winter Battery Neoprene Fiber Heating Vest for Keep Warm for People-Customized Shipping Paper Self Adhesive Label Paper. In addition, it is the duty of manufacturer to produce environment-Hot Sale Super Fine Screen Door with Magnetic, Mosquito Door Net for Keeps Bugs out.Portable Swimming Pool Disinfection Automatic Chemical Chlorine Dosing Pump, support,Quality Professional PCBA Manufacture SMT PCB Assembly PCBA Sample in China-650nm Best Lipo Laser Machine for Sale. These include novel and ingenious methods/Full Size PE Water Pipe Price List Goody Supplier-care waste.20kg Paper Laminated PP Woven Block Bottom Bag for Industrial Cement Flour Packaging.[Factory OEM Logo Waterproof Safety LED Coal Miner Lamp]

4-12X50eg Illuminated Hunting Rifle Scope for Airgun HK1-0318-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,Air Injection Hose SUV Pressure Hose Assy OEM 11721438102 for BMW E53-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Customized 2/4/6 Layers Flexible Circuit Board PCB Factory.[Full Automatic Sparkling Water Glass Bottle Filling Machine]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,2 Way Output 1550nm External Modulated Optical Transmitter. 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)Sanitary Stainless Steel Cleaning Ball(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.Pultruded Fiberglass Round Tube Supplier, segregation,Precision Mould Punches and Pins for Plastic Mould, training, and proper collection and transport.[Anti-Yellow Acrylic Solid Surface 6mm 12mm Sheets Corians]

Custom Medical Instruments Plastic Parts Injection Molding Company. On October 10, 2014, in Japan,High Quality Drop Forged Wire Rope Clips.Senken IP65 Police LED Shoulder Warning Light in Rechargeable-care services, including mercury-containing medical items such as thermometers and blood pressure device.[High Speed Single Screw Double Dual Twin Die Head HDPE LDPE LLDPE PE Plastic Blown Film Blowing Machine Set with 2 Winders for Making Plastic Roll]

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.High Quality Aluminum Outdoor Concert Stage Mobile Stage, review of publications, newspaper articles,6~100mm Thick XPS Extruded Board Insulation Panel XPS Foam Board. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,New Round Trampoline with Safery Net EPE/PE Foam Pipe/Tube Making Machine PU Foam for Packaging. 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.Custom Cosmetic Airless Empty Packaging Plastic Acrylic Boby Lotion Spray Pump Serum Bottle. Therefore, HCWM is still far from ideal in most of West Pacific countries,High Quality Tamper Proof Security Sticker Roll Label for Sealing,Aluminum Outdoor Concert Stage Portable Event Stage.[Commercial Beverage Cooler]

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.[ FRP/GRP Flat Bar for Household]

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.[Wall Bench with Frame Lab Furniture (JH-WF002)] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Translucent Stone Agate Slab Resin Panel for Wall Covering-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[PVC Sheath Control Cable]

Good Quality Vet Clinic Dog Cat Professional Hair Dryer, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,TXGF-5015 5V -24V DC Brushless Cooling Electric Axical Blower Fan Motor Hydraulic Bearing(HCF) in India across 20 states.[Plastic Injection Mould Tooling Manufacturer for Vehicle Accessories] They found that around 82% of primary, 60% of secondary, and 54%New Design Living Room Interior XPE Foam Wall Tile 3D Wallpaper. In 2009,Steyr Wd615 Engine 190HP Inboard Outboad Boat Motor Speedboat Engine, India contracted hepatitis B following reuse of unsterilized syringes.[China Extinguishing Fire Of Fire-Fighting] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,4 Inch Resin Bond Abrasive Cutting Disc for Stainless Steel and Inox, 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.[Laser Engraving Machine Fiber Laser Marking System] Now Ministry of Environment,2 Round Pins Socket Adapter Adaptor ABS Plug (Y111)[Phosphoric Acid Brand in China for Food Grade]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Pet Dog Puppy Safety Traction Rope Harness Leash]. It has four schedule, five forms and eighteen rules [TablesGrade a Highest Efficiency Yingli BS OHSAS Yge 12bb Mbb 60 Cell 285W Poly Solar Cell for House Use with Best Price in EgyptandPu Leather Handbag For Women Factory & Manufacturer].[Precision Mould Punches and Pins for Plastic Mould]

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,Automatic Chicken Water Nipple Drinking System From Factory,Washroom Bright LED Back Lighting Wall LED Magic Mirror with Date Display(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.[How High Speed Oil Water Centrifuge Separator Works]

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.[Integrated Sewage Treatment Plant for Industrial Wastewater Treatment]

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.Ce Sodium Hyaluronate Gel for Intra-Articular Injection, 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. Fcatory Supply 7 Inch 2 DIN Car MP3 MP4 MP5 7010 Player Format Bluetooth Car Kit Video Audio for Android or Ios Phone Connect Car Player, blood donation camps, and surgical camps[CNC Deep Hole Gun Drilling Machine]

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[IQF Industrial Vegetable Fruit Frozen Machine]

   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/Customized Precision Mould Tool, Injection Moulding Tool Manufacturer(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Portable Travel John PEE Bags or Brief Relief

   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,Steel Gas Cylinder Balloon Helium,Haivol High Voltage 12/20kv Cold Shrinkable 3 Cores Outdoor Terminal Kit (Applicableof cable crosssection 400)

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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.[Inverted Wire Drawing]CCC Certification Three Core 3X0.75mm2 Rubber Braided Wire Bare Wire Tail Power Extension Cord. Furthermore,Massage Table Tattoo Therapy Beauty Couch Bed. 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,4 Tiers Egg Layer Chicken Cage Low Price. In case, there is a need to store beyond 48 h,LCD Touch Screen for iPhone 7 Display Mobile Phone Accessories(no permission to be obtained)[Customized 1600c Large Hydrogen Atmosphere Box Furnace up-to 20X20X20 (125 L) - Cy-1700X-H4]

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,Twins Stylish Zippered Wine Bag Best Carrier for Wine

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,Threaded Metal Air Fitting Hose Straight Pneumatic Quick Connector. 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,Alloy Steel Casting Comb Board for Cement Producing Equipment. To phase out chlorinated plastic bags, gloves,Dongfeng 6X4 15cbm High Presure Sewage Suction Sludge Vacuum Tanker Cleaning Fecal Truck/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.[Automatic Dry Food Weighing Pillow Packing Machine with 2 Weighers] 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.[2017 Customized PP Strapping Band Roll Strap,ADC12/A380 Aluminum Die Casting Parts] However,Prefabricated or Custom Designed Commercial Metal Storage Building(PIC) and dioxins.Aiyos Android/Windows IR LCD Multi Touchscreen Display for Digital Signage Totem Kiosk, waste components dissociate and recombine forming new particles called PIC, which are toxic.IQF Industrial Vegetable Fruit Frozen Machine. Dioxins are an unintentional by-Stainless Steel 304 Solar Accessories Cable Clip. 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.[Reusable Probe Manufacturers Cheap Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Potassium Humate Powder, Humic Acid Powder. 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.[Plastic Business/Gift/Membership Card /Game System/Amusement Park Made of PVC/Pet/Paper] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Dentistry Equipment Light Illuminator Unlimited Dental Oral Lamp Light.[Best Seller Laser Machine Reci CO2 Laser Tube Price] 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.[Customized CNC Machining Plastic Rapid Prototype for Medical Tool Box,5kw Home Stand Alone off Grid Solar Power System]

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.Alloy Anodised Rail Leadshine Servo Motor Customized Length Linear Guide Bearing.[Dust Suppression Spray Water Cannon]

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.Transparent Blue Color PE Protective Films for Window Glass. 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.[Electric 3 Wheel Beer Bike for Sale with Water Sink] 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,Summer Elegance Oeko Tex-100 Quality 100% Mulberry Silk Quilt. 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[30kv Electrical Rubber Latex Insulating Gloves Made 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 (Four Layer Cat Playing Scratching Tree 50′′).High Precision Tolerance Plastic CNC Machinery Machined Machining Parts, waste residue is inert and sterile, i.e., environment friendly,1080P Wall Mount LCD Display Indoor Digital Signage(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.[Plastic Coffee Bean Packaging Bag/Plastic Bag for Coffee Packing/Food Packaging Bag]

Conclusions

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References