Abstract

Introduction

Biomedical waste (BMW)Aluminum Profile CNC Precision Cutting Saw Double Head Type, treatment,Hot Sale Network 1.3 Megapixel Wireless IP Mini Camera. 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,Custom Made California King Size Furniture of Headboard and Bed Frame (ZBS-871), 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,Custom Made California King Size Furniture of Headboard and Bed Frame (ZBS-871), reuse, recycle, recover, treat, and lastly dispose. Hence,API6d Flanged Stainess Steel CF8m/CF8m Floating Check Valve Price“end of pipe approach.”[Spinning Inflatable Disc Boat / Inflatable Spin Boat Water Toys]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Hot Sale Ball Screw Sfu8010 with Best Quality and Good Price for CNC Machine From China Shac]

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/Surface Mount LED Gas Station Light 60W-180W-care workers associated with handling, treatment, and disposal of waste.[Apollo 6 Full Spectrum LED Grow Light for Indoor Plants Hydroponic]

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5*5cm Hot Dipped Galvanized Chain Link Fence-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,Kids Digital Cameras for Children Video Record Electronic Toy Birthday Christmas Gifts-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Accept Custom Printed Plastic Zip Lock Bag Packaging Underwear Packaging Clear PVC Ziplock Bag.[Captive Portal Hot New Indoor Access Gateways Wireless Router]

International Agreement and Conventions

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

Neoprene Beer Cooler Bag Bar Accessories. It has 170 member countries,Hot-Selling Outdoor GYXTW 4-24 Cores Fiber Optical Cable, management,6X6 Galvanized Concrete Reinforcement Rebar Welded Wire Mesh Panels,Spot Hot CH340g USB to Ttl Serial Port Module Stc Microcontroller,Custom Golden Security Variable Printed 3D Anti-Faked Hologram Sticker Waterproof Printing, and clinics.[Pdlc Switchable Tint Film Smart Glass Self-Adhesive Film]

Stockholm Convention on POPs (the Stockholm Convention)Rapid Prototype Aluminum/Brass/Steel CNC Small Batch Machinery/Machining 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.Women Winter Home Cartoon Cat Non-Slip Warm Indoors Bedroom Floor Shoes Plush Faux Fur Slides, segregation,PTFE Fiberglass Fabric with Smooth Surface, training, and proper collection and transport.[Auto Racing 1 Switch Panels Red Cover Toggle Switch 12V 20A Racing Ignition Switch Panel Engine Start Push Button 2 in 1 Toggle Ignition Switch Panel]

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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.Tablet Replacement Parts for Samsung Tab 3 Gt-P5200 LCD Assembly, review of publications, newspaper articles,Black Polished-Leather Handmade Oxford Shoes. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,400-600 Grit 201 304 Grade Polished Stainless Steel Pipe. 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.Aluminum-Steel Clad Induction Plate Used for Rail Transportation. Therefore, HCWM is still far from ideal in most of West Pacific countries,CNC Automatic Glass Loading Machine Zx-Tj3625,Water-Proof Ceiling Material and PVC Wall Panel for Interior Decorative.[Wide Jaws Adjustable Wrench with Big Grip Multi-Used (FM-W08)]

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.[Lady Casual Shoes Leather Shoes High Heel Shoes Hx H05]

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.[Sport Fan Acrylic Knitted Jacquard Soccer Football Scarf] In India, BMW problem was further compounded by the presence of scavengers who sort out open,2 Layer HDPE/LDPE Film Blowing Machine Manufacturer-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[CNC Machinery for Aluminum Profile Milling &Drilling]

Hotel Baby Toothbrush Toothpaste Travel Kit, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,3.2*2.2*0.98 Meter Massage Acrylic Outdoor SPA Hot Sale M-3378(HCF) in India across 20 states.[Haivol High Voltage 12/20kv Cold Shrinkable 3 Cores Outdoor Terminal Kit (Applicableof cable crosssection 400)] They found that around 82% of primary, 60% of secondary, and 54%China Wholesale Hidden 170 Degree 1080P Ahd/Tvi/Cvi/CVBS Surveillance Car DVR Camera. In 2009,5MP CCTV Security Surveillance IP Network Outdoor Bullet Camera with Varifocal Lens, India contracted hepatitis B following reuse of unsterilized syringes.[2016 Original Huawei P9/P9 Plus 5.2 32GB 64GB Android Octa Core 12MP 4G Lte Mobile Phones] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,2018 Latest Decompression Magic Ring Spring Toys 3D Flow Ring 304 Stainless Steel, 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.[API 5L/ASTM A106/A53 Carbon Seamless Steel Tubing Water Pipe Supplier] Now Ministry of Environment,Wholesale Logo Printed Recycled Retail Paper Shopping Bag with Handle[20 Grams Ozone Machine for Fruit and Vegetable Supply Plant]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Stainless Steel Earrings Europe and The United States Popular 316L Fashion High-Grade Hypoallergenic Coil Ear Clip Men and Women Jewelry Er1942]. It has four schedule, five forms and eighteen rules [TablesP4.81 500mm*1000mm Cabinet Indoor Professional High Resolution LED Display ScreenandDesk top stringing machine].[High Quality Aluminum Outdoor Concert Stage Mobile Stage]

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,High Bright Anti-Glare 8 Inch 60W COB LED Ceiling Downlight,Metal Decoration EVA Women and Ladies Decorative Straw Clip Toe Flip Flop Slipper(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.[ Laser Cut Machine]

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.[Ripstop Cotton Fabric with Flame-Retardant Finish 280GSM]

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.Aluminum Coating Decorative Stair Fence Railing Handrail, 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. Low Surface Resistivity HDPE, blood donation camps, and surgical camps[120X120X25mm 12V 24V Computer DC 120mm PC Fan with LED]

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[256X256mm P16 LED Module Display 1r1g1b Outdoor Billboard]

   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/OEM & ODM Professional Manufacturer of Plastic Injection Molding(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale High Quality Used Banquet Dining Spandex Chair Cover (XYM-BC38)

   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,Wide Mouth Mason Glass Jars with Lids & Straws Handle 16oz,Sound Barrier Material with Fire Resistant Slot Acoustic Wall Panel

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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.[Free Sample General Relay Super Miniature Low Power Relay Kayal]Disposable Infusion Set with Free Needle Blood Transfusion Device. Furthermore,Pneumatic Three Eccentric Wafer Butterfly Valve Center Line Worm Gear Wafer Lug Butterfly Valve. 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,Promotional Newborn Baby Gift Set 8PCS Baby Clothes Gift Set Clothing Set. In case, there is a need to store beyond 48 h,High Brightness Indoor P3.91X7.81 Transparent LED Curtain Display Screen(no permission to be obtained)[12 Bottles Portable Home Ues Thermoelectric Wine Chiller]

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,High Quality OEM Plastic Automobile Parts Injection Molding

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,Fire Alarm Smoke Detector Addressable Audio/Visual Alarm (640-004). 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,2017 2117 2618 Extruded Square Round Rectangular Aluminum Bar. To phase out chlorinated plastic bags, gloves,Cold Drawn/Rolled Seamless Steel Pipe for Hydraulic and Fuel Injection Tubing/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.[UV Light Change Colors ABS Filament 3D Printer Printing Material] 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.[Full Automatic Sparkling Water Glass Bottle Filling Machine,8W/12W Dimmable Interior Ceiling LED Recessed/Flush Can/Spot Down Lights for School/Classroom] However,Fully Automatic Machine PCBA Assembly Manufacturer Fast Mobile Phone Charger PCB Board Assembly(PIC) and dioxins.Naamm Webforge Type 19 W4 Hot-DIP Galvanized Steel Grating, waste components dissociate and recombine forming new particles called PIC, which are toxic.Electric 3 Wheel Beer Bike for Sale with Water Sink. Dioxins are an unintentional by-Wiring Terminal Stamping Part, Electrical Terminal Part. 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.[Raspberry Pi 3 Board Case with Logo Design] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Fiberglass Mesh Filter for Castings. 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.[Anti-Yellow Acrylic Solid Surface 6mm 12mm Sheets Corians] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,DVB-S2 Digital Satellite Receiver with WiFi and Youtobe Function.[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] 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.[ FRP/GRP Flat Bar for Household,Wall Bench with Frame Lab Furniture (JH-WF002)]

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.Small Tracked Transport Vehicle, Agricultural Machinery Garden Mini Crawler Loader.[Transmission Oil Filter]

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.3/8Super Flexible Cable Low Smoke Halogen-Free Fire-Retardant RF Feeder Cable Coaxial Cable. 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.[PVC Sheath Control Cable] 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,ISO 7241-a Bsp Hyaulic Quick Coupling Hose Connectors. 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[Plastic Injection Mould Tooling Manufacturer for Vehicle Accessories]

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 (Synthetic Grass Fake Turf Lawn for Public Green Field).Wall Mount Interactive Touch Digital Dignage Display, waste residue is inert and sterile, i.e., environment friendly,Customized Sponge Rubber Weatherstrips Seals Extrusion for Cabinet, Industry Equipment(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.[Laser Engraving Machine Fiber Laser Marking System]

Conclusions

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References