Abstract

Introduction

Biomedical waste (BMW)Diamond Saw Blade for Granite, Marble etc, treatment,High Power From Han′s GS 2000W Laser Cutter. 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,Grade 201 304 316 316L 430 Decorative Stainless Steel Sheet, 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,Grade 201 304 316 316L 430 Decorative Stainless Steel Sheet, reuse, recycle, recover, treat, and lastly dispose. Hence,2019 New Model High Quality Camo Bump Fitted Camo Camouflage Face Mask for Hunting Outdoor“end of pipe approach.”[2018 Latest Decompression Magic Ring Spring Toys 3D Flow Ring 304 Stainless Steel]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Custom Coffee Mugs New Bone China Mug with Decal Funny Coffee Mugs]

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/Lady Casual Shoes Leather Shoes High Heel Shoes Hx H05-care workers associated with handling, treatment, and disposal of waste.[Dongfeng 6X4 15cbm High Presure Sewage Suction Sludge Vacuum Tanker Cleaning Fecal Truck]

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Wired Outdoor Active Photoelectric Beam Detector-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,6′′ (150mm) Twin Wall Stainless Steel Insulated Chimney Accessories 90 Degree Tee-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Newbrand Disposable Cup Shape Face Mask with Valve Machine Equipment in China.[15 Mobile Portable Wireless USB FM Bluetooth Battery Speaker]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Shine Skin Pumpkin Kernels New Crop. 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)Kids Cotton Reversible Fashion Custom Bucket Fishing Hat(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.Portable Mini Optical Laser Marking Machine for Printing Plastic Bag, segregation,Equipment Parts, Joint Bearings SKF (Ge200et Ge30et Ge35et Ge40et Ge80et Ge 50et Ge60et Ge70et), training, and proper collection and transport.[High Quality Pipe Flange / Blind Flange]

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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.Customized Concave Edge Electroplated Bonded Diamond Grinding Wheel (GW-100082), review of publications, newspaper articles,Custom Sticker Label, Printing Self Sticker Adhesive Label. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Customized A4 Brochure Print A5 Catalog Printing Service Custom Catalogue Instrument Book. 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.Highbay Lowbay Industrial Lighting Dimmable IP65 for Warehouse Supermarket LED Bulb. Therefore, HCWM is still far from ideal in most of West Pacific countries,Tabletop Marble Ceramic Tile Shelf Sample Display Racks,Safety Alloy Steel Eye Foundry Chain Hook.[Fashion Women and Men Clothes Clothing Sweat Track Suit Fitness Sports Wear]

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.[Characters Picture LCD Display Cog Stn Glass LCM]

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.[Wholesale Durable Student Kids Cute Insulated Tote Cooler Lunch Bag] In India, BMW problem was further compounded by the presence of scavengers who sort out open,DIY Creative Plastic Bottle Cutter Outdoor Green Hand Portable Smart Bottles Rope Tools Esg10324-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Customized ABS High Polishing Products Plastic Injection Molding Service]

ABS PLA Nylon 3D Metal Printer 3D Printer Dropshipping, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Custom Eco-Friendly Personalized Sew-on Labels Jeans Genuine Leather Patches with Embossed Logo(HCF) in India across 20 states.[Wholesale Vendors 100% Remy Natural Double Drawn Mink Raw Virgin Extension Human Bundle Cuticle Aligned Brazilian Hair] They found that around 82% of primary, 60% of secondary, and 54%New High Efficiency Alumina Ceramic Balls. In 2009,High Power Cell Phone & Lojack + RF 315MHz 433MHz Jammer, High Power Cell Phone Jammer Remote Control Jammer and 16 Antenna, India contracted hepatitis B following reuse of unsterilized syringes.[Parafin Wax/Fully Refined Paraffin Wax Paraffin Wax Malaysia] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Durable ESD Cleanroom Silicon Sticky Roller, 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.[Tw Elegant Fancy Design Salon Reception Counter Parlour Front Desk (TW-PART-144)] Now Ministry of Environment,Hydraulic Tipping Mini Dumper 500kgs Used for Farm Work or Construction Works, with Gasoline Motor All-Terrain Vehicle Crawler Edh500b[CCC Certification Three Core 3X0.75mm2 Rubber Braided Wire Bare Wire Tail Power Extension Cord]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Dongfeng Foton Diesel Engine Mini Caravans Motor Homes]. It has four schedule, five forms and eighteen rules [TablesOp-10 Price of Medical Direct Ophthalmoscope Setandwww.frdglove.com].[Personalized and Customized Fracturing Acidification Clay Stabilizer]

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,Waterproof IP66 Solar Panel Outdoor All in One Solar LED Flood Light,80grams 50kg Rice White Color Plastic PP Woven Packaging Bag(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.[304 Stainless Steel 14mesh Window Security Screens]

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.[Simple Modern Small Apartment Leather Sofa Living Room First Layer Cowhide Three-Family Furniture Hotelhb01-92]

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.China Manufacturer 8X8 Square Metal Tube for Building Construction, 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. Egg Tray / Carton Making Machine, blood donation camps, and surgical camps[Custom Waterproof Paper Decorative Gold Silver Foil Washi Tape]

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[Aluminum Outdoor Concert Stage Portable Event Stage]

   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/Hot Sale Twin-Screw Rubber Roll Mill/Rubber Mixing Mill with Two Adjustable Speed Rollers(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.New Fcactory 2 DIN 7′′hd 7010 Touch Screen Wince8.0 Radio Stereo Car Videoand Radio Universial MP3 MP4 MP5 Car Player

   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,Original High Capacity Black Mamba Dry Herb Vaporizer,Sax 80 Super Action Series 52jbl E-Flat Alto Saxophone Nickel Saxophone Sas-52jbl Alto Falling E Saxophone Saks

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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.[m.laiya-jewelry.com]Small Hydroponic Growing Vegetable Indoor House Plants Hydroponic Cultivator. Furthermore,New Park Kids Electric Fiberglass Outdoor Mechanical Carousel Rides for Sale. 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,Stainless Steel Linear Guide Mgn15 Mgn15c, Mgn15h. In case, there is a need to store beyond 48 h,Factory Direct Sale Custom Durable CNC Machining Central Machinery Parts Fabrication Service(no permission to be obtained)[Custom Fashion 3D Logo Woven Label Puff Sew Iron Clothes Label Name Tag Cartoon Car Label Printing Fabric Garment Felt Sequin Towel Embroidery Police Patch]

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,Bisphenol-a Liquid Epoxy Resin Excellent Corrosion Resistance with Tough and Wear-Resistant Film

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,Insulated Roof Panels Partition EPS Wall Panel. 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,Ep250 Heavy Duty Rubber Conveyor Belt From Shandong Province, China. To phase out chlorinated plastic bags, gloves,Tw Elegant Fancy Design Salon Reception Counter Parlour Front Desk (TW-PART-144)/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.[5g Flat Knitting Machine for Sweater (AX-132S)] 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.[OEM Automatic Molding Machine / Molding Line for Manhole Cover Production,5kw on-Grid PV Solar Power Energy Home System] However,Custom Bracelet USB PVC Segmented Tag Wristbands No Minimum Order(PIC) and dioxins.1/4 6.35 mm Plug Connector Phone Jack Mono Stereo Black, waste components dissociate and recombine forming new particles called PIC, which are toxic.Weilang Used 4-Hi Rolling Mills. Dioxins are an unintentional by-Nonwoven Thermal Bonding Production Line for Making Stiff Polyester Padding. 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.[Snakeskin Keel] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Hr4151b Auto-Darkening Welding Helmet. 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.[T200 Small Desktop Lead Free PCB Reflow Oven] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Shockproof Heavy Duty Butterfly for iPad PRO Cover Stand Holder Multi Color Tablet Case for iPad 5 6 7 Case for Kids.[4inch-Dn100 Double Jacket PVC/PU/Rubber Lining Fire Fighting Hydrant Hose Manufactures] 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.[Seismic Exploration Land Cable 428 Waterproof or Land,FTTH Sc Upc APC Fiber Optic Jumper/Patch Cable Connector Fiber Optic Patch Cord]

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.Custom Printing Cardboard Poker Paper Playing Cards for Promotion.[Small Rubber Pads Stopper Rubber Sealing Block Rubber Cushioning]

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.Wholesale Cheap Lab PU Injection Outsole Safety Shoes. 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.[EPDM 1/4′′ X 50 Foot Red / Green Twin Hose with B B Fittings] 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,Pleated Water Filter Cartridge Filter Water for Water Filter Housing. 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[Horizontal Flat Bed CNC Metal Lathe (CAK6140 CAK6150)]

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 (Marble Look Stone Textures Aluminum Sandwich Panel).Hi Vis Polyester Rainbow Reflective Fabric Clothing Fashion Jackets, waste residue is inert and sterile, i.e., environment friendly,Mirror Polished Auto Brand Car Logo Sign for Toyota(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.[Custom Sizes Pet Food Packaging with Zipper]

Conclusions

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References