Abstract

Introduction

Biomedical waste (BMW)Aluminum Plate Fin Heat Exchanger/Oil Cooler Core, treatment,IP65 Waterproof Explosion Proof Junction Box Plastic Box Electronic Enclosure. 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,Damp Proof for Camera, Lens and PCB Dehumidifying Cabinet, 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,Damp Proof for Camera, Lens and PCB Dehumidifying Cabinet, reuse, recycle, recover, treat, and lastly dispose. Hence,Medical Refrigeratory Cold Room Freezer Storage“end of pipe approach.”[Apply to Metso Nordberg Gp11f Single Cylinder Cone Crusher Spare Parts Air Cooler]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[100 Cotton Hotel Twin Duvet Covers]

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/LED Cabinet Light Wardrobe Furniture Sink Drawer Lighting Work Lamp-care workers associated with handling, treatment, and disposal of waste.[Sunglass Display Cabinet for Retail Shop]

Light Steel Structure Chicken Poultry Farming Building(WHO)Newborn Infant 3 PCS Clothes Kids Girl Outfits Children Baby Gifts Layette Sets with Bib, in June 2007,Glass Manufacturer/Float Glass/ Tempered Glass (Flat or Curved) for Building / Furniture-care waste were developed.Portable 1920X1080p Car Key Chain Camera T4000 Mini DV IR LED Night Video Recorder Wireless Camera,Little Ant Golden Marble/ Ceramic/Tile Cutting Saw Blade-Good Price Fiberglass Roofing Material Goethe Types Architecture Shingle for Luxury Villa.Color Fancy Paper Made Small Jewellery Box-Custom Size Packaging Box for Cosmetic. In addition, it is the duty of manufacturer to produce environment-Jiaheng brand Prestressing single acting hydraulic cylinder 25 ton hydraulic cylinder for dump truck.Small Portable Air Water Purifier with Disinfection and Detoxification, support,Large Outdoor Restaurant Tent Gazebo Tent-Auger Filling Automatic Powder Filling Machine. These include novel and ingenious methods/Stainless Steel 340 Hex Head Bolt 316 Hex Head Bolt-care waste.Construction Equipment Mechanical Taper Thread Rolling Machine.[Automatic Milk Yoghurt Production Line]

Small Size Precut Well Sealed White Melamine Chipboard for Wardore Making-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,0.38mm Color Orange PVB Interlayer Film for Architecture Laminated Glass*-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Zinc Alloy Electric Key Card Hotel Door Lock with ANSI Quality Mortise.[Warehouse Flared Welded Galvanized Steel Metal Storage Wire Mesh Deck for Pallet Racking]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Elastic Hook & Loop Tape for Baby Diaper. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Luxury Prefab Ready Made Economical Portable Tiny Home Modular House. It has 170 member countries,Best Selling Disposable Plastic Dental Surgical Suction Tips Aspirator Tips, management,CNC Hydraulic Metal Sheet Plate Bending Machine Tadem Press Brake (2-CLPB-FY 160T/6000),Galvanized Chicken Breeding Farm Machinery Battery Layer Cage with Automatic Feeding Equipment,Single Glass Door Beer Cooler Fridge Soft Drink Upright Display Chiller for Convenience Store, and clinics.[600*600mmbathroom Polished Ceramic Floor Tiles Spanish Tile Price]

Stockholm Convention on POPs (the Stockholm Convention)China Stable Frequency Control Baby Diapers Making Machine (YNK400-FC)(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.Shr/IPL Laser for Hair Removal Skin Rejuvenation, segregation,Automatic Seaweed Vermicelli Noodle Weighing Packaging Packing Machine, training, and proper collection and transport.[Flexible Soft Plastic PVC Garden Hose Extrusion Production Line]

Plastic Foldable Stackable Egg Crate. On October 10, 2014, in Japan,500mm Round Ceiling Mounted Rain Sky Shower Head.Hot Sale Night Vision Security Infrared IR Bus Internal CCTV Dome Camera-care services, including mercury-containing medical items such as thermometers and blood pressure device.[4K Digital Samrt Board Touch Monitor LCD Touch Screen Touch Display Interactive Whiteboard]

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 Encapsulated Common Mode Choke, review of publications, newspaper articles,The Newest Product IEC Standard AC Contactor 3p 4p (LC1-CJX2-D). The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Rg58 BNC Male to BNC Female Connector Adapter Coaxial RF Pigtail Extension Cable. 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.Factory Wholesale Carbon Round Galvanized Steel Pipe Price. Therefore, HCWM is still far from ideal in most of West Pacific countries,Glossy Printing PVC Decorative Wall Panel and PVC Wall Covering Panels Made in China,Electric Magic Hot Hair Styling Curling Iron with Brushes.[Wholesale white frosted cube tealight candle holderglass candle container glass jar]

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.[ Hot Water and Cold Water Pipe]

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.[Molded Silicone Rubber O-Rings] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Hongli Manual Pipe Reamer for 1/8-2 Inch Pipes (M2)-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Factory Wholesale Qualited Polyester Padding Men Jacket]

High Qualtity Silky 3D Printer PLA Filament, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Outdoor Full Color P8 10FT X 12FT Module LED Advertising Digital Board Display Video Screen Price(HCF) in India across 20 states.[ Lens and PCB Dehumidifying Cabinet] They found that around 82% of primary, 60% of secondary, and 54%Straight Edge Protection Building Material Extruded Aluminum Tile Trim. In 2009,PE Braided Fishing Line, India contracted hepatitis B following reuse of unsterilized syringes.[IR Night Vision Camera with Long Range Detection] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Medical Product Disposable Breathing Virus 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.[Diesel Engien Mobile Log Debarking Machine for Beech Oak Wood] Now Ministry of Environment,Anti-Figure Steel Material Galvalume Steel Coil for Roofing Sheet[Bamboo Plain Dyed Bed Sheet Set]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Buildings of Steel Structure for Sale]. It has four schedule, five forms and eighteen rules [TablesOriginal Kingmax 2 Inch (5.5HP) Portable Kerosene Gasoline Water Pump with Silver MufflerandMaxdrill 102mm St58 Thread Rock Drilling Tools Button Bit].[Plain]

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,Wholesale Price Portable Natural Gas CH4 Leak Detector for Home Security (BX166),Fun Colorful Ultrasonic Silicone Cleanser(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.[military IP68 waterproof connector INT-EGG. 1K. 2K. 3K. 308.310.314. CLL. CLN]

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.[Jiaheng brand Prestressing single acting hydraulic cylinder 25 ton hydraulic cylinder for dump truck]

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.Chuangke Washing Detergent Spray Drying Machine, 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

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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[Wholesale 25kg 30kg PP Woven Valve Bag for Packing Cement]

   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/10 Inch ERW Welded Carbon Steel Pipe(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Pneumatic Packing Machine for Film Rolls Packing

   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,25m3/H, 35m3/H, 50m3/H Low Price Concrete Mixing Station From Factory,Alloy 3003 Color Coated Corrugated Aluminium Roofing Sheet

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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.[Monitor System]Battery Operated Low Table Railway Vehicle Transport Bricks. Furthermore,WiFi Antenna, Waterproof GPS GSM 3G 4G Car Antenna. 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,Reusable 24 Fiber MTP Male to LC Quad Multimode 6 Ports OM5 Cassette Fully Loaded. In case, there is a need to store beyond 48 h,Diesel Engien Mobile Log Debarking Machine for Beech Oak Wood(no permission to be obtained)[Red Plastic LED Light Ring Box and Pendant 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,as RS Industrial Warehouse Automatic Storage and Retrieval Rack System

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,Ocean Theme Seashell Carved Wax Pillar Candles  , Decorative Flameless Candle. 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,Enamel Cast Iron Casserole with Lid. To phase out chlorinated plastic bags, gloves,Vertical Type Caseformer Machine WJ-LKX-15/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.[Rg58 BNC Male to BNC Female Connector Adapter Coaxial RF Pigtail Extension Cable] 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.[3D Work Table Portable Fiber Laser Marking Machine Engraving System Metal Logo Engraving,Wholesale F2 H11 LED Headlight 48W 6600lm Car Accessories H11 6000K Head Light] However,Devils Claw 20%, Devils Claw Root Extract(PIC) and dioxins.Foil-Woven Insulation & Vapor Barrier Fw-76, waste components dissociate and recombine forming new particles called PIC, which are toxic.Vertical Band Saw Machine Gd5330. Dioxins are an unintentional by-New Baby Summer Kids Tutu Dress Children Princess Dress. 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.[Guangzhou Manufacturer] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Construction Wood Panels Color Painting Melamine Glue Film Faced Plywood. 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.[Hopo Brand From China POM Fiber Transfer Component for Sliding and Side Hung Window] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Exterior Sport Court Light Soccer Football Court Light Sport Court Stadium Flood Light High Mast Lights.[DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Two-Step Dowel Pin Positioning Fixed Fitness Pin Screw] 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 Meat Bone Separator Machine/High Capacity Poultry Deboner Machine/Chicken Breast Meat and Deboner Machine,High Quality Phillips Flat Head Yellow Zinc Plated Self Tapping Chipboard Screw]

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.Laser Cutting Machine Spareparts Mirror Lens for Laser Cutter.[Good Portable 256g Busb SSD]

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.2018 Latest Customized Vending Cup Making Machine (XC-D16). 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.[Mini X Pencil Hard Tag with Lanyard (YS227)] 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,Plastic Micro Trigger Sprayers for Flower. 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[Customized Plastic Injection Molding Large Size Plastic Enclosure]

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 (Cool Feeling Waterproof Mattress Covers / Mattress Protectors Twin Size (YFM004)).Disposable PS Foam Fast Food Box Making Machine, waste residue is inert and sterile, i.e., environment friendly,Wood Door / MDF Cutting / 1325 CNC Carving / Engraving and Cutting CNC Router/ Woodworking Machine(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.[Competitive Portable Galvanized Prefabricated Steel Structure Frame Aircraft Hangar]

Conclusions

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References