Abstract

Introduction

Biomedical waste (BMW)Children Plastic Outdoor Playground Amusement Equipment with Ce/ISO Certificate, treatment,Butterfly Angel Wing Costume Set Stage Props. 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,Ce FDA Approved Patient Monitor for X-ray Diagnostic, 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,Ce FDA Approved Patient Monitor for X-ray Diagnostic, reuse, recycle, recover, treat, and lastly dispose. Hence,41 Solid Spruce Top Acoustic Guitar with Fishman Pickups (J45)“end of pipe approach.”[Sinotruck HOWO 6*4 10cbm Concrete Mixer Truck Price in India]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Medical Product Disposable Breathing Virus Filter]

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/Slip Ring Rolling Mill Motor-care workers associated with handling, treatment, and disposal of waste.[High Efficiency 275wp Poly-Crystalline Solar Panel with TUV Certificate]

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Aluminum Sheet Metal Fabrication Bending Part-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,3*5FT Sports Team Logo Custom Wholesale NFL Carolina Panthers Flags (J-NF01F09039)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,ASTM A335 Alloy Seamless Steel Pipe for Power Plant.[20W Max Fiber Laser Marking Machine Price for Metal Battery]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Custom Printing PLA Pbat Corn Starch Biodegradable Bag with Sticky Tape HDPE LDPE PP Self Adhesive Bag. 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)High Efficiency PTFE Filter Dongguan Pure-Air PA-2400SA Activated Carbon Cyclon laser tube cutting machine fume extractor(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.Brass Female Thread Union Inserts Fitting with Nickel Plated for PPR, segregation,High Speed Corrugated  Cardboard Single Facer Machine Carton Box Making Machine, training, and proper collection and transport.[Roll Crusher Used for Animal Feed]

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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.Injection Mold for Keyboard Cap, review of publications, newspaper articles,Hot Dipped Galvanized Wire Chain Link Fence Weight. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Industrial Sublimation Paper 90GSM for Transfer Printing. 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.Stainless Steel 304 Wire Rope Fork Terminal. Therefore, HCWM is still far from ideal in most of West Pacific countries,OEM Customized Parts CNC Machining Service with CNC Milling Turning Lathing,Galvanized Hexagonal Chicken Metal Wire Mesh.[Hans Promotion Cheap Price New Design Zig-Zag Tape with Gold Thread]

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.[Loss Weight Cavitation Machine RF Ultrasonic Slimming]

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.[110V-240V LED Filament Bulb Globe Cafe Patio String Light] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Common Rail Injector Parts Orginal Delphi 9308-622b Control Valve-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Guaranteed Quality WPC PVC Flooring/Vinyl Wood Plank Flooring 2mm 3mm 4mm 5mm 6mm 7mm Avaliable]

LED Lighted Mirror with Bluetooth Functions, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,50d Twist Stretch Satin Chiffon Fabric for Women′s Wear(HCF) in India across 20 states.[Supermarket Chest Type Display Freezer with Sliding Glass Door] They found that around 82% of primary, 60% of secondary, and 54%China High Quality Ctorch 30W E27 Dimmable LED Christmas Light T Bulb. In 2009,Wholesale New Designer Waterproof Fashion Ladies Laptop Backpacks School Bags, India contracted hepatitis B following reuse of unsterilized syringes.[Common Nail Making Machine Factory OEM/ODM Products] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Galvanized/PVC Chain Link Garden Security Wire Mesh Iron Metal Farm Fence for Safety, 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.[Fryer Equipment Potato Chip Banana Chips Frying Production Line Snack Food Processing French Fries Making Machine] Now Ministry of Environment,Free Sample Custom Personalized Metal Gold Plated Fruit Pineapple Christmas Badge Wear on Clothes[Roll up High Quality Luxury Comfort Spring Mattress]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [PVC Flexible Pipe Hose Garden Hose Reel Cart (KS-3020HT)]. It has four schedule, five forms and eighteen rules [TablesHot Sale CAS 24916-51-6 AcetylspiramycinandAbs Kitchen Sink].[New Aluminium Alloys Quality Unique Raised Luxury Pet Dog Bed 4]

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,Industrial Semi-Automatic Big Ice Lolly Tube Filling Machine,Custom Metal Stamp-Car Part Accessories-Progressive Die Drawn-Brackets(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.[Lamella Clarifier for Wastewater Sedimentation Treatment]

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.[Desktop LCD Mount with 4-Monitor 10-32 (LCD 0004)]

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.Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan, 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. SJIII-F2000 Vertical Automatic Powder Packing Machine for Milk Detergent Coffee, blood donation camps, and surgical camps[aluminium sheet disc]

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[Circlip/Retaining Rings DIN 472]

   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/Full New Brand Mobile Phone Screen for iPhone 6s LCD Display(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.16 Strand Braided Hollow Poly Rope Towable Rope

   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,Toyon 12032 120*120*32mm 12V 24V 48V DC Blower Fan 120mm,Seaflo 12V 0.7gpm/70psi Mini Electric Garden Pump

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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.[Washable Polyester Wadding]Best Manufacturer Artificial Plants Synthetic Turf China. Furthermore,CCA Copper Clad Aluminum Wire Coper Cable. 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,15kv 133% Insulation Level Tr-XLPE/XLPE Urd Power Cable Electric Cable. In case, there is a need to store beyond 48 h,China 1 & 100 RMB Acrylic Currence Frame(no permission to be obtained)[Bucket Hat in Floral Fabric (BT005)]

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,Polyester Twill Yarn Dyed Check Spandex/Elastic Shirting Fabric for Garment/Trousers (YD1114)

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,Amazon & Ebay′s Choice Razor Barbed Wire Galvanized Barbed Wire for Fencing (BW). 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,Xfl-200 Automatic Vertical Weighing and Packing Machine. To phase out chlorinated plastic bags, gloves,Commercial Refrigerator 2 Glass Doors Refrigerator and Freezer/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.[Superfine Anti-Slip Class Spc Flooring Rigid Vinyl Plank 48′x9′] 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.[8e6208 Heavy Machine Bucket Tooth Pins Retainer for Excavator Loader,Large-Span Prefab Structural Steel Poultry Farm Shed House Steel Building] However,Mouse Pad with Gel Wrist Rest(PIC) and dioxins.Stainless Steel Balustrade Handrails for Staircase, waste components dissociate and recombine forming new particles called PIC, which are toxic.Custom Zinc Alloy Plating Marathon Finisher Medal for Events. Dioxins are an unintentional by-PPGI / PPGL Corrugated Metal Roofing Sheet / Iron Steel Tile. 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.[China Factory Offer New Core I7 15.6 Laptop] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Mgmn Series Tungsten Carbide 2.5mm Grooving Inserts/CNC Tool Parts Grooving Inserts/Zhuzhou Grooving Inserts with High Quality. 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.[Nonwoven Fabric Cloth PP Geotextile] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,925 Sterling Silver Jewelry CZ Heart Necklace.[Best Selection Assorted Colour Available Romantic Valentine Heart Candles for Cake] 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.[Ye3 4kw Three-Phase Asynchronous Squirrel-Cage Cast Iron Induction Electric Motor,50*100 Rectangular Fiberglass Profile FRP GRP Composite Pultruded Tube]

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.Motorcycle Scooter Parts Ignition Coil for Gy6 125 150.[Korean Ramen Noodles]

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.Christmas LED Light Hair Band Headband Accessories Santa Reindeer Snowman Xmas. 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.[Quality Plastic Injection Mould Plastic Tooling Maker] 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,Low Cost Large Scale Rotary Cup Compost Packing Packaging Machine Price. 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[LC/Upc-LC/Upc Single-Mode Simplex Fiber Optic Adapter]

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 (Hot Trends Spc Rigid Vinyl Plank Floor with Silent Pad).High Lumen Output 160W LED Factory Light with IP66, waste residue is inert and sterile, i.e., environment friendly,Sarms Powder Gw501516 (GSK-516, Endurobol) for Bodybuilding CAS: 317318-70-0(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.[Drywall Partion Light Steel Keel Stud]

Conclusions

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References