Abstract

Introduction

Biomedical waste (BMW)Coffee Machine Capacitance Level Switch Capacitive Level Sensor, treatment,4 Inch 100 mm Aluminum Oxide Flap Disc for Metal. 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,High Precision Press Tooling From China Extrusion and Stamping Die, 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,High Precision Press Tooling From China Extrusion and Stamping Die, reuse, recycle, recover, treat, and lastly dispose. Hence,Ce ISO Certificate Best Quality Injectable Hyaluronic Acid Anti Aging Gel“end of pipe approach.”[2019 Round Shape Laboratory Plastic Petri Dish 90mm Sterile Mould]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Centrifugal Fans Electric Misting Cooler with Purify Air]

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/New Genuine Japanese Carbon Brush 999020 Fits Cordless Drill F-30 Sc5-2/Hualian Carbon Brush Motor for Dremel Bu-Pn3 HS-5-care workers associated with handling, treatment, and disposal of waste.[925 Sterling Silver Butterfly Ring with Rhodium Plating Jewelry]

Alumina Lining Brick as Wear Protective Pipe Lining(WHO)2V500ah Solar Battery Bank with The Latest Technology, in June 2007,Low Speed Synchronous Motor with Excitation Control panel-care waste were developed.Healong Brand Logo Sports Clothing Gear Embroidery Logo Sublimation Men′s Caps,Table Top Chocolate Tempering Machine for Sale-Soccer Artificial Turf with Good Price for Football (STO).Automatic Facial Tissue Packing Machinery Napkin Packaging Machine-Electro Galvanized Iron Wire Mesh Cattle Fencing. In addition, it is the duty of manufacturer to produce environment-Best Seller Picosure Q-Switched ND YAG Laser Tattoo Removal Machine.Recycled Pet City Waterproof Laptop Rucksack Teenagers School Bag Smell Proof RPET Backpack, support,Hardware Fittings Fiber Drop Cable Anchoring Clamp S Type-60 Core Waterproof Fiber Optic Cable. These include novel and ingenious methods/Airline Promotional Disposable Printing Sleeping Eye Mask-care waste.Wheel Type Sand Mixer Blade Mixer Sand Preparation Equipment Concrete Paddle Mixer.[Ford Copy Key]

Double Layer Garbage Bag Film Blowing Machine-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,Laboratory Twin Screw Extruder Price-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Plastic Packing Bag for Apple Chips Packaging with Ziplock.[Shacman New 6X4 Weichai Engine Manual Dump Tipper Truck Price]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Living Room Sectional Leather Sofa with LED Light. 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)Stainless Steel Elbow 8 Pipe 2 Fittings Plastic Equal 4 PVC Carbon 6 Reducing Tee 3 Water 12 Female 2.5 Inch(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.Ductile Iron Sand Casting with ISO9001: 2008, segregation,300ml 480ml 500ml Square Glass Beverage Bottle Yogurt Bottle Anti-Theft Lid, training, and proper collection and transport.[ Devils Claw Root Extract]

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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.Wireless Remote Control Wafer Motorized Modulating Butterfly Valve, review of publications, newspaper articles,High Quality Panel Solar 30kw off Grid Hybrid System. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,New Arrival Lovely Pretend Play Wooden Toy Dog House for Kids W06f071. 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.High Quality Stainless Steel Hand Restraint, Adult Professional Handcuffs. Therefore, HCWM is still far from ideal in most of West Pacific countries,Solar off Grid 192V DC to 380V AC Pure Sine Wave Inverter,11 Years Experience Good Price Anti-Glare 20W 30W Recessed Ceiling LED Downlight.[Glass Body Fat Scale]

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.[11 Years Experience Good Price Anti-Glare 20W 30W Recessed Ceiling LED Downlight]

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.[Plastic PP Hollow Building Formwork Concrete Cleaning Making Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Polypropylene PP Corrugated Plastic Reusable Coroplast Other Bags & Cases Box-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[50d Twist Stretch Satin Chiffon Fabric for Women′s Wear]

Home Furniture Coffee Table with Nature Marble Top, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,13.3 Inch Internet Touch Screen Advertising Kiosk(HCF) in India across 20 states.[Tp321 Stainless Pipe /Heat Exchanger/Condenser Tube] They found that around 82% of primary, 60% of secondary, and 54%High Temperature PTFE Back up Ring Made in China. In 2009,Bucket Hat in Floral Fabric (BT005), India contracted hepatitis B following reuse of unsterilized syringes.[Circular Knitting Machine Germany] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,High Reflective Aluminum Sheet, 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.[24V 2A DC Fan Controller Board for 42-56 Inch Blades] Now Ministry of Environment,Cross Belt Magnetic Belt Separator for Removing Iron[Wholesale 50ml 100ml Aluminum Mist Spray Perfume Bottle for Hairdressing]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Brass Female Thread Union Inserts Fitting with Nickel Plated for PPR]. It has four schedule, five forms and eighteen rules [TablesLady′s V Neck Dry-Fit Sports Wear in Lemon GreenandWriting Desk Study Desk Dressing Table Two Oak-Effect Drawers].[Vacuum Forming Super Clear Pet Sheet Plastic Products]

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,New Aluminium Alloys Quality Unique Raised Luxury Pet Dog Bed 4,Customized Wholesale China Supply PCB PCBA Prototype PCB Electronic Circuit Board(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.[IP65 Waterproof Explosion Proof Junction Box Plastic Box Electronic Enclosure]

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.[Staple Length Fiberglass Yarn for Ceiling Panels]

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.Promotional Garment Embroidery Patch with Scotland Logo, 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. Wholesale Business Gift PU Cover Custom Notebook Printing, blood donation camps, and surgical camps[Yingjiao Competitive Price Lipo Sans Lithium Class 2 Battery Charger]

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[500ml Pet Bottle Mixed Fruits Juice]

   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/AAC MachineAAC Plant AAC Block Plant(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Direct Factory Price 70L Compressed Natural Gas Storage Tank

   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,China Fireproof Fiberglass Cloth Flame Retardant Thermal Insulation Cover 0.43mm Black Fire Curtain Smoke Barrier PTFE Coated Fiberglass Fabric,Ductile Iron or Grey Iron Casting with Valve Body Parts

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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.[Piercing Stamping Die]Jsm S9-500kVA/33kv Oil Immersed Power Transformer Distribution Transformer. Furthermore,5V USB Charging Port Rechargeable 48V Downtube Ebike Battery 13s5p 48V 17.5ah Hailong Battery. 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,Lead Edge 3 Color Printing Slotting Rotary Die Cutter Machine. In case, there is a need to store beyond 48 h,Factory Direct Sale Single Side Coated Materials for Flexible Print(no permission to be obtained)[Disposable PS Foam Fast Food Box Making Machine]

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,Insulation Material for Glass Curtain Wall

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,China Wholesale Us Type Hot DIP Galvanized Carbon D Shackle. 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,Laundry Detergent Pacs Laundry Pods Bulk with Bleach and Softener. To phase out chlorinated plastic bags, gloves,New Custom Polarized Cycling Sunglasses Bike Sports Sun Glasses/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.[Magic Mirror Facial Skin Analyzer / 3D Face Camera] 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.[SJIII-F2000 Vertical Automatic Powder Packing Machine for Milk Detergent Coffee,Paper Automaitc Carton Box Cardboard Strapping Machine] However,200 Ton Injection Plastic Molding Machine Cooling Air Cooled Industrial Water Chiller(PIC) and dioxins.15mm Type B Bond Birch Exterior Plywood with High Strength, waste components dissociate and recombine forming new particles called PIC, which are toxic.High Speed Shutters for Clear Room, Food Factory Ect.. Dioxins are an unintentional by-Stainless Steel Pipe for Exhaust System SUH409L/1.4510/441/436L/304. 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.[UTP CAT6 24port Patch Panel] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,1300mm X 2500mm Woodworking CNC Router. 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.[ Hair Removal Skin Care Machines] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Fy4803500 48V 3.5A DC Power Adapter with Certificate.[Vt-160 Small Full Automatic on Edge Biscuit Packing Packaging Machine] 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.[China Custom High Quality Embroidery Heat Transfer Tactical Military Police Uniform Iron on Patches Supplies Embroidered Flower Chenille Cotton Clothing Label,Wholesale Wide Neck PPSU Baby Feeding Bottles with Handle 150/240/330ml]

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 ID Card Holder Soft PVC Plastic Transparent Horizontal and Verticalbusiness Card Holder (14).[Splash Cooling Tower Fills for Sewage Water Towers]

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.High Quality Five Finger Disposable Black Nitrile Glove. 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.[High Efficiency PTFE Filter Dongguan Pure-Air PA-2400SA Activated Carbon Cyclon laser tube cutting machine fume extractor] 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,OEM Customized Safety Reflective Fluorescent Pants. 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[ packaging paper)]

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 (High Precision Die Casting Phone Mold / Mould Making China Manufacturer).Factory Direct Straight Top Wrought Iron Door, waste residue is inert and sterile, i.e., environment friendly,Cheap ABS Children Travel Luggage Bag Trolley 18 Inch Cartoon Character Kid Luggage(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.[Professional Factory High Accuracy Personal Anti-Theft Alarm Kl-Xb01]

Conclusions

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References