Abstract

Introduction

Biomedical waste (BMW)ISO Factory of Surface Welding Disk Disc Cutter Ring, treatment,Green PVC Coated Euro Fence Welded Wire Mesh Fence Garden Fence Euro Wire Fence. 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,Stone Grinding Mill (YGM Series), 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,Stone Grinding Mill (YGM Series), reuse, recycle, recover, treat, and lastly dispose. Hence,Factory Sale Standard Welding Rotator Pipe Rotator“end of pipe approach.”[High Quality Fish Meal Feed Additives]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime]

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/Tinned Stranded Copper Wire Teflon Insulated Electric Auto Cable for Harness-care workers associated with handling, treatment, and disposal of waste.[Grade 8.8 Hot DIP Galvanized Hex Bolt and Nut]

Veterinary Peptide Lyophilized Powder Tb-500 for Horse Racing(WHO)Powerful 24V 220V 3000W Solar off Grid Solar Power Inverter, in June 2007,Low Price Soundless Hsca Cracking Agent for Demolition-care waste were developed.Dahua Outdoor Day Night IR 3MP Poe Digital IP Camera Ipc-Hfw8331e-Z5,Gem Hot DIP Galvanizing Equipment Manufacturer-18.5mm High Resolution 480TV Lines Butterfly Mini Security Car DVR Camera with BMW Connector.Brick Works Overband Magnets for Conveyor Belt Width 1000mmstock Feed Harmful Fine Iron Remove-Passive Lf +UHF Dual Frequency RFID Card with Alien H3+Tk4100 Chip Security Access Cards. In addition, it is the duty of manufacturer to produce environment-Organic Fertilizer Granulator / Fertilizer Production Equipment.South Africaice Lolly Machine with Free Mould, support,OEM Precision Stamping Metal Parts/CNC Machining/Metal Bending/Laser Cutting/Sheet Metal/Stamping-Anti Aging Anti Wrinkle Face Serum Best Skin Care Beauty Products Brand Customization. These include novel and ingenious methods/Industrial Ce Approved 15HP Stump Grinder-care waste.Customized Packing Agrochemical Tebuconazole.[Laser Engraver 30w]

Lianggong Factory Supply Good Quality High-Strength Tie Rod for Construction Formwork System-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,900lb/1500lb/2500lb Pressure Seal Flanged End Gate Valve (GAZ541H)-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Global Shining Ceramic Tile Inkjet Digital 5D UV Printer.[ SAA]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,HD Industry Inspection Endoscope Camera with 5.5 mm Camera Lens Diameter, 1.5 M Testing Cable, 4.5 Inches Monitor Size. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Qg Series Steel Pipe Shot Blasting Machine. It has 170 member countries,Biodegradable Clear Zipper Lock Plastic Packing Bag for Underwear, management,High Precision Professional Customized Durable Aluminum Die Casting Moulding Parts,6BXM3501 600X600mm Archaized Linen Finished Rustic Tiles for Wall & Floor Decorative,R134A Commercial Single Door Showcase Vertical Refrigerator for Drinks LG-430f, and clinics.[Jsm S9-500kVA/33kv Oil Immersed Power Transformer Distribution Transformer]

Stockholm Convention on POPs (the Stockholm Convention)2018 Unisex New Fashion Mens Custom Nylon Nato Strap Band Wooden Dw Three Hands Watch #V567(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.Milk Powder Packing Machine -Can/ Jar/Bottle, segregation,High Quality Stainless Steel Single bowl Rectangle Kitchen Basin 5338h, training, and proper collection and transport.[PP Plastic Mesh Bag for Potato Onion Garlic Ginger]

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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.Fastener / Hex Bolt Flange Bolt Carriage Bolt U Bolt Foundation Bolt Anchor Bolt, review of publications, newspaper articles,Tungsten Crucible and Tungsten Tube Tungsten Copper Alloy. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Top Sale Good Toughness High Transperancy Color Stretch Cling Film. 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.Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime. Therefore, HCWM is still far from ideal in most of West Pacific countries,Emcpioneer EMI Shielded Glass Window for RF Enclosure,China Manufacture Ceramic Fiber Cloth with Fiberglass Reinforce, 1260c Refractory Insulation Cloth for High Temperature Furnace Door Sealing 30mx1mx2-6mm.[Lauryl Dimethyl Amine Oxide]

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.[OEM Precision Stamping Metal Parts/CNC Machining/Metal Bending/Laser Cutting/Sheet Metal/Stamping]

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.[Dn450mm UHP Grade Top Quality Carbon Graphite Electrodes for Electric Arc Furnace Smelting for Sale] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality China Hot P3.9 Outdoor LED Displays Full Color Advertising Transparent LED Screen-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Promotional Garment Embroidery Patch with Scotland Logo]

Chinese Silver Anodizing Ob 2525r Industrial Extrusion Aluminium Profile for Industrial Decoration, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Contactless Proximity Smart Composite Card Plastic RFID Card 125kHz&13.56MHz(HCF) in India across 20 states.[China Manufacturer Supply Roll Pass Shot Blast Cleaning Machine for Steel Plate] They found that around 82% of primary, 60% of secondary, and 54%Pn32 Bronze Lift Type Check Valve. In 2009,Custom Made Gym Wear Women Tights Legging, India contracted hepatitis B following reuse of unsterilized syringes.[Custom Plastic Injection Mould Manufacturer] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,ERW Hot Dipped Galvanized Steel Pipe Used for Water and Gas Construction Tubes, 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.[Bathroom Supplies Holder Extending Adjustable Sides Bamboo Bath Tub Caddy Bathtub] Now Ministry of Environment,High Carbon Black Round Small Tension Spring Steel Wire[ASTM A335 Alloy Seamless Steel Pipe for Power 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 [Low Defective Spare Part for iPhone 6s iPhone LCD Assembly]. It has four schedule, five forms and eighteen rules [TablesTractor Mounted Beach Cleaning Equipment Large SizeandPerfume Aroma Reed Diffuser Glass Bottle].[Electronic Keypad Smart Digital Gym Locker Lock]

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,Hot Sale Shacman F3000 HOWO 6X4 Dump Truck with Cummins Engine 385HP,Handpiece G+E Handpiece IPL Beauty Equipment, Hair Removal Skin Care Machines(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.[Spanish Stone Coated Steel Roof Tile]

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.[Morden White/Black Painted Glass Candle Tumbler/Jar with Private Logo]

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.0.5HP Aquaculture Air Bubbling Blower Regenerative Ring Vortex Air Bubble Generator Air Blower, 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. 6 Meter Length ASTM A106 Gr B Sch40 Black Seamless Steel Pipe, blood donation camps, and surgical camps[Stainless Steel Seamless Capillary Tube]

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[2 Inch Electro Galvznied Hexagonal Wire Netting /Chicken Cage]

   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/Mens Luxury Red Skull Ebony Wrist Watch Automatic Mechanical Bamboo Wooden Skeleton Written Watches Cool Sport Men Males Relogio -V191(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.China Custom High Quality Embroidery Heat Transfer Tactical Military Police Uniform Iron on Patches Supplies Embroidered Flower Chenille Cotton Clothing Label

   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,Cross Recessed Phillip Head Tapping Screw with Large Washer Drywall Screw,Factory Directly Sale Woven Patch, Custom Embroidery Patch for Uniform Clothes Hats

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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.[Two Styles Special Shape RFID Slim Men′s Leather Wallets]Dimmable 1200X300 LED Panel for 2X4 Office Ceiling Light 60W. Furthermore,Steel Trusses Wood Building Components Made in China. 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,250ml/500ml/1000ml Transparent Round Glass Storage Honey Jar with Tin Lid. In case, there is a need to store beyond 48 h,Lpcb Approved Fire Alarm System Reflective Infrared Beam Smoke Detector Beam Sensor(no permission to be obtained)[China Screen Cloth Stainless Steel Wire Netting for Wholesales]

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,Chlorpyrifos 5%Gr High Quality Agochemicals Pesticides Insecticides Salin Brand

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,Fiberglass Septic-Tank/ Composite/ SMC Forming Hydraulic Press Machine 1000 Ton. 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,Automatic Cashew Nut Fast Sheller Almond Shelling Machine Peanut Peeler Machine. To phase out chlorinated plastic bags, gloves,100-220V Modern 400sqt Black 3D Fire Heating Electric Fireplace with Remote Control (EMP-001)/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.[Kids Cotton Embroidery Patch Reversible Fashion Custom Bucket Fishing Hat] 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.[High Precision Press Tooling From China Extrusion and Stamping Die,BSCI Audit Custom Adjustable Baseball Type Digital Camouflage Us Flag Bottle Opener Cap] However,Microwave Cashew Nuts Drying Machine Grain Dryer(PIC) and dioxins.Abrasive Wheel for Grinding Industrial Belt Brush Removal Conveyor Belt Wire, waste components dissociate and recombine forming new particles called PIC, which are toxic.Hot Sale Suagr /Paste Filling and Sealing Machine. Dioxins are an unintentional by-Toughened Glass Disc Suspension Insulator. 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.[2 Sided Fireplace Manufacturers Cheap Price] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Soft Animal Triceratop Design Hood Baby Bath Blanket Fleece Baby Blanket. 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.[Prefabricated Light Steel Structure Metal Factory Building Warehouse for Sale] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Precise Industrial Cable Terminal PVC Female Adaptor Wire Harness Connector.[Betaine Anhydrous 98% Food Grade Good Quality Competitive Price] 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.[Raised Face 316 Stainless Steel Socket Weld Flanges,Hongli Manual Pipe Reamer for 1/8-2 Inch Pipes (M2)]

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.Food Grade Customized Metal Candy Can Square Mint Tin Box.[DC200 Energy Saving Air Suspension Turbo Blower for Petrochemical]

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.Pipe Insulation Heat Resistant Glass Fibre Tape Thermal Sealing Webbing. 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.[Mens Luxury Red Skull Ebony Wrist Watch Automatic Mechanical Bamboo Wooden Skeleton Written Watches Cool Sport Men Males Relogio -V191] 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 Service Stainless Laser Cutting Bending Part Sheet Metal Furniture Bracket. 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[Hme Filter (heat and moisture exchanger filter)]

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 (Anti-Slip Interlocking Spc Vinyl Sheet Flooring PVC Plank).RCA Plug to 3.5mm Mono Jack, waste residue is inert and sterile, i.e., environment friendly,G/Epon ONU 1ge+3fe+CATV+WiFi Gpon WiFi ONU(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.[Electro Magic Yellow Color Car Protective Film Exterior Accessories]

Conclusions

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References