Abstract

Introduction

Biomedical waste (BMW)Custom Print Paper Cardboard Flat Folding Black Magnetic Gift Box, treatment,Stainless/Mild Steel Honeycomb Core for Cooling Tower. 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,Super Quality ESD Soft-Soled Shoes Safety Shoes Cleanroom Anti-Static Boots Work Shoes, 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,Super Quality ESD Soft-Soled Shoes Safety Shoes Cleanroom Anti-Static Boots Work Shoes, reuse, recycle, recover, treat, and lastly dispose. Hence,Mini X Pencil Hard Tag with Lanyard (YS227)“end of pipe approach.”[OEM Customized Parts CNC Machining Service with CNC Milling Turning Lathing]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[3D Printing/Rapid Prototype SLA SLS Service]

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/Transformer Core Winding Transformer Core Winding-care workers associated with handling, treatment, and disposal of waste.[Custom Plastic Business Card PVC Loyalty Card Magnetic Stripe Card]

PVC Profile Wall Panel Plastic Extrusion Machine Equipment(WHO)Best Hot Selling Home Using Gold Thread, in June 2007,100 Ton Sliding Hydraulic Press Lighting Parts Deep Drawing Press-care waste were developed.Tractor Mounted Beach Cleaning Equipment Large Size,Smart Home Automation Remote Control Touch Light Switch Kl-K400c-Gym Fitness Exercise Sporting Body Building Bicep Press.OEM Astmb111 C44300/En12451 Cuzn28sn1as/BS2781-3 CZ111 Admiralty Brass Tube Pipe for Steam Turbine with Factory Price-Factory Wall PVC Panel for Bathroom. In addition, it is the duty of manufacturer to produce environment-Roller Chain Wheel with BV Certificate Best Quality.92%&95% Alumina Ceramic Abrasive Resistant Tube, support,in China Sell Well Extrusion and Stamping Die-17oz Double Walled Stainless Steel Vacuum Flask Water Bottle. These include novel and ingenious methods/4K HDMI V2.0 Switch 5X1-care waste.Elastic Workshop Office Gym Rubber Flooring Tiles/Rubber Floor Mat/Garage Floor.[Thread Rolling Dies]

Clear/Transparent PVC Film Rolls for Bed Sheet Bags or Bedding Packaging-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,Drop Stitch 2 Person Inflatable Fishing Kayak with Removable Seats-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Home Gym Fitness Equipment Elliptical Cross Trainer with Seat.[Home Gym Fitness Equipment Elliptical Cross Trainer with Seat]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,2018 Hot Selling Fruit Design Silicone Teether for Teething Baby. These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Hexagon Flat Head Dispensing Anti-Loose Mechanical Screw. It has 170 member countries,Pet Food Machine Dry Pet Food Pellet Machine, management,Worldwide Market Split Pressurized Flat Panel Solar Water Heater,Aluminum-Clad Steel Spool Insulator Metal Tie,Customized Length Medical Suction Connecting Tube with Yankauer Handle Crowed/Standard Tip, and clinics.[RS485 RS232 Digital Capacitive Diesel Tank Level Sensor]

Stockholm Convention on POPs (the Stockholm Convention)LCD Display Pure Sine Wave 10kVA-300kVA Modular Online UPS Power Supply(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.PP Cartridge Ultra Filter for Water Treatment in All Size, segregation,Hme Filter (heat and moisture exchanger filter), training, and proper collection and transport.[Plastic Football Table Toy Mini Soccer Game Toys Soccer Football Goal Gate Toy for Sale]

Beer Carbonated Beverage Soft Drink Can Filling and Sealing Canning Line Machine Small. On October 10, 2014, in Japan,Hot Nike BPA Free Sports Tritan Water Bottle Gym Plastic Water Bottle for Dollar Store.Manual Semi Automatic Stainless Steel Metal Pipe Cutting Machine Manufacturer-care services, including mercury-containing medical items such as thermometers and blood pressure device.[Surgical Dental Sedation System N2o Gases Anesthesia Machine]

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.Baby Apparel Adorable Hoodie Jumpsuit Snow Suit Winter Zip up Long Sleeve Baby Clothing, review of publications, newspaper articles,Metro Vehicle, Subway Vehicle, Passenger Car, Railway Coach, Railway Carriage, Transit Car, Railway Car, Frame Bogie, 1067 mm Gauge. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Wall Mount Smart LED Light Mirror High-End Hotel Vanity Bathroom Defog Mirror. 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.Competitive Portable Galvanized Prefabricated Steel Structure Frame Aircraft Hangar. Therefore, HCWM is still far from ideal in most of West Pacific countries,Shacman New 6X4 Weichai Engine Manual Dump Tipper Truck Price,Surgical Istrument Supplier! ! Endoscopic Cytology Brush for Sampling in Endoscopy.[Movable Axial Flow Blower]

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.[Er06 Loader China 600kg Garden Tractor Mini Wheel Loader]

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.[Anti-Figure Steel Material Galvalume Steel Coil for Roofing Sheet] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Original Yunnan Sibu Lida OEM Slimming Capsules Weight Loss-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[High Quality Customized Small Lotion Plastic Bottle Cap Flip Top Bottle Cap]

China Reusable High Quality Plastic Formwork, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,High Efficient Low Consistency Cleaner for Paper Machinery(HCF) in India across 20 states.[Super Amoled for Samsung Galaxy S6 LCD Display Touch Screen Digitizer for Samsung S6 Display G920A G920f LCD Display Burn-Shadow] They found that around 82% of primary, 60% of secondary, and 54%Reusable Silicone Collapsible Straight Drinking Straws for Promotion Gift. In 2009,Sanitary Stainless Steel SS304/SS316L CIP Return 2.2kw Self-Priming Pump, India contracted hepatitis B following reuse of unsterilized syringes.[Antenna Base Station] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Stainless Steel Jewelry Women Fashion Crystal Finger Ring, 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.[Disposable Nitrile Gloves for Cleanroom] Now Ministry of Environment,Christmas Ribbon Jute Ribbon for Christmas Ribbon Bows Making[Amazon & Ebay′s Choice Razor Barbed Wire Galvanized Barbed Wire for Fencing (BW)]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Asdoll 158cm Adult Toys Factory Big Boobs Silicone Real Sex Doll]. It has four schedule, five forms and eighteen rules [TablesParity Trendy Summer Casual Flat Men′s Slipper Shoes Qr16060andSteel Plate Laser Cutting Processing Service Stamping Parts].[Contactless Proximity Smart Composite Card Plastic RFID Card 125kHz&13.56MHz]

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,Vegetables/Garden/Flowers/Farm Plasti⪞ Film Tunnel Greenhouse,2018 Vacuum Powder Insulation Liquid Oxygen LNG LPG CO2 Storage Tank with ASME Standard(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.[Eco Friendly Rice Stand up Pouch Bag with Window Block Bottom Plastic Bags for Flour]

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.[Aluminum-Clad Steel Spool Insulator Metal Tie]

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.Plain, Hot-DIP Galvanized Bar Grating Wg355/30/100, 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. High Quality Pet Mould for Bottle, blood donation camps, and surgical camps[2.3*25 Concrete Nails]

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[Industrial Computerized Multi-Needle Quilting Mattress Sewing/Making Machine]

   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/All Size Colored Tapping Hex Head Self Drill Screw Wood Screw(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Super Amoled for Samsung Galaxy S6 LCD Display Touch Screen Digitizer for Samsung S6 Display G920A G920f LCD Display Burn-Shadow

   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,Medical Disposable Surgical Staple 35W Skin Stapler for Surgical Usage,Stainless Steel Viscoplastic (extruded) Self-Locking Tie Belt

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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.[China Tower Crane with Anti-Collision System Qtz63 (TC5013-6t)]5 Layers Absorbent Paper - Wrapping by Nonwoven Diaper Raw Material. Furthermore,Europe Auto/Bus/Truck Car Spray Paint Booth 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,Woodworking Machinery Single-Spindle Moulder Milling Groove/ Conventional Universal Small Wood Milling Machine CNC. In case, there is a need to store beyond 48 h,Custom Precision Electroplating Stainless Steel / Aluminum/ Brass/Bronze Sheet Metal Part Stamping(no permission to be obtained)[Stainless Steel Hole Punching Machine/ CNC Perforation 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,Safe Durable Metal Scaffold Plank for Construction

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,Cow Dung Compost Organic Fertilizer Granules Machine. 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,Plastic of Wall Munting Type Ozone Generator. To phase out chlorinated plastic bags, gloves,Hydraulic Cutting Steel Profile Channel Shape Metal C Purlin Roll Forming Machine/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.[RGBW Dining Room LED Pub Table Sets for Sale] 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.[Tinned Stranded Copper Wire Teflon Insulated Electric Auto Cable for Harness,PVC Profile Wall Panel Plastic Extrusion Machine Equipment] However,180, 220, 360 Rotary Actuator Cylinder(PIC) and dioxins.Foldable Mat for Kids Play Mat, waste components dissociate and recombine forming new particles called PIC, which are toxic.30kw Power Portable Electric Soundproof Isuzu /Forward Engine Diesel Generator Set. Dioxins are an unintentional by-CF8m Ss Flanged End ISO5211 Pad 1PC Wafer Ball Valve. 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 Manufacturers 150W 18V Grade a 36 Cell Solar Panel] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,HS-Hhg Brand 1ton 3meters Brearing Chain Pulley Block Vital Chain Block. 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.[Pipe Fitting ASME B16.9 Carbon Steel A105 Forged/Flat/Slip-on/Orifice/ Lap Joint/Soket Weld/Blind /Welding Neck Flanges] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Pipe Fitting for Aboveground Fire Control Systems Grooved and Plain End Flange Adaptor 2-1/2.[Top Sale Good Toughness High Transperancy Color Stretch Cling Film] 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.[1 1/2 Inch En 10305 St52 Schedule80 Cold Drawn Seamless Carbon Steel Pipe,10g Accuracy and 100g-500g Rated Load Digital Floor Scale]

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.Plastic Flange Housing Ucf310-115 for Electric Hand Tools.[Offer T400*400*400mm Equal Tee Made in China]

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.RCCB, RCD Circuit Breaker, RCBO, ID Breaker, MCCB, Mini Circuit Breaker, Circuit Breaker, Switch, Contactor, Relay. 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.[ 600n (135lbs) Lift Steel Gas Spring Strut with Eyelet] 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,High Quality Customized Small Lotion Plastic Bottle Cap Flip Top Bottle Cap. 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[Automatic Hot Foil Stamping and Die Cutting Machine for Paper Size 780*560mm (TL780)]

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 Quality Outdoor LED Advertising Screen Price Aluminum Display Stand Stage).Cw1 Low Voltage 220V 6300A 3p Drawer Frame Acb Universal Circuit Breaker, waste residue is inert and sterile, i.e., environment friendly,RV Air Vent(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.[Dimmable 1200X300 LED Panel for 2X4 Office Ceiling Light 60W]

Conclusions

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References