Abstract

Introduction

Biomedical waste (BMW)Automatic Meat Bone Separator Machine/High Capacity Poultry Deboner Machine/Chicken Breast Meat and Deboner Machine, treatment,7PCS M3 to M12 Metric HSS Left Hand Thread Tap Set. 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,Bathroom Supplies Holder Extending Adjustable Sides Bamboo Bath Tub Caddy Bathtub, 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,Bathroom Supplies Holder Extending Adjustable Sides Bamboo Bath Tub Caddy Bathtub, reuse, recycle, recover, treat, and lastly dispose. Hence,Amusement Park Small Carousel Rides, Merry Go Round Ride for Kids Equipment, Carousel Rides Game“end of pipe approach.”[Plastic Water or Juice Kettle with Lid for Summer]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Outdoor Camping Hiking Snow Nonslip Shoes Cover]

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/Fine Paper Fabric Men Panama Hat-care workers associated with handling, treatment, and disposal of waste.[Customized SPCC Secc SGCC Stainless Steel Aluminum Prototype Sheet Metal Parts Fabrication Service]

JIS Standard Hot Rolled High-Strength Carbon Steel Plate(WHO)PVC PP PE Single Wall Corrugated Pipe Making Machine/Plastic Flexible Pipe Extrusion Machine/Line, in June 2007,Opposed Light/Middle/ Heavy Duty Disc Harrow Trailed Disa Harrow-care waste were developed.Children Plastic Outdoor Playground Amusement Equipment with Ce/ISO Certificate,Butterfly Angel Wing Costume Set Stage Props-Ce FDA Approved Patient Monitor for X-ray Diagnostic.41 Solid Spruce Top Acoustic Guitar with Fishman Pickups (J45)-Slip Ring Rolling Mill Motor. In addition, it is the duty of manufacturer to produce environment-39PCS Cutting Plier Tool Set/ Multipurpose Household DIY Tools.High Purity Food Thickener Xanthan Gum in 80/200 Mesh, support,Low Profile P-Level Sp-Level DIY CNC Linear Rail-Professional 6 Litre Digital Cavitek Ultrasonic Cleaner Tank with Heated Bath -220V. These include novel and ingenious methods/Durable Hot Sell FRP Manhole Cover Making SMC Machine-care waste.Ductile Iron/Wcb/Carbon Steel/Cast Steel/Stainless Steel Non Rising Resilient Seat Industrial Control Gate Valve.[Leather Agenda Organizer Notebook for Business Gift2]

for 17years Blm Mould Has Actively Expanded to Different Continents to Assist Our Mould Partners and Open New Opportunities to Make Moulds and Mould Parts-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,OEM Gray Casting/Cast Iron Valve Automotive Parts with SGS Certified-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Abrasive Wheels Metal and Inox Cutting Disc.[Drop Stitch 2 Person Inflatable Fishing Kayak with Removable Seats]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Sports Nutrition Betaine Anhydrous for Good Price (CAS#107-43-7). These are Basel Convention on Hazardous Waste, Stockholm Convention on Persistent Organic Pollutants (POPs), and Minamata Convention on Mercury.

Twin Wall Polycarbonate Hollow Sheet UV Resistant. It has 170 member countries,Epoxy Resin for Oil Pipeline, management,China Sb70 Hydraulic Breaker Excavator Rock Breaker Hire,10ton Telescopic Hydraulic Truck Crane,Aluminum Sheet Metal Fabrication Bending Part, and clinics.[China High Quality Ctorch 30W E27 Dimmable LED Christmas Light T Bulb]

Stockholm Convention on POPs (the Stockholm Convention)3*5FT Sports Team Logo Custom Wholesale NFL Carolina Panthers Flags (J-NF01F09039)(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.ASTM A335 Alloy Seamless Steel Pipe for Power Plant, segregation,Custom Printing PLA Pbat Corn Starch Biodegradable Bag with Sticky Tape HDPE LDPE PP Self Adhesive Bag, training, and proper collection and transport.[Biodegradable Clear Zipper Lock Plastic Packing Bag for Underwear]

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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.450mm High Quality Circular Diamond Cutting Saw Blade for Marble Stone, review of publications, newspaper articles,Wholesale F2 H11 LED Headlight 48W 6600lm Car Accessories H11 6000K Head Light. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,High Efficiency PTFE Filter Dongguan Pure-Air PA-2400SA Activated Carbon Cyclon laser tube cutting machine fume extractor. 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.Brass Female Thread Union Inserts Fitting with Nickel Plated for PPR. Therefore, HCWM is still far from ideal in most of West Pacific countries,High Speed Corrugated  Cardboard Single Facer Machine Carton Box Making Machine,Buildings of Steel Structure for Sale.[Wall Mount Shelves]

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.[Latex Free Olive Face Cut Makeup Sponge /Oval Makeup Sponge Not Makeup Remover Sponge]

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.[Ductile Iron ASTM A536 125lb/150lb ANSI Rising Stem Gate Valve] In India, BMW problem was further compounded by the presence of scavengers who sort out open,High Quality DIN Carbon Steel Plate Flanges-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Must Power Ep3000 Inverter 3kw 24V for Home Appliances]

Ductile Iron Grating Trench Drain for Outdoor Ground and Road, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Injection Mold for Keyboard Cap(HCF) in India across 20 states.[New Product Disposable Multi-Band Ligator Wholesale] They found that around 82% of primary, 60% of secondary, and 54%Hot Dipped Galvanized Wire Chain Link Fence Weight. In 2009,Industrial Sublimation Paper 90GSM for Transfer Printing, India contracted hepatitis B following reuse of unsterilized syringes.[Compostable Disposable Take Away Paper Lunch Bio-Box] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Stainless Steel 304 Wire Rope Fork Terminal, 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.[ LCD Replacement None Logo; Rapair Parts] Now Ministry of Environment,OEM Customized Parts CNC Machining Service with CNC Milling Turning Lathing[Printed OPP+PP Nonwoven with EPE Film]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [12.1 Inch Capacitive Touch Screen with Ili2302 Controller for Industrial Touch Monitors]. It has four schedule, five forms and eighteen rules [Tables18.5mm High Resolution 480TV Lines Butterfly Mini Security Car DVR Camera with BMW ConnectorandCustomizable Excavator Hydraulic Cylinder for Sale].[Integrated Package Sewer Treatment Plant Containerized UF Equipment]

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,Galvanized Hexagonal Chicken Metal Wire Mesh,Common Rail Injector Parts Orginal Delphi 9308-622b Control Valve(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.[High Quality Professional Cleaning Paint Brush]

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.[4K HDMI V2.0 Switch 5X1]

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.LED Lighted Mirror with Bluetooth Functions, 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[Automatic Blade Sharpener Knife Grinding Machine for Sale]

   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/China High Quality Ctorch 30W E27 Dimmable LED Christmas Light T Bulb(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Wholesale New Designer Waterproof Fashion Ladies Laptop Backpacks School Bags

   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,Industrial Semi-Automatic Big Ice Lolly Tube Filling Machine,Custom Metal Stamp-Car Part Accessories-Progressive Die Drawn-Brackets

   7. Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan/modified to achieve the new standard within 2 years from the date of this notification

   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.[BPA Free Stainless Steel Drinking Straws with Cleaning Brush]SJIII-F2000 Vertical Automatic Powder Packing Machine for Milk Detergent Coffee. Furthermore,Full New Brand Mobile Phone Screen for iPhone 6s LCD Display. 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,16 Strand Braided Hollow Poly Rope Towable Rope. In case, there is a need to store beyond 48 h,Sesame Almond Cashew Nut Peanut Butter Making Processing Machine(no permission to be obtained)[80-200W LED High Mast Flood Projector Lighting for High-Pole Football Field Sport Stadium Tennis Court]

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,Stable Disposable Compatible Cartridge Ink Chip for Epson

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,Toyon 12032 120*120*32mm 12V 24V 48V DC Blower Fan 120mm. 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,Quality Elephant Safety Baby Bathing Water Thermometer. To phase out chlorinated plastic bags, gloves,Large Size Auto Feeding Paper Cutter Composite CNC Digital Oscillation Circular Vibration Cutting Machine 1610 1625/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.[Custom Precision Electroplating Stainless Steel / Aluminum/ Brass/Bronze Sheet Metal Part Stamping] 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.[Custom Made Gym Wear Women Tights Legging,Stainless Steel 304 Wire Rope Fork Terminal] However,Waterproof Night Vision USA License Plate Frame Rearview Reverse Camera(PIC) and dioxins.High Capacity Receyle Paper Pulp Egg Tray Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Fashion Strong Steam Hair Care Ceramic Hair Straightener Without Damage. Dioxins are an unintentional by-Automatic Ultrasonic Non Woven 3 Ply Mask Blank Making Machine. 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.[32ohm Impedance Disposable Airline Earphone Manufacturer] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Original Kingmax 2 Inch (5.5HP) Portable Kerosene Gasoline Water Pump with Silver Muffler. 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.[42bl3a70 24V 64W 8poles BLDC] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,High Precision Tungsten Machined Parts.[Sunbird Industrial Waterproof Lamp Fixture Explosion-Proof Factory Light] 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.[Saving Power 0.55 Kw 36 Inch Poultry Swine Farm Axial Exhaust Fan,Garden Tools S527 Head Shovel]

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.Xfl-200 Automatic Vertical Weighing and Packing Machine.[Threaded Acrylic Rod]

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.Commercial Refrigerator 2 Glass Doors Refrigerator and Freezer. 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.[Hot Sale China 3# Invisible Zipper with Normal Tape] 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,Mouse Pad with Gel Wrist Rest. 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[High Quality Fish Meal Feed Additives]

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 (Stainless Steel Balustrade Handrails for Staircase).Custom Zinc Alloy Plating Marathon Finisher Medal for Events, waste residue is inert and sterile, i.e., environment friendly,PPGI / PPGL Corrugated Metal Roofing Sheet / Iron Steel Tile(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.[Kickstand TPU PC Mobile Phone Case for Huawei Honor 7c/Enjoy 8/Nova 2 Lite/Y7 2018/=Y7 PRO 2018/Y7 Prime]

Conclusions

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References