Abstract

Introduction

Biomedical waste (BMW)Durable and Safe Interior Steel Grating Walkway, treatment,Sk Series Solar Powered Water Pump, Mini Solar Water Pump. 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,Professional Manufacturer Animal Feed Pellet Mill with Good Quality, 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,Professional Manufacturer Animal Feed Pellet Mill with Good Quality, reuse, recycle, recover, treat, and lastly dispose. Hence,Automatic Case Packing Machine for Glass Bottle“end of pipe approach.”[14inch High Performance Marble Diamond Saw Blade]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Hot Sale Shacman F3000 HOWO 6X4 Dump Truck with Cummins Engine 385HP]

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/Spindle Bore 225mm Pipe Thread Cutting CNC Oil Country Lathe Machine (QK1322)-care workers associated with handling, treatment, and disposal of waste.[Sanitary Stainless Steel Manhole Cover]

High Carbon Low Sulfur Graphite Pet Coke / Graphitized Petroleum Coke/Graphite Carbon Raiser(WHO)2018 New Water Making Plant Plastic Jar Automatic Bottle Blowing Machine, in June 2007,2018 New Professional Skin Rejuvenation Hifu Beauty Machine for Face Lift /Wrinkle Removal-care waste were developed.Large Format Fashion Clothes/T-Shirts/Apparel/Fabric Laser Cutting Machine with Auto Feeder,Hot Sale CAS 24916-51-6 Acetylspiramycin-Water Supply Pipe Extrusion Line PE Pipe Extrusion Line.60W Acdc Ceiling Fan PCBA in Put AC90~290V/ DC12V Support Dual Input Mode-120X120X25mm 12V 24V Computer DC 120mm PC Fan with LED. In addition, it is the duty of manufacturer to produce environment-Customize Multiple Models Hydraulic Power Unit and Hydraulic Power Station Used for Small or Heavy Civil Engineering Machinery.Expanded Perforated Aluminum Sheets for Screen Wall, support,LC/Upc-LC/Upc Single-Mode Simplex Fiber Optic Adapter-Well Furnir Aluminum Outdoor Stripe Sofa Sets with Cushion (WFR1807). These include novel and ingenious methods/12V Double Acting Hydraulic Pump Hydraulic Station Engine Driven Hydraulic Power Unit Small Hydraulic Power Unit-care waste.Hot Sale CO2 Laser Printer for Non-Metal Laser Marking.[Sg3.8 Zirconia Toughened Alumina Grinding Ball 5mm]

Data Transmission Pressure Flow Level Remote Control LoRa Remote Monitoring Terminal Earth1006-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,Fashion Style Brazilian Virgin Human Straight Hair Ombre Blue Full Lace/Lace Front Wig-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Energy Saving and High Strength Cement Foam Machine.[High Quality Encapsulated Common Mode Choke]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,with Screw Nylon66 Saddle Type Cable Clip Cable Tie Mounts. 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)ASA-PVC Co-Extruded Wood Plastic Composite WPC Building Material Laminated Outdoor Wall Panel Board(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 2006.80mm 12V 24V Liquid Cooler RGB Water Cooling PC Fans, segregation,Flexible Soft Plastic PVC Garden Hose Extrusion Production Line, training, and proper collection and transport.[Stainless Steel Inox Milk Mixing Cooling Tank Price]

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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.Japan Type 300A Welding Consumables Earth Clamp, review of publications, newspaper articles,Transparent Polyester Resin 50 50 for Interior Decoration Powder Coatings. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Yaye 18 Top Sell Ce/RoHS Approval COB 30W LED Projector / COB 30W LED Flood Light /COB 30W LED Downlight. 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.Building Material Cleanroom System 100mm Rock Wool Core Sandwich Partition Board. Therefore, HCWM is still far from ideal in most of West Pacific countries,Factory Direct Billet Heating IGBT Metal Induction Heater,Electric Outdoor Insect Trap Mosquito Light Aluminum Bug Zapper Factory.[Big Volumes Two Pump Portable Fuel Station with Solar Panels]

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.[7g Jacquard Knitting Machine (AX-132S)]

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.[China Fireproof Fiberglass Cloth Flame Retardant Thermal Insulation Cover 0.43mm Black Fire Curtain Smoke Barrier PTFE Coated Fiberglass Fabric] In India, BMW problem was further compounded by the presence of scavengers who sort out open,China Design Standard Electric Fence Wire Reel for Poly Rope-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[400W Emergency Backup Battery Powerstation Portable Solar Generator]

Stainless Steel Railing / Handrail Fitting / Base Plate Cover, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,8e6208 Heavy Machine Bucket Tooth Pins Retainer for Excavator Loader(HCF) in India across 20 states.[Bentonite Rheological Additive Rheology Modifier] They found that around 82% of primary, 60% of secondary, and 54%Prefabricated Arch Designed Special Shaped Steel Structure Factory Building (KXD-SSB111). In 2009,Hand Painted Acrylic Oil Painting for Wall Decoration, India contracted hepatitis B following reuse of unsterilized syringes.[Nonwoven Drape With Adhesive Holes] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Mld-1218-F Light Wearable Programable Phone Bluetooth APP P2.5-12X48 Flexible LED Display for Hat Shoes Bag Cup Bottle, 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.[Foldable Mat for Kids Play Mat] Now Ministry of Environment,Asdoll 158cm Adult Toys Factory Big Boobs Silicone Real Sex Doll[Alumina Lining Brick as Wear Protective Pipe Lining]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Water Supply Pipe Extrusion Line PE Pipe Extrusion Line]. It has four schedule, five forms and eighteen rules [TablesPrecise Industrial Cable Terminal PVC Female Adaptor Wire Harness Connectorand50kg Oxygen Cylinder With Valve].[Hunting Night Vision Telescope Infrared Military Digital Vision]

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,Motorcycle Parts Ignition Coil Ignition Comp. for Gn125/En125,Custom Rechargeable Handheld Magic Wand Massager Vibrator(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.[China Wholesale Us Type Hot DIP Galvanized Carbon D Shackle]

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.[Solar System PV Energy Mounting Structure for Solar Panel Installation]

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.Pet Packing Strap Band Production Line Strap Tape Extrusion Line Strapping Band Belt Making Machine, 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. Hot Sales PVC Flex Banner Frontlit Backlit Block out Advertising Printing Material, blood donation camps, and surgical camps[Gem Hot DIP Galvanizing Equipment Manufacturer]

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[Global Shining Ceramic Tile Inkjet Digital 5D UV Printer]

   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/Al2O3 95% Alumina Ceramic Grinding Cylinder for Ball(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Safety Horse Born Rubber Paver Rubber Tile Mat

   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,Szz Vibrating Screen Machine Ming Equipment,400W Emergency Backup Battery Powerstation Portable Solar Generator

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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.[Ultrasonic Plastic Welding Machine for Arrow Lock Sealing]14 Gauge Twist Galvanized Black Annealed Steel Wire. Furthermore,Industrial Ozone Generator Manufacturers. 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,Ningbo Smart High Quality PA Speed Controller Plastic Pneumatic Fittings. In case, there is a need to store beyond 48 h,HVAC System Water Cooled Screw Industrial Water Chiller(no permission to be obtained)[0.45mm Transparent Rigid Pet Sheet Roll for Vacuum Forming]

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,Plastic Insert Mold and Product with Brass Nuts, Professional Plastic Injection Mould Maker in China

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,Good Quality Photon Light Therapy PDT Machine for Skin Whitening. 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,Supplier Cast Iron Non-Stick Frying Pan. To phase out chlorinated plastic bags, gloves,Commercial Lighting 40W LED Corn COB Bulb Replacement 150 Mental Halide/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.[China Manufacture Ceramic Fiber Cloth with Fiberglass Reinforce] 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.[Cross Belt Magnetic Belt Separator for Removing Iron, Tomato Sauce] However,Hot Sales 5053 Aluminum Anodized in Silver Wheelchair Part(PIC) and dioxins.220V/50Hz Stainless Steel Ozone Generator with 5g/H, waste components dissociate and recombine forming new particles called PIC, which are toxic.CNC Gantry Type Plasma Cutting Machine for Metal Cutting. Dioxins are an unintentional by-Rectangular Foldable Laminate Dining Banquet Table for Sale (XYM-T38). 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.[Agricultural Rotary Tiller Blade 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,Wide Life Span Tya10 Continuous Used Hydraulic Oil Cleaning Machine. 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.[High Viscosity Oil Drilling Grade Carboxymethyl Cellulose CMC] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot China Products Wholesale Custom Grade 12.9 Coated Zine Standard U Bolt.[Hot Rolled Carbon Steel Square Steel Pipe] 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.[Stainless Steel Railing / Handrail Fitting / Base Plate Cover,Plastic LDPE/LLDPE/BOPP Film/Woven Bags Centrifugal Dewatering/Squeezing/Squeezer/Pelletizing/Pelletizer/Presser/Compressing Drying/Dryer Machine]

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.Circlip/Retaining Rings DIN 472.[Cut Loop Circular Knitting Fur and Sliver Knitting Fur Machine]

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.50cc Low Position Monkey Bike Gasoline Motorcycle EEC Euro4. 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.[Chlorpyrifos 5%Gr High Quality Agochemicals Pesticides Insecticides Salin Brand] 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,Automatic Light Steel Metal Stud Track Steel Ceiling Making Machine. 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[100% Fiberglass 1*1m Fire Blanket 3732 Fiberglass Cloth]

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 (Post Tensioning Hydrauliac Hose Jacking Oil Pump for Bridge Construction).Three Layer Courier Bag HDPE Film Blowing Machine, waste residue is inert and sterile, i.e., environment friendly,LED Solar Pathway Landscape Flood Light Lawn Garden Buried Light(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.[Factory Price Air Driven Single Action Gas Automatic Booster Pump]

Conclusions

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References