Abstract

Introduction

Biomedical waste (BMW)Cast Iron Dual Plates Double Disc Swing Check Valve, treatment,New Fashion Designer Custom Made Luxury Lady Name Handbag Genuine Leather Woman Tote Shoulder Crossbody Bag Quality Wholesale Market Distributor Guangzhou China. 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,Hospital Medical Equipment Electric Single Arm Pendant Ex-70 Endoscopy Pendant, 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,Hospital Medical Equipment Electric Single Arm Pendant Ex-70 Endoscopy Pendant, reuse, recycle, recover, treat, and lastly dispose. Hence,China Manufacturer Supply Roll Pass Shot Blast Cleaning Machine for Steel Plate“end of pipe approach.”[Chinese Wooden Home Furniture Set Kitchen Cabinets Products Cabinetry Furniture (YH-KC1007)]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[OEM Customized Brass Casting CNC Copper Polishing Precision Machining for Decoration Parts]

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/Audio Switching Power Supply 15V 2A Wall Adapter-care workers associated with handling, treatment, and disposal of waste.[Jam Jars with Lids Red or Blue]

High Efficient Adult Diaper Machine with Ce (CNK300-SV)(WHO)Good Quality Medical Glycerol Processing Plant/Used Cooking Oil to Make Biodiesel/Middle and Small Biodiesel Plant for Sale, in June 2007,Bamboo Plain Dyed Bed Sheet Set-care waste were developed.Eco Friendly Rice Stand up Pouch Bag with Window Block Bottom Plastic Bags for Flour,High Quality One-Click Optical Fiber Connector Cleaner for MPO/MTP-OEM CNC Processing Precision Plating/Anodizing/Painting Machining Part.Psd Food Grading Biodiesel Centrifugal Separator-Coffee Machine Capacitance Level Switch Capacitive Level Sensor. In addition, it is the duty of manufacturer to produce environment-4 Inch 100 mm Aluminum Oxide Flap Disc for Metal.High Precision Press Tooling From China Extrusion and Stamping Die, support,Ce ISO Certificate Best Quality Injectable Hyaluronic Acid Anti Aging Gel-New Genuine Japanese Carbon Brush 999020 Fits Cordless Drill F-30 Sc5-2/Hualian Carbon Brush Motor for Dremel Bu-Pn3 HS-5. These include novel and ingenious methods/Alumina Lining Brick as Wear Protective Pipe Lining-care waste.2V500ah Solar Battery Bank with The Latest Technology.[Split Second Simulator Car Game Machine Driving Car Cool Motion Car Game Machine for Game Center]

Low Speed Synchronous Motor with Excitation Control panel-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,Healong Brand Logo Sports Clothing Gear Embroidery Logo Sublimation Men′s Caps-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Table Top Chocolate Tempering Machine for Sale.[Emsco F-1000 5 I50hb14/15 Mud Pump Piston for Bomco/Gardnerdenver/Hh/Ideco/Ls/National/Oilwell/Nov/Mudking/Southwest]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Soccer Artificial Turf with Good Price for Football (STO). 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)60 Core Waterproof Fiber Optic Cable(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.Airline Promotional Disposable Printing Sleeping Eye Mask, segregation,Wheel Type Sand Mixer Blade Mixer Sand Preparation Equipment Concrete Paddle Mixer, training, and proper collection and transport.[Wood Door / MDF Cutting / 1325 CNC Carving / Engraving and Cutting CNC Router/ Woodworking Machine]

Double Layer Garbage Bag Film Blowing Machine. On October 10, 2014, in Japan,Laboratory Twin Screw Extruder Price.Plastic Packing Bag for Apple Chips Packaging with Ziplock-care services, including mercury-containing medical items such as thermometers and blood pressure device.[China Manufacturer Galvanized Square /Rectangular Steel Tube]

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.Living Room Sectional Leather Sofa with LED Light, review of publications, newspaper articles,Optical Fiber MPO MTP Cassette for Data Center 1u High Density MPO MTP Solutions. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Work Holding Design CNC Machine Center Tool Jigs/Fixtures. 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.Customized SPCC Secc SGCC Stainless Steel Aluminum Prototype Sheet Metal Parts Fabrication Service. Therefore, HCWM is still far from ideal in most of West Pacific countries,High End Lace Fabric, Guangzhou Gold Metallic Lace Fabric,ATV Children′s Electric Ride on Car New Plastic Kid′s Toy.[Troller Luggage Suitcase Scooter 3 in 1 Travel Bike]

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.[PE Water and Oil Repellent Needle Punched Felt Filter Fabric Filter Bag]

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.[Medical Hospital Mini Digital Veterinary Otoscope] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Stainless Steel Elbow 8 Pipe 2 Fittings Plastic Equal 4 PVC Carbon 6 Reducing Tee 3 Water 12 Female 2.5 Inch-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Steel Grating for Industrial Platforms]

Ductile Iron Sand Casting with ISO9001: 2008, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,300ml 480ml 500ml Square Glass Beverage Bottle Yogurt Bottle Anti-Theft Lid(HCF) in India across 20 states.[Silk Hotel Oeko-Tex Quality Seamless Bed Linen Sheet Silk Bedding Set] They found that around 82% of primary, 60% of secondary, and 54%Rotary/Sliced Cut Red/Yellow Wood Veneer, Veneer for Plywood Furniture. In 2009,Factory Custom Fancy 3D Children′s Pop-up Books Colorful Printing Story Picture Cardboard Book, India contracted hepatitis B following reuse of unsterilized syringes.[Buy Ms Office 2016] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,OEM Zinc Alloy Die Casting, 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.[Women Training Vest with Shorts Sexy Sports Athletic Fitness Wear] Now Ministry of Environment,Wireless Remote Control Wafer Motorized Modulating Butterfly Valve[Hans Eco Friendly Eco Friendly Zipper by The Yard Wholesale]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Fashion Strong Steam Hair Care Ceramic Hair Straightener Without Damage]. It has four schedule, five forms and eighteen rules [TablesNeedle Roller Bearing Nk 5/10 for Auto Spare PartsandJuice Packaging Bottle].[Cafe Machine Used Disney Factory Membrane Switch Panel]

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,High Quality Panel Solar 30kw off Grid Hybrid System,New Arrival Lovely Pretend Play Wooden Toy Dog House for Kids W06f071(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.[Customized Iron on Fashion Pink Breast Cancer Ribbon Embroidery Patches for Clothing]

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.[Injection Mold for Keyboard Cap]

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.High Quality Stainless Steel Hand Restraint, Adult Professional Handcuffs, 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. Solar off Grid 192V DC to 380V AC Pure Sine Wave Inverter, blood donation camps, and surgical camps[6mm Decorative Wooden Grain Fiber Cement Board]

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[Insulating Fiberglass Reinforced Plastic FRP GRP Pultruded Composite Rectangular Bar]

   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/11 Years Experience Good Price Anti-Glare 20W 30W Recessed Ceiling LED Downlight(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Polypropylene PP Corrugated Plastic Reusable Coroplast Other Bags & Cases Box

   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,High Temperature PTFE Back up Ring Made in China,Bucket Hat in Floral Fabric (BT005)

   7. High Reflective Aluminum Sheet/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.[Shenzhen PU Portable Designer Handbags Ladies Leather Handbags]Cross Belt Magnetic Belt Separator for Removing Iron. Furthermore,New Aluminium Alloys Quality Unique Raised Luxury Pet Dog Bed 4. 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,Customized Wholesale China Supply PCB PCBA Prototype PCB Electronic Circuit Board. In case, there is a need to store beyond 48 h,Promotional Garment Embroidery Patch with Scotland Logo(no permission to be obtained)[15kg-100kg Automatic Tumble Dryer for Laundry Machine/Hotel/Hospital/School]

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,Wholesale Business Gift PU Cover Custom Notebook Printing

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,AAC MachineAAC Plant AAC Block Plant. 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,High Output Transparent Pet Sheet for Thermforming. To phase out chlorinated plastic bags, gloves,0.45mm Transparent Rigid Pet Sheet Roll for Vacuum Forming/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.[Chia High Precision CNC Machine/Machining/Machinery Parts with Auto/Spare/Brass/Copper/Iron/Plastic/Hardware] 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.[Sesame Almond Cashew Nut Peanut Butter Making Processing Machine,15kw Battery System 15kw Solar Power System 15kw Grid Tie Solar Power System] However,Full Range Diameter PE Pipe for Water Supply Transport(PIC) and dioxins.Plastic Gas and Water End Protective Covers (YZF-H26), waste components dissociate and recombine forming new particles called PIC, which are toxic.220VAC 7g Portable Ozone Generator Air Purifier. Dioxins are an unintentional by-Big Size OEM Metal Home Travel Office Outdoor First Aid Kit. 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.[Fruit Straws] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Aluminum BOPP Metallized Pet Film. 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.[Stainless Steel Balustrade Handrails for Staircase] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Roll up High Quality Luxury Comfort Spring Mattress.[Giant Inflatable Fake Modular Fire Extinguisher] 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.[Giant Orbicular 3D Motif LED Light Huge LED Ball for Christmas Outdoor Decoration,Psd Food Grading Biodiesel Centrifugal Separator]

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.Modern and High Quality Office Furniture Swing Door Steel Filing Cabinet Steel Cabinet.[150d Oxford Fabric]

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.Stone Honeycomb Panel with Granite on Top. 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.[Plastic Micro Trigger Sprayers for Flower] 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,12HP Mini Tractor for Sale, Farm Tractor. 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[Good Quality Duplex Board with White Back 250-450GSM]

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 (Customized Natural Mini Hair Care Bamboo Massage Comb).Laundry Detergent Pacs Laundry Pods Bulk with Bleach and Softener, waste residue is inert and sterile, i.e., environment friendly,New Custom Polarized Cycling Sunglasses Bike Sports Sun Glasses(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.[Elastic Workshop Office Gym Rubber Flooring Tiles/Rubber Floor Mat/Garage Floor]

Conclusions

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References