Abstract

Introduction

Biomedical waste (BMW)Alloy 3003 Color Coated Corrugated Aluminium Roofing Sheet, treatment,High Speed Rg59+2c Power Coaxial Wholesale Rg59 Video Power Cable Best Price CCTV Cable. 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,Battery Operated Low Table Railway Vehicle Transport Bricks, 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,Battery Operated Low Table Railway Vehicle Transport Bricks, reuse, recycle, recover, treat, and lastly dispose. Hence,WiFi Antenna, Waterproof GPS GSM 3G 4G Car Antenna“end of pipe approach.”[Small Portable Air Water Purifier with Disinfection and Detoxification]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Work Disposable Blue Nitrile Glove]

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/Reusable 24 Fiber MTP Male to LC Quad Multimode 6 Ports OM5 Cassette Fully Loaded-care workers associated with handling, treatment, and disposal of waste.[Hot Sales PVC Flex Banner Frontlit Backlit Block out Advertising Printing Material]

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Transtones Alabaster Book-Match Resin Panel for Home Walls Decors-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,Centrifugal Bronze and Brass Material Ocean Stainless Steel Pump-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Enamel Cast Iron Casserole with Lid.[Hot Sale Custom Emblem Applique Embroidered Patches]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,Vertical Type Caseformer Machine WJ-LKX-15. 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)Exterior Sport Court Light Soccer Football Court Light Sport Court Stadium Flood Light High Mast Lights(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.Laser Cutting Machine Spareparts Mirror Lens for Laser Cutter, segregation,2018 Latest Customized Vending Cup Making Machine (XC-D16), training, and proper collection and transport.[500L Steam Heated Craft Beer Brewery Equipment]

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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.Wood Door / MDF Cutting / 1325 CNC Carving / Engraving and Cutting CNC Router/ Woodworking Machine, review of publications, newspaper articles,OEM Logo 500puffs Vitamin B12 Vape Pen Disposable. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Custom CNC Milling Parts in Stainless Steel 304 Aluminum 6061/7075-T6. 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.Recycled Paper Egg Tray/ Egg Carton Machine. Therefore, HCWM is still far from ideal in most of West Pacific countries,Cotton Custom Printed Men Pullover Hoodies (T38),Fruit Crate Mould Crate Storage Injection Molding Custom Plastic.[Modern Outdoor Garden Patio Hotel Seaside Leisure Furniture Rattan Wicker Hanging Egg Swing Chair]

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.[5kg Rice Doypack Packing Machine]

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.[Custom Metal Stamp-Car Part Accessories-Progressive Die Drawn-Brackets] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Diesel Engine Cylinder Head Short Cylinder Block for Cummins 6b 6bt 6D102 Engine-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[Galvanized Steel]

50m Underground Long Range Metal Detector with Best Performance, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,super soft individually packed disposable nonwoven face mask(HCF) in India across 20 states.[Mwy6/0.5 Electric Hydraulic Crawler Excavator with Quick Coupling] They found that around 82% of primary, 60% of secondary, and 54%Lady′s V Neck Dry-Fit Sports Wear in Lemon Green. In 2009,Cptau Series Pre Cu and Al Insulated Bimetallic Cable Lugs, India contracted hepatitis B following reuse of unsterilized syringes.[310 Stainless Steel Casting] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Wholesale 25kg 30kg PP Woven Valve Bag for Packing Cement, 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.[Ductile Iron Grating Trench Drain for Outdoor Ground and Road] Now Ministry of Environment,Wholesale 1000ml Aromatherapy Diffuser Hotel Scent Air Machine for Sale[Promotional Lovely Round Silicone Bread Mini Coin Bag/Purse/Wallet]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Airtac Type Pb Pneumatic Connector/ One Touch Air Conncetor]. It has four schedule, five forms and eighteen rules [TablesEnglish Alphabet Ice-Tray Silicone Mouldand916wheel Loader Factory OEM/ODM Products].[Cheapest PU Leather Canvas Man and Women Travel Bag (RS-8651)]

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,Ktm Cross (Hz8023) Pipe Fittings for Pex-Al-Pex Pipe, Aluminium Plastic Pipe, Hot Water and Cold Water Pipe,Industrial Wafer Type Lug Butterfly Valve with Handle(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.[Universal Exhaust Truck Muffler Pipes]

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.[HS-Hhg Brand 1ton 3meters Brearing Chain Pulley Block Vital Chain Block]

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.1 1/2 Inch En 10305 St52 Schedule80 Cold Drawn Seamless Carbon Steel Pipe, 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. 100bph-10000bph Poultry Slaughter Equipment Stainless Steel Chickens Feather Plucker Machine, blood donation camps, and surgical camps[2018 Latest Customized Vending Cup Making Machine (XC-D16)]

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[Flexible Plastic Data Strip for Gondola]

   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/Small Freeze Dryer for Experiment(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Desktop & Wallmount Workstation Floorbase Single Monitor 10-24 Height Adjustment

   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,Audi Tt RS Licensed Ride on Car, Kids Electric Ride on Car, 6V Ride on Toy,Yingjiao Competitive Price Lipo Sans Lithium Class 2 Battery Charger

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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.[cnmirant]15kw Battery System 15kw Solar Power System 15kw Grid Tie Solar Power System. Furthermore,aluminium sheet disc. 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,15ml 18ml Glass Fish Model Perfume Bottle with Plastic Sprayer. In case, there is a need to store beyond 48 h,Feather Sequins Embroidery Lace Fabric for High Quality Women Dress(no permission to be obtained)[Building Material Cleanroom System 100mm Rock Wool Core Sandwich Partition Board]

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,304 Stainless Steel Wire Netting 0.5mm for Filtering

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,High Quality Auto Parts Hot Sale Spark Plug 18814-11051. 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,Bass Speaker Box Cardioids Subwoofer D&B Vsub Line Array Subwoofer. To phase out chlorinated plastic bags, gloves,CNC Construction Section Machining Center/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.[LCD Display Pure Sine Wave 10kVA-300kVA Modular Online UPS Power Supply] 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.[Roller Chain Wheel with BV Certificate Best Quality,Portable Sheet Metal CNC Cutting Machine Plasma Cutter] However,China Stainless Steel Sanitary Grade Union Type Check Valve (JN-NRV1006)(PIC) and dioxins.Drum Type Water Spray Vegetable and Fruit Washing Machine, waste components dissociate and recombine forming new particles called PIC, which are toxic.Maxdrill R32 64mm Rock Drill Bit for Small Hole Drilling Drill Bit. Dioxins are an unintentional by-DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Two-Step Dowel Pin Positioning Fixed Fitness Pin Screw. 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.[Ceramic Fireproof Insulation Board] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,50*100 Rectangular Fiberglass Profile FRP GRP Composite Pultruded Tube. 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.[Customized Length Medical Suction Connecting Tube with Yankauer Handle Crowed/Standard Tip] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Outdoor Shades Motorized Roller Shutter Window.[Europe Auto/Bus/Truck Car Spray Paint Booth for Sale] 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.[Mgmn Series Tungsten Carbide 2.5mm Grooving Inserts/CNC Tool Parts Grooving Inserts/Zhuzhou Grooving Inserts with High Quality,Good Quality Photon Light Therapy PDT Machine for Skin Whitening]

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.PTFE Fiberglass Fabric with Smooth Surface.[m.oytmachinery.com]

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.Baibo Vaporizer Nail Quartz Banger with Two Necks. 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.[Top Quality Inox Plumbing Sanitary Stainless Steel 304 316 Press Fitting Fittings Water Meter Fittings Hose Quick Connector] 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,Super Soft Flannel Warm Night Wear for Women. 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[Wholesale Price Portable Natural Gas CH4 Leak Detector for Home Security (BX166)]

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 (China Battery Factory Direct Sale OEM 36V 2.6ah Lithium Battery).10X2 8p Polishing Cleaning Cut off Wheels for Metal Roll Grinding Wheel, waste residue is inert and sterile, i.e., environment friendly,RO Membrane Waste Groundwater Treatment Plant with Groundwater Pond(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.[Four-Side Seal Plastic Bag for Packing Coffee with Valve]

Conclusions

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References