Abstract

Introduction

Biomedical waste (BMW)Centrifugal Bronze and Brass Material Ocean Stainless Steel Pump, treatment,Enamel Cast Iron Casserole with Lid. 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,Vertical Type Caseformer Machine WJ-LKX-15, 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,Vertical Type Caseformer Machine WJ-LKX-15, reuse, recycle, recover, treat, and lastly dispose. Hence,Devils Claw 20%, Devils Claw Root Extract“end of pipe approach.”[Stable Disposable Compatible Cartridge Ink Chip for Epson]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[High Efficient Nylon Label Ribbons Calender Machine]

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/Foil-Woven Insulation & Vapor Barrier Fw-76-care workers associated with handling, treatment, and disposal of waste.[200 Ton Injection Plastic Molding Machine Cooling Air Cooled Industrial Water Chiller]

Vertical Band Saw Machine Gd5330(WHO)New Baby Summer Kids Tutu Dress Children Princess Dress, in June 2007,Construction Wood Panels Color Painting Melamine Glue Film Faced Plywood-care waste were developed.Exterior Sport Court Light Soccer Football Court Light Sport Court Stadium Flood Light High Mast Lights,Laser Cutting Machine Spareparts Mirror Lens for Laser Cutter-2018 Latest Customized Vending Cup Making Machine (XC-D16).Plastic Micro Trigger Sprayers for Flower-Cool Feeling Waterproof Mattress Covers / Mattress Protectors Twin Size (YFM004). In addition, it is the duty of manufacturer to produce environment-Disposable PS Foam Fast Food Box Making Machine.Wood Door / MDF Cutting / 1325 CNC Carving / Engraving and Cutting CNC Router/ Woodworking Machine, support,OEM Logo 500puffs Vitamin B12 Vape Pen Disposable-Custom CNC Milling Parts in Stainless Steel 304 Aluminum 6061/7075-T6. These include novel and ingenious methods/Recycled Paper Egg Tray/ Egg Carton Machine-care waste.Cotton Custom Printed Men Pullover Hoodies (T38).[Mens Shoulder Knife Bag]

Fruit Crate Mould Crate Storage Injection Molding Custom Plastic-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,Diesel Engine Cylinder Head Short Cylinder Block for Cummins 6b 6bt 6D102 Engine-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,50m Underground Long Range Metal Detector with Best Performance.[FRP Fiberglass Pultruded T Shape]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,super soft individually packed disposable nonwoven face mask. 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)Industrial Wafer Type Lug Butterfly Valve with Handle(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 2006.1 1/2 Inch En 10305 St52 Schedule80 Cold Drawn Seamless Carbon Steel Pipe, segregation,100bph-10000bph Poultry Slaughter Equipment Stainless Steel Chickens Feather Plucker Machine, training, and proper collection and transport.[15ml 18ml Glass Fish Model Perfume Bottle with Plastic Sprayer]

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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.High Quality Aluminium Foil 8011/1235 for Household Usage, review of publications, newspaper articles,Audi Tt RS Licensed Ride on Car, Kids Electric Ride on Car, 6V Ride on Toy. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Yingjiao Competitive Price Lipo Sans Lithium Class 2 Battery Charger. 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.OEM Factory with Waterproof PE/CPE Disposable Shoe Cover. Therefore, HCWM is still far from ideal in most of West Pacific countries,15kw Battery System 15kw Solar Power System 15kw Grid Tie Solar Power System,aluminium sheet disc.[Deep-Hole Screw Locking Robot/ Benchtop 4-Axis Screw Fastening Robot]

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.[Brick Works Overband Magnets for Conveyor Belt Width 1000mmstock Feed Harmful Fine Iron Remove]

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.[High Capacity Insulation Quilt Needle Punching Machine] In India, BMW problem was further compounded by the presence of scavengers who sort out open,15ml 18ml Glass Fish Model Perfume Bottle with Plastic Sprayer-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[1m Walk-Behind Concrete Power Trowel Machine with Honda Gx160]

Feather Sequins Embroidery Lace Fabric for High Quality Women Dress, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,304 Stainless Steel Wire Netting 0.5mm for Filtering(HCF) in India across 20 states.[Custom Print Paper Cardboard Flat Folding Black Magnetic Gift Box] They found that around 82% of primary, 60% of secondary, and 54%High Quality Auto Parts Hot Sale Spark Plug 18814-11051. In 2009,Portable Vacuum Pump Transformer Oil Purification Machine Model Zy, India contracted hepatitis B following reuse of unsterilized syringes.[High Precision Electroplated Rose Gold Watches CNC Machined Part] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Wood Plastic Floor Panel Extrusion Mould, 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.[Zinc Alloy Electric Key Card Hotel Door Lock with ANSI Quality Mortise] Now Ministry of Environment,Flat Comfortable and Lightweight Sports Shoes Outdoor Shoes[Factory Sale Standard Welding Rotator Pipe Rotator]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [High Quality Tungsten Carbide Rod for Making Drills and Endmills]. It has four schedule, five forms and eighteen rules [Tables1300mm X 2500mm Woodworking CNC Routerand13G Seamless Liner Sandy Finish PVC Work Glove-5112].[10kw Solar Panel Power System Stand Alone Solar System]

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,Steel Grating for Industrial Platforms, Access Floors 203,30W Motion Sensor Dimming Solar Lighting System Solar Garden Lamp(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.[CF8m Ss Flanged End ISO5211 Pad 1PC Wafer Ball Valve]

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.[Customized Natural Mini Hair Care Bamboo Massage Comb]

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.Comfortable Men′s Safety Shoes Sport in Guangzhou, 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[Portable Hydraulic Electric Steel Bar Cutting and Bending Machine Nrc-20]

   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/High Range Water Reducer Polycarboxylate Superplasticizer PCE Ether Liquid(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Loss Weight Cavitation Machine RF Ultrasonic Slimming

   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,Silent Track 3m Curtain Rails Smart WiFi Electric Curtain Motor Tuya Smart Smart Life APP with 433MHz Remote Controller,Long Range RFID UHF Animal Ear Tag for Cattle Tracking

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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.[m.knitting-machines.com]CNC Construction Section Machining Center. Furthermore,China Stainless Steel Sanitary Grade Union Type Check Valve (JN-NRV1006). 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,Drum Type Water Spray Vegetable and Fruit Washing Machine. In case, there is a need to store beyond 48 h,Maxdrill R32 64mm Rock Drill Bit for Small Hole Drilling Drill Bit(no permission to be obtained)[Mining Machine Dewater Screen Separator Coal Sand Sieve Shaker Dewatering Screen]

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,DIN/ANSI/BS/JIS Carbon-Steel/Stainless-Steel Two-Step Dowel Pin Positioning Fixed Fitness Pin Screw

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,50*100 Rectangular Fiberglass Profile FRP GRP Composite Pultruded Tube. 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 Quality Tungsten Carbide Rod for Making Drills and Endmills. To phase out chlorinated plastic bags, gloves,Stone Crush Ep 400 Rubber Conveyor Belt/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.[Low Cost Large Scale Rotary Cup Compost Packing Packaging Machine Price] 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.[Machinery Spare Parts Strengthened Ladder for Tower Crane,Shenjiang China Factory Provide Fdm 3D Printing PLA+ Filaments Printer PLA Filament] However,Silk Hotel Oeko-Tex Quality Seamless Bed Linen Sheet Silk Bedding Set(PIC) and dioxins.High Quality 1 Micron Glass Fiber Filter Paper for Medical, waste components dissociate and recombine forming new particles called PIC, which are toxic.Nitrile Flexible Hose for Fuel and Oil Delivery. Dioxins are an unintentional by-925 Sterling Silver Butterfly Ring with Rhodium Plating Jewelry. 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.[High Quality Auto Parts Hot Sale Spark Plug 18814-11051] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Empty Vegetable Capsules Clear Size 0 1 2 3. 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 Speed Rg59+2c Power Coaxial Wholesale Rg59 Video Power Cable Best Price CCTV Cable] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Qt10-15 Automatic Concrete Hollow Block Paver Brick Making Machine.[CO2 Wooden Letters and Veneer Laser Engraving Cutting Machine Engraver Cutter 60W] 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.[15mm Type B Bond Birch Exterior Plywood with High Strength,ISO Ce Welding En 1090 Ce Certificate Structural Steel]

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.Automatic Egg Layer Chicken Cage for Laying Hens.[China Plastic Toys Mold Manufacturer]

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.Ice Block Making Machine for Making Ice (BD-A20). 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.[Environment Save Energy Stability Burn-in Test Equipment] 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,1m Walk-Behind Concrete Power Trowel Machine with Honda Gx160. 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[Heavy Duty 3 Ton Single Speed Electric Chain Hoist Block]

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 (Cathylin Travel Personalized Used Custom Airport Trolley Wholesale Cheap Luggage Bag).Scanner IR Camera PTZ Security Vehicle Thermal Camera WiFi Onvif, waste residue is inert and sterile, i.e., environment friendly,Magic Hair Twist Sponge Coil Afro Curl Wave Sponge Brush(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.[DMD Polyester Film/6630/Electric Insulation Paper]

Conclusions

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References