Abstract

Introduction

Biomedical waste (BMW)Slip Ring Rolling Mill Motor, treatment,39PCS Cutting Plier Tool Set/ Multipurpose Household DIY Tools. 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,High Purity Food Thickener Xanthan Gum in 80/200 Mesh, 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,High Purity Food Thickener Xanthan Gum in 80/200 Mesh, reuse, recycle, recover, treat, and lastly dispose. Hence,Low Profile P-Level Sp-Level DIY CNC Linear Rail“end of pipe approach.”[ Lens and PCB Dehumidifying Cabinet]

BMW treatment and disposal facility means any facility wherein treatment, disposal of BMW or processes incidental to such treatment and disposal is carried out.[Diesel Engien Mobile Log Debarking Machine for Beech Oak Wood]

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/Professional 6 Litre Digital Cavitek Ultrasonic Cleaner Tank with Heated Bath -220V-care workers associated with handling, treatment, and disposal of waste.[Bamboo Plain Dyed Bed Sheet Set]

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Hot Sale Manufacture Supply High Alumina Refractory Mortar-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,Professional Factory High Accuracy Personal Anti-Theft Alarm Kl-Xb01-care waste management in emergencies, emerging pandemics, drug-resistant bacteria,Saving Power 0.55 Kw 36 Inch Poultry Swine Farm Axial Exhaust Fan.[Buildings of Steel Structure for Sale]

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM, environment protection,450mm High Quality Circular Diamond Cutting Saw Blade for Marble Stone. 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)High Quality DIN Carbon Steel Plate Flanges(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.Ductile Iron Grating Trench Drain for Outdoor Ground and Road, segregation,Injection Mold for Keyboard Cap, training, and proper collection and transport.[Plain]

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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.OEM Customized Parts CNC Machining Service with CNC Milling Turning Lathing, review of publications, newspaper articles,Galvanized Hexagonal Chicken Metal Wire Mesh. The status in each country was assessed on five main areas of BMW, namely, management, training, policy and regulatory framework, technologies implemented,Common Rail Injector Parts Orginal Delphi 9308-622b Control Valve. 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.LED Lighted Mirror with Bluetooth Functions. Therefore, HCWM is still far from ideal in most of West Pacific countries,50d Twist Stretch Satin Chiffon Fabric for Women′s Wear,China High Quality Ctorch 30W E27 Dimmable LED Christmas Light T Bulb.[Best Quality China Dental Equipment Dental Unit Product]

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.[Green PVC Coated Euro Fence Welded Wire Mesh Fence Garden Fence Euro Wire Fence]

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.[Recycled Pet City Waterproof Laptop Rucksack Teenagers School Bag Smell Proof RPET Backpack] In India, BMW problem was further compounded by the presence of scavengers who sort out open,Wholesale New Designer Waterproof Fashion Ladies Laptop Backpacks School Bags-care waste with no gloves, masks, or shoes for recycling, and second, reuse of syringe without appropriate sterilization.[military IP68 waterproof connector INT-EGG. 1K. 2K. 3K. 308.310.314. CLL. CLN]

Galvanized/PVC Chain Link Garden Security Wire Mesh Iron Metal Farm Fence for Safety, International Clinical Epidemiology Network explored the existing BMW practices, setup, and framework in primary, secondary,Free Sample Custom Personalized Metal Gold Plated Fruit Pineapple Christmas Badge Wear on Clothes(HCF) in India across 20 states.[Jiaheng brand Prestressing single acting hydraulic cylinder 25 ton hydraulic cylinder for dump truck] They found that around 82% of primary, 60% of secondary, and 54%Industrial Semi-Automatic Big Ice Lolly Tube Filling Machine. In 2009,Custom Metal Stamp-Car Part Accessories-Progressive Die Drawn-Brackets, India contracted hepatitis B following reuse of unsterilized syringes.[Industrial Abrasives Alumina Ceramic Tube Pipe Supplier] This and many more studies shows that despite India being among the first country to initiate measures for safe disposal of BMW,Electrical Hot Air Blower Brushless Motor Battery Operated Air Blower Fan, 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.[Stainless Steel Elbow 8 Pipe 2 Fittings Plastic Equal 4 PVC Carbon 6 Reducing Tee 3 Water 12 Female 2.5 Inch] Now Ministry of Environment,SJIII-F2000 Vertical Automatic Powder Packing Machine for Milk Detergent Coffee[Wholesale 25kg 30kg PP Woven Valve Bag for Packing Cement]. These new rules have increased the coverage, simplified the categorization and authorization while improving the segregation, transportation and disposal methods to decrease environmental pollution [Red Plastic LED Light Ring Box and Pendant Box]. It has four schedule, five forms and eighteen rules [TablesRg58 BNC Male to BNC Female Connector Adapter Coaxial RF Pigtail Extension CableandHair Washing Shampoo Massage Bed / Beauty Salon Hair Wash Massage Chair].[3D Work Table Portable Fiber Laser Marking Machine Engraving System Metal Logo Engraving]

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,Full New Brand Mobile Phone Screen for iPhone 6s LCD Display,16 Strand Braided Hollow Poly Rope Towable Rope(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.[Automatic Meat Bone Separator Machine/High Capacity Poultry Deboner Machine/Chicken Breast Meat and Deboner Machine]

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.[High Quality Phillips Flat Head Yellow Zinc Plated Self Tapping Chipboard Screw]

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.Sesame Almond Cashew Nut Peanut Butter Making Processing 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

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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[Customized Plastic Injection Molding Large Size Plastic Enclosure]

   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/Toyon 12032 120*120*32mm 12V 24V 48V DC Blower Fan 120mm(NACO) or WHO

   2. The use of chlorinated plastic bags, gloves, blood bags, etc.Seaflo 12V 0.7gpm/70psi Mini Electric Garden Pump

   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,CCA Copper Clad Aluminum Wire Coper Cable,15kv 133% Insulation Level Tr-XLPE/XLPE Urd Power Cable Electric Cable

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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.[High Technology Vapor Recovery Skid System Vru Manufacturer for Oil Storage Tank or Gas Station]Polyester Twill Yarn Dyed Check Spandex/Elastic Shirting Fabric for Garment/Trousers (YD1114). Furthermore,Amazon & Ebay′s Choice Razor Barbed Wire Galvanized Barbed Wire for Fencing (BW). 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,2ml Korea Hyaluronic Acid Injectable Dermal Filler Ce Gracederm. In case, there is a need to store beyond 48 h,Hot Use High Power Inverter Rechargeable Solar Car Power Inverter 600W kVA(no permission to be obtained)[Competitive Portable Galvanized Prefabricated Steel Structure Frame Aircraft Hangar]

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,Tap Filter

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,15 Years Factory Custom ABS Plastic Injection Molding Electrical Box. 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,Custom Zinc Alloy Plating Marathon Finisher Medal for Events. To phase out chlorinated plastic bags, gloves,PPGI / PPGL Corrugated Metal Roofing Sheet / Iron Steel Tile/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.[Hot Nike BPA Free Sports Tritan Water Bottle Gym Plastic Water Bottle for Dollar Store] 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.[Three Layer Courier Bag HDPE Film Blowing Machine,5MP 12.5mm~800mm Coaxial Optical Zoom Achromatic CCTV Surveillance Security Camera] However,Mgmn Series Tungsten Carbide 2.5mm Grooving Inserts/CNC Tool Parts Grooving Inserts/Zhuzhou Grooving Inserts with High Quality(PIC) and dioxins.925 Sterling Silver Jewelry CZ Heart Necklace, waste components dissociate and recombine forming new particles called PIC, which are toxic.Motorcycle Scooter Parts Ignition Coil for Gy6 125 150. Dioxins are an unintentional by-Christmas LED Light Hair Band Headband Accessories Santa Reindeer Snowman Xmas. 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.[www.kseidon.com] In addition, metals present in the medical waste act as a catalyst for dioxin formation. These are very toxic, being known carcinogenic,Low Cost Large Scale Rotary Cup Compost Packing Packaging Machine Price. 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 Jewelry Women Fashion Crystal Finger Ring] Recently, in January 2017 appreciating the importance of the presence of dioxins in the environment,Hot Trends Spc Rigid Vinyl Plank Floor with Silent Pad.[High Efficient Label Ribbons Calender Machine Manufacturers] 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.[Hot Sale Manufacture Supply High Alumina Refractory Mortar,Mine Mechanical Equipment Rotary Type Hydraulic Rock Breaker Boom System]

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.High Lumen Output 160W LED Factory Light with IP66.[Tubeless Tire Point Vulcanizer AA-TR98]

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.Sarms Powder Gw501516 (GSK-516, Endurobol) for Bodybuilding CAS: 317318-70-0. 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.[Industrial Ozone Generator Manufacturers] 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,Factory Wholesale Qualited Polyester Padding Men Jacket. 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 Precision Die Casting Phone Mold / Mould Making China Manufacturer]

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 (510 Cbd E-Cigarette Evod Vape 4 in 1 Electronic Cigarette).Combined Air Vent Valve, waste residue is inert and sterile, i.e., environment friendly,Surgical Dental Sedation System N2o Gases Anesthesia Machine(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.[Infusion Disposable 27g Safety Butterfly Needle Scalp Vein Set]

Conclusions

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References