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EE %Ri MedTMeecTecch Bh uEurrnopee d PFAS in the Medical Technologies Sector 1 I MedTech Europe 12December 2022 I Contents * tAebcohuntoltohgeiemhseediincdaulstry + Uses and role of PFAS in medical technologies + Substitution --availability and assessment of alternatives + Conclusions W SF = z , =SH S=f= . = _ @ - N ( yy No' > - p- LN E-- : IN HE MedTech Europe About the medical technology sector 3 ERR ER ERESS IIESaa EN About MedTech Europe The European trade association for the medical technology industry including diagnostics, medical devices and digital health. %7 MedTech Europe % from diagnosis to cure OUR MEMBERS 5 140+ multinational corporations* @w 50 medical technology associations. . SMe ime HMM In::iiiM in " About medical technology Medical technology is any technology used to save and improve lives of individuals suffering from a wide range of conditions. There are more than 500,000 products, services and solutions. cuarvraielnatbllye s 2S & 3 Toa > V4 | + Yom I} & N 3 uN -= i -----r -2 a. b LL LA A * 74) 3 > TmJ %Modlesh Supe MM In Vitro Diagnostics (vps) What are r FE e 5 A IVDs? uit r rroBran tens LL OCL ATELVkE s oars , e er es E+ xapmrpelgensanocfyItVeDssts HN ---- HIVtests + Cancer screenings + Blood type identification ++ TDBNtAesgtiengnoty&panialnysgis + Companion diagnostics | ! . Le 5 EE MedTech Eure MII Medical Devices (Ms) What are LULL obser-------- aeishet im LET ee cet R CAVAVETCL (Vg orssndione: et rev [3b A) -r A 7 17 (| ' Examples of medical devices ++ sHospuitalrtboeogdss,,miglaovtcets,artaeblslessheeset,s ++ WBhaenedlacgheasirs + surgicalrobots + Pacemakers, defbilators, stents + EApetlenisehsifp,kcneea,lelgs. + earingaids ! MedTech Europe CC _-- Complexity of the medical technologies' supply chain . MedTech Europe Uses of PFAS in medical technologies 9 L EEE EeA E IES E Where can PFAS be found in Medical Devices and IVDs? Representative examples EE Bot en EE. ELL EEE ERE EEmEm EHEemEe BEeTsE EBEE Boas BE.p F=ER % MedTech Europe What are the types of PFAS/groups thereof used (non-exhaustive list) IVD instruments & reagents PTFE FEP PCTFE ETFE PVDF FKM/FPM fluoroelastomers FFKM/FFPM perfluoroelastomers Hexafluor propanol Triflouracetic acid Triflouracetic acid anhydride Triflourmethane-sulfonic acid anhydride Triflourtoluene Methyl trifluoromethanesulfonate 11 MDs PTFE FEP Perfluoropolyether PVDF PVDF-HFP Perfluorinated acrylates (C6 - C14) Hydrophobic surface treatments - surface bound or reacted fluoropolymers of undisclosed composition PTFE coatings Specialty fluorinated lubricants FKM/FPM fluoroelastomers FFKM/FFPM perfluoroelastomers PTFE and PVDF suture materials Semifluorinated alkanes (for example 1-(Perfluorhexyl)octane and 1-(Perfluorobutyl)pentane) BE EPR@A MeEiENEiatiiii4mum---- Why PFAS -- properties & functions fulfilled by PFAS Properties such as chemical and heat resistance, lubrication and fe PFAS is either a component of the final medical device or IVD, ora processing aid used during upstream manufacturing ( PFAS substances are often key to achieving the required high -- \ performance and durabilityofthe products in the various use areas # MedTech Europe Im" What typical essential functions do PFAS fulfill in medical technologies? 1/2 Medical Devices PfTroi-- n ed e-- MedTechEurope HE ' B= EN--=------mm--m-- What typical essential functions do PFAS fulfill in medical technologies? 2/2 In Vitro Diagnostic Reagents& Instruments N _ [ER li r REeee ) CECE EEE AEREE) Heat-transfer agent in IVD PTS EE Aree testing instruments, which Pp S CRa RON instrument Ed vitrodiagnosticassays, [ i rps [ - eS rar in serum, plasma and urine Fluoropolymers like PTFE E EEL p LET analytical instruments her: Coatingonth dispense tip, tubing and | RdisL tribuT tors,EseL alsE and vaglvaessk,etOs-,risnygrsinagnedpsueamlpants MedTech Europe Substitution - availability and assessment of alternatives 15 EC _-- Challenges with alternatives to PFAS Without PFAS, these medical technologies would not be able to perform their intended purpose ) EIST Sometimes, the alternative is ar fo PES, ial that ary aerate woul av ia or sper functions. RCT EES TE El e1.h crrocivci,csarr ohehveryl same sp t rtr Whbi ri Tnedonrs tthehasnairocn:s them preferred over alternatives CINE ERTAM [LECCE IN `es uvireioccacthresothnadgaensocfpioco renwricnhedr nsvdersaraSoftYhe matoncion rainingofot geo to cri volo ow sh. % MedTech Europe -_---------rMrrfe--LETETThSEEEBEBDBDLYEBLELErrr===m Examples of applications of PFAS where alternatives are not feasible ep capoifpleraiphreryal venous catheter + Technically can be replacedwith PUR, but this may affect diagnostic performance and patient well-being. + No alternative since the main function of the device s based on this material, PGTuFiEdecworateionfgtohnetdheevigceuitdoewithreetrorePaTFtEmceomnipttoe.nent nthe catheter i esentil or the delivery of the + there is no other cass of surfactants that represent a direct replacement PE EEE E Alternatives assessment under sectoral legislation Medical technologies are invasive and/or cormeeguilnatocontact with the human body and are strictly * Medical Devices Regulation and In Vitro Diagnostic Regulation have stringent: ++ driesskimgnanagement + safety quality + performance and + alternatives validation requirements. + Manufacturers of IVD reagents and systems fluids must proceed to design change procedures under specific regulations that can take between 3 to 12 years to complete. FqouraliFfliucaotrioopnoalcycmoerrdsinign tcooem.gp.ocneerntatisn IoEfC asntaalnydtaircdasl. modules, all products would require new * Materials with contact to blood or similarcits require a minimum approval time in case of is approximatively 3 years and can further exceed this range. % Medlesh Supe Risk management under sectoral legislation Where a CMR 1A/1B and/or endocrine-disrupting substances is used, it triggers a justification procedure, which includes a risk-benefit analysis (Section 10.4 of the MDR). Most applications are medical devices that end up as clinical waste which is collected separately treated in accordance with applicable legislation (e.g. WEEE Directive) by licensed waste operators Healthcare institutions as a major user of medical devices represent a strictly regulated, professional work environment. 19 Conclusions 20 a ! y-- = a Sun = i. ET3 a L | Concluding remarks + We have been doing a survey of our uses since the summer of 2022 + tPeFcAhSnoalroeguiessed in a range of critical medical + Due to the expected broad impact of a ftuetcuhrneologiPeAs S andrestsreicrtviiocne,s cnouumlderoubse affected in parallel + PFAS often have no alternative, and where there is, it tends to be another PFAS + When considering a transition to a piomtpeonrttiaalnt tnoonc-oPnFsAiSder aplatteirneanttivwee,ll-ibteinigs asencdtotrhale lteigmiesllaitnieonand requirements under MedTechEwrope EE Thank you! | EC medtecheurope.org www.medtecheurope.org 3 i MedTech Europe