1 Advancement of Medical Nonwovens Seminar on Medical Textiles Opportunities & Applications 6 th September 2008 Madurai Organized by: Ministry of Textiles Govt. of India. Presented by: Ajay Sahni Senior Business Development Manager Ahlstrom Fibercomposites India Pvt Ltd.

2 Ahlstrom overview Headquarters in Helsinki, Finland Global network of fiber specialists serving niche markets worldwide Group net sales in 2007 of approximately EUR 1.8 billion 5700 employees worldwide Home

3 The biggest name in fiber-based specialty materials. The widest range of cost-effective solutions. The longest track record in the industry. We are the world leader. Home

4 Our knowledge benefits many sectors Healthcare Environment Automotive Packaging Homes Offices

5 Ahlstrom’s global network of operations Ahlstrom Research Corporate Center France Belgium Korea Brazil Netherlands China Norway Estonia Poland Finland Russia France Spain Germany Sweden Great Britain USA Italy Finland Russia Australia Japan BelgiumKorea Brazil Russia China Singapore FinlandSouth Africa Great BritainSpain Germany IndiaTaiwan Indonesia Thailand ItalyUSA Sales offices Production units Head office Finland International office France Affiliated production units USA Joint venture production units

6 OVERVIEW Global leader in medical nonwovens globally Broadest technology offering of any Nonwoven producer Research focus on fiber management & web formation Customer satisfaction survey rated #1 in quality & service

7 Drapes Gowns Sterile Barrier Systems Face mask cover stock Medical applications

8 Ahlstrom Invests in INDIA Ahlstrom, a global leader in high performance fiber-based materials will invest EUR 38 million in a new medical nonwovens plant utilizing spunmelt technology in India. The investment is in line with Ahlstrom's strategy to grow in the fast growing emerging markets.The new plant will manufacture a full range of spunmelt fabrics with a main focus on the medical fabrics & hygiene. The new facility, using state of the art nonwovens technology, will be located in the Mundra Special Economic Zone (SEZ) in the western state of The plant will start its production in last quarter of 2009.

9 Why Nonwovens ? Need for Infection Control !! ± 1800 : about 60% of the patients died of hospital fever ± 1867 : Lister was one of the first who acknowledged cross-infections, aseptic technique. Reduced morbidity to 1.5% Today, we are still talking about infection control. Cost of Hospital Infection in England alone is 1 Billion pounds and 5000 deaths. Advent of super bugs such as Avian Flu, AIDS, Hepatitis makes infection control a high priority.

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11 Why Nonwovens ? Need for Infection Control !! Use of disposable nonwoven medical fabrics plays an important role in reducing hospital infections. A study by Moylan indicated that single-use nonwoven products reduced infection by 2.5X compared to traditional textiles. A study by Werner showed that 56% of reusable textiles had significant defects that could sacrifice their performance

12. High barrier/Protection Traditional textiles are typically absorbent. Nonwoven fabrics are engineered to have high barrier. Re-usable textiles can develop tears and holes during the washing process. Why Nonwovens ? Need for Infection Control !!

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16 Low Linting. Lint is a source of infection since bacteria can use it as a carrier Re-usable generate lot of lint during washing process. Nonwoven fabrics typically have low lint Why Nonwovens ? Need for Infection Control !!

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18 Proven Sterilization Performance Nonwovens are compatible with multiple sterilization methods such as steam, ETO,gamma (depending on composition) Why Nonwovens ? Need for Infection Control !!

19 Comfort/Conformability Comfort critical for gowns Nonwovens have good breathability Conformability imp. for drapes Nonwovens are flexible/soft Why Nonwovens ? Need for Infection Control !!

20 Single Use and Economical Various studies indicate that when total costs are calculated single-use fabrics are generally lower cost than re-usables. Why Nonwovens ? Need for Infection Control !!

21 Meets New Regulatory Standards AAMI PB 70/CEN standards for drapes and gowns EN and EN for sterilization wraps Additional standards for face mask and protective clothing Why Nonwovens ? Need for Infection Control !!

22 AAMI Classification System LevelTestResult 1AATCC 42 Water Impact (WI) < 4.5 g 2AATCC 42, WI AATCC 127 Hydro Head (HH) < 1.0 g > 20 cm 3AATCC 42, WI AATCC 127, HH < 1.0 g > 50 cm 4ASTM F1671, Gowns ASTM F1670, Drapes Pass Least Protective Most Protective There are four levels of barrier performance, level 4 being the highest protection available AAMI - Association for the Advancement of Medical Instrumentation

23 General relationships between barrier performance and anticipated exposure risks ANSI/AAMI PB70 Barrier Performance Fluid AmountFluid Spray or Splash Pressure on Gown or Drape Examples of Procedures with Anticipated Exposure Risks Level 1Minimal Simple/excisional biopsies Excision of “lumps and bumps” Opthalmological procedures Simple eye, nose, and throat (ENT) procedures Level 2Low Tonsillectomies and adenoidectomies Endoscopic gastrointestinal procedures Simple orthopedic procedures with tourniquets Open hernia repair Minimally invasive surgery Interventional radiology/catheter lab procedures L:evel 3Moderate Mastectomies Arthroscopic orthopedic procedures Endoscopic urological procedures(e.g., transurethral prostate resections) Open gastrointestinal and genito- urinary procedures Anticipated Risk of Exposure

24 General relationships between barrier performance and anticipated exposure risks (cont.) ANSI/AAMI PB70 Barrier Performance Fluid AmountFluid Spray or Splash Pressure on Gown or Drape Examples of Procedures with Anticipated Exposure Risks Level 4High Any procedure in which te surgeon’s hands and arms are in a body cavity. Orthopedic procedures without a tourniquet Open cardiovascular/thoracic procedures Trauma procedures Caesarean sections Anticipated Risk of Exposure

25 Good protection level for cost Different fabrics for the AAMI levels 1-4 (US Regulations) Product offering that meets Regulations & 2 FDA PB-70 Standard Surgical Gown Market Spunlace; Wetlaid; Spunbond Ahlstrom SMS Ahlstrom BVB; Film re-inforced

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27 What do we do till standards come in India ? Do Hospitals need to put specifications for procurement ?

28 Indian Market Trends Single-use disposables have started getting recognized. Face mask, head covers and shoe covers primarily disposable. Private hospitals are beginning to use disposable drapes and gowns Spunbond is widely used which provides little barrier for most applications No standards for medical disposables; Quality is poor

29 Conclusions Significant Marketing & Education effort needed to increase awareness Single-use / Disposable pricing is a key factor in decision making Indian Medical market provides an excellent opportunity for growth due to its large population, increasing affluence and a good healthcare system.