June 6, 2005

breathability and barrier resistance are key requirements in the medical sector

In the healthcare sector of the nonwovens industry, R&D efforts remain focused on improved breathability, wearer comfort and increased barrier resistance for a variety of applications in both commodity and specialty markets. Meanwhile, despite ongoing technological innovation, the message from the healthcare market is clear: costs must be cut.

In response to this dilemma, some companies have adopted a broad, long-term approach to healthcare costs. “Cost reduction efforts may not mean that nonwovens manufacturers will offer cheaper products,” explained Paul Farren, vice president and general manager of nonwovens for Georgia-Pacific. “Ultimately there are many cost factors involved, whether they relate to labor, energy or the environment.”

Other companies are also seeing strong pressure from the market to control costs. For its part, roll goods giant BBA Fiberweb expects an increase in acceptance and demand for nonwovens and a continuation of the push to drive costs down. “Nonwovens have proven themselves as more cost effective than traditional fabrics for a number of reasons,” opined Betty McVey, director of BBA’s medical business, “but now we need to focus on how we can optimize the use of nonwovens in different applications.”

Looking ahead, she predicted more opportunities for nonwovens. “We will see growth in Europe and Asia, which are really still in their infancy stages. In the U.S., the question is how to utilize new technologies in existing nonwoven products to make them more effective and cost-efficient while finding new applications,” she said.

Ms. McVey referred to the recent effect of the Association of the Advancement of Medical Instrumentation (AAMI) standards as an opportunity for BBA to upgrade its products and offer higher levels of protection than before. “While in the past, some customers had been buying lower end spunbond products from China, these standards have led customers to rethink this decision. However, the medical market remains a challenging market where there is continuing pressure from the healthcare industry to keep costs down,” she added.

Another response to cost concerns in the healthcare arena has been an increased use of spunbond nonwovens in certain disposable apparel applications. With its recent launch of MediSoft at IDEA04, N. Charleston, SC-based PGI is one roll goods producer leading the shift toward spunmelt fabrics. A blend of spunmelt and spunlace properties, MediSoft is a proprietary spunmelt product enhanced with softness and breathability. Produced at the company’s facility in Nanhai, China, the product is offered in the U.S. and Asia and targets disposable apparel applications such as gowns and facemasks.

The new MediSoft fabrics exhibit a 50% increase in softness compared to standard spunmelt fabrics used in medical applications, according to the company’s internal test results. The new fabrics also exceed industry standards for protection against fluids for their targeted class of applications. MediSoft fabrics exceed the AAMI gown and drape industry standard (PB70) for Level III garments of 50 centimeters in hydroheads, a measurement of barrier properties, according to test results.

“There has been a shift in this market to spunmelt,” commented Dennis Norman, vice president strategic planning and communications for PGI. “The focus on controlling costs has led to an increase in the use of spunmelt fabrics because they offer better barrier properties on a more economical basis,” he suggested.

Wilmington, DE-based DuPont has also introduced a new spunmelt-based proprietary medical fabric as part of a new family of medical fabrics. DuPont Acturel is made of three layers—including a polyester nonwoven inner layer, DuPont Hytrel as a breathable membrane layer and spunbonded polypropylene as an outer layer. The first two layers are formed by an extrusion coating process, and the final outer layer is attached to the layer of Hytrel by an adhesive lamination process.

Texel’s nonwoven Bathfelt product competes against reusable wash cloths.
DuPont Acturel was designed for high-fluid, long-duration procedures that pose special challenges, including heat, moisture and increased stress. The company calls its breathable, impervious barrier “smart,” able to adjust to the body temperature over time to maximize comfort. The fabric has been available on a limited basis for about two years.

Also new from DuPont is Suprel, the first in a series of next generation fabrics supported by more than 20 new manufacturing patents. The new fabric combines a high level of protection and the ability to glide easily without catching or grabbing. It transfers heat away from the body quickly, adding to comfort in the O.R. DuPont Suprel fabric is based on DuPont Nonwovens Advanced Composite Technology (ACT), which uses a bi-component polyester/polyethylene formulation. Suprel single-use O.R. gowns are available from Medline Industries.

In another update to its medical fabrics business, DuPont has renamed its Sontara brand Softesse. The fabric represents the newest generation of DuPont’s spunlaced technology. Softesse is designed to provide acceptable barrier protection against liquid penetration as well as breathability.

In the spunbond area, a new product for medical applications has been unveiled by BBA. In conjunction with Dow Chemical, the company has launched Advanced Design Concepts (ADC), a joint venture for the development of proprietary technologies using elastic nonwovens for a number of applications. Areas with potential include medical applications such as surgical gowns and other surgical apparel.

Based on core/sheath technology, these spunbond products offer improved form and fit and use elastic nonwovens in a cost-effective way. The thermoplastic urethane and polypropylene-based products are created through a single production step without blending multiple materials as in the past. “Although ADC is in the very early stages of its launch, we have received extremely positive feedback so far,” offered Ms. McVey of BBA.

Saudi Arabia-based roll goods producer Advanced Fabrics (SAAF) has also experienced the shift toward spunmelt in medical applications. “Increasing barrier performance requirements for medical fabrics will increase the move to spunmelt,” commented Ian Disley, SAAF general manager. “We are seeing this happen, at different rates, in all the markets we are involved in worldwide.” He added that SAAF has designed fabrics to meet the new proposed FDA standards for Level I, II and III gowns at economic price and weight points. “Medalon fabric continues to penetrate the market for top end surgical gowns with high hydrohead, antistatic and alcohol repellency characteristics. A provisional patent has been filed for an SMS fabric with inherent antimicrobial characteristics,” he added.

Wisconsin-based medical products converter Triad Group has taken note of the popularity of spunbond nonwovens in the wiping segment. “We see a lot of spunbonded substrates in this market and not a lot of airlaid,” observed Ron Pontililo, director of contract manufacturing sales. Triad often uses a similar substrate for its wiping products, although it uses a variety of nonwovens technologies. “We do not use one particular nonwovens technology; we really run the gamut. The last four products we introduced were made through different technologies and all came from different suppliers,” he said.

Mr. Pontililo described 2004 as a record R&D year for Triad. The company has introduced an unprecedented number of new products and many are still in the pipeline. “We have a half dozen or so new topical patient/consumer care wipe products coming out. We will launch two or three before the end of 2004, with the balance slated to be introduced in the first quarter of 2005,” he said.

Triad’s wiping products are used in hospitals, physicians’ clinics and long-term care facilities, but some of these products cross into the consumer care sector and are offered in the mass pharmacy market. Triad offers private label products to marketers as well as to store chains. Its medical division drives the company’s consumer care business.

Counting On Composites
Another key approach for manufacturers is the use of composites to meet the varied performance demands often required of medical products. For roll goods producer Ahlstrom, such efforts are evident in the introduction of a variety of nonwoven composite products leveraging the company’s broad nonwoven portfolio with customers’ requirements of a balance between barrier, comfort and cost. “These products are currently in use as premium gowns, drapes and in auxiliary applications where these performance criteria are valued by the end user,” said Paul Marold, Jr., vice president and general manager, medical products for Ahlstrom’s FiberComposites division.

Another company benefiting from the use of composites for healthcare uses is Techni-Met, Windsor, CT. The company produces thin film coatings for nonwoven materials in medical product applications. It custom designs functional physical, electrical and chemical coatings to provide barrier, shielding, conductive, protective and reflective properties. The coated and metallized flexible materials offer potential medical application opportunities in barrier packaging, filters and screens, conductive and reflective fabrics, EMI interference shielding, charge dissipation and barrier protection materials for electronic applications, antimicrobial fabrics, wound dressing materials and other biomedical products.

Techni-Met’s vacuum-sputtered depositions are produced on a broad range of flexible substrates in widths from 6 to 62 inches and gauges .25 to 20 mils including nonwovens and polymeric films. Its precision single and multiple-layer functional thin film coatings include precious and non-magnetic metals and alloys, chemicals and compound coatings. They can be deposited onto flexible polymeric substrates, nonwovens and other materials, which can either be utilized as a stand-alone product or part of an end-use laminated or composite structure.  

According to the company’s director of corporate development Charles Regul, the products are ideal for technology-driven applications. “The functional performance characteristics from thin film coatings can allow thinner, lighter and less costly materials to be used and eliminate the need for expensive, alternative materials or laminations. The coated polymeric substrates, too, can be used in slit form, in laminates with other substrate materials and as composites, depending upon end use applications and functional performance requirements,” he said.

“In the medical industry, particularly, there are many new applications in development that will effectively utilize flexible thin, film-coated products, as well as existing applications for which thin film depositions can be utilized either for performance properties or as effective alternatives to other coatings,” said Mr. Regul. Possible applications are: antimicrobial packaging, multi-layer antibacterial films, barrier-protected nonwovens, antimicrobial coated wound dressing materials, drug-eluting coatings, polymeric matrix and transdermal medication materials.

Also in the area of composites, Totowa, NJ-based Precision Custom Coatings offers a new product designed to meet the unique requirements of the medical market. The company has introduced a needlepunched product laminated with a polyurethane barrier film for use in reusable bed pad applications.

The new product is chlorine bleach resistant and can be washed multiple times. “We have been involved in lamination for some time,” explained Shaile Dusaj, director of industrial sales and marketing for PCC, “but our new focus on odor absorption and chlorine resistant products as an extension of our portfolio. These innovations are being driven in part by concerns over costs. Laminated film products are lighter, and therefore less costly, to wash than the vinyl composites that currently dominate the U.S. market. Our new laminated product offers performance and cost advantages over the product’s lifetime.”

PCC is also in the process of introducing absorbents for incontinence pad applications featuring improved odor absorption capabilities in addition to the absorption of fluids. The needlepunched nonwoven products are made from a blend of different fibers and are sold on the market in roll good form to converters targeting hospitals and institutions.

New Needlepunch Niches
Another innovation in the needlepunch area comes from Canadian absorbent roll goods producer Texel. In the disposables area, Texel sells needlepunch felts for band-aid applications to customers such as Johnson & Johnson. As for durables, the company sells bed pads, soaker pads and adult diapers.

One emerging market for Texel is its Bathfelt needlepunched product, which features eight no-linting wipes for post-operative use. Each wipe is used to clean a different part of the patient’s body, which avoids cross-contamination. The wipes are treated with an antibacterial soap and require no rinsing. The lofty needlepunch fabric lends the product a washcloth feel. “Spunlace fabrics try to compete in this area, but more solution can be loaded into a needlepunched wipe than a spunlaced wipe for this type of application,” explained Jeff Girard, Texel’s product manager for wipes and absorbents. “They save time and money for hospitals, which is a concern for U.S. hospitals since they are run like companies. This is not necessarily the case in other parts of the world.”

According to Mr. Girard, the market in the U.S. for disposable bathing wipes is $70-80 million in hospitals alone and is projected to grow to a $300 million market. By 2008, Texel predicts that the peak of the baby boom generation will reach age 75 and more elderly parents will require these products in home settings and nursing homes.

“To get users to switch from a reusable washcloth to this type of product is a matter of changing habits,” commented Mr. Girard. “There is also a security factor. With a traditional washing system, soap has to be diluted in a specific amount. If there are mistakes, patients’ skin can be burned.” He predicted that Europe will be an easier market for Bathfelt to penetrate because of the high price of water. “People don’t have the same bathing habits in Europe as they do in North America because they consider the cost of water before they bathe. The wipe culture in Europe is more developed than the U.S., but there is little differentiation. Most wiping products are the same with a different package and name. We see potential here, but you need to manufacture there otherwise the transportation costs are prohibitive,” he said.

Now sold as an institutional catalog product, Bathfelt has not yet made an impact on the retail market but is expected to do so once the homecare market opens. “This product will take off. It will be sold on the mass market in private label and branded versions,” Mr. Girard stated. He added that there are no big players offering a similar product yet, but he expects this to change. “When it does,” he said, ”the level of competition and the playing field will change completely.”

Currently the dominant player in the disposable bathing wipe market is Sage Products, a producer that is integrated as both a roll goods producer and converter. The company reportedly holds approximately 70% of the $70 million market. “Our strategy has been to create alliances with converters and associate Texel and other names with the product,” explained Mr. Girard. “We are underway with an aggressive marketing push. At the end of the day, marketing will win the war.”

Mr. Girard stressed that Bathfelt is more economical than a washcloth, lowering the cost of laundry services and saving caregivers’ time as patients can be washed more quickly. “However, the union may look at this as a disadvantage,” he pointed out. “We are not facing it now in the U.S, but we are facing this type of mentality in Canada. A product may make sense but external factors may play a role in its ultimate success. Some people will never switch to it because of such issues. Economy and safety may be positives, but they aren’t the only factors, no matter how much sense a product makes,” he said.

Making The Switch
Not surprisingly, most manufacturers described the trend toward disposable nonwoven medical fabrics—and away from reusable products—as one that has already happened in North America, although companies are enjoying continuing growth in Europe and other parts of the world. “All the discussions we have had with customers would indicate that the trend away from reusable and toward disposable fabrics is growing,” commented Mr. Disley of SAAF, “and more so outside of North America as presently penetration of nonwovens is lower but growing.”

According to Miray Pereira, global business manager for DuPont Medical Packaging, FDA guidelines are helping this trend along. “The single-use trend in medical devices is growing and recent FDA regulations on reprocessors of single-use devices is expected to increase the trend.”

“Europe is continuing to transition from reusables to single-use products,” said Ahlstrom FiberComposites’ Mr. Marold. “We are finding this to be mostly due to the balance of performance and cost of single-use nonwoven products versus linens. As we continue to promote the benefits of an engineered nonwoven fabric, the European clinicians are recognizing the need for improved material performance without a loss of comfort. Of course, the challenge for nonwovens producers is to be able to achieve both of these requirements economically,” he said.

PGI’s Mr. Norman cited more nonwovens displacing traditional fabrics on the garment side. “In the woven gauze area, for example, the growth rate has slowed because they were replaced by nonwovens many years ago. We manage our medical business globally and this is true worldwide. There is definitely more converting demand going to Asia and there continues to be roll goods demand in developed regions,” he offered. Mr. Norman added that PGI is seeing higher penetration levels in Korea and Japan as well as growth in disposable nonwovens in Europe. “The U.S. market has been highly penetrated for a while now,” he suggested.

According to Georgia-Pacific, continued displacement of traditional fabrics is happening along with product differentiation. “In the U.S. the nonwoven washcloth market is pretty well penetrated; however, there are still hospitals that are using traditional washcloths and soap,” stated G-P’s Mr. Farren. “We are seeing continued growth even in penetrated areas because producers are differentiating products by adding new features and working to lower costs. In the U.S., we are seeing both growth from displacing traditional materials as well as growth from product differentiation. Wipers are also a well-penetrated area, but there are still institutions and hospitals that are behind the times. This means that there are good opportunities for continued market growth as more government regulations are passed and consumers’ expectations grow,” he said.

“There is a continued trend away from reusable products and this is a viable market segment for nonwovens,” Mr. Farren continued. ”The healthcare industry is looking for disposable products because they are more hygienic. By controlling bacteria, they can reduce costs ultimately. Individual application means less risk of cross contamination, which is a concern in this industry.

“In North America, we have already seen a shift to nonwovens from traditional textiles,” concurred BBA’s Ms. McVey, “but we are seeing a change in thought from reusables to nonwovens in Europe. In some areas this shift is slow, but it is happening.”

From the perspective of Triad’s Mr. Pontililo, nonwovens have not yet scratched the surface in terms of their displacement of other fabrics. “There are still many areas where nonwovens can replace other materials. This is true in patient care, but it is also true in the medical cleaning market. For instance, a treated nonwoven can replace spray bottles in industrial and institutional cleaning applications,” he said. Another potential area for growth is nonwoven cleanwipes, which could be used to sterilize. “There is definitely an opportunity for nonwovens in cleaning applications such as products treated with disinfectant surface cleaners,” he said.

Unlike some industries—such as baby diapers or filtration—where the consumer drives technological innovation, here the onus is on converters and manufacturers to offer a better, cheaper product. “Facilities generally rely on companies to supply them with cleaning systems, which traditionally have centered on alcohol and bleach,” offered Mr. Pontililo. These facilities look to the industry for cost-savings and efficacy. “They look to us to be innovators. We get cleaning down to a science by doing a good job and cutting costs. If you can substantiate that claim, you will be the vendor.”

Sizing Up The Market
When it comes to sales—despite concerns over price pressure and competition—the medical market continues to experience slow but steady growth at about 2.6-3% per year in North America, according to INDA, Association of the Nonwoven Fabrics Industry, Cary, NC. INDA forecasts North American sales to end users (hospitals, clinics, etc.) at $1.4 billion in 2004. This figure includes disposable surgical apparel, drapes, caps, masks, shoe covers, other related apparel, bandages, sponges and wipes. These disposable medical markets will consume approximately 1.9 billion square meters of nonwoven materials with a value close to $320 million, INDA reports. These North American consumption figures include imports of converted products but do not include medical exports of disposable products.

That said, the medical market is predominantly mature with high penetration levels. Surgical drapes made of nonwovens have about a 90-95% marketshare in the U.S. medical market and somewhat lower in Canada, according to INDA. Nonwoven surgical gowns represent about 80-85% of the total and are engaged in a tough battle from the reusable gown industry.  

“While the number of surgical procedures is rising about 5-7% per year, the growth is not reflected in the volume of disposable surgical gowns and drapes, which have been rising 2-3% per year,” commented Ian Butler, director of market research and statistics at INDA. “The reason for the disparity is that many surgical procedures are not as invasive and a growing number of procedures are performed outside the traditional hospital surgical room,” he said.

Like many issues in the nonwovens industry, just which medical product segments are experiencing growth is a matter of perspective. According to Ahlstrom FiberComposites’ Mr. Marold, the company has experienced growth in most of its segments, although drape and gown applications are growing much more quickly than sterilization wrap. “There was a huge surge in facemask demand during the SARS crisis but that has since subsided and sales of these products are more in line with conventional growth rates. We are finding growth of drape and gown applications in Europe to be much greater than those in North America where these applications are already predominantly nonwoven.”

From PCC’s perspective, the bed pad sector is plagued with competition from lower-priced products out of China. “Lower end finished goods are being sold in the U.S. as one-time use bed pads,” said the company’s Mr. Dusaj. “The quality and cost of manufacturing these products is lower. We compete against this by targeting customers who are specifically interested in reusable products because of their environmental and long-term cost advantages. There is a mentality out there that reusable is better, but we do still need to reiterate this to new customers and in our advertising so that people understand the advantages of reusable—as opposed to use-and-throw-away—products. The U.S. lags Europe when it comes to environmental awareness.” Mr. Dusaj added that tough competition in the marketplace is exacerbated by the fact that companies are being forced to pay higher raw material costs that are not easy to pass on to customers.

Also reporting negative trends in the bed and soaker pad area is Texel, which is phasing out its efforts in this segment as part of a strategy to concentrate on value-added, niche areas. “We have to do this as a small company,” explained Mr. Girard. He described the market as mature with price wars that have moved the business to China. According to Texel, roll goods as well as finished products are being manufactured in China. Mr. Girard referred to soaker pads as a multimillion-dollar business that now has products selling for 50% of the price from two years ago.

“We saw this coming,” he added. “There are no longer requests for quality. Specifications aren’t tight anymore. It’s now purely a commodity market where contracts are won on the Internet. The lowest price wins. Period. We used to say that the products from China were coming. Well, now they have arrived and they are just copies of what we have here. It’s not rocket science. They can sell the finished product for half the price of the needlepunch in it. We are fighting like crazy just to stay in this market one more year,” he said.

Texel has not yet seen significant competition from China in the area of wound care, according to Mr. Girard. “Here roll goods need to be very clean. The buzz now is that you can add coatings with antibacterial agents and other additives. It used to just be one felt that was used. Now there is segmentation; we see different coatings being used and different felts for wound care,” he said.

Future Challenges
In addition to growth, industry experts foresee several sizable obstacles ahead for the medical market. One such challenge, according to G-P’s Mr. Farren, is dispersability in washcloths and other products. “Healthcare workers like disposable products because they are hygienic, but they need to be disposed of. Here’s where dispersability is an obstacle. At G-P, we are working on it and have a patent on this type of dispersable product,” he said.

Mr. Farren described dispersability as an issue of technology, but one that won’t require a new nonwovens technology. “There are a lot of ways to come at dispersability and there are certain price and cost factors associated with it. The question is whether people will pay more for this kind of convenience and improved hygiene.” He added that G-P is working out cost issues and has found ways dispersability can be created. Looking forward, Mr. Farren believes the companies that can achieve dispersability will have a major opportunity for growth.

According to Mr. Farren, currently there are smaller sized wipers being used in hospitals and nursing homes that are making it through the pipes after being flushed. Such wipers are flushable, but are not necessarily dispersible and are not the easiest size for healthcare providers to work with. The key, he said, is to create dispersability in large-sized wipers. “Size and dispersability will be the winning combination. The market demands ease of use and disposal. Disposing of the product should not be a problem.”

Mr. Marold of Ahlstrom pointed to comfort as a future challenge for nonwovens in medical applications. “The medical consumer is becoming more aware of the risks they are exposed to in their daily activities,” he explained. “At the same time, there is a high desire to be comfortable when performing their activities in order to maintain their stamina and concentration on the task at hand—healing. As such, Ahlstrom has invested in the ability to produce a variety of nonwovens and then engineer products that promote protection yet are comfortable for extended surgeries. These products have been successfully introduced in North America, and we are starting to see some very keen interest in Europe and Asia,” stated Mr. Marold.

For Triad, foreign competition represents a significant obstacle for medical nonwovens. “Foreign markets are affecting our business. We try to keep a strong eye on foreign competition because it is a prime concern as we develop new products,” said Mr. Pontililo. “Competition is coming from the Pacific-Rim, specifically there are a lot of Korean products out there. There was a time when roll goods were coming out of this area, now we are seeing converted goods as well,” he said. “In the medical market, quality is still an issue, so domestic converters have an advantage there. But in the household area, the quality issue does not have as significant an impact.”

Streamlining the value chain is the key challenge that lies ahead, according to BBA’s Ms. McVey. “ In the medical nonwovens arena, North America is the strongest market and there are a lot of producers here. Most competition comes from other North American roll goods producers. What we are seeing is more products being shipped overseas and treated, converted or packaged and then shipped back. The key question today is ‘how can we streamline this value chain?’ The needs of U.S. customers are different than those of European or even Asian customers. Moving forward, the challenge we face is whether we can manage this globally or will it remain regional? Five years from now, I predict that we will be looking at a very different landscape,” she said.

“The push to keep costs down will continue and to respond to this pressure, producers will need to form stronger partnerships and allegiances to get this done,” Ms. McVey continued. “It’s not an every man for himself philosophy anymore. How can we team up to open new markets and keep costs down? We see resin and roll goods producers partnering, now we need to get the medical end product manufacturer involved to generate the best solutions. This does not happen enough. We still have a supplier/customer mentality, but we’ll see more partnerships moving ahead.”

For the future, hospital-acquired infection is expected to be another area of substantial concern for employees, patients and visitors. Greater awareness of protection for both patients and healthcare providers and the recognition of the cost of cross-infection within healthcare establishments is driving the industry to develop higher quality fabrics to address these issues. “The argument about the direct cost of laundering versus disposables becomes minor against the cost of cross-infection,” opined SAAF’s Mr. Disley.

“While we are not certain that the SARS effect has passed, it certainly has not reached the concern levels of 2002,” said Ahlstrom’s Mr. Marold. “However, today there is an even stronger awareness of the risks of ‘superbugs’ and the need to protect caregivers from these. Most recently, the avian flu is afflicting Europe, North America and Asia, creating a concern over clinician protection. Hopefully, through the use of single-use nonwoven fabrics, these types of viruses won’t spread at the same level as SARS did.”


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