< PreviousWritten by Pauline Müller for the industry. Last year, research pointed toward a global medical equipment market value exceeding $600 billion, with the sector following a steady compound annual growth rate of just over seven percent over the past six years. Current estimates indicate an average one percent climb in this number—possibly resulting in an overall international market value of more than $300 billion developing over the next three to four years. Word is that in-vitro diagnostics equip- ment is set to outshine other market divisions, with its earning potential positioned at over $58 billion by as soon as 2027, while disposable-and- consumable sales are expected to earn well over double that amount over the same period. Experts ascribe this rigorous expansion to the improving economies of countries with new, emerging healthcare markets coupled with an overall boom in the healthcare industry across established, thriving economies. Currently, some of the United States’ most notable contribu- tors in medical equipment supply include Thermo Fisher Scientific in Waltham, Massachusetts; Becton, Dickinson and Company based in Franklin Lakes, New Jersey; PerkinElmer, Inc. also in Waltham, Massachusetts; conglomerate Danaher Corporation headquartered In Washington, D.C.; and Waters Corporation in Milford, Massachusetts, amongst others. In a time where antibiotic resistance and other looming medical quan- daries are driving innovation in an ever-growing industry committed to saving lives, growing the manufacturing of laboratory and hospital equipment, pharmaceuticals, and medical devices on North American soil is imperative to national safety. To this end, the United States’ medical equipment industry alone is rearing to expand to nearly $75 billion over the next four years—predict- ed to be the largest single market of this kind in the world. Mainly driven by increased life expec- tancy and lifestyle- and environment- related long-term health issues, robust market growth is anticipated globally 11 MANUFACTURING IN FOCUS Pharmaceuticals have been a greater challenge, however. In 2020, medicine shortages were described as “unacceptable” by many. Despite significant efforts to secure pharmaceutical supplies locally, the end of last year still saw truly chilling figures doing the rounds online alongside claims that China and India supply North America with nearly all of its antibiotics. Some reports claim that even medicines manufactured locally rely heavily on active ingredients from abroad. Although closer scrutiny bore no reliable sources for the claims, the Food and Drug Administration’s available medi- cines website page still reflects a concerning list of “currently in shortage” tabs. Though the question concerning how much medicine America imports remains without a clear, endorsed answer for now, the recent supply chain issues that we saw globally appear to suggest prudence and to err on the side of higher guesstimates when approaching the matter. Right now, that is enough reason to continue the drive for medical independence. Due to these shortages, some medicine prices hit the roof since supply chain issues started in what appears to be a supply and demand battle of sorts. In a piece exploring why this is happening, stats. com reported in October 2022 that fludarabine, a well- known chemotherapy treatment in the United States, had been readily available at just over $100 before the shortages but started selling for over $2000 wholesale in some cases as supply challenges continued. To illustrate, the current going retail rate for this specific drug is approximately $119 for 25 mg/mL depending on where people buy, according to drugs.com. The good news is that, to remedy the entire situation, the American Made Pharmaceuticals Act (S. 3991 and H.R. 7400) was introduced into U.S. Congress earlier this year, requiring The Centers for Medicare & Medicaid Services to prioritize locally produced medicines over imported ones as set out by the Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Time will tell how soon—or whether—prices return to pre-shortage rates. In a detailed report in February, IBISWorld noted California as the largest manufacturer of medical devices with just under 230 such companies calling the state home. California’s industry dominance is followed by Massachusetts and Florida, with just under eighty manufacturers of medical devices in each state. As it happens, Miami, Florida is also home to FIME, the Florida International Medical Expo taking place from 21 to 23 June of this year. With over 1000 exhibitors and more than 11,000 industry professionals from around the world, the event brings JUNE 2023 12cutting-edge medical equipment and technology to end users across the continent and beyond. While there are many smaller, growing players in the medical device industry, the USA’s main contributors remain constant. Toward the end of last year, Medtronic was the leader, with a market value of nearly $32 billion, followed by Johnson & Johnson MedTech and Siemens Healthineers. With a consis- tent one percent annual growth rate since 2018, according to recent reports, overall growth in the medical device fabrication industry alone is increasingly becoming a considerable con- tributor to North America’s gross domestic product. Following the lessons learned from the COVID-19 pandemic, the national drive to improve medical resource security in light of Asian market dominance grew more urgent alongside the nearly ninety percent of American personal protective equipment imported at the height of the crisis. As a result of much work invested to remedy the situation, as well as this specific industry being heavily reliant on human labour, staff appointments have increased with over one percent con- secutive growth per annum since 2018, with indicators reflecting close to 281,000 individuals currently employed in the medical device fabricating industry overall. Its median employment rate is just under 20 people per business in the United States alone. In addition, research suggests that the number of new opera- tors in the industry has increased by around one percent over the past five years. As many in the industry may know, plans are underway to solve the fabrication labour deficit with initiatives such as free training like the ACE program offered to machinists and other aspiring artisans by America’s Cutting Edge and others. As an industry that prides itself on its efforts to establish and prolong human wellness, setting up and retaining more manufacturers—and in the process, providing employment— appears to have become a legitimate part of the medical indus- try’s mandate across North America. Toward the end of last year, Deloitte estimated that the U.S. established 25 percent more positions compared to the previous year, with around 350,000 new jobs, thanks to reshoring manufacturing in general. To successfully re-shore manufacturing, those in the know rec- ommend that considering the demands of its bill of materials (BOM), or detailed manufacturing outline, should be every manufacturer's deciding factor in ascertaining the best way to secure steady and reliable supply chains, coupled with calcu- lating whether the cost of available supplies would outweigh the value of having improved control over distribution. Other challenges can include red tape—but often for the greater good. Because while Food and Drug Administration control, for instance, may slow some processes for manufacturers in this industry, putting in the work means that the general public remains protected—which, after all, remains the main aim of the entire mission. Designed by Ashley DowlingContact with moving machine parts, slips and falls, chemical burns, falling objects, fatigue, overexertion, and vehicles are just a few causes of workplace injuries. Fortunately, technology and smart factories can make manufacturing far safer… 14 JUNE 2023Written by Robert Hoshowsky The macabre fascinates us, and no television show embodied our dark curiosity about acci- dents, illness, and reckless, life-end- ing antics more than the aptly-titled 1000 Ways to Die. Even today, over a decade after the docufiction anthol- ogy series ended its six-season run, viewers vividly remember the show’s mishaps and mayhem. Unsurprisingly, many episodes centered on people acting foolishly and paying the ultimate price in gruesome ways many of us could never imagine. Recreating fatal inci- dents with actors, animations, stunt people, and special effects, episodes documented the misadventures of well-known historic figures like fabled escape artist / illusionist Harry Houdini and American distiller Jack Daniels, or sometimes retold tales of workers ignoring safety, falling into a vat of acid, or being impaired on drugs and maimed while playing around with a forklift. Tragically, these cautionary tales weren’t far removed from actual incidents going on worldwide today, with workers losing a digit, a limb, or their lives through carelessness (theirs or someone else’s), improperly main- tained equipment, a lack of personal protective equipment (PPE), inad- equate training, or failing to respect health and safety protocols. According to the International Labour Organization (ILO), approximately 2.3 million men and women “succumb to work-related accidents every year; this corresponds to over 6,000 deaths every single day.”A global issue Many of these deaths are in developing countries, where causes include work-related diseases and death by hazardous substances, estimated to claim about 650,000 lives annually. But Western countries, too, need to be mindful of their own workplace accidents. According to the 2022 Report on Work Fatality and Injury Rates in Canada from the University of Regina, work-related causes claimed the lives of 924 workers in 2020. And the U.S. Department of Labor’s Bureau of Labor Statistics notes that “From being familiar with operating machinery to cleaning up spills immediately, there is much that can be done to ensure staff go home after their shifts with zero workplace incidents.” there were 5,190 fatal work injuries in the United States in 2021, an increase of 8.9 percent from 4,764 in 2020: “The fatal work injury rate was 3.6 fatalities per 100,000 full-time equiv- alent (FTE) workers, up from 3.4 per 100,000 FTE in 2020 and up from the 2019 pre-pandemic rate of 3.5.” Some of the deadly causes included slips, falls, trips—which also increased 5.6 percent from 2020 to 2021—exposure to harmful substances or environments, and transportation- related incidents. JUNE 2023 16101 minutes Along with additional, preventable deaths, other key findings reveal disturbing trends. The 3.6 fatal occupational injury rate of 2021 represented the highest annual rate since 2016. In 2021, a worker in the U.S. died every 101 minutes from a work- related injury. That same year, the number of Black or African American workers fatally injured on the job jumped from 11.4 percent of total fatalities (in 2020) to 12.6 percent in 2021, an all-time high. Although the construction sector is responsible for most of these accidents and deaths, manufacturing is not far behind, with many incidents the result of improper use of PPE, care- lessness, ignoring safety standards, and acting before thinking about the consequences. Manufacturers frequently share the blame with their workers. Earlier this year, a Pennsylvania candy company was fined almost US $15,000 after two unauthorized, improperly trained workers fell into a partly filled chocolate tank and had to be freed through a hole cut into the tank’s bottom. Fortunately, both the above workers survived, unlike a mother of two in Russia in 2016, whose similar accident resulting in death made the world reel. It is believed candy factory worker Svetlana Roslina, 24, had accidentally dropped her cell phone into a massive mixing tank of molten chocolate, or perhaps was adding a sack of ingredi- ents when she fell headfirst into the boiling tank. When rescue crews arrived, only her legs remained. And just last year, a 39-year-old Illinois foundry worker was taking a sample of molten hot iron when he tripped and fell into a 2,600-degree Fahrenheit crucible, dying instantly due to “thermal annihilation.” It was the fifth day at his new job for this father of three. Everyone’s business As the saying goes, “Safety is everyone’s business,” and this is especially true in manufacturing. From being familiar with operating machinery to cleaning up spills immediately, there is much that can be done to ensure staff go home after their shifts with zero workplace incidents. A safe and healthy work environment is vital not only to keeping production flowing, but to a company’s very existence; few people want to work for a manufacturer with a reputation for carelessness or for looking the other way regarding safety hazards and violations. Unsafe production floors take a toll on worker productivity, standards, and morale, and accidents can even impact the cost of products for consumers. According to the latest industry data, 11,190,902 men and women are currently employed in America’s manufacturing industry. To protect these workers and others worldwide, safety guidelines must be in place and enforced. Manufacturing systems must also be designed to ensure they do not overload operation capabilities and do not limit workers through poor lighting or visibility, inadequate room to work, accessibility issues like obstructions or obstructed movement, and consider- ations like excessive noise, temperature, sound, and vibration. 17 MANUFACTURING IN FOCUS The technology of safety Along with conducting risk assessment, mandatory training and communication, keeping machinery in working order, and PPE like glasses, gloves, masks, and earplugs, technology is making manufacturing work safer. Instead of old-fashioned spreadsheets, comprehensive software tracks not only performance and progress, but logs of incidents, employee safety training records, and more. Software can also track the maintenance of equipment and other assets, ensuring machinery not only works at peak effi- ciency but also functions safely. One of the greatest causes of workplace injury in manufactur- ing is physical strain from lifting heavy objects and repetitive tasks. To reduce the risk of lower back injuries, some manu- facturers are investing in robotic systems to literally take the load off human workers, significantly lowering the risk of musculoskeletal injuries or disorders. Most of these robotic systems, when operating in tandem with AI, learn and contin- ually improve their performance. And for potentially danger- ous manufacturing requiring extreme heat or cold, chemicals, noise, or gases harmful to human life, robots are ideal. Another way technology is benefiting humans is through advanced medical monitoring, where breathing, hearing, and even particles of materials and chemicals that may have entered the system of a member of the workforce through inhalation, ingestion, or contact and absorption are measured before they become health issues. Capable of much more than just filling in for a human worker, many robots have cameras and sensors and can detect poten- tial hazards, preventing accidents before they can happen. This precise information is gathered, and the data analyzed. JUNE 2023 18Representing the next generation of manufacturing, smart factories and Industry 4.0 incorporate AI, robotics, inter- connected machinery, communication tools, and machine learning. The need for better, safer, and more productive technologies became especially apparent during COVID when a combination of supply chain issues, manufacturing plant closures, and social distancing slowed production. In May 2020, when death rates were climbing and stay-at- home orders were being issued, Forbes magazine published a strong piece underscoring the need for change. “COVID- 19 has shown the world something that the manufacturing industry should already know,” said the article: “Traditional supply chains and manufacturing ecosystems are failing and we need to shift to a more adaptable, agile solution that is fully digitally enabled. “The virus, like any crisis, has merely underlined both that need and the urgency and will likely serve to accelerate that change. This needs to result in real plans of action, rather than debate.” Of course, for the benefits of AI, robotics, and other technolo- gies to be successful, they must be founded on consistent, up-to-date training of both new and existing manufacturing employees and ideally, underpinned by a rich and compre- hensive overarching culture of safety. Employers, employees, and automation all have roles to play in contributing to safer and healthier working environments for all. “Some manufacturers are investing in robotic systems to literally take the load off human workers, significantly lowering the risk of musculoskeletal injuries or disorders.” Designed by Ashley Dowling 19 MANUFACTURING IN FOCUS Next >