Sterilization and Irradiation – Operator Perspective “Why Gamma remains important”

1. Sterilization and Irradiation – Operator Perspective“Why Gamma remains important” Dipl.-Ing. (FH) Reiner Eidenberger MBA Synergy Health Allershausen GmbH A STERIS Company

2. STERIS Business Units Healthcare Product48% of total revenue * Serves patient care facilities. Sterilizers and accessories, Washers, Lights and tables, Connecting software OR Healthcare Services21% of total revenue * Serves patient care facilities. On/off-site decontamination services,Surgical instrument management, Equipment service and parts • Our Mission: • At STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare • and life science product and service • solutions around the globe. PATIENT CARE Applied Sterilization Technologies (AST)18% of total revenue * Serves mainly medical product manufacturers. 59 global locations Radiation processing, ethylene oxide, steam Microbiological laboratories Life Sciences13% of total revenue * Serves research/pharmaceutical facilities GMP sterilizers Washers VHP Chemical cleaners *FY17 Data

3. Global Strength – Local Focus 56% Service 22% Consumables 22% Capital Equipment $2.6 BILLION revenue in FY17 12,000employees worldwide Over 3,000 Customer • Notes: • STERIS AST locations in blueand manufacturing locations in orange • not listed are close to 50 outsourced reprocessing centers in the UK, US, Italy, China and the Netherlands.

4. STERIS AST – Technology neutral service provider

5. Industrial Sterilisation Methods – basic Overview • Moist Heat • no residues  to dry • not suitable for thermoplastics • limited suitable for bigger volumes • Ionizing Radiation • „Cold Sterilisation“ • no residues • impact on materials • Chemical Methods – EO • critical for hollow spaces, tight cavitiesand porous material • „Quarantine“  degassing • EO - residues

6. STERIS AST – two main sterilization Methods We provide terminal sterilization services, primarily for single-use medical devices, using two main modalities of sterilization – Radiation and Gas.

7. Ionizing Radiation – three Technologies • Gamma Rays (g) from Cobalt 60 (60Co) • Photon Radiation • suitable for palletized goods • no induced radioactivity • Accelerated Electrons (E-Beam) • Particle Radiation • suitable for single boxes • X-Ray • accelerated electrons being transformedinto Photon Radiation(Bremsstrahlung, hard X-Ray) • suitable for palletized goods

8. Ionizing Radiation – Dose Distribution

9. Cobalt 60 used for terminal sterilization

10. Global need for Cobalt 60 • Worldwide ≈ 250 Gamma Plants • ≈ 475 MCi installed • ≈ 59 MCi for decay compensation p.a. (12.3%) • global market growth ≈ 3% to 5% p.a. • ≈ 14 MCi to 24 MCi p.a. • ≈ 80 MCi p.a.needed fordecay compensation+ market growth

11. Challenges operating a Gamma Plant • Cobalt availability • Capacityconstraints at the Cobalt manufacturers • Regulatoryissuesregarding • Transportation Licenses • Disposal & DisposalRoutes • Delays in gettingsufficientamountof Cobalt • Increasingcosts

12. Summary • Customers need Gamma • very reliable service • wellknown and wellestablishedtechnology • many Customers reluctanttochangetechnology • X-Ray as an alternative technology already available • up to date not sufficient capacity • very complex technology • high energy costs • many Customers reluctanttochangetechnology • Gamma Radiation Industry will be there for the next 50 years • ≈ 20% more Cobalt needed in 5 years…

13. STERIS Business Units Thank you very much for your kind attention! Dipl.-Ing. (FH) Reiner Eidenberger MBA Synergy Health Allershausen GmbH A STERIS Company