{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/medical-equipment-preparers/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Medical Equipment Preparers",
    "soc_code": "31-9093",
    "category": "Healthcare Support",
    "us_employment": 77420,
    "median_annual_wage": 47700
  },
  "verdict": "EXPOSED",
  "risk_resistance": 52,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 17,
    "liability_shield": 6,
    "trust_premium": 5,
    "judgment_accountability": 9
  },
  "reasoning": {
    "task_resistance": "Brushing lumens on a laparoscopic instrument, verifying ratchet action on a hemostat, matching 60+ items against a count sheet and re-wrapping trays are hand-and-eye tasks that washer-disinfectors and tracking software support but do not perform, which is why this sits at 15 rather than higher — case cart pick lists, load documentation and instrument tracking are already digitised and the sterilizer runs its own cycle parameters.",
    "embodiment": "You work in a decontam room in fluid-resistant gown, face shield and heavy gloves, handling blood-soiled instruments, sharps and heavy trays at 100°F+ near steam autoclaves, and cross the hospital to the OR with case carts — 17 not 20 because the department is a fixed, engineered space with controlled airflow rather than a field or patient bedside.",
    "liability_shield": "CRCST or CBSPD is preferred and increasingly required by employers, and a handful of states (NJ, NY, CT, TN, PA) mandate certification, but the sterility failure lands on the hospital's infection control and Joint Commission survey, not on your license — hence 6 rather than a licensed 11+.",
    "trust_premium": "Surgeons and OR nurses judge the tray, not the person who wrapped it; you build reputation with a specific service line over time and get requested for complex sets, which is the only thing lifting this above pure anonymity at 5.",
    "judgment_accountability": "You decide whether an instrument's hinge is too stiff to reissue, whether a wet pack gets reprocessed, whether a failed biological indicator triggers a recall of every load back to the last negative — real calls, but bounded by AAMI ST79, IFU documents and a supervisor's sign-off, which keeps this at 9 rather than in the ambiguous-ownership range."
  },
  "rationale": "Sterile processing techs spend their day physically handling contaminated instruments — manual decontamination, disassembling and inspecting surgical trays, loading autoclaves, assembling case carts to surgeon-specific preference lists. Language AI cannot touch that; the exposure is inventory software, RFID/barcode tray tracking, and washer-disinfector automation that thins headcount per OR rather than eliminating the role. The shield is weak on the credential side: CRCST/CBSPD certification is required by only a handful of states and employers, and nobody signs a personally liable document.",
  "outlook": "Employment holds roughly flat or grows slowly with surgical volume, but tracking software and automated washers mean each tech covers more ORs, so wage growth stays modest and the certified complex-instrument tier pulls away from the general decontam pool.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "More states adding statutory certification mandates for sterile processing personnel, following NY, NJ, CT, TN and PA — bills modeled on those have been introduced repeatedly in states like Michigan, Ohio and Texas with HSPA (formerly IAHCSMM) backing. A mandate naming CRCST/CBSPD as a condition of employment, plus a named-technician load-release signature requirement under AAMI ST79 that surveyors cite individually rather than citing the department, would move this from 'employer preference' toward a credential someone can lose.",
        "plausibility": "already happening",
        "would_add": 5
      },
      {
        "dimension": "judgment_accountability",
        "change": "If Joint Commission / CMS infection-control findings and device-recall investigations continue to trace back to a specific reprocessing decision — an IFU deviation, an immediate-use steam sterilization call, a borescope finding on a lumened scope that was passed anyway — and hospitals respond by requiring a documented, attributable decision record for every non-routine instrument (duodenoscopes, robotic arms, powered handpieces), the role owns consequential calls it currently makes informally. Duodenoscope-related outbreak litigation has already pushed some systems toward this.",
        "plausibility": "plausible",
        "would_add": 4
      },
      {
        "dimension": "task_resistance",
        "change": "Genuine two-tier structure: barcode/RFID tray tracking and washer-disinfector automation eat the counting, logging and cart-picking tier. What remains is IFU interpretation across thousands of device-specific instructions that change with every new implant system, disassembly of robotic and powered instruments, and visual/borescope inspection for bioburden in channels no camera scores reliably. If headcount thins to the inspection-and-IFU tier, the residual day is less automatable than today's average day.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "No plausible route on trust_premium: patients never meet this worker, never know their name, and cannot choose them. Purchasing is hospital-side cost center, and the visible trend is outsourcing to offsite regional reprocessing vendors — which pushes trust premium down, not up. Even with full licensure, the ceiling here is roughly the mid-60s; embodiment is doing most of the work and the shield gains are capped because the liability lands on the hospital's accreditation, not on a personal signature with malpractice exposure attached."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 53920,
        "wage": 35370
      },
      {
        "y": 2018,
        "emp": 55610,
        "wage": 36240
      },
      {
        "y": 2019,
        "emp": 56900,
        "wage": 37440
      },
      {
        "y": 2020,
        "emp": 56870,
        "wage": 38800
      },
      {
        "y": 2021,
        "emp": 61170,
        "wage": 38220
      },
      {
        "y": 2022,
        "emp": 63890,
        "wage": 41480
      },
      {
        "y": 2023,
        "emp": 66790,
        "wage": 45280
      },
      {
        "y": 2024,
        "emp": 72760,
        "wage": 46490
      },
      {
        "y": 2025,
        "emp": 77420,
        "wage": 47700
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 43.6,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}