Infection Control Principles for the Management of Construction ...

Accumulated dust inside a hospital ceiling has
been shown to contain as much as 10 3 CFU/
g (colony forming units per gram) of Aspergillus
fumigatus. 1
Building and maintenance activities disturb
these reservoirs and can send millions of spores
throughout the health care facility. These spores
can infect any person whose immune system is
severely compromised. Humid spaces such as
riser shafts, wall cavities with plumbing, and
ceiling spaces with services provide the ideal
environment for the proliferation of fungi.
What are the Likely
Causes of Fungal
Related Infections?
Environmental Exposure
Patients in health care facilities are exposed to
airborne fungal spores that are derived from
indoor sources and outdoor sources.
Aspergillosis in high-risk immunosuppressed
patients has been associated with indoor
environmental reservoirs from sources including
bird droppings in the air ducts supplying highrisk
patient areas, contaminated fireproofing
material, damp timber and plaster (especially
particle board) and potted indoor plants.
Protective environment rooms and strict
management procedures are generally used to
reduce the risk of infection from these sources.
The outdoor environment is by far the largest
reservoir of fungal spores. Building supply air
systems must be
The removal designed, installed and
of just one ceiling maintained in such a
tile can send way as to control the
millions of fungal number of fungal
spores into an spores delivered to an
occupied area occupied space.
Correctly fitted and
maintained high efficiency deep bed filters
(Grade F7) will remove 90–95% of spores at
2–3.5 µm.
Building and Maintenance
Building works are a recognised source of
Aspergillus sp related nosocomial infections. 2
The Health Canada publication Constructionrelated
Nosocomial Infections for Hospitalized
Patients: Decreasing the Risk of Aspergillus,
Legionella and Other Infections cites 25
outbreaks of nosocomial Aspergillus sp
infections over a twenty year period resulting in
106 deaths. These deaths were either
suspected or confirmed as being caused by
construction activity.
Before You Start
– Plan, Plan, Plan
Establishing a Multidiscipline Team
Before a project starts a multidisciplinary team
should be established to consider infection
control strategies, business and services
continuity, and
Ensure your team occupational health
and safety (OHS) for
has members that
patients, staff and
represent all the
Contractors. 11 This
areas affected by team can consist of
the work
senior representatives
of the client
department, infection control, engineering,
architect, project manager, OHS and
specialised areas concerned with or impacted
upon by the project. The key functions and
responsibilities of this team could be to: 2
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