Healthcare Construction Guidelines & Solutions
Meeting CDC Guidelines for Infection Control in Health Care Facilities with Solutions from Abatement Technologies®
Construction, renovation and repair activities in hospital and healthcare facilities are likely to create and/or disturb particles, and cause them to become aerosolized (suspended in the air). These particles can include Aspergillus spp., a fungus commonly found in indoor environments that attaches to and feeds on dirt and dust particles and cellulose-based building materials. Patients with suppressed immune systems are especially susceptible to developing aspergillosis–a potentially life-threatening infection.
Examples of activities that can release particles into the
air that may be
harmful
to
sensitive patients include:
- Construction (Adding new hospital space)
- Renovation (Updating patient rooms or facility space. Adding new equipment with electronic cabling and pneumatic systems. Installing or removing cabling above drop ceilings)
- Update existing facilities (Adding network cabling for nurse call stations, fire control systems, TV systems and computer communications. Updating electrical service)
- Remediation tasks (Removal of mold or asbestos)
- Repair or replacement of existing equipment (Removing ceiling tiles or sheet rock to access plumbing and cabling networks)
- Maintenance (Replacing fluorescent light bulbs in ceiling tiles. Painting walls)
- Demolition (Tearing out ceiling tiles. Ripping down sheet rock walls. Removing cabling, pipes and electrical lines)
Determining Protective Measures Required By an ICRA
In 2003, the Centers for Disease Control and Prevention and HICPAC (Healthcare Infection Control Practices Advisory Committee) published updated Guidelines for Infection Control in Health Care Facilities. HICPAC is a 12-member group that advises CDC on ways to help prevent opportunistic, environmentally related infections in immunocompromised patients.
Under these guidelines, the facility or facility contractor must determine the protective measures required based on an evaluation of the risks called an Infection Control Risk Assessment (ICRA). (The complete document is available from the CDC’s Division of Healthcare Quality Promotion at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm.)
There are four ICRA Classes: Class I, Class II, Class III and Class IV. The assigned Class is based on where the activity fits on the ICRA Matrix of Precautions for Construction and Renovation. Class I requires the fewest measures and Class IV the most.
The activity Class is in turn determined via a two-step process. First, it is assigned to one of four Activity Types based on the size and scope of the work: Type A, Type B, Type C or Type D. Then, it must be assessed as Low Risk, Medium Risk, High Risk or Highest Risk based on the patient and staff groups that may be exposed. Specific protective measures include:
- Class I: Executing work by methods that minimize raising dust from construction operations.
- Class II: Means to prevent airborne dust from dispersing into the atmosphere and the HVAC system, and the use of HEPA vacuums to clean surfaces.
- Class III & Class IV: Implementation of full particle containment measures, including erection of enclosures, with negative pressure and HEPA filtration.
The specific language includes the following:
“Construct barriers to prevent dust from entering patient-care areas; ensure that barriers are impermeable to fungal spores and in compliance with local fire codes.”
Abatement Technologies Solutions for Meeting CDC Recommendations
CDC Recommendations |
Abatement Technologies Solutions |
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Create and maintain negative air pressure in work zones adjacent to patient-care areas and ensure that engineering controls are maintained. |
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Use Abatement Technologies HEPA-AIRE® or PREDATOR® Portable Air Scrubbers to create or enhance negative pressure levels, and continuously filter the air within the enclosure. Seal off air registers and grills using DUCT-PRO® grill masks for HVAC registers. Prevent tracking of contaminants on the bottom of shoes using Sticky Mats.
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Monitor negative airflow inside rigid barriers and review documentation to verify that pressure differentials were appropriate for their settings. |
Choose the portable PPMT differential pressure monitor to monitor and record pressure conditions between contained workspaces and adjacent environments. Select the PC401 Laser Particle Counter for tracking down contamination sources, and measuring airborne particle counts before, during and after the job.
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For major repairs in patient areas that include removal of ceiling tiles & disruption of the space above the false ceiling, use plastic sheets or prefabricated plastic containment units to control dust. |
Abatement Technologies offers several types of prefabricated containment barriers to contain airborne particles within the work zone, depending on the job task. When removing ceiling tiles for maintenance tasks, such as replacing fluorescent light bulbs, choose the AIRE GUARDIAN Mobile Containment Module. For mobile construction projects that require installing or removing cabling above drop ceilings, the AIRE GUARDIAN Mobile Containment Module is your top choice. Select the ZipWall® Temporary Construction Barrier to set-up a stationary protective barrier system without special tools. Install the Safe-Flex Work Area Containment Barrier Sheet to reduce airborne infection risks with awareness. Use Abatement HEPA Vacs to capture particles that settle onto surfaces. Choose the V8000WD Canister Style, Wet/DRY HEPA Vac or the V1300H Hip-Mounted HEPA Vac. Both vacuums are made of ultra-tough, polyethylene cabinets.
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Use a negative pressure containment system within the enclosure to remove dust; and either pass air through a portable HEPA unit capable of filtration rates ranging from 300-800 cfm, or exhaust air directly to the outside. |
For small enclosures, the airflow of the PAS600HC Portable Air Scrubber or PRED600HC Portable Air Scrubber, (both up to 600 cubic feet per minute), is the perfect unit to HEPA-filter the air and maintain negative pressure. For larger enclosures, select the PAS1200HC Portable Air Scrubber or PRED1200HC Portable Air Scrubber (both up to 900 cfm). For large containment areas and for high concentration levels of airborne particles released during construction, renovation & demolition, choose our popular PAS2400HC Portable Air Scrubber (up to 2,100 cfm). The PAS2400HC can also be used at lower speeds for small enclosures so you get the benefit of having one portable air scrubber for all types of work enclosure requirements. To add the germ-killing power of Germicidal UV technology with HEPA filter air cleansing, select the PRED1200UVHC. |
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Canadian Standards for Health Care Construction ( Canada Healthcare Facilities)
The Canadian Standards Association (CSA) has also developed and implemented similar standards for Canadian health care facilities. The Canadian Standards association (CSA) has issued CSA Z317.13-03 Infection Control During Construction or Renovation of Health Care Facilities, which outlines similar requirements for Canadian healthcare settings.
They also led to the 2007 development and implementation of CSA (Canadian
Standards Association) standard
CAN/CSA-Z317.13-07
for Canadian facilities.
Economical ICRA Compliance Packages 
Use Abatement Technologies convenient ICRA Compliance Packages to meet CDC and CSA requirements for containing particles during facility construction, renovation and maintenance. These money saving packages include the equipment most commonly needed by facility contractors and in-house maintenance staff to maintain the required air changes per hour (ACH) and negative pressure.
Each Abatement Technologies ICRA Compliance Package includes:
- HEPA-AIRE® or PREDATOR® Portable Air Scrubber
- HEPA-CARE® differential-pressure monitor
- HEPA-AIRE HEPA vacuum
- Assortment of useful containment accessories
Learn more about our money-saving ICRA Compliance Packages for meeting ICRA levels 1, 2, 3 and 4.