Whether
a Senior Administrator, Director of Engineering,
Facility Manager, Maintenance Manager, Architect,
Engineer or Infection Control Professional,
construction within Health Care Facilities has
become an important issue. Emerging knowledge tells
us that construction within such facilities can have
a significant negative impact on the health of
individuals that such facilities cater to if
improper safety control measures are not
implemented.
It has
long been known that due to the undeveloped,
depressed, or weakened state of the immune system in
infants, the sick and the elderly that such
individuals are at greater risk of acquiring
infection. In Canada it is estimated that 250,000
patients a year acquire hospital, or “nosocomial”
infections, resulting in approximately 8,000 to
12,000 deaths a year. Of these, 5% (or 400 to 600)
deaths a year are estimated to occur as a direct
result of construction-related activities within
Canadian health care facilities.
Maintaining sterile conditions within occupied areas
of health care facilities has long been a
requirement for reducing the risk of nosocomial
infections. Until recently, construction,
maintenance or renovation projects within these
facilities have been overlooked as a potential
source of infectious agents.
However, evidence now
suggests that serious health risks for patients,
staff, and visitors are created during construction
and renovation during the dispersal of dust
particles contaminated with bacteria and fungi.
Soil borne moulds such as Aspergillus fumigatus,
A. flavus and A. niger are common
components of settled dust. This genus of fungi is
known to cause serious invasive infections,
specifically termed Aspergillosis. There are now a
host of published reports documenting incidents in
health care facilities of construction-related
infections caused by Aspergillus,
Legionella (which causes legionnaires’ disease),
and other agents. In addition to infections, mould
and bacteria that may be present in dust, soil or
water-damaged building materials can also cause a
number of other health effects such as allergic
reactions.
Settled
dust on horizontal surfaces such as ceiling tiles,
ventilation ductwork and cable runs can become a
source of exposure to fungi and bacteria.
Building
materials that are mould-contaminated may pose an
even greater risk while even soil excavation near
health care facilities can pose a risk of exposure.
Although patients or residents may not be located
directly within the area of renovation or
construction, settled dust and debris associated
with these activities may be disturbed and
distributed to adjacent locations or other areas of
the facility through the ventilation system(s).
Therefore, adequate precautions should be taken to
ensure that debris created during construction,
renovation and maintenance work is contained within
the area of work and cleaned up in order to protect
the health of patients, staff, and visitors.
