Most patients in health facilities or hospitals have a compromised immune system. This is exactly why construction, renovation, and demolition jobs in such facilities require planning and forecasting to address any potential vulnerabilities that could trigger infections.

This post covers the different factors ranging from bacterial threats to construction activity responses that need to be addressed when it comes to controlling infection during construction in any health facility.

Bacterial/Microbe Threats

The instances of construction work triggering fungi and bacterial infections are common around the globe. The population at risk has a weakened immune system either from the illness itself or any treatment pertinent to it e.g. chemotherapy.

Even though construction activities pose several risks in general, the work area within the facility can present some unique risks to the vulnerable population at close proximity.

Aspergillus

Aspergillus species is a fungus variant that is found both indoors and outdoors including building structures. Construction, renovation, and demolition activities can trigger an Aspergillus outbreak.

With a high settling time of the aspergillus fungal spore can pose serious health risks to immune-compromised patients. These fungal spores usually infect the respiratory system to present the following symptoms:

• Fever
• Haemoptysis (coughing up blood)
• Coughing up plugs of mucus
• Worsening asthma

Legionella

With over 50 identified species, Legionella is ubiquitous and found in warm and wet habitats. Legionella multiplies in the presence of other organisms (e.g amoeba).

Legionella is found in structures including cooling towers and biofilms of the water supply pipe. A poorly planned construction or demolition activity can lead to either the bacteria contaminating the clean water supply or getting airborne. An infected patient can show the following systems which may vary greatly based on his/her health statistics:

• Shortness of breath.
• Muscle aches.
• Headaches
• Fever
• Cough

 Listeria

Listeria is a bacteria type that affects pregnant women, newborns, and elderly people. The bacteria are usually passed along through food leading to food poisoning.

Any construction activities near the food preparation zone have to be pre-planned specifically to address the concern of Listeria infection.

The symptoms of Listeria can range from just a simple headache to blood poisoning.

Preplanning and Consultation

Prior to starting a construction or renovation projects, the Engineering team and the Infection Control specialist needs to consider, decide, and agree on the following:

• The purpose of the new structure or area
• Potential means to address any activity related risks at hand e.g. noise control
• The inspection and monitoring work to be carried out throughout the project duration
• Strategies to address the infection risks from any microorganisms including Listeria, Legionella, and Aspergillus
• Any certification or approval required for carryout certain works e.g. asbestos removal

Risk assessment & control measures (Risk Assessment and Infection Prevention Measures)

Some critical factors to consider when addressing the constructional activity-related risks in a hospital are as follows:

• The duration of the project
• The need for work-related exit or traffic supply routes
• The need for designated parking spaces and bathrooms for personnel involved in the construction activity
• The need for special ventilation or air control equipment e.g. filters
• Agreeing on the work perimeter and the patient population at risk
• Identifying the frequencies at which infection assessment tests need to be taken e.g. air quality check
• Patient population risk assessment needs to be considered based on the proximity of patients to the activity location as well as the health statistics of the patient

Site inspections and reporting

Site inspections and reporting frequency are decided prior to the project commencement. The site supervisor or contractor in charge prepares a comprehensive site inspection test plans for review and approval by the key stakeholders. The frequencies of inspection are usually determined by the type and activity locations.

Infection control during construction is overlooked on some occasions, even when the structure under consideration is a health facility. Construction, renovation, or demolition work can present many health hazards irrespective of the concerning facility type. Make it a point to jump in with a comprehensive analysis and plan for better and prolonged results. Here at Titan, our team of infection control professionals adopts and planned and consistent approach to foresee and control any health hazards during construction or renovation.

 

Next: How Titan Performs Preconstruction Risk Assessment