The majority of an individual’s day is typically spent indoors which makes maintaining good indoor air quality essential to a person’s overall health.
Fifty percent of all illnesses are either caused by, or aggravated by, polluted indoor air. Maintaining the highest levels of air quality is most important in healthcare facilities where occupants are most susceptible to irritants in the air. It is vital to maintain a sterile environmental in health care facilities to prevent the spread of infection as well as the threat of exacerbating preexisting conditions. Poor indoor air quality only exacerbates the issue.
Burn patients and patients with compromised immune systems are at the greatest risk for infection and demand the most stringent infection control measures combined with high indoor air quality. It is reported that 5% of all patients who go to hospitals for treatment will develop an infection while they are there (O'Neal C,2000) . The levels of some hazardous pollutants in indoor air at some places have been found to be up to 70 times greater than in outdoor air. Studies show that patients in controlled environments generally have more rapid physical improvement than do those in uncontrolled environment.
Special precautions must be taken into account especially during construction projects to prevent infections from spreading as well as dust and other irritants contaminating adjacent areas.
When undertaking a construction project in a healthcare facility it is highly recommended to contract an indoor air quality specialist to provide indoor air quality (IAQ) oversight during construction activities. It is important to support construction projects with IAQ oversight in all applications within a healthcare facility due to air systems communicating with the entire building. If construction projects are needed in areas such as burn units, operating rooms, or any area where sterilization is vital special precautions must be taken to assure the air quality is not compromised during the project. Infection control risk assessment (ICRA) measures must be taken and followed to varying degrees based on the sensitivity of the work area to maintain proper air quality and infection control. In areas of highest risk for infection such as burn units and operating rooms ICRA containments must be created and special work practices must be implemented.
ICRA Special Work Practices
- Isolate the HVAC system in the area where work is being done to prevent contamination of the duct system. Complete all critical barriers i.e. sheetrock, plywood, plastic, to seal area from non work areas or implement control a cube method (cart with plastic covering and sealed connection to work site with a HEPA vacuum for vacuuming prior to exit) before construction begins.
- Maintain negative air pressure within the work site utilizing HEPA equipped air filtration units. Seal holes, pipes, conduits, and punctures.
- Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time they leave work site.
- All personnel entering the work site are required to wear shoe covers. Shoe covers must be changed each time the worker exits the work area.
A thorough sampling protocol must be created by an indoor air quality specialist to provide data that the work areas were properly contained and all construction generated particulates were being contained. Upon completion of the work in a contained area an experienced industrial hygienists will perform a visual inspection and additional particulate sampling to confirm the area was suitable for re-occupancy. Through expert design of the sampling protocol and analysis of all data collected by the indoor air quality specialists it can be definitively shown that the air quality was not compromised during the construction project. As always, the goal is to establish the highest level of indoor air quality to promote a healthy working environment as well as maintaining a sterile environment for patients to heal.