facility-borne illness poses environmental risk in hospital construction

The ongoing demand for cutting-edge healthcare services continues to drive the need for new healthcare construction in the United States despite recent volatility in the overall trend of the healthcare construction industry, largely attributable to healthcare reform. Hospital executives recognize that new construction and renovation projects hold the promise of a state-of-the-art future. However, they also should be cognizant of the environmental risks that are inherent in such projects.

Mold, legionella, and other environmental contaminants are potential risk factors in any construction project, but are particularly troublesome during renovations of healthcare facilities. In particular, the most common group of bacteria associated with construction-related nosocomial infections are Legionella species, including L. pneumophila, which is the major cause of the disease familiarly known as Legionnaires' disease. Legionella also is a common cause of hospital-acquired pneumonia. The first reported outbreak of hospital-acquired Legionnaires' dis- ease was in a psychiatric hospital in Washington, D.C., in 1965, in which 81 patients contracted pneumonia, with 15 deaths.

Hospital renovations can pose a high risk of loss because when these environmental contaminants are released in an active hospital setting, they can be harmful to immunocompromised patients. It is incumbent on hospital leaders to make sure proper construction protocols are in place to reduce the threat of environmental exposures.

For example, there should be a focus on control- ling indoor air quality when renovations are tak- ing place at an active facility. Fugitive emissions, dust and debris, and vapors associated with chemicals that contractors may use during the renovations all can compromise the air quality within both the immediate construction site and the surrounding facility. Ensuring that proper environmental risk management controls are in place is essential and can help decrease the potential for harm.

Healthcare facility managers have a special responsibility for preventing facility-borne illnesses or other conditions. However, in the current economic and regulatory landscape, environmental risks should be a paramount concern not only for healthcare facilities man- agers, but also for all hospital executives. *

This analysis was prepared by the Ace Group. For more information, contact Craig Richardson (craig.richardson@acegroup.com).