Preventing Aspergillosis During Building Work

  • Reference Number: HEY-426/2016
  • Departments: Infection Prevention and Control

Introduction

This leaflet has been produced to give you general information about preventing the risk of Aspergillosis to patients during building work. Aspergillosis is the name given to a wide range of infections that can be caused by mould spores being released during building work.  Patients who have weak immune systems are at risk of infection and death should they breathe them in.

It is your responsibility to ensure that any risks to these patients are minimized during your building activities and that suitable prevention methods are in place before you start.

Most of your questions should be answered by this leaflet. More detailed information is explained in Trust Policy CP 261 ‘The control and prevention of Aspergillosis and other invasive fungal infections during building work’. If after reading this leaflet you have any concerns or require further explanation, please discuss this with a senior member of the Estates Department or your Project Manager.

What are the main pathogens (infective agents) causing invasive fungal infections?

There are many fungal species in the environment but only a small proportion of these present an infection risk. The main species causing significant human infection is Aspergillus. Whilst this leaflet refers to Aspergillus, the same principles apply for the prevention of infection due to fungi which may be released into the environment during building work.

Where does aspergillus come from?

Aspergillus species are found in soil, water and decaying vegetation. Aspergillus spores survive well in the environment and have been identified in unfiltered air ventilation systems, false ceiling dust, dust dislodged during hospital renovation and construction building work.  Due to their small size, Aspergillus spores can remain suspended in the air for long periods.

Who is at risk?

Whilst Aspergillus rarely poses a threat to healthy people, it can cause illness and mortality in highly immunocompromised (weak immune system) patients. Because of the problems associated with invasive Aspergillus in vulnerable patients, it is essential to minimize these risks. For each building project there must be a risk assessment carried out to determine which patients may be vulnerable. This is undertaken by the Project Manager and/or Estates Manager and the Infection Prevention and Control Team.

How do patients acquire aspergillosis?

Aspergillus species are inhaled into the nasopharynx (air passage connecting nasal cavity to top of throat). The fungal spores colonize the lungs and spread through the blood stream to other major organs.

How can fungal infections be prevented?

When hospital construction and renovation activities are in the planning stage it is important to implement a strategy which attempts to protect patients at risk from Aspergillosis and to minimize exposure to air-borne spores.

There are two main strategies to protect patients from Aspergillosis in the hospital environment. These are to keep high risk patients away from any area where fungal spores may be present and to minimize the amount of fungal spores released. This is achieved by creating and maintaining an environment as free from Aspergillus spores as possible using specific precautions during building work, such as providing physical barriers around the construction area to contain the spread of spores.

How is this achieved?

In order to eliminate Aspergillus, the aim is to minimize the dust generated by building work and to prevent dust infiltration into adjacent patient areas. The measures implemented to reduce dust emission from the construction area may vary depending on the activity being undertaken and should be based upon a risk assessment of the individual situation. The risk assessment and precautions required will be planned by the Project Manager, Estates Department and Infection Prevention and Control Team. The control measures agreed are outlined in the work permit completed before work commences and should be adhered to by all construction workers involved in the building project.

General Advice

Most of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion. Further information may be obtained from the Project Manager, Estates Manager or the Infection Prevention and Control Team.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Infection Prevention and Control Team on telephone no:  Castle Hill 01482 623066 or Hull Royal 674869 or 675551

Information if you are a patient who has received this leaflet:

As part of your care, when you come to the hospital, information about you is shared between members of a healthcare team, some of whom you may not meet.  It may be used to help train any staff involved in your care.

We may pass on information to other health organisations to help improve the quality of care provided by the NHS generally.

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Under the Data Protection Act (1998), Hull and East Yorkshire Hospitals NHS Trust is responsible for maintaining the confidentiality of any information we hold on you.

This leaflet was produced by the Infection Prevention and Control Team, Hull and East Yorkshire Hospitals NHS Trust and will be reviewed in December 2019.