6 minute read
Infection Control during Construction
from CHF Winter 2022
by MediaEdge
Release of fifth edition of CSA Z317.13 comes with a slew of changes
By Gordon Burrill
First introduced in 2003, CSA Z317.13, Infection Control during Construction, Renovation and Maintenance of Health Care Facilities, has evolved to keep pace with changes in the industry. The fifth edition, released last March, brings the standard up-to-date with advances in construction and facilities management industry practices.
HISTORY OF THE STANDARD
The premier edition of the standard was the first document in Canada written in normative language to speak to the increasing awareness of the connection between construction dust, stagnant water systems and notable negative patient outcomes among immunocompromised or immune-suppressed building occupants. The second version, released in 2007, built on this model by introducing requirements for new construction projects to reduce the risk of infections among building occupants over the lifetime of the building.
While these two renditions of the standard revolutionized techniques commonly used in construction in healthcare, the next two (2012 and 2017) removed ambiguities and the potential for misinterpretation, while at the same time keeping pace with the everchanging healthcare construction industry.
The newest edition has once again moved to revolutionize the industry. Its predecessors had reached a level where contaminants raised or elevated during construction were well-controlled and generally kept away from vulnerable building occupants. The latest version continues with this but also aims to reduce the bio load that construction has historically left behind.
IMPORTANT UPDATES
While the structure of the standard is unchanged and its foundational preventive measures analysis remains, there have been some adjustments to the detail of that analysis. Users should consult the most recent edition to become familiar with the adjustments to construction activity types and population risk groups. Of note is clarification around construction activities that include working on plumbing systems.
Guidance provided with respect to performance leak testing of construction air handling units has also been significantly updated. With the 2021 release of a performance leak testing guideline from the Environmental Abatement Council of Canada, these critical pieces of equipment have benefited from national industry-wide knowledge in this area.
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New techniques and equipment currently available in the market, such as purpose-built modular wall systems, have seen requirements added into the standard so that construction teams will be able to best utilize the tools available today.
One other noteworthy addition is the introduction of a new Annex J. This annex provides users with a checklist to review existing spaces to ensure they have been prepared for safe access to begin the renovation. Checklist items include ensuring any personal identifiable health information or sharps have been removed from the area so construction teams can safely focus on their work.
When it comes to new construction projects — whether brand-new healthcare facilities, additions to existing facilities, new buildings on healthcare campuses or a complete refurbishment of existing spaces — the standard has seen a complete overhaul. All information from previous editions remains; however, the sequence of requirements has been reordered to match construction sequencing. There is also now a Category 4 for new construction (refurbishment of large areas of an existing building). The old, familiar word ‘phase’ of construction has been replaced with the word ‘stage’ to avoid confusion with financial phases, which occurred under previous renditions of the standard.
This leads to Section 8 that covers four new construction categories, each of which has been broken down into five stages of construction. While many requirements apply across a multitude of categories and stages, there are requirements that are particular to specific combinations. Users will be well-served to thoroughly understand clauses 8.1 and 8.2 that apply to all four new construction categories and then augment those requirements with the category specific requirements that can be found in clauses 8.3 through 8.6 (new construction categories one through four, respectively). A significant change within Clause 8 is the requirement that further advanced stages of construction must have a measured and quantifiable differential air pressure of 2.5 pascals. The introduction of quantifiable pressure differentials ensures the development of structured airflow from further advanced (cleaner) areas of construction toward less advanced (less clean) areas. The goal of such requirements is to reduce the load of microscopic particulate that becomes incorporated into the built environment. This, in turn, curtails the potential for future infections amongst vulnerable occupants.
Gordon D. Burrill, P.Eng., is president of Teegor Consulting Inc., an international consulting firm specializing in healthcare construction, operations and maintenance with a particular focus on codes and standards compliance. Gordon is also president of the Canadian Centre for Healthcare Facilities, chair of CSA Group’s technical committee for healthcare facilities and represents CHES as a committee member of the CSA technical subcommittee for standard Z317.13, Infection Control during Construction, Renovation and Maintenance of Health Care Facilities. Gordon can be reached at info@teegor.com.
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