Guidelines for Precautions During Construction and Renovation Based on Type of Work and Exposure Risk (Infection Control Risk Assessment or ICRA Matrix)

inspection and non-invasive actions

removal of a few tiles for visual inspection; painting a wall without sanding; minor activities not generating dust or the cutting of walls

A

small scale, short duration activities which generate minimal dust

running a few cables, access to chase spaces, cutting o walls or ceilings with easy dust control

B

work that generates a moderate-to-high level of dust, or requires demolition or removal of fixed building components or assemblies

sanding of walls, removal of floor coverings or ceilings, new wall construction, minor duct work, electrical work above ceiling, major cabling project, any project that cannot be completed in 1 work shift

C

major demolition and construction projects

projects involving consecutive work shifts, heavy demolition, new construction

D

office area

office area

low

procedural, non-tissue invasive

cardiology, echocardiography, endoscopy, nuclear medicine, physical therapy, radiology, MRI, respiratory therapy

moderate

emergency care, clean work areas, minor invasive procedures, susceptible populations

CCU, emergency department, labor and delivery, laboratory, newborn nursery, outpatient surgery, pediatrics, pharmacy, post-anesthesia recovery

high

long term critical care, immunocompromised patients, sterile areas

burn unit, oncology wards, cardiac cath lab, central sterile supply, intensive care unit, negative pressure isolation rooms, operating rooms

very high

I

minimize dust; immediately replace items removed

NA

II

barrier with dust control; seal unused doors with duct tape; seal air vents; isolate HVAC to area; dust mats to area

wipe work surface with disinfectant; contain waste in tightly sealed containers before removal; wet mop or vacuum using HEPA vacuum; restore HVAC to area

III

as for II; seal off area; maintain negative pressure in area with HEPA equipped air filtration; securely cover carts going in and out of area

as for II;  barriers not removed until area cleaned and inspected; barriers removed with minimum spreading of dust

IV

as for III, plus more stringent controls on any openings; immediate repair of any holes in area seals; shoe covers by workers

as for III, but more extensive

Type A

Type B

Type C

Type D

low risk

Class I

Class II

Class II

Class III or IV

moderate risk

Class I

Class II

Class III

Class IV

high risk

Class I

Class II

Class III or IV

Class IV

highest risk

Class II

Class III or IV

Class III or IV

Class IV