hough it’s hardly rare, new construction at a major health care facility is anything but ‘business as usual.’ A building project can disrupt normal safeguards, create stress and open pathways for infection. When an outpatient cancer care clinic embarked on a sixfloor expansion in June 2005, health and safety and infection control professionals worked closely to develop and implement a detailed program to monitor and control airborne particulates. Aspergillus species are ubiquitous in the outdoor environment and we are exposed to them daily. However, conditions such as water intrusion can allow growth inside buildings and within wall cavities. The greatest danger to immunocompromised patients is the potential for exposure to spores released during the construction process. Exposure can result in aspergillosis, a disease that can be fatal to such patients. “We consider all the patients to be at risk,” says Debbie Shiozaki, director of Environmental Health & Safety (EH&S). If Aspergillus infects an immuno-compromised patient, she says, “the mortality rate is unfortunately around 50 to 70 percent.” Shiozaki is a member of a team of infection control specialists, industrial hygienists, project managers, planners, and contractors engaged in the construction project.