Healthcare construction · 6 min

ICRA for Construction: Infection Control Risk Assessment, Explained

How a hospital sets the infection control class for construction work, what each class asks of the contractor, and the paperwork that shows the controls held.

What an ICRA is

An infection control risk assessment (ICRA) is how a hospital decides what dust and air controls construction work needs before it starts. The hospital's infection preventionist and facilities team run it. The contractor builds the controls it calls for and keeps them in place until the area is signed off.

How the class is set

What each class asks of the contractor

Class I: non-invasive work with no dust. Put back any ceiling tile you move.
Class II: limited dust only, controlled at the source. Under ICRA 2.0 it is never used for construction or renovation.
Class III: active dust control. Containment with closed doors, supply and return diffusers isolated, sealed debris containers, tacky mats at the entry, and the space kept neutral or negative.
Class IV: hard barriers to the deck with penetrations sealed, negative pressure with HEPA-filtered exhaust and a pressure monitor, and shoe covers or clean clothing for workers.
Class V (ICRA 2.0): everything in Class IV, plus an anteroom and disposable coveralls.

The paperwork

The ICRA permit, approved before the work starts, naming the class and the controls.
A daily log of the containment: barriers intact, the pressure reading, mats changed, the debris route.
Sign-off before the barriers come down. For Class III and up, the infection preventionist and engineering inspect the cleaned area before precautions are reduced.
A new assessment when the scope changes or a hazard such as mold or asbestos turns up. Work stops until it is approved again.

How BuildControl tracks this

BuildControl keeps the ICRA permit on the job with its class worked out from the type of work and the risk group, on the original matrix or ICRA 2.0, and a daily ICRA log of each room under containment. When the surveyor asks who checked the barriers and when, the record is on the job.

This is general information, not legal or regulatory advice. HCAI's, the Joint Commission's and each hospital's requirements change and differ by facility. Confirm anything here against the current published guidance and your project's approved documents before relying on it.