Celebrating the 20th Anniversary of the CDC/HICPAC Environmental Infection Control Guideline
Expert Contributors and Reviewers Share Their Memories
By Kelly M. Pyrek
2003 was a busy year, epidemiologically speaking. Twenty years ago, Severe Acute Respiratory Syndrome (SARS) was first discovered in Asia; the Centers for Disease Control and Prevention (CDC) responded by providing guidance for surveillance, clinical and laboratory evaluation, and reporting. While the U.S. was not as impacted as other countries in this outbreak, in hindsight it helped set the stage for preparedness for SARS-CoV-2 in 2019.
Meet the EIC Guideline
2003 also marked the release of the CDC/HICPAC Guidelines for Environmental Infection Control in Health-Care Facilities (2003), a compilation of recommendations for the prevention and control of infectious diseases associated with healthcare environments. This document revised multiple sections from previous editions of the CDC’s Guideline for Handwashing and Hospital Environmental Control, and also incorporated discussions of air and water environmental concerns from CDC’s Guideline for the Prevention of Nosocomial Pneumonia. It also consolidated relevant environmental infection control measures from other CDC guidelines and included two topics not addressed in previous CDC guidelines — infection control concerns related to animals in healthcare facilities and water quality in hemodialysis settings.
The 2003 EIC guideline was the first to provide a comprehensive review of the scientific literature relating to environmental hygiene and issuing recommendations on engineering and infection control concerns during construction, demolition, renovation, and repairs of healthcare facilities. Importantly, it advocated for use of an infection-control risk assessment before the start of these or any other activities expected to generate dust or water aerosols. The guidance reviewed infection-control measures used to recover from catastrophic events such as flooding, sewage spills, loss of electricity and ventilation, and disruption of the water supply, as well as the limited effects of environmental surfaces, laundry, plants, animals, medical wastes, cloth furnishings, and carpeting on disease transmission in healthcare facilities.
This guideline outlined environmental infection control in the healthcare setting, describing measures for preventing infections associated with air, water, and other elements of the environment. It synthesized the views of different divisions within CDC’s Division of Healthcare Quality Promotion (DHQP) and the Division of Bacterial and Mycotic Diseases (DBMD) and reflected the consensus of the Healthcare Infection Control Practices Advisory Committee (HICPAC), a 12-member group that advises CDC on concerns related to the surveillance, prevention, and control of healthcare associated infections (HAIs) in U.S. healthcare facilities.
“The 2003 CDC HICPAC Environmental Guidelines addressed activities associated with the environment that infection prevention and control professionals had not faced when the 1985 guidelines were published, such as animal visits in healthcare facilities,” explains infection prevention expert Beth H. Stover, who served as an expert reviewer on the EIC guideline. “It provides a template for healthcare facilities to incorporate into their policies and procedures. The guideline serves as a teaching or learning tool for new infection prevention and control professionals, hospital/healthcare epidemiologists, infectious disease professionals, or others who served as healthcare facilities’ infection control committee chairs.”
Read further from the June 2023 issue HERE