An Infection Control Risk Assessment is a planning process used before construction or maintenance in a healthcare facility. It decides which precautions are needed to keep dust and contaminants away from patients.

ICRA 2.0 is an updated tool from the American Society for Health Care Engineering (ASHE). It matches the type of work with the risk level of the patients nearby to set a class of precautions.

Who is involved in an ICRA?

The facility's infection preventionist and engineering or facilities staff lead it, with input from the contractor. They inspect the work area before precautions are reduced or removed.

Do small jobs like ceiling tile work need ICRA precautions?

Often yes. Even short above-ceiling tasks can release dust. ICRA 2.0 treats inspection-only work, small short tasks and major renovation differently, so each job is assessed.

ICRA in Healthcare Renovations: What Contractors Must Do

October 17, 2026 · Northlane Enterprises

Construction inside a hospital or clinic carries a risk that ordinary commercial work does not: dust and contaminants can harm patients. An Infection Control Risk Assessment (ICRA) is how healthcare facilities and contractors plan to prevent that.

What an ICRA does

An ICRA looks at two things:

The type of work, from simple inspections to major demolition
The patients nearby, from non-clinical areas to the most vulnerable, such as operating rooms and intensive care units

Together, these decide which precautions the contractor must use.

How ICRA 2.0 works

The American Society for Health Care Engineering (ASHE) published ICRA 2.0 as an updated version of the tool. It walks through four steps:

Classify the project type, from Type A (inspection and non-invasive work) to Type D (major demolition or multi-room renovation)
Identify the patient risk group, from low to highest
Find the class of precautions, Class I through Class V, from the matrix
Review the surrounding areas: above, below and next to the work, for noise, vibration, dust, ventilation and impacts on building systems

What the classes mean on site

In general terms:

Lower classes cover work that creates little or no dust and needs simple controls.
Class III adds active dust control, such as HEPA vacuums, plastic containment and sealed doors.
Class IV adds critical barriers, negative air pressure in the work area and pressure monitoring.
Class V adds an anteroom and protective coveralls.

Higher-class work typically needs an infection control permit before it starts.

What contractors must do

On an ICRA project, the contractor is responsible for:

Building barriers as specified, often from floor to the deck above
Keeping the work area under negative pressure with HEPA-filtered exhaust when required
Installing pressure monitors on the containment
Using walk-off mats and cleaning paths
Following clothing and shoe-cover rules
Removing debris in covered carts along approved routes
Not removing barriers until the facility inspects and approves

Training matters

Every worker on site, including subcontractors, must understand the rules. Many facilities require infection control training before workers can enter.

Plan it before you price it

ICRA requirements add time and cost: barriers, air handling equipment, after-hours work and inspections. These should be in the bid from the start, not added as change orders.

Healthcare projects with Northlane Enterprises

Northlane Enterprises plans and manages renovation work for healthcare facilities across Dallas–Fort Worth, coordinating trade partners who follow each facility's infection control requirements. Request a quote to discuss your project.