Professional Assessment of Infection Control Engineering in Hospital Design and Renovation Projects in Enugu State

Infection control engineering principles including spatial layout, ventilation design, surface material selection, and water system hygiene are critical determinants of healthcare-associated infection rates in Nigerian hospitals, but their systematic application during hospital design and renovation projects in Enugu State is inadequately documented. This study professionally assesses the application of infection control engineering principles in five recent hospital design and renovation projects in Enugu State, covering one new tertiary care block, one laboratory renovation, two operating theatre upgrades, and one isolation ward construction project. Assessment methodology combined architectural drawing review against WHO and Health Technical Memorandum infection control engineering guidance, on-site environmental engineering measurement, and structured interviews with architects, engineers, infection control nurses, and hospital administrators involved in each project. Common deficiencies identified include inadequate single-pass ventilation provision in isolation rooms, absence of anteroom design in three isolation ward projects, inappropriate surface material specifications allowing water pooling in clinical areas, and water system designs predisposing to Legionella colonization risk. One operating theatre upgrade achieved appropriate laminar flow provision, while two others implemented mixed turbulent flow systems below recommended air change rate standards. Biomedical engineering input into design review was absent in four of five projects, with clinical engineering specialists first engaged only post-construction for equipment installation. The study recommends mandatory infection control engineer involvement in all healthcare construction projects in Enugu State from initial design stage. Keywords: infection control engineering, hospital design, ventilation, isolation ward, Enugu State.