Aspergillus infections have been associated with building constructions. We reported, for the first time, an outbreak of aspergillosis in lung transplant recipients exposed to heavy building construction work during hospitalization. We reviewed the files of 115 patients who underwent lung transplantation between May 1994 and June 2005. Patients operated on from May 1994 to December 2003 (group 1) were compared with those operated on between January 2004 and June 2005 (group 2) for findings of aspergillosis on follow up. Thirty-six transplant recipients (31%) had evidence of Aspergillus colonization, including six of the 64 patients (9.4%) operated on from 1994 to 2003 and 30 of the 51 patients (59%) operated on in 2004-2005 (P=0.0001). Eight had aspergillosis, in all group 2 (P=0.001) compared with group 1. All infections occurred within the first 4 month after the transplantation. On comparison of the two groups for background and medical factors, the only difference found was the initiation of building construction at the hospital, close to the transplant ward, in early 2004. We concluded that lung transplant recipients are prone to Aspergillus colonization following exposure to building construction work, despite prophylactic treatment. Established guidelines for the prevention of aspergillosis should be implemented and enforced during construction activities in hospitals.