Staff sickness, fitness to work and personal hygiene

Today, I want to talk about staff sickness, fitness to work and personal hygiene. Proper management of these is essential to ensure food safety within a food business.

People who work with or around open food while suffering from certain infections (mainly from bacteria and viruses) can contaminate food or surfaces. The infection can then spread to other people via the food.

Diarrhoea and vomiting are the main symptoms of illness that can be passed on through food. This is why staff who handle food must report these symptoms to their manager or supervisor immediately. They must then be prevented from working with or around open food. Normally, for 48 hours from when the symptoms stop naturally.

It is also possible to have an infection with no symptoms. This is why all food handlers must wash their hands thoroughly before handling food. This is especially important after going to the toilet.

What is a food handler?

The term food handler generally means a person who directly touches open food as part of their work. It can also include a person who touches food contact surfaces or other surfaces in rooms where open food is handled. This is because they may indirectly contaminate food by spreading bacteria onto the surfaces that food or food packaging may touch. They can also contaminate surfaces such as door handles which may then contaminate the hands of people who directly handle food.

Food handlers must practice high standards of personal hygiene to protect food and the spread of infection. This includes personal cleanliness and wearing suitable clean, protective clothing. This is required by the law.

Why are infections from bacteria or viruses a problem?

Bacteria live and multiply in a person’s gut when they get infected and are suffering from gastrointestinal illness (i.e. food poisoning). The bacteria then come out in the person’s faeces or in their vomit.

When a person has diarrhoea or vomiting there are lots of bacteria present which are highly likely to contaminate hands and other things such as surfaces. In these circumstances, the risk of bacteria spreading is very high. Food may become contaminated directly by an infected food handler or by coming into contact with a surface that an infected food handler has contaminated.

If bacteria contaminate foods that are to be cooked, the cooking process will kill most, if not all, of the bacteria. However, foods which are ready-to-eat will not be cooked therefore they are at greater risk.

Hand washing is very important. Especially because some people can have an infection but not have any symptoms or just have very mild symptoms that they aren’t really aware of. Alternatively, they may be just developing the infection so symptoms have not yet appeared.

Some viruses (i.e. norovirus) can be transmitted to a person via food. This happens in the same way as for bacteria and the symptoms are often similar. The key difference between bacteria and viruses is that viruses are unable to grow in food but they can survive on food for long periods.

Viruses use food as a ‘vehicle’ to infect a person. Like bacteria, viruses can spread onto food via contaminated hands or surfaces. Some viruses can even spread through the air, for example, when a person vomits. Fortunately, viruses in food are easily destroyed by cooking.

What are the symptoms of gastrointestinal infection?

The most common symptoms of gastrointestinal infections (such as food poisoning) are diarrhoea and vomiting. Other symptoms may include stomach cramps, nausea and fever.

What should you do if a food handler has an infection that could be passed on through food?

If you run a food business, by law, you must exclude anyone from work if they have an infection that can be passed on through food if there is any likelihood of them contaminating food directly or indirectly.

This applies to people who are employed as food handlers (i.e. chefs) and also to any other staff working in areas where open food is handled (i.e. managers, cleaning staff, maintenance contractors, auditors etc).

It is important to train all staff to report the symptoms of infection and also to report if they have close contact with someone with symptoms (i.e. a household member).

A staff member who reports these symptoms must be excluded from working with or around open food. You should also assess whether the safety of food has been affected as a result of the infected food handler. Where necessary, you must take action to ensure that unsafe food is removed from sale/use.

The level of risk and action required will depend on factors including:

• The nature of the food and any processes that will be applied to it (i.e. cooking)
• The storage conditions and shelf-life of the food
• The level of contact that the person had with the food. For example; a manager who walked through a food preparation area will be less likely to have contaminated the food compared to a chef who had been preparing it
• The people who may consume the food (if known). For example; food for children or elderly people will require greater precaution.

In some situations, you could move the infected food handler to work elsewhere in the business where open food will not be at risk. In these circumstances, the staff member must follow strict personal hygiene practices (i.e. thoroughly washing hands after using the toilet) so as not to infect other staff members.

If the food handler has infected skin (i.e. a septic cut or boil), these can become infected with bacteria such as Staphylococcus aureus. As long as the food handler can completely cover the infected area of skin, with a brightly coloured, waterproof dressing, then it will usually be acceptable for them to carry on working. Exclude the food handler from activities that could lead to food contamination if it is not possible for the infected skin to be completely covered.

When should a food handler return to work after illness?

In normal circumstances, a food handler should be excluded for 48 hours from when the symptoms stop naturally. This is because even after symptoms have stopped bacteria and viruses can still be present in a person’s faeces. In certain circumstances (i.e. if the individual is diagnosed with a specific infection), different actions may be required. Alternatively, a food handler may return to work if the cause of the illness gets confirmed as non-infective.

The food handler must be instructed to take extra hygiene precautions such as regular and thorough hand washing upon their return to work.

What responsibilities do food handlers have?

Food handlers must practice high standards of personal hygiene to protect food and the spread of infection. This includes personal cleanliness and wearing suitable clean, protective clothing. This is required by law.

Staff should be ‘fit for work’ at all times. This means that they must not be suffering from, or carrying, an illness or disease that could cause a problem with food safety.

All staff must be told to report to their manager or supervisor if they are ill. Specifically, if they are suffering from an illness that is likely to be passed on through food. For example; food poisoning, sickness, diarrhoea, any skin or nose infections or any infected wounds.  Staff must also inform their manager or supervisor if they have a certain medical illness that could be passed on through food.

When should food handlers wash their hands?

Our hands come into contact with bacteria and viruses from various sources such as raw foods, other people and ourselves. Effective hand washing is therefore extremely important. Food handlers should wash their hands regularly throughout the day. In particular;

Before:

• Starting work
• Touching ready-to-eat foods

After:

• Visiting the toilet
• Taking a break
• Touching raw foods such as raw meat, poultry, fish, vegetables and eggs
• Touching hair or face
• Sneezing, coughing or blowing nose
• Carrying out cleaning tasks
• Handling waste or touching bins
• Touching any dirty surfaces or equipment
• Changing a dressing or plaster
• Contact with any faeces or vomit
• Touching animals or pets
• And at appropriate times during the day

An adequate number of unobstructed wash hand basins must be available for use in convenient locations. These must be provided with a hot and cold water supply, anti-bacterial soap and a method of drying hands effectively (ideally disposable towels).  Hands must be dried thoroughly as wet hands can spread bacteria more easily.

Food handlers should avoid touching their nose, mouth, face, ears and hair when handling food. Food handlers should also minimise the amount that ready-to-eat foods and food contact surfaces they touch.

What about gloves?

Many people believe that gloves are safer than using their hands to prepare food. This is not necessarily true. Gloves are not a substitute for good hand washing. Gloves can become contaminated with bacteria in the same way as our hands.

If gloves are to be used, they must be changed after each task. Contamination of the new glove and hands must be avoided when changing gloves.

What about hand sanitisers?

Hand sanitisers (or anti-bacterial hand gels) can be used in addition to hand washing. They work by killing bacteria but they don’t work properly on dirty or greasy hands so they must not be used instead of washing hands. They also don’t work on certain viruses such as norovirus. If you decide to use them, train staff on their limitations and don’t let them be a substitute for hand washing.

References:

Food Standards Agency – Food Handlers: Fitness to work– Regulatory Guidance and Best Practice for Food Business Operators.