How to maintain food staff fitness for work.

This article has been written by Pilla Founder, Liam Jones, click to email Liam directly, he reads every email.

The fitness for work policy is to ensure that food handlers do not present any health risks to the food itself, if they show or have previously shown signs or symptoms of a food borne illness or skin diseases/disorders.

A convalescent carrier is a person who has suffered from a food borne illness and appears to have completely recovered but, is still harboring and excreting these pathogenic bacteria, sometimes for a long period after recovery and therefore, as a food handler, they still present a significant risk to food safety until the point when all pathogenic organisms have been shown to have been excreted, usually this is proven by negative stool samples, monitored under the auspices of a doctor.

Occasionally some individuals can harbor pathogenic bacteria internally without ever showing any apparent symptoms of a food borne illness, these are known as asymptomatic or healthy carriers. Some individuals can also carry naturally high levels of pathogenic bacteria such as staphylococcus aureus on their skin and hands, these individuals may unknowingly present a serious risk to food safety, hence why only the highest standards of personal hygiene are acceptable.

Before starting work

Before commencing work, all potential new employees must complete a fitness to work questionnaire template to help eliminate personnel who may not be safe to be working around food. They may be potentially carriers of food borne diseases, both healthy or convalescent. The form should be completed by the manager and the staff member together sat together as a 'Note' on the Pilla weekly planner.

This form must be completed when returning to work from any gastrointestinal illness any notifiable illness and when having suffered severe skin conditions such as boils on the hands or wrists also infected skin caused by eczema, psoriasis or dermatitis.

This form must be completed also when returning to work from a holiday from a country where gastrointestinal illness commonly occurs.

Illness reporting

All food handlers must notify their managers of any food poisoning symptoms, infectious diseases, septic lesions or infected skin conditions immediately. They must also report to their managers if any immediate family members are suffering any of the above conditions. 

Staff should report any illness to managers using the private communication thread on a shift inside the Pilla app. This process has been explained in full on this article about reporting and sickness and absence.

The food handler’s fitness to work form must be completed on return to work.

First aid provision

All cuts and wounds must be covered with blue waterproof plasters.

Ample provisions in first aid kits must be available in food areas, these must be checked regularly to ensure plentiful supply always available.

Food handler exclusion

Food handlers showing symptoms of food borne illness, skin lesions or skin disease will be sent home or restricted from food handling duties. They must not return to work until safe to do so, see following guidance for notification and exclusion.

Return from holiday

Food handlers who fall ill whilst abroad on holiday must not return to work until safe to do so. Many diseases and infections that are prevalent in other countries which are rare or unknown in this country can develop quickly however some can take weeks to develop.

Food handlers must not return to work or handle food until symptoms cease. If any doubt exists regarding the illness the individual must seek advice from a doctor before returning to work.

On return to work the individual must complete the fitness to work form.

Notification and exclusion procedure for food handlers with certain conditions

Food handlers suffering with general sickness and diarrhea should be excluded from food handling duties immediately.

These food handlers must not return to work until a minimum of 48 hours free from any symptoms. 

On returning to work these individuals must be given advice regarding extra vigilance with personal hygiene and ensure that they wash their hands more frequently.

The exclusion of food handlers with specific infections who could expose food to risk of contamination, see chart below:

Organism/disease

Criteria for clearance to return to work when symptom free

Bacillus spp.
Campylobacter spp.
Clostridium perfringens
Cryptosporidium
Giardia lamblia
Salmonella spp. (excluding typhoid and paratyphoid)
Shigella sonnei
Staphylococcus aureus (including MRSA)
Vibrio (except vibrio cholerae 01 and 0139)
Worms except threadworm and taenia solium
Yersinia spp.

Must ensure at least 48 hours after first normal stool, providing that good personal hygiene is practiced on return.

Typhoid and paratyphoid (enteric fever)

Clearance by GP, requires extensive antibiotic treatment and confirmation of clearance of infection through extensive stool sample testing over long period.

Verocytotoxin-producing escherichia coli (e.g. E. coli 0157)
Shigella dysenteriae, flexneri and boydii

In addition to the minimum 48-hour exclusion, medical clearance usually requires at least 2 consecutive negative stool samples taken at intervals of at least 48 hours apart.

Hepatitis a

At least a minimum of 7 days after onset of jaundice and/or other symptoms

Entamoeba hystolitica

In addition to the 48-hour exclusion. One negative stool sample taken at least one week after the end of treatment.

Threadworm

Until treated successfully when GP gives final clearance.

Taenia solium

2 negative stool samples required at one and two weeks post treatment.

Vibrio cholerae 01 and 0139

In addition to the normal minimum 48-hour exclusion, medical clearance usually requires 2 consecutive negative stool samples taken at intervals of a minimum 24 hours.

Norovirus

Symptom free for a minimum of 48 hours, however, if the individual has had sickness and diarrhea in the workplace, a robust clean and disinfection regime should take place as the virus is highly contagious and can be carried in the air as well as on food.

Nasal, eye, ears discharge

GP to advise.

Septic wounds which cannot be completely covered by waterproof dressing

When septic lesion has healed.

Infected psoriasis, dermatitis, eczema or other infected skin condition

GP to advise.

Non-infective cause of symptoms

Infections are not always the cause of sickness and diarrhoea and exclusion is not required when there is good evidence of a non-infective cause, see examples below:

• •Morning sickness due to pregnancy
• •Some medications for other conditions can cause nausea, sickness whilst others can cause diarrhoea.
• •Certain conditions affecting the gastrointestinal tract such as, inflammation of the bowel or stomach, diverticulitis, colitis, crohns disease, ibs, cancer, coeliac disease, food allergies, intolerances and sensitivities, cystic fibrosis etc.
• •Dietary indiscretions such as drinking too much alcohol or consuming too much spicy food.

If in doubt, it is better to assume that the cause is an infection, therefore exclude the food handler unless there is evidence to show otherwise.

Corrective actions if things go wrong

• •Food handlers that report food poisoning symptoms or have been in contact with somebody who has, they must be temporarily suspended from food handling duties or sent home. They can return to work as per the above schedule.
• •Staff must be retrained if any of the above safety points are not strictly adhered to.
• •Increase supervision and monitoring of staff in in any doubt.