Medical surveillance of food handlers requires more attention. The vast majority of workplaces we visit have their own in-house canteens that prepare and serve food to the employees of the organisation – and in some instances provide meals to them more than once a day.
Food handlers, what is the risk?
What I have observed from conducting audits is that there is generally still little awareness about the fact that the food handler him/herself is the biggest risk to health of the employees. Since there is nothing hard and fast in National legislation requiring a food handler to undergo medical surveillance, most employers neglect to follow this course of action.
A food handler is a person who, in their normal routine work, comes into contact with uncovered food not intended for personal use. Food includes water and any other liquid intended for human consumption. For our purpose a food handler is thus any person involved in the processing, production, manufacturing, packaging, preparation, sale or serving of any foodstuff including water and beverages.
Medical surveillance of Food Handlers
According to the Occupational Health and Safety Act, medical surveillance is the planned program of periodic examination of employees by an occupational health practitioner.
With food handlers, the hazard is the food handler as he/she carries the pathogenic organisms. This is why it is necessary for them to undergo medical surveillance – to determine whether or not they will be exposing our employees to such health risks.
In South Africa, the aspect of routine medical examination of food handlers varies considerably amongst health authorities, especially at local government level. Some enforce it through legislation, which makes it compulsory, while others do not require it at all. This situation is not in the best interest of all concerned and the Department of Health has therefore issued guidelines in this regard.
Proposed Strategy for the Health Surveillance of Food Handlers
The Department of Health (DoH) has issued the following six principles to be applied in respect of the management of health issues of food handlers:
- Management Commitment
- Education and Training
- Health Interviews
- Reporting illness to Management
- Applying basic food handling practices
- Applying basic personal hygiene practices.
In my opinion, what is most important is that managers should encourage employees to report to their supervisors whenever they have diarrhoea, sore throat, fever, a cold or open skin lesions, or are jaundiced.
The following conditions disqualify a person temporarily from food handling:
- infection of the eyes or eyelids;
- inflammation and/or discharge from ears;
- oral sepsis;
- staphylococcal conditions e.g. recurrent boils or open sores; or
- recent history of gastrointestinal infection.
- According to the DoH, the following rule with regard to the length of exclusion from work after specific illnesses should be applied. (Return to work in these cases should, however, only take place after consultation with and consent of a medical doctor):
- Hepatitis A: six weeks from onset of jaundice;
- Salmonella food poisoning, cholera, dysentery and typhoid and paratyphoid: three consecutive negative stool specimens taken 48 hours apart;
- Parasite worms and other parasitic conditions: until successfully treated;
- Staphylococcal and streptococcal: until successfully treated;
- All other gastrointestinal illnesses (bacterial or viral): until symptom free: and;
- Tuberculosis: seven days from onset of effective treatment.
It is therefore clear that in the absence of proper medical surveillance of our food handlers, we could essentially infect the entire workforce with illness.