Learning Resource. Involving bacteria types such as Salmonella and Campylobacter from unwashed hands touching raw foods and then high risk foods.

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1 Babcock International Group Learning Resource Food Safety - Personal Hygiene High standards of personal hygiene are essential to ensure that food does not become contaminated by microbiological, physical, chemical or allergenic contaminants. It is also a prerequisite for the implementation of HACCP. It should never be assumed that good personal hygiene is common sense that will be automatically implemented by all staff. Procedures and rules for staff hygiene must be documented as part of the companies *food safety policy and covered with new employees during their induction training. Staff must then be trained, motivated, supervised and monitored to ensure the continuous implementation of good hygiene practices. Potential Hazards Bacterial contamination Cross-contamination Carriers Physical contamination Chemical contamination Allergenic contamination E. coli 0157, Norwalk-like viruses, Hepatitis C, Campylobacter and particularly Staphylococcus aureus, from septic cuts, hands, hair, the nose or mouth. Involving bacteria types such as Salmonella and Campylobacter from unwashed hands touching raw foods and then high risk foods. Incubatory carrier - a person who excretes organisms during the incubation period of an disease but shows no symptoms. Convalescent carrier - a person who continues to excrete organisms while recovering from a disease and after symptoms have ceased. From jewellery, hair, piercings, fi ngernails etc. From perfume, aftershaves, highly scented soaps, body lotions, deodorants etc. From unwashed hands after touching allergens (such as nuts, shellfi sh etc.) and then prepared food that is supposed to be allergen free. 1

2 HAND HYGIENE Food handlers touching contaminated poultry and raw meats are likely to have Salmonella, Campylobacter, Staphylococcus aureus and E.coli on their hands. High numbers of pathogenic bacteria on the hands, fingertips and nails are also likely from faecal contamination after using the toilet. High levels of Staphylococcus aureus are likely after touching infected cuts or boils. Microorganisms may survive on the skin from a few minutes to several hours; so effective, regular hand washing is essential. Food handlers must wash their hands regularly throughout the day and in particular: Before entering a food preparation area. Between handling raw poultry, meat or vegetables and handling ready to eat foods. After taking a break. After going to the toilet. After handling waste food or refuse. After eating, smoking, sneezing, touching their nose or any other part of the body. Information on *Food Safety Policy can be found on Handout R6079 Hygiene Training. Supervisors need to be aware of other bad hygiene practices that can lead to contamination by food handlers and prevent this occurring: Using the same spoon to taste different foods or using fingers to taste foods. Licking fingers to separate grease proof paper etc. Breathing onto glasses or cutlery when polishing them. Biting nails or sucking fingers. To prevent chemical contamination, food handlers must wash their hands after handling cleaning chemicals and to prevent allergenic contamination after handling known allergens. 2

3 EFFECTIVE HAND WASHING The result that food handlers should achieve when washing their hands is to reduce pathogens to a safe level. Hand washing should be carried out at a designated wash-hand basin and will require: An accessible wash-hand basin or trough, preferably with non-hand operated taps. Clean, warm (35 C to 50 C) running water. Suitable liquid soap, unperfumed and bactericidal. Paper towels. A foot operated or open topped bin for used towels, this must be emptied as often as is necessary. An effective management system must be in place to ensure that the facilities are kept clean and well maintained and that soap and paper towels are always available. An important part of a supervisors role is to ensure that correct hand washing procedures are followed at all times. Step 1 Step 2 Use hot running water ideally 35 C to 50 C. Apply unperfumed, bactericidal liquid soap. Rub hands together vigorously for about 15 to 20 seconds. Ensure that both sides of the hands are washed, paying particular attention to thumbs, between fi ngers, fi nger tips, wrists and under the nails. Rinse the hands under clean, warm running water (around 4 to 8 litres per minute). Continue to rinse until all lather, dirt and contamination are removed. Step 3 Hands, wrists and arms should be completely dried, preferably using a paper towel. Step 4 The paper towel should then be used, if necessary to turn off the tap. It should then be disposed of in a foot operated, or open waste container. The container or lid must not be touched with clean hands. 3

4 A nail brush can be used to clean fingernails. In theory cross contamination from one food handler to another, via a nailbrush is unlikely. However, nailbrushes should be changed at least daily. Disposable or plastic nail brushes with nylon bristles are recommended. Cleaning and disinfection of nail brushes may be achieved in a dishwasher or by using chemical disinfectants followed by drying. Hot air dryers are not recommended for food handlers, as they often take a long time to completely dry hands. This results in food handlers walking away drying their hands on their protective clothing resulting in the re-contamination of the hands. Fingernails should always be short, clean and unvarnished as varnish can harbour dirt and bacteria and may flake off into food and contaminate it. False nails, nail extensions etc. should not be permitted for the same reasons. People who bite their nails run the risk of transferring Staphylococcus aureus from their mouth to their hands, then to food. This aspect of someones behaviour should always be taken into account when considering employing food handlers. JEWELLERY AND SCENTED PRODUCTS Food handlers should not wear any jewellery including; earrings, visible piercings, watches, bracelets, chains, jewelled rings or brooches which harbour dirt and bacteria, Jewellery can also cause physical contamination if it falls into food, (there is also a risk of entrapment if food handlers wear jewellery whilst operating machinery.) Some companies allow staff to wear a plain wedding band and specific arrangements may be necessary for the wearing of jewellery for religious or cultural reasons, always check the company policy. Food handlers should not wear strong-smelling perfumes, aftershaves, body lotion or deodorant as they may taint foods, especially food with a high fat content. PROTECTIVE CLOTHING Staff need to be aware that protective clothing is worn primarily to protect the food from risk of contamination and not to keep their own clothes clean. Protective clothing should be appropriate for the work being carried out and it should completely cover ordinary clothing, jumper and shirt sleeves must not be visible. If short-sleeved overalls are worn then only clean forearms must be visible. Protective clothing must be: Clean. Washable or disposable. Light coloured. Without external pockets. Ideally fi tted with press stud fastening not buttons which have a tendency to become detached and fall into food. Aprons if worn, should be suitable for the job and capable of being thoroughly cleaned. If disposable aprons are used they should be disposed of after each use. Rubber gloves should be maintained in a clean condition and torn gloves should be discarded. Food handling gloves should be changed between tasks and disposed of. If there are any punctures in the gloves they should be disposed of as this may lead to contamination from Staphylococcus aureus to high risk food. If gloves are used a glove policy should be provided, effective supervision of staff training on how and when to put on gloves and their correct safe use is essential. Boots may be provided for wearing in wet areas. They should be anti-slip, unlined and easy to clean. Shoes should be sensible and fit for purpose, they should be comfortable, fully encase the foot, fit correctly and be non-slip. Employers may provide steel toe-capped shoes/boots if a risk assessment indicates the need for these in particular work areas. 4

5 Hats staff need to wear a hat or head covering for many jobs involving food. It should cover as much of the hair as possible. In some companies food handlers must also wear hairnets to contain hair. If hair is long it must be tied back to prevent it falling into food and contaminating it, beards and moustaches should also be covered for the same reasons. Hats or head covering must always be put on before changing into protective clothing to avoid any hair falling onto clothing. Protective clothing must not be worn outside the premises or for travelling to and from work. Dust, pet hairs and woollen fibres are just a few of the contaminants carried on clothing exposed to the outside environment. Outdoor clothing and personal effects must not be brought into food rooms. They should be stored in suitable lockers or well ventilated, clean cloakrooms. VISITORS Hygiene rules should also apply to any visitors to the food areas, this can include maintenance staff, cleaning/pest control contractors, suppliers, customers, as well as company staff who visit food areas. They should be provided with appropriate protective clothing, rules on jewellery etc. should also be complied with. In some cases visitors may be asked to sign to say that they have read and understood the company hygiene rules and also to complete a medical questionnaire, especially if they are entering an area where open high risk foods are being prepared. CUTS, BOILS, SEPTIC SPOTS AND SKIN INFECTIONS Staff with septic cuts or boils should be excluded from food handling areas as these lesions are likely to contain Staphylococcus aureus. Uninfected cuts should be covered with a brightly coloured waterproof dressing (normally blue in the food industry). All dressings must be waterproof to prevent blood and bacteria from contaminating the food and also to prevent bacteria from the food (especially raw meats or fish) making the cut septic. Waterproof dressings specifically for food use have a metal strip incorporated in the dressing to assist detection where metal detectors are used. Lost dressings must be reported immediately. Perforated plasters are not recommended. Staff reporting for work wearing unacceptable dressings must have them changed before entering the food room. Staff must have access to adequate first aid facilities, including appropriate waterproof dressings. THE NOSE, MOUTH AND EARS Up to 40% of adults carry Staphylococcus aureus in the nose and throat and 15% on their hands. Eating should be prohibited in food areas, if food handlers eat or pick at food whilst working they are likely to transfer the bacteria from their mouths to their fingers, then to food or utensils. If food needs to be taste tested then a clean spoon should be used every time to prevent contamination. Smoking should only take place in designated areas, physical contamination can occur if cigarette ends or ash fall into food, bacterial contamination can occur if staff touch their lips whilst smoking. If staff leave the premises to smoke, they must change out of their protective clothing and into their own outdoor clothes before leaving and then change back into their protective clothing and wash their hands before re-entering the food area. Coughing and sneezing spreads Staphylococcus aureus by air borne droplets therefore anyone with a bad cold and/or sore throat should not handle open food. REPORTING ILLNESS/EXCLUSION There is a requirement to report illness that may present a hazard to food safety and to exclude people from food handling duties where there is any likelihood of causing contamination of food with pathogenic micro-organisms, either directly or indirectly, as a result of their work activities. 5

6 GASTROINTESTINAL ILLNESS Diarrhoea and Vomiting Diarrhoea and vomiting may be indicative of a gastrointestinal infection. Food business managers must encourage the prompt reporting of diarrhoea and vomiting by their food handlers. Immediate Action Anyone who has diarrhoea and vomiting should report to their line manager and leave the food handling area immediately. Subsequent Action If vomiting has occurred, the area and all contaminated surfaces, equipment and utensils should be cleaned and sanitised. Dispose of any food which may have been contaminated. Toilet handles, taps and surfaces must be cleaned and sanitised after contact with anyone reporting diarrhoea and vomiting. If there is only one bout of diarrhoea and vomiting in a 24 hour period, and there is no fever, the person may resume food handling duties when they should be reminded of the importance of good hygiene practice, particularly hand washing. If symptoms persist, the person should seek medical advice and return to work once the conditions detailed below are met: Requirements for return to work following illness due to gastrointestinal infection No vomiting for forty-eight hours once any treatment has ceased. The bowel habit has returned to normal for fortyeight hours either spontaneously or once any treatment has ceased. Good hygiene practice, particularly hand washing, is observed in all circumstances. STOOL TESTING Negative stool samples from an employee recovering from a diarrhoeal illness are not necessary conditions of return to work, with the exception of typhoid and paratyphoid infections and infection caused by Verocytotoxin-producing E. coli (VTEC). See below: Infections requiring special consideration. ENTERIC FEVER Typhoid and paratyphoid fevers, collectively called enteric fever, need special consideration because of the severity of the illness and because, following recovery, individuals can continue to carry and excrete the organism over a long period with a consequent risk of food contamination. This is referred to as the carrier state. Anyone suffering from typhoid or paratyphoid must be excluded from food handling. Investigation and management of these individuals will usually be carried out by the local authority, who will usually require them to remain off food handling work until stool tests indicate that the infecting organism is no longer being excreted. This will generally take at least three months, there should be six negative faecal samples before a return to work. The food handler who is still excreting but is otherwise well could be considered for return to work in a non-food handling capacity after discussion with officers from the local authority Environmental Health Department. If a food handler who is a carrier of typhoid or paratyphoid organisms is identified (for example, during investigation into an outbreak) they must be excluded from food handling and follow the same course of action that applies for an individual who is suffering from a typhoid or paratyphoid illness. The food handler who has been in close domestic contact with a known case, or who has been exposed to an outbreak in the UK or abroad, must be excluded from food handling duties. Advice should be sought from relevant health care professionals. VTEC In the exceptional circumstance where VTEC (the most common strain in the UK being E. coli 0157:H7) infection is identified in a food handler, they should be excluded from work until the bowel habit has been normal for 48 hours, and two negative faecal samples taken 48 hours apart have been obtained. 6

7 HEPATITIS A Food handlers with hepatitis A should remain off work until seven days after symptoms have appeared, usually jaundice. Advice should be sought from the relevant health care professionals. Symptom-less contacts of a case of Hepatitis A can continue food handling provided they the highest standards of hygiene practice are observed. Please note that some individuals may have medical conditions that cause changes to bowel habits and which are not associated with a risk of infection. In such cases, only a change in bowel habit associated with a possible infection should be considered as significant. SKIN CONDITIONS Food handlers with lesions on exposed skin (hands, face, neck or scalp) that are actively weeping or discharging must be excluded from work until the lesions have healed. An infection of the finger nail-bed (whitlow) or a boil on the face or other exposed skin, even if covered with a suitable waterproof dressing, will usually be considered a bar to working as a food handler. In contrast, infected lesions on non-exposed skin, e.g. the back or legs, are not a bar to food handling duties. The importance of meticulous hand hygiene should be emphasised. Clean wounds on exposed skin, such as cuts, must be totally covered with a distinctively coloured waterproof dressing but there is no need to discontinue food handling. 7