PERSONNEL HYGIENE

EDITOR: AGRICULTURAL UNIVERSITY OF ATHENS

OCTOBER 2017

INTRODUCTION

CHAPTER 1 – PERSONAL HYGIENE

1.1 DEFINITION OF PERSONAL HYGIENE

1.2 GOAL OF PERSONAL HYGIENE

1.3 EU REGULATIONS RELEVANT TO PERSONAL HYGIENE

CHAPTER 2 – GOOD HYGIENE PRACTICES

2.1 HAND WASHING

2.2 CLOTHING AND CLEANLINESS OF CLOTHING

2.3 PROHIBITED CLOTHING/MATERIAL

2.4 PERSONNEL BEHAVIOR - DESCRIPTION OF GOOD AND BAD EMPLOYEE (IN TERMS OF FOOD SAFETY)

2.5 HANDLING OF FOOD PRODUCTS

2.6 INSTRUCTIONS FOR VISITORS

CHAPTER 3 – HEALTH AND MEDICAL SCREENING

3.1 HEALTH CERTIFICATE-MEDICAL EXAMINATION OF PERSONNEL

3.1.1 INTRODUCTION

3.1.2 DEFINITION

3.1.3 CERTIFIED FOOD HANDLER

3.1.4 MEDICAL EXAMINATION

3.1.5 ISSUING OF HEALTH CERTIFICATE

3.2 FOODBORNE ILLNESSES

3.2.1 DEFINITION AND NATURE

3.2.2 ECONOMIC IMPACT OF FOODBORNE ILLNESS

3.2.3 HEALTH CONSEQUENCES OF FOODBORNE ILLNESS

3.2.4 INFECTIOUS DOSE

3.2.5 INFECTION

3.2.6 INTOXICATION

3.3 OCCUPATIONAL HEALTH AND SAFETY IN FOOD COMPANIES

3.3.1 IMPLEMENTING SAFETY TRAINING FOR NEW EMPLOYEES

3.3.2 TRAINING ON PERSONNEL HYGIENE

3.3.3 GUARDRAILS AND FLOORS

3.3.4 VENTILATION AND LIGHTENING

3.3.5 EQUIPMENT, MACHINE GUARDING AND MAINTENANCE

3.3.6 PERSONAL PROTECTIVE EQUIPMENT

3.3.7 SAFE AND HYGIENIC PRACTICES

3.3.8 WORKING IN CONFINED SPACE

CHAPTER 4 – EMPLOYEE TRAINING

4.1 CONTENT OF TRAINING MATERIAL

4.2 GOALS OF TRAINING

INTRODUCTION

Personnel hygiene is probably the most important factor which is relevant to food safety. Lack of personnel hygiene procedures in a food facility could lead to serious contamination of food products due to physical, chemical or microbiological dangers. For example the published literature confirms that food poisoning outbreaks can be caused by contamination from personnel, and reinforces the need to ensure strict personnel hygiene procedures in the food industry. Guzewich and Ross (1999) reviewed published scientific literature for the period 1975-1998 and concluded that food workers, particularly those that were ill, could serve as the source of infection in food poisoning outbreaks and that hand contact with food was a mode of contamination.

The main purpose of this e-book is to increase the awareness level of food handlers in order to understand the importance of their role in food safety. After the conclusion of this e-book there should be a clear understanding of what personnel hygiene really means and the ways to achieve it.

The main sections of this e-book are:

Personal hygiene

Good hygiene practices

Health and medical screening

Employee training: training program and content of training

The main objectives to be achieved by this e-book are:

To describe the basic principles and reasons for effective personal hygiene

To present an effective personnel hygiene model in food business, but most importantly:

To ensure that those who come directly or indirectly into contact with food are not likely to contaminate food by:

– maintaining an appropriate degree of personal cleanliness;

– behaving and operating in an appropriate manner (Codex Alimentarius, 2003).

1

PERSONAL HYGIENE

AUTHORS:

Massouras Theofilos
(Agricultural University of Athens)

Papanikolaou Nestor
(Agricultural University of Athens)

1.1 Definition of personal hygiene

1.2 Goal of personal hygiene

1.3 EU Regulations relevant to personal hygiene

Chapter Objectives:

To define personal hygiene in terms of food safety

To present the basic principles of personal hygiene

To set the main goals of personal hygiene

To present current EU Regulations relevant to personal hygiene

1.1

DEFINITION OF PERSONAL HYGIENE

Personal hygiene is the implementation of rules and procedures that a food handler should follow in order to ensure the safety of the food products. The maintenance of a high personal hygiene level depends on the following elements:

Personal health status. No person suffering from, or being a carrier of a disease likely to be transmitted through food or afflicted, for example, with infected wounds, skin infections, sores or diarrhea is to be permitted to handle food or enter any food-handling area in any capacity if there is any likelihood of direct or indirect contamination. Any person so affected and employed in a food business and who is likely to come into contact with food is to report immediately the illness or symptoms, and if possible their causes, to the food business operator.(Reg. 852/2004, Chapter VIII)

Personal cleanliness. Every person working in a food-handling area has to maintain a high degree of personal cleanliness.

Suitable and clean protective clothing. Every person working in a food-handling area has to wear suitable, clean and, where necessary, protective clothing.

Personal behavior. Every person working in a food-handling area should comply with the rules in order to promote food safety.

1.2

GOAL OF PERSONAL HYGIENE

The basic goal of personal hygiene in a food handling facility is to reduce or eliminate the risk of contamination of food products. The contamination could be indirect or direct (depending on whether there is a physical contact with the food or not) and could be due to the following factors:

Physical

Chemical

Microbiological

Food industries are obliged to apply processes and procedures in order to ensure that employees and visitors implement personal hygiene practices. Such practices will result to the sanitary handling and delivery of safe and quality products to consumers.

1.3

EU REGULATIONS RELEVANT TO PERSONAL HYGIENE

Reg. 852/2004 on the hygiene of foodstuffs: Chapter VIII-Personal hygiene.

Codex Alimentarius, Recommended, Code of Practice - General Principles of Food Hygiene, CAC/RCP 1-1969, Rev. 4-2003 (Section VII).

2

GOOD HYGIENE PRACTICES

AUTHORS:

Josipa Giljanović (University of Split)

Ante Prkic(University of Split)

Prof. Anas Al-Nabulsi(Jordan University of Science and Technology)

2.1 HAND WASHING

2.2 CLOTHING AND CLEANLINESS OF CLOTHING

2.3 PROHIBITED CLOTHING/MATERIAL

2.4 PERSONNEL BEHAVIOR- SHORT DESCRIPTION OF GOOD AND BAD EMPLOYEE THAT HANDLES FOOD (IN TERMS OF FOOD SAFETY)

2.5 HANDLING OF FOOD PRODUCTS

2.6 INSTRUCTIONS FOR VISITORS

Chapter Objectives:

To present Good Hygiene Practices in terms of food safety;

To set the basic rules for a food handler in food industry in order to achieve high level of personal hygiene;

To describe the importance of the role of every food handler in terms of food safety;

To present easy rules and procedures that a food handler should follow in a food industry.

2.1

HAND WASHING

Hands are usually in direct contact with food products, so there is a major possibility that food poisoning bacteria could be transferred from hands to food. This fact could result to serious contamination of food products. Thorough hand washing of every food handler reduces the possibility of contaminating food with bacteria (The Food Hygiene Handbook for Scotland, 2016).

Hands washing and disinfection procedures always use hot water, liquid soap and disposable paper towels.

Every food handler should wash his/her hands regularly throughout each working day and especially:

After using toilet

When entering the food facility

After a break, lunch, smoking

After handling row food, including eggs

Before handling ready to eat food

After throwing away garbage or waste

After putting on or changing clothes

After getting in touch with animals, or handling boxes, or waste contaminated by birds dropping

After cleaning or handling of dirty cloths, crockery etc.

After coughing or sneezing

After contacting with nose, ears, hair, mouth etc.

After cleaning – disinfecting

After getting in touch with anything dirty (e.g money, external packaging, flowers, etc.)

After dealing with an ill customer or a baby's nappy.

Handwashing procedure:

Washing basins must be provided with hot and cold water, soap and drying facilities. The correct hand washing procedure is essential to prevent food contaminating. All necessary places should have a protocol for proper hand washing. (Higijenski minimum, 2016).

First step:

The hands should be washed right up to the elbow using running hot water (35 ⁰C to 45 ⁰C) in order to remove all the lather, bacteria and dirt.

Figure 2.1 - First step in handwashing

“Adapted from (Šimunović Jure, 2012)”

Second step:

Apply sufficient liquid soap with antibacterial activity (with disinfectant) to ensure a good lathe.

Figure 2.2 - Second step in handwashing

“Adapted from (Šimunović Jure, 2012)”

Third step:

Rub hands together vigorously for 10 to 15 seconds while ensuring that dirt is removed from and under the fingernails and from the surfaces of the hands and arms. Rub the back of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds.

Figure 2.3 - Third step in handwashing

“Adapted from (Šimunović Jure, 2012)”

Fourth step:

Rinse your hands well under clean, hot running water.

Figure 2.4 - Fourth step in handwashing

“Adapted from (Šimunović Jure, 2012)”

Fifth step:

Dry thoroughly with a single use paper towel. This technique relies on the paper absorbance and removes excess moisture. Turn off faucet handles with paper towel. Use a paper towel to touch the door handle when exiting the lavatory. Reusable towels should not be used.

Figure 2.5 - Fifth step in handwashing

“Adapted from (Šimunović Jure, 2012)”

As fingernails may harbor bacteria, they must be kept short and clean. Nail polish and false fingernails may contaminate food and should not be used.

2.2

CLOTHING AND CLEANLINESS OF CLOTHING

The Food Safety (General Food Hygiene) Regulations state that “Every person working in a food handling area shall maintain a high degree of personal cleanliness and shall wear suitable, clean, and where appropriate, protective clothing.” These Regulations also state that “adequate changing facilities for personnel must be provided where necessary”.

In order to protect food products from contamination (microbiological or physical), employees are obliged to follow a strict dress code policy according to food industry’s instructions.

Food handlers should keep all parts of their body and clothing clean, and should have suitable protective clothing provided by the employer.

Protective clothing and footwear includes working clothes overcoats, gloves, aprons, hats, caps, protective shoes, gumboots or plastic protection for shoes. In areas where food is handled, protective clothing should fully cover personal clothing. Protective caps should be used to fully cover hair and facial masks should cover the beard and mustache.

Protective clothing should completely cover or replace personal clothing. Food handler should wear clean, washable, light colour protective clothing without external pocket provided by the employer. Press studs or velcro fastening should be preferred over buttons.

Food handlers should be informed about Good hygiene practices and apply all relevant regulations in daily jobs, including the use of suitable protective clothing and the application of high standards of personal cleanliness. They should always change protective clothing when they get dirty; avoid wiping hands on clothing, especially after handling raw food.

Protective clothing should be suitable for carrying out work and should cover ordinary clothing. Shirt and shirt gloves should not be slipped and in case of short sleeves, only the forearm should be visible. Appropriate footwear should be used in order to prevent slipping and ensure the protection of the feet.

Protective clothing should never be worn outside of the food premises, especially when visiting the toilet. Food handlers should change when leaving the production area or when leaving their work area or even when visiting the canteen.

Personal and protective clothing should never be stored in the production area unless they can be stored in suitable lockers/wardrobes.

Plastic aprons worn over clothing may offer extra protection in situations with high levels of humidity.

Food handlers should use disposable gloves where necessary. In this case the same principles of good hygienic practices apply as in the case of bare hands. Gloves shall be replaced when it is recommended by hygiene practices or when they become contaminated. If gloves are not used properly, then the risk of contamination is the same as in the case of a bare hand. Gloves can be an effective protective barrier between food handlers’ hands and the food products they handle.

Proper Use of Gloves: (ASSETS, 2010)

Hands should be washed and dried thoroughly:

Before the use of gloves

When changing to a new pair of gloves

After the use of gloves

A new pair of gloves should be worn:

When changing tasks (e.g. when moving to a new working place, after handling raw products, before handling ready-to-eat food products, after cleaning, etc.).

After coughing or sneezing or touching hair or blowing nose.

As frequently as possible. A pair of gloves should not be worn for a period longer than 4 hours. Prolonged use of gloves could result to excessive perspiration of hands, which provides the perfect conditions for bacterial growth on human skin.

Disposable gloves should not be reused for any reason.

In case that durable re-usable gloves are used, they should be washed and sanitized between each task and stored carefully after been removed in order to prevent contamination.

Protective gloves should always be used by employees:

Who have sores or cuts or rashes on their hands

Who wear orthopedic support devices on the hands (e.g casts, braces, etc. which cannot be cleaned in an adequate way

Who have artificial nails or fingernail polish

Protective footwear could be necessary either for health or for safety reasons. Protective footwear should be appropriate for the working area in order to provide maximum levels of safety. Food handlers should ensure that the shoes are comfortable and well fitting, with appropriate non slip soles and easily cleanable. They should be stored in cleanable racks in the changing room.

Working boots will be required where wet processing or cleaning is carried out. Footwear should be coded by colour wherever possible depending on the hygiene requirements of each production area.

All visitors should comply with the use of protective clothing and footwear. Disposable protective clothing and plastic overshoes should be available for visitors.

Food handlers should wear a suitable head cap. Hair may confine certain kinds of bacteria which may prove to be a serious food contamination risk. Food handlers should regularly keep their hair clean and keep their hair under protective cap during their job. Protective caps should always be put on before entering the food premises and always away from food preparation area. Long hair should be tied back. The protective caps, hats or scarves, which are used should be clean and completely cover the hair. If a food handler has a beard or a mustache, he should wear a protective cover (a facial mask for example).

Most protective clothing is nowadays made from a blend of 65% polyester and 35% cotton. This is proven to be really appropriate for food industry and can be efficiently cleaned using modern laundry equipment. An adequate supply of clean protective clothing is important. The frequency in changing depends on the working area and on the job description (e.g for daily or weekly change). Washing of the protective clothing depends on the policy of each company – clothing could be washed at home by each worker or at a laundry house. However if workers are instructed to wash their clothes at home, they should be trained to apply the laundry procedure according to HACCP principles.

2.3

PROHIBITED CLOTHING/MATERIAL

Food handlers should not wear jewelry and strong smelling perfume or aftershave as it may damage foods especially those with a high fat content. Food handlers should not wear watches, earrings, jeweled rings or brooches because small pieces of metal may end up in food products and present a serious physical hazard. Such clothing and material may contain dirt and bacteria, which can contaminate a food product.

2.4

PERSONNEL BEHAVIOR - DESCRIPTION OF GOOD AND BAD EMPLOYEE (IN TERMS OF FOOD SAFETY)

People engaged in food handling activities should refrain from behavior which could result in contamination of food, for example:

smoking;

spitting;

chewing or eating;

sneezing or coughing over unprotected food.

Personal effects such as jewellery, watches, pins or other items should not be worn or brought into food handling areas if they pose a threat to the safety and suitability of food. (Codex Alimentarius, 2003)

Figure 2.6 Examples

“Adapted from (Hellenic Food Authority, 2004)”

A good employee that handles food:

Is always clean

Washes his / her hands often according to hand washing instructions

Takes care of his/her health (health certificates / examinations)

Reports to his / her supervisor in case of an illness that could be transmitted through food

Wears a proper and clean work outfit

Wears necessary protective equipment (gloves, head caps, footwear, etc.)

Avoids bad personal habits which could contaminate food directly or indirectly

Knows how to handle food in order to protect food safety

Supervises and guides his / her colleagues when needed

Figure 2.7 – Example of good employee

“Adapted from (Hellenic Food Authority, 2004)”

A bad employee that handles food:

Is dirty

Does not wash his / her hands often according to hand washing instructions

Does not wear disposable protective gloves or other necessary protective equipment

Does not report to the supervisors when he / she suffers from a disease that is transmitted through food

Has infected wounds, pimples, etc. which are not covered

Does not wear clean work outfits

Gets in touch with things which could contaminate food

Has bad personal habits which could contaminate food directly or indirectly

Does not cooperate and does not handle food properly

Figure 2.8 – Examples of cases where hand washing is required

“Adapted from (Hellenic Food Authority, 2004)”

2.5

HANDLING OF FOOD PRODUCTS

Food whether from plant or animal origin harbors foodborne pathogens. Consequently, food products need to be handled in a proper way in order to ensure that they do not become contaminated and that the bacteria which already exist in each food product are not allowed to grow.

Food handling depends mainly on the category of food (raw or cooked/ready to eat).

Raw foods, which will be cooked in a later stage, could be safely handled with bare hands (provided that hands are clean and sanitized).

Cooked or ready-to-eat food products should be carefully handled with utensils such as spoons, tongs, spatulas or disposable gloves.

It is critical to apply Good Hygiene Practices (GHP) in all stages from production until consumption. GHP and proper handling of food should be applied to the following cases:

During delivery

During transportation

During storage

During food preparation (washing, cutting, mixing, etc.).

During food processing (heating, cooking, etc.)

During cooling-freezing

During serving/disposal of food products and serving utensils

Figure 2.9 – Example of handling during serving food

“Adapted from (Hellenic Food Authority, 2004)”

Figure 2.10 – Example of handling of serving utensils

“Adapted from (Hellenic Food Authority, 2004)”

2.6

INSTRUCTIONS FOR VISITORS

Visitors to food manufacturing, processing or handling areas should, where appropriate, wear protective clothing and adhere to the other personal hygiene provisions in this section. (Codex Alimentarius, 2003)

The basic rules that should apply to all visitors that enter a food handling area are:

Visitors shall take all reasonable measures and precautions to prevent contamination and to ensure general personal cleanliness.

If any of the visitors has an open wound or an infected area on his/her hands, arms or face, he/she should notify company representative before entering the facility.

No shorts, sleeveless shirt or open-toed shoes should be allowed in the facility. When appropriate or required, protective clothing, such as aprons, should be worn.

Hands should be washed and sanitized before entering the facility.

All jewelry, such as necklaces, chains, bracelets, exposed piercings, earrings, watches and rings should be removed before entering the facility.

Visitors who enter food processing areas should wear head caps and should cover all exposed hair. Beards and mustaches of any length should be covered by protective nets.

The consumption of food and drinks should be restricted inside the facility. There should be a separate room for these type of activities.

Smoking should be strictly forbidden inside the facility and No Smoking signs should be placed. Smoking should be permitted only in designated areas.

No visitor should be permitted to curry pencils, pens or any other dangerous tools inside the facility.

Visitors are obliged to follow the rules that apply in a food facility in order to promote Good Hygiene Practices and high level of Personal Hygiene.

3

HEALTH AND MEDICAL SCREENING

AUTHORS:

Ihab Ghabeish (Al- Balqa' Applied University)

Prof. Maher Al-dabbas (The University of Jordan)

Safa Smadi (The Jordan Food and Drug Administration)

3.1 HEALTH CERTIFICATE-MEDICAL EXAMINATION OF PERSONNEL

3.1.1 INTRODUCTION

3.1.2 DEFINITION

3.1.3 CERTIFIED FOOD HANDLER

3.1.4 MEDICAL EXAMINATION

3.1.5 ISSUING OF HEALTH CERTIFICATE

3.2 FOODBORNE ILLNESSES

3.2.1 DEFINITION AND NATURE

3.2.2 ECONOMIC IMPACT OF FOODBORNE ILLNESS

3.2.3 HEALTH CONSEQUENCES OF FOODBORNE ILLNESS

3.2.4 INFECTIOUS DOSE

3.2.5 INFECTION

3.2.6 INTOXICATION

3.3 OCCUPATIONAL HEALTH AND SAFETY IN FOOD COMPANIES

3.3.1 IMPLEMENTING SAFETY TRAINING FOR NEW EMPLOYEES

3.3.2 TRAINING ON PERSONNEL HYGIENE

3.3.3 GUARDRAILS AND FLOORS

3.3.4 VENTILATION AND LIGHTENING

3.3.5 EQUIPMENT, MACHINE GUARDING AND MAINTENANCE

3.3.6 PERSONAL PROTECTIVE EQUIPMENT

3.3.7 SAFE AND HYGIENIC PRACTICES

3.3.8 WORKING IN CONFINED SPACE

Chapter Objectives:

To present basic medical examination required for a food handler in Jordan

To describe the procedure of issuing a Health Certificate in Jordan

To present the most important foodborne illnesses and their consequences

To set the basic rules/instructions for safety of the workers in food industries

3.1

HEALTH CERTIFICATE-MEDICAL EXAMINATION OF PERSONNEL

3.1.1 INTRODUCTION

“People known, or suspected, to be suffering from, or to be a carrier of a disease or illness likely to be transmitted through food, should not be allowed to enter any food handling area if there is a likelihood of their contaminating food. Any person so affected should immediately report illness or symptoms of illness to the management. Medical examination of a food handler should be carried out if clinically or epidemiologically indicated.”(Codex Alimentarius, 2003).

Employers should ensure that all employees who handle food (directly or indirectly), are healthy and do not pose a threat to food safety and public health.

Each food handler should undergo medical examination conducted by certified medical institutes and doctors.

The main aim of this guideline is to prevent food contamination by food handlers.

3.1.2 DEFINITION

Food handler: Any person dealing directly or indirectly with packaged and unpacked foods or with equipment or Food products or food contact surfaces, thus requiring compliance with the application of food safety requirements

Food handling includes: Food receipt, food storage, food processing, food cooking and catering, food service and food transportation

Health certificate: A certificate attesting a person's good health and free from communicable and infectious diseases.

3.1.3 CERTIFIED FOOD HANDLER

A food handler can be certified as fit if all findings are normal or there is no risk to food safety.

All food handlers and workers that contact food directly or indirectly in an establishment should have a valid health certificate according to the established instructions.

Medical examination for food handlers should be conducted every six months according to article 14 paragraph 1 from the Law of crafts and industries no 16 year 1953. However, at any time, a certified food handler is excluded from work and should undergo re-examination if one of the following conditions arise:

Jaundice

Diarrhea

Vomiting

Fever

Sore throat with fever

Visibly infected skin lesions (boils, cuts, etc.)

Secretion from ears, eyes or nose.

Food handlers or workers that are suspected to be suffering from infectious illnesses should be reported and excluded from food handling.

3.1.4 MEDICAL EXAMINATION

A. OBJECTIVES

The main objectives of medical examination among food handlers are:

To ensure that all food handlers are not carriers of any pathogens related to foodborne diseases

To ensure that those who come directly or indirectly in contact with food are not likely to contaminate the food

To ensure that food products in Jordan are safe and do not pose any risk of foodborne diseases to the consumers.

B. FOOD HANDLER CATEGORIES OBLIGED TO ISSUE HEALTH CERTIFICATE

Food handlers working in one of the following categories of food producing or food processing or food selling establishments are obliged to issue a health certificate:

Bakery and public ovens;

Cold stores;

Sweets, jams, hallawah and tahini;

Preserved fruits and pastries;

Ice-cream, beverages, and Ice shops, storage and factories;

Fish shops;

Fruits and vegetables storage and shops;

Pasta factories;

Shops selling milk, butter, cheese and dairy products;

Olive presses and olive oil stores;

Manufacture of edible oils and grease;

Sugar refineries and sugar and molasses factories;

Fruits and vegetable canning, preserving factories and shops;

Public markets and supermarkets;

Vinegar manufacturing;

Shops dealing with the manufacturing, selling, storing, packaging or preparing of foods;

Butchery and meat shops and factories;

Breweries, alcohol, beverages;

Restaurants, cafes, cafeterias and tea shops;

Dairy and cheese factories;

Butter factories and stores;

Slaughterhouses.

C. MEDICAL EXAMINATION TYPES

Medical screening includes the following examinations (indicative list – not strictly limited):

Physical examination:

Fever

Jaundice

Skin infection on hands, arms, face

Boils, sties or septic finger

Secretion from eyes, ears, nose or gums/mouth

Lab examination:

Blood test:

 Typhoid

 Hepatitis A

 Tuberculosis

 HIV (for foreign workers)

Feces test:

 Eggs of worms and parasites

 Harmful intestinal bacteria (salmonella and shigella)

X-ray for chest:

 Tuberculin test for pulmonary tuberculosis

Smear pharynx test

 Staphylococcus

 Diphtheria (for ice-cream workers)

Other tests:

 Any additional tests which the doctor deems necessary in order to proceed to the issue of the health certificate (free from communicable and infectious diseases).

3.1.5 ISSUING OF HEALTH CERTIFICATE

According to Law of crafts and Industries No. 16 of 1953 Article 14, the worker is not allowed to handle food directly or indirectly, unless he/ she is medically examined and has obtained a certified health certificate, which proves that he/she is free from communicable and infectious diseases.

Health departments of Ministry of health in Jordan are responsible for the medical examination and issuing of health certificates. However Health and Occupational Control Departments of the Greater Amman Municipality are responsible for lab examination and issuing of health certificates in the governorate of capital (Amman) of Jordan.

Health certificate format should be according to the format determined by the Ministry of health.

Jordan Food and Drug Administration cooperatives along with Amman Municipality and Ministry of health are responsible for inspection and controlling of the validity of health certificates of food handlers and workers.

3.2

FOODBORNE ILLNESSES

Foodborne diseases, especially those caused by pathogenic organisms, remain a serious problem in most countries. Diarrhea is the basic feature of most of these diseases and a large percentage of diarrhea episodes may result from the consumption of contaminated food and water.

The Center for Disease Control and Prevention estimates that about 1 in 6 Americans gets sick of foodborne diseases each year. Food poisoning causes vary from year to year as the environment is subject to changes. For example, the number of cases from 2006 to 2013 involving E. coli 0157, Salmonella, Listeria and Yersinia remained relatively consistent. However, illnesses caused by Campylobacter have been increased by 13% and Vibrio vulnificus by 75%. There are also some signs of improvement in certain cases, such as a slight decrease in Salmonella infections over the last years (2010 to 2013).

Most foodborne illnesses could be prevented. This fact means that hospitalizations and deaths related to foodborne illnesses are preventable as well. It is estimated that reducing food poisoning by just 1% would prevent approximately 500,000 Americans from getting sick each year. If the reduction reached 10% this would prevent about 5.000.000 individuals from getting sick each year.

3.2.1 DEFINITION AND NATURE

The term “food poisoning” is often used in many cases, but it could sometimes be misleading or restrictive. Foodborne illness or foodborne disease are nowadays the terms that are generally preferred. Foodborne disease can be defined as: “any disease of an infectious or toxic nature caused by or thought to be caused by the consumption of food or water”(WHO, Basic Food Safety for Health Workers, 1999). The illnesses which are caused by foodborne microorganisms (mainly bacteria), are associated with gastrointestinal symptoms of nausea, stomach pains, vomiting and diarrhea.

It is generally believed that in developed countries less than 10% of cases of foodborne illnesses ever reach official statistics. Statistics from both developed and developing countries show an increasing trend in foodborne illness over the past years.

In developed countries the exposure to biological or chemical hazards is in most cases much lower than in developing countries. This improvement is due to the strict restriction of the use of toxic chemicals and pesticides and due to the improved control techniques of environmental pollution.

There are many different types of organisms which could cause foodborne illnesses. Bacteria are considered to be the most important foodborne pathogens and the mostly well-studied until now.

There is a large number of human viruses that can be transmitted by food and human diseases. Animal parasites such as protozoa, nematodes and helminths are considered to be important problems in many countries. The main difference between animal parasites and most bacterial foodborne illnesses is that the causative organism does not multiply in the food itself. Table 3.1 shows the main causes of foodborne illnesses.

Table 3.1 - Causes of foodborne illness

INTRINSIC HAZARDS | Examples
Natural toxins or anti-nutritional factors | oxalic acid (rhubarb, spinach)
alkaloids
solanine (potatoes)
dioscorine (yams)
cyanide (cassava, lima beans)
haemagglutinin (red kidney beans)
protease inhibitors (legumes)
phytic acid (bran)
amatoxin, psilocybin and others(toxic Mushroom)
EXTRINSIC HAZARDS | Examples
Chemical Contamination | dioxins, PCBs
| heavy metals (Cd, Hg, Pb, …)
| pesticides residues, hormone residues
Biological Contamination | Bacteria
| causing infection e.g. Salmonella
| causing intoxication e.g. C. botulinum
| Parasites
| helminths e.g. roundworms
| protozoa e.g. Giardia lamblia
| Viruses e.g. Hepatitis A
| Viruses (SRSVs)
| Fungi/mycotoxins e.g. aflatoxin
| Algae (e.g.dinoflagellates leading to paralytic shellfish poisoning

“Adapted from (M Adams; Y. Motarjemi, 1999)”

3.2.2 ECONOMIC IMPACT OF FOODBORNE ILLNESS

Foodborne illnesses have major economic impacts on any country’s economy.

These costs include the following cases:

Loss of income by the affected person

Cost of health care

Loss of productivity due to absenteeism

Costs of investigation of a food poisoning outbreak

Loss of income due to closure of businesses

Loss of sales when consumers avoid certain food products

In 1989 it was estimated that the total cost of bacterial foodborne illness to the United States economy was US$ 6,777,000,000. The problem of diarrheal disease in developing countries is far greater, so the effect on economic activity and development is estimated to be much more severe.

In developing countries, diarrheal diseases and particularly infant diarrhea, are a major public health problem. It has been estimated that annually about 1500 million children under five years of age suffer from diarrhea and over 3 million die as a result (Motarjemi Y. et al, 1993). The main cause of death from diarrheal disease is the dehydration that results from the loss of fluid and electrolytes in diarrheal stools, but diarrhea can also have other serious health consequences. It may lead to malnutrition due to the reduced food intake (either as a result of loss of appetite or the withholding of food).

3.2.3 HEALTH CONSEQUENCES OF FOODBORNE ILLNESS

In developed countries, incidents of foodborne illness are normally mild and not usually life threatening.

Exceptions occur usually with specific groups of people (e.g very old people, babies or young children, pregnant women sick or weak people, etc.). A diarrheal disease could be fatal for these population groups.

A number of foodborne pathogens such as Clostridium botulinum cause a severe neuroparalytic syndrome which in many cases could be fatal. Survival in cases of botulism depends on early diagnosis and immediate treatment.

Infection by Listeria monocytogenes can vary from a mild, flulike illness to meningitis and meningoencephalitis. If a pregnant woman is infected with Listeria this could result to abortion, stillbirth or premature labour (although the mother usually experiences relatively mild symptoms).

3.2.4 INFECTIOUS DOSE

Pathogens can infect human organisms through a variety of sources. In the past, it was a common belief that contaminated water was the main source of the pathogens which lead to diarrhea. This is probably still true in most of the cases, but more recent researches have shown that food also has a large responsibility concerning pathogens.

Infectious dose is the amount of pathogen (measured in number of microorganisms) required to cause an infection in the host. Usually the infectious dose varies according to the pathogenic agent and the consumer's age and overall health. For example Campylobacter jejuni has a quite low infectious dose, while non-typhoid Salmonella has relatively high levels of infectious dose.

3.2.5 INFECTION

Infection is the invasion of an organism's body tissues by disease - causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce.

Foodborne infections can be caused by the following agents (most common examples):

Bacteria: Salmonella spp., Listeria monocytogenes, Campylobacter jejuni, Vibrio parahaemolyticus, Vibrio vulnificus, Yersinia enterocolitica

Viruses: Hepatitis A, Rotavirus, Norovirus

Parasites: Trichinella spiralis, Anisakis simplex, Toxoplasma gondii, Giaria duodenalis

The time needed between food consumption and the first symptoms can range from several hours to one week. The most common symptoms are diarrhea and/or vomiting and typically last from 1 until 7 days.

3.2.6 INTOXICATION

In foodborne intoxications, the microorganisms which already exist in food produce toxins. It is the toxins, rather than the microorganisms, that cause illness. The most common foodborne bacteria which may cause intoxication are Clostridium botulinum, Staphylococcus aureus, Clostridium perfrigens and Bacillus cereus. Seafood toxins and plants or mushrooms could cause an intoxication. Viruses and parasites are not able to cause intoxications.

The time needed between food consumption and the first symptoms is usually quite short (1-2 hours and in some cases even shorter). The symptoms vary between nausea, diarrhea and vomiting and are usually quite intense.

3.3

HEALTH AND SAFETY OF WORKERS IN FOOD COMPANIES

Workers in food processing plants are exposed to many potential risks and dangers due to improper training or misunderstanding or less knowledge about the plant safety regulations. Assessment of risks and their management is an important issue that must be considered in each food processing plant. This assessment is going to create a healthy workplace that enhances worker performance and promotes human health. Improvement of occupational safety and health is achieved through focusing on equipment and best work practices.

The most common risks are listed in the following categories:

Knife cuts and amputations due to the use of knives, cutters, choppers and slicers or slips.

Falls due to slippery floors and inadequate lights.

Burns and scalds due to the contact with hot oils, utensils, open fires from ovens and steams

Electrical shocks from cleaning tools or kitchen appliances

Back pains due to heavy lifting or bad posture position

Redness and swelling and itching of skin due to high temperatures, chemicals used in cleaning or food preparation

Coughing due to inhalation of flour, dust, spices and additives

Occupational safety and health administration regulations within food industries could minimize these dangers and create a safe working environment. This could be succeeded by proper and contentious training in safety measures and regulations that should be followed. The company and all workers must comply with these regulations in order to maintain safe surroundings and avoid any risks. Some useful safety tips that should be considered in order to minimize such potential risks are mentioned in the following chapters.

3.3.1 IMPLEMENTING SAFETY TRAINING FOR NEW EMPLOYEES

Effective safety training is one of the main tools for preventing occupational injury and illness. Employees should be trained in order to perform their jobs productively, ensure product quality and practice safe behavior. It is essential to apply systematic and focused training in order to accomplish these goals. Health and safety training for new employees should include the potential hazard of the job, training responsibility, reporting of hazards, emergency guide, safety and protective clothing and equipment, first aid kits and emergency room, cleaning, maintenance and company safety measures. Implementing a safety training program helps to succeed the following objectives:

Increase safe and reduce dangerous behaviors

Detect potential hazards and eliminate them before injuries occur.

Reduce absenteeism.

Increase employees’ awareness level

Improve relations between employees and management.

Reduce injuries on the job

3.3.2 TRAINING ON PERSONNEL HYGIENE

Personnel hygiene training should include:

Hand washing good practices

Daily shower, good dental hygiene, short clean nails etc.

Clean clothing

Protective clothing, for example gloves, hair caps, etc.

Prohibited clothing, for example rings, watches, jewelers, etc.

Immediate reporting for any sudden cut or illness

3.3.3 GUARDRAILS AND FLOORS

Slips and falls are one of the greatest risks for workers in food processing plants. There are three important ways to prevent these types of incidents:

Keep walking surfaces free of slippery materials (water, grease, etc.).

Check that walking surfaces provide enough friction

Provide workers with slip-resistant shoes or boots.

In addition, guardrails must be placed around elevated platforms and open surface dip tanks. Guardrails must be securely attached and rails and mats must be in good condition.

3.3.4 VENTILATION AND LIGHTENING

Food industries should have both localized and general ventilation systems to protect workers from air contaminants. The local ventilation should remove exhaust from equipment and other contamination from the air. These systems must be located around the source of air contamination. General ventilation, including windows, fans and roof ventilators, for the building is also required in order to maintain low levels of air contaminants. Lights, either natural or artificial or both, and emergency lights should be adequate in order to ensure workers safety.

3.3.5 EQUIPMENT, MACHINE GUARDING AND MAINTENANCE

Equipment should be checked regularly in order to make sure that it is in good condition and regular maintenance should be followed according to manufacturer instructions. Electrical equipment must be grounded and examined for any defects. Knives and other tools must be kept clean and sharp and should be properly stored when not in use. Any moving machine part that may cause injury must be safeguarded. Any safety hazard should be either controlled or eliminated. Machinery-related injuries are often severe, causing crushed hands and arms, severed fingers, blindness, even death. Proper guarding from machine hazards is essential to protect workers from needless and preventable injuries.

3.3.6 PERSONAL PROTECTIVE EQUIPMENT

Workers should wear non-slip, closed shoes while performing their duties in order to prevent slips and falls. Additional personal protective equipment varies depending on the worker's role in the plant. For example, workers who use knives to cut food should be provided with metal-mesh gloves, wrist and forearm guards and aprons. Workers exposed to hazardous chemicals must be provided with gloves, goggles and a respirator. In addition, ear plugs are required for workers near loud machines. If any workers are exposed to noise at an average of 85 decibels (dBA) or more, a hearing loss prevention program is needed.

3.3.7 SAFE AND HYGIENIC PRACTICES

Workers must follow regulations to maintain a safe environment. This includes regularly inspecting the equipment they work with and immediately cleaning up any spills, including water, to prevent falls. Hand-washing facilities must be available close to all workers who handle hazardous substances, such as ammonia, or possibly infectious materials, such as raw meat. In addition, employers should provide safety training so that workers are aware of potential dangers in the plant and how to prevent injury and illnesses. Furthermore workers should know basic hygienic practices and efficient use of sanitizers in order to avoid contamination of food and spreading of infection.

3.3.8 WORKING IN CONFINED SPACE

Typical examples of confined spaces in food industry are silos, tanks, mixing vats, and storage bins. Confined space usually has limited means of entry or exit (e.g., only one exit) and is not usually designed to have people working continuously (e.g., elevator shaft, pit). Potential hazards in such places should be identified and managed. Some examples of these hazards are:

Hazardous atmosphere condition (lack of oxygen, air contaminants, etc.)

Physical obstacles or limitations to movement (including exit and entry)

Instability of stored products

Other mechanical or electrical hazards.

Each type of confined space has different safety and regulatory requirements. However, some tips to prevent confined space problems are:

Evaluate the workplace in order to determine if there are confined spaces.

Inform workers not to enter confined spaces unless they have permission.

Put signs in all confined spaces.

Write and distribute a detailed process for employees who are permitted to enter a confined space.

Train workers to recognize the hazards of working in a confined space.

Check the atmosphere conditions of each confined space in order to determine whether the atmosphere is safe.

Evaluate confined spaces for the following:

Oxygen level, flammability and toxic substances (already known or possibly present).

Methods for isolating the space - either by mechanical or electrical means

Adequate ventilation of the space.

Work procedures for the persons working in the confined space.

Personal protective equipment (clothing, footwear, respirator, boots, etc.).

Assign a person to remain outside of the confined space.

Define rescue procedures in case of an emergency.

Have a monitoring system in place in order to continuously monitor the conditions of the confined space.

4

EMPLOYEE TRAINING

AUTHORS:

Dr. Ebraheem Suliman Al-Tahaat (Jerash University)

4.1 Content of training material

4.2 Goals of training

Chapter Objectives:

To present the parts of basic training material on personnel hygiene

To set employer and employee responsibilities regarding training

To present examples of training formats and training programs established by employers

To emphasize on the role of training in order to achieve a high level of personal hygiene

Employees who handle food, including nursery and nursing home personnel, should be trained on Food safety. The Basic Food Safety Training Course focuses on procedures against food contamination in order to prevent food-borne illnesses. The importance of good personal hygiene, proper handling of food products and avoiding cross-contamination should be emphasized throughout the Training Course.

After completing the course, participants should be able to:

define and understand the meaning of food borne illnesses

identify hazardous foods in terms of food safety

understand the role of personal hygiene and relationship with food contamination

understand the importance of time and temperature in food handling

define cross-contamination in a food industry

describe cleaning and sanitizing methods in a food industry

It is the company’s responsibility to train their employees in order to have a clear understanding of the importance of good personal hygiene and the impact of their personal behavior on food safety.

All employees should receive training when required and especially:

when they are first hired

before beginning in a new work place

when company’s policies or procedures are revised or need to be reinforced

Training should be performed at least once a year for all personnel that handle food according to company’s training program. The language of training courses should be understandable for every employee – images and photos could be really useful in the training procedure.

The annual training program should include the following information:

Training Year

A list of employees and their job description

The training objective (e.g Personnel Hygiene, etc.)

The exact date and training duration

Trainer’s name

The training program could be divided in two parts concerning internal (in house training) and external training (provided by external professionals).

The company should keep records of each employee’s training history which should include:

the employee's name

employee’s job description

the hiring date

the training date

duration of training

training objective

the name of the trainer or training provider

evaluation of the training – trainee

A variety of training modules could be selected, including:

One-on-one or group training

Coaching or mentoring based on each job description

On-line courses

Review of company’s policies and procedures(SOP’s and SSOP’s)

Trainers could choose between different training formats including videos, presentations, company’s written working instructions or manuals, etc.

4.1

CONTENT OF TRAINING MATERIAL

Healthy personnel in terms of food safety

Signs and symptoms of infectious diseases

Ways of contaminating food by personnel

Personal hygiene – Good hygiene practices

Hand washing

Protective clothing

Protective Equipment

Instructions for visitors

4.2

GOALS OF TRAINING

 To identify typical signs and symptoms of infectious diseases

Employees should report any active case of illness to their supervisor before beginning their duties.

Supervisor should be familiar with the signs and symptoms in order to identify each illness

 To be able to provide protection from a lesion

Any lesion that is located on parts of the body that might have contact with the product increases the risk of contamination and should be covered.

If the lesion cannot be effectively covered then the employee should not handle food in any way.

 To understand the conditions of contaminating food and vice versa

When a food handler suffers from infectious diseases

When a food handler has symptoms of gastrointestinal illness

By wounds or lesions

When a food handler is in contact with ill individuals

By hand contact

Contaminated food could infect personnel as well

 To understand the importance of good hygiene

Understand the importance of personal cleanliness and sanitary practices

Good hygiene protects food handlers from illnesses

Good hygiene reduces the risk of contamination of food products

Good hygiene could prevent a significant number of illnesses

 To understand the importance of hand washing and proper hand washing techniques

Contaminated hands could transmit infectious diseases

Learn employees proper hand washing techniques

 To train personnel how to use protective clothing, footwear and equipment depending on each job description

Protective clothing material and accessories

Cleanliness of clothing

Protective footwear

Protective equipment

Prohibited clothing/accessories

 To ensure that good hygienic practices are followed by visitors

Visitors dress code and entry permission

Visitors should be provided with necessary clothing/footwear/equipment

Instructions for visitors regarding food safety

Bibliography

Academy of Nutrition and Dietetics, Food safety tips, 2005, www.eatright.org/resources/food-safety-tips

ASSETS; Alberta Health Services, Guidelines For Proper Glove Use in Food Establishments, 2010, http://www.albertahealthservices.ca/assets/wf/eph/wf-eh-guidelines-proper-glove-use.pdf

Canadian center for occupational health and safety. Food Service Workers Safety Guide. 5th Edition. pp 1-139, 2005 ,http://www.ehs.uconn.edu/forms/TTT/fwsg.pdf,.

Codex Alimentarius ,Recommended, Code of Practice - General Principles of Food Hygiene, CAC/RCP 1-1969, Rev. 4-2003.

FAO-Food and Agricultural Organization of the United Nations, Food & Nutrition, A Handbook for Namibian Volunteer Leaders, 2001, http://www.fao.org/docrep/008/a0104e/a0104e08.htm

Guzewich, J., & Ross, M.P. , Evaluation of risk related to microbiological contamination of ready-to-eat foods by food preparation workers and the effectiveness of interventions to minimize those risks, 1999.

Hashemite kingdom of Jordan, Law of crafts and Industries No.16, 1953.

Hellenic Food Authority, Good Manufacturing Practices Guidelines No1 (for Catering services and Pastry Companies), 2002.

Hellenic Food Authority, Basic Education Manual in Health and Food Safety, 2004.

Higijenski minimum, Nastavni zavod za javno zdravstvstvo Primorsko-goranske županije, Rijeka 2016, pp 1-5, Rijeka 2016, www.zzjzpgz.hr/

Jordan Food and Drug Administration, Instructions for sanitary conditions for restaurants and public kitchens, 2008.

Minnesota Food Charter, HEALTHY FOOD, SAFE FOOD ACTION GUIDE, 2014, http://mnfoodcharter.com/wp-content/uploads/2014/10/HFSF_FoodSafeFood_D6_REV.pdf

Motarjemi Y. et al. Contaminated weaning food a major risk factor for diarrhoea and associated malnutrition. Bulletin of the WHO, 71: 79–92, 1993.

Reg. 852/2004, Chapter VIII-Personal hygiene.

Royal Environmental Health Institute of Scotland, The Food Hygiene Handbook for Scotland, 17th Edition, pp 33-38, 2016.

Šimunović Jure, The Importance of Good hygiene practices in food manufacture- Personal hygiene, Split, 2012

Society of Food Hygiene and Technology, Protective Clothing for the in Food Industry, section 4, 2016, http://www.sofht.co.uk.

Washington Department of Labor and Industries, Safety and Health Assessment and Research for Prevention (SHARP) Program, pp 1-49, Washington, USA, 2001.

WHO, WHO Food Safety Programme, Basic Food Safety for Health Workers, editors M Adams; Y. Motarjemi, 1999.

Keywords (Index)

-B-

Bacteria

-C-

Cleaning

Contaminant

Contamination

-D-

Diarrhea

Disinfection

-E-

Ear plugs

-F-

Foodborne illness

Food business operator

Food handler

Food hygiene

Food safety

-G-

Good Hygiene Practices (GHP)

-H-

HACCP

Hand washing

Hazard

Head cap

Health Certificate

-I-

Infection

Infectious dose

Injury

Intoxication

-M-

Medical screening

-O-

Occupational Health & Safety

-P-

Parasites

Pathogens

Personal hygiene

Protective clothing

Protective gloves

Protective footwear

-S-

Standard operating procedures (SOPs)

Sanitation standard operating procedures (SSOPs)

-T-

Toxins

Training

-V-

Ventilation

Virus

Visitors’ instructions

Glossary

Cleaning: The removal of soil, food residue, dirt, grease or other objectionable matter.

Contaminant: Any biological or chemical agent, foreign matter, or other substances not intentionally added to food which may compromise food safety or suitability.

Contamination: The introduction or occurrence of a contaminant in food or food environment.

Disinfection: The reduction, by means of chemical agents and/or physical methods, of the number of micro-organisms in the environment, to a level that does not compromise food safety or suitability.

Foodborne illness: Any disease of an infectious or toxic nature caused by or thought to be caused by the consumption of food or water

Food handler: Any person who directly handles packaged or unpackaged food, food equipment and utensils, or food contact surfaces and is therefore expected to comply with food hygiene requirements

Food hygiene: The measures and conditions necessary to control hazards and to ensure fitness for human consumption of a foodstuff taking into account its intended use.

Food Safety: The assurance that food will not cause harm to the consumer when it is prepared and/or eaten according to its intended use

Good Hygiene Practices (GHP): Set of requirements to prevent contamination of food in order to provide safe food to the consumers

HACCP: A system which identifies, evaluates, and controls hazards which are significant for food safety.

Hazard: A biological, chemical or physical agent in, or condition of, food with the potential to cause an adverse health effect.

Health certificate: A certificate attesting a person's good health and free from communicable and infectious diseases.

SOPs: A set of step-by-step instructions compiled by food business to help employees carry out routine operations

SSOPs: Written documents of procedures or programs used to maintain equipment and the environment in a sanitary condition for food processing.

Abbreviations

GHP: Good Hygiene Practices

HACCP: Hazard Analysis Critical Control Point

RDN’s: Registered Dietitian Nutritionists

SOPs: Standard operating procedures

SSOPs: Sanitation standard operating procedures

WHO: World Health Organization