Health surveillance and management procedures for food-handling personnel : report of a WHO consultation, held in Geneva from 18 to 22 April 1988

1. Introduction -- 2. The potential of food-handling personnel to transmit diseases via food -- 3. selected diseases and their relevance to food safety -- 4. Limitations of routine health examinations of food-handling personnel -- 5. Special problems -- 6. Effective preventive measures -- 7. Management and health surveillance in the food industry -- 8. Conclusions and recommendations -- Acknowledgements -- References -- Additional selected reading -- Annexes

Records the conclusions and recommendations of an international group of experts commissioned to evaluate the effectiveness of current procedures for protecting the public from disease outbreaks caused by food handlers. The report focuses on the question of whether routine medical examinations of food handlers are sufficient to prevent, or at least minimize, food contamination. To answer this question, the report first examines all infections and intoxications potentially transmissible by food handlers and then considers the extent to which physical examinations, medical histories, throat swabs, blood tests, x-rays, skin tests, and examination of faeces are capable of detecting symptomatic or asymptomatic carriers. Readers are reminded that the information obtained from a health examination is valid only for the time at which it was carried out, that some infections are detectable for periods as short as 48 hours, and that others, such as infectious hepatitis, are contagious before the onset of any clinical symptoms. On the basis of this review, the report concludes that pre-employment and subsequent routine medical examinations of food handlers are ineffective and thus unnecessary. The remaining sections concentrate on the identification of effective alternative preventive measures, including outbreak surveillance, use of the Hazard Analysis Critical Control Point (‎HACCP)‎ system, and several measures within the food industry.