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Employee health training is crucial for promoting food safety, protecting public health, and maintaining compliance with regulations in North Carolina food establishments. This type of training benefits the business, workers and customers by lowering the risk of foodborne illness and creates a culture of safety and responsibility.
Effective training makes employees feel confident and aware of their role in food safety. To succeed, managers should emphasize the importance of employee health by providing ongoing education and reinforcement of reportable symptoms, foodborne diseases, and exclusion/restriction requirements.
Benefits of Employee Health Training:
- Reduces the number of employees who report to work when sick.
- Reduces the risk of a food borne illness outbreak.
- Results in responsible employees.
- Saves costs by minimizing the need to discard contaminated or improperly handled food.
- Minimizes the risk of legal issues and protects the business's reputation.
- Demonstrates a commitment to food safety and builds trust with customers.
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Section 2-103.11 of the North Carolina Food Code Manual requires the person in charge to be responsible for certain duties. One of those duties is to inform employees that they must report any of the designated reportable symptoms, diagnoses, or exposures to foodborne illnesses. Management must also explain the causes of foodborne illness and how an employee's job and personal hygiene are connected.
Symptoms and diagnoses that must be reported include:
- Vomiting, diarrhea, jaundice, sore throat with fever, or any exposed boil or open, infected wounds or cuts on the hands or arms;
- An illness diagnosed by a health practitioner that was caused by one of the Big 6 pathogens*: Salmonella Typhi, Shigella spp., Norovirus, Hepatitis A virus, nontyphoidal Salmonella or Shiga toxin-producing Escherichia coli;
- Exposure to typhoid-like fever, Shigella spp. Norovirus, Hepatitis A virus, or Shiga toxin-producing Escherichia coli, by eating or serving food that was implicated in a foodborne illness outbreak or if residing with a diagnosed individual.
- *Management must report Big 6 pathogen diagnoses to the regulatory authority.
Management staff must also verify that food employees are knowledgeable and have received required employee health information. Section 2-103.11 (P) requires the person in charge to verify this by providing training documentation to the inspector during routine inspections.
The following are examples of approved documentation:
- Providing forms such as Form 1-B Food Employee Reporting Agreement found in the FDA Employee Health and Personal Hygiene Handbook or similar forms containing the same information such as the NC DHHS Food and Facilities Branch Food Employee Reporting Agreement.
- Providing curriculum and attendance rosters showing that each employee has completed a training program that includes all reporting information in Form 1-B Food Employee Reporting Agreement.
- Implementing an employee health policy that includes a system of employee notification using a combination of training, signs, pocket cards or other information that includes all reporting information in Form 1-B Food Employee Reporting Agreement.
There are specific criteria that food employees must meet before returning to work after being excluded due to certain illnesses or symptoms. A detailed description of exclusion/restriction scenarios for each Big 6 pathogen can be found here.
When To Exclude/Returning To Work:
The person in charge is responsible for excluding a food employee in the following situations:
- When the food employee is experiencing vomiting or diarrhea (unless symptoms are due to a noninfectious condition): They Can return to work when symptom-free for 24 hours.
- When the food employee has been diagnosed and symptomatic with a Big 6 pathogen: They Cannot return to work until cleared by the regulatory authority.
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Food employees should have specific knowledge of the following:
- Know the reportable symptoms/Big 6 diagnoses/Big 6 exposures that must be reported to management.
- The importance of reporting requirements and why illnesses/exposures must be immediately reported to management.
- How restriction and/or exclusion from working with food prevents foodborne illness.
- How proper hand hygiene and no bare hand contact with ready-to-eat food can prevent foodborne illness.
An inspector can choose to question an employee at random to verify their knowledge. It is best practice for management to post their employee health policy in the establishment for employees to reference when needed.
1. Restricting or Excluding Sick Food Employees:
Allows management to take action and prevent a sick or exposed food employee from spreading bacteria and/or viruses to food. Taking swift action can prevent a foodborne illness outbreak.
2. Using Proper Handwashing Practices:
Proper handwashing practices are necessary in reducing the spread of bacteria and viruses. Food employees must know when, where and how to wash their hands. Management staff must emphasize the importance of washing hands before and after handling food, after using the restroom, after touching the face or hair, and after handling potentially contaminated items.
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Employees must properly clean their hands and exposed portions of their arms for at least 20 seconds using the following method:
- Rinse under clean, warm running water.
- Apply soap and vigorously rub all surfaces of the hands and fingers together with friction for at least 10 to 15 seconds, paying particular attention to the area under the fingernails, between the fingers/fingertips, and surfaces of the hands and arms.
- Rinse thoroughly with clean, warm running water.
- Thoroughly dry the hands and exposed portions of arms with single-use paper towels or a heated-air hand-drying device.
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3. Eliminating Bare Hand Contact with Ready-To-Eat Foods:
Proper handwashing reduces the number of bacteria and viruses on the hands, but it does not remove all of them. It only takes a small amount of Norovirus viral particles to cause a foodborne illness. This is why proper handwashing in conjunction with proper use of single-use gloves is crucial in preventing the spread of bacteria and viruses to food.
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