It is evident that the foodservice worker is the most important link in the transmission of disease through food. The workers' health, personal habits, understanding of bacteria, and the methods of preparing and serving of food are of concern not only to themselves but also to their shipmates as well. BACTERIA

An understanding of bacteria is valuable to all personnel and essential to those who work with food in any way. Bacteria are one-celled microorganisms; so small they are visible only under a microscope. They are widely distributed in the air, water, soil, and in animal and plant tissues.  Bacteria are classified according to their shape.  Those round in shape are called cocci; the rod-shaped ones are called bacilli; and the spiral-shaped ones are called spirilla.

Since bacteria camnnot be seen, our best defense against the harmful bacteria is strict adherence to sanitation principles. Bacteria can move of their own accord only in liquids and cannot leave a fluid surface unless transported as "passengers" by other agents such as dust, food dishes, silverware, cooking utensils, dirty fingers or fingernails, a common drinking cup, a hand towel, water, insects, or rodents.

Bacteria reproduce themselves simply by dividing in half. On the average each bacterium, under favorable conditions, will divide and become two bacteria every 20 minutes. The rate of multiplication or growth of bacteria is affected by heat or cold. Certain types of bacteria, if allowed to grow and multiply, produce toxins that cause food poisoning. Boiling will kill all bacteria, but it will not kill the toxins once they are allowed to form. Certain strains of the staphylococcus bacteria will withstand boiling temperature for long periods of time before they are killed and are virtually impossible to kill by normal cooking methods. Once toxins have been allowed to form, no amount of cooking will make the food safe. Refrigeration will prevent the bacteria from producing toxins but will not kill the toxins once they are formed.

FOODSERVICE PERSONNEL

Since foodservice personnel are considered to be the most likely mode of transmission of disease through food, certain requirements such as medical examinations, sanitation training, and personal hygiene must be completed before such personnel can work in food preparation areas.

Physical Examination

All foodservice personnel including personnel employed by civilian contract services must be examined and determined to be free from communicable diseases before initial assignment in foodservice. Subsequent physical examinations will be conducted annually. The physical examination must be sufficiently comprehensive to detect acute or chronic diseases. Laboratory tests and other diagnostic determinations are performed at the discretion of the senior medical officer; however, all foodservice personnel must be examined for evidence of tuberculosis. Employees of contract services must be examined by either local or military medical departments to make sure a complete and thorough physical examination has been done.

Personnel having any open lesions, particularly on the hands, face, or neck or acne on the face, are prohibited from performing foodservice duty.

Examination of personnel with questionable medical or social histories must be comprehensive including X-ray of the chest, stool and urine examinations for parasite and bacterial pathogens, and other such determinations as may be indicated by international agreements.

All personnel must repeat medical tests when away from duty for 30 days or more. All personnel must submit to laboratory examinations and other tests to detect and treat acute or chronic diseases and be relieved from duty if they are infected.

Training

All foodservice personnel must be thoroughly indoctrinated in personal hygiene and food sanitation, as well as in the methods and importance of preventing food-borne illness. Temporary foodservice personnel must be indoctrinated as follows:

All foodservice personnel will receive a minimum of 6 hours' initial training and 6 hours' annual refresher training in foodservice sanitation principles.

All foodservice sanitation training will be conducted by environmental health officers and/or preventive medicine technicians.

In those cases where it can be shown that environmental health officers or preventive medicine technicians are not available to perform such training, medical department representatives, MSs in paygrade E-5 and above, or civilian foodservice supervisors who have received special training to qualify them as foodservice sanitation instructors maybe used. Special instructor certification training may be taken at either a Navy environmental and preventive medicine unit or naval regional medical center preventive medicine service, and completion of training must be documented. Certified instructors must use and maintain up-to-date, standard Navy lesson plans in their training programs. Instructors must be recertified every 3 years and are authorized to sign the Foodservice Training Certificate, NAVMED 4061/1.

Personal Hygiene

The group of principles and rules designed to promote personal health and cleanliness is known as personal hygiene. The following procedures should be used to ensure personal cleanliness.

TAKE DAILY SHOWER OR BATH.- Maintain a high degree of cleanliness by thoroughly soaping and rinsing the body to remove dirt, perspiration, and bacteria. This practice improves circulation, appearance, and health, and is the foundation of personal hygiene. Frequent washing of hair is mandatory. Keep teeth clean by brushing at least twice daily, but preferably after each meal.

WEAR CLEAN GARMENTS.- Wear clean inner and outer garments. Germs are harbored in clothing as well as on skin surfaces, and diseases are likely to be transmitted. Caps (or hairnets for women) completely covering the hair must be worn at all times when working with food. Keep hair trimmed for neat appearance. Change clothing and aprons soon after soiling.

WASH HANDS BEFORE STARTING AND AFTER FINISHING WORK WITH FOOD.- Provide plenty of hot and cold running water under pressure.  Soap and paper towels with adequate waste receptacles must be available. Continuous rolled paper toweling that is sanitary may be used if it is approved by the National Sanitation Foundation Testing Laboratory or meets equivalent standards, but use of such toweling must be supervised.

Thorough washing of hands with hot soapy water to remove soil and contamination before commencing work is mandatory. After each visit to the toilet, all food handlers are required to scrub hands and nails. When interruptions occur during routine duties in the galley, personnel are required to wash their hands before resuming work. Frequent washing of soiled hands during work is also essential. Never wear an apron to the toilet or washroom.

Hands are probably the most common vehicle for transmitting germs. Personnel should keep fingernails closely clipped, trimmed, and cleaned underneath and around cuticle. Cleaning is effective only with soaps or detergents and warm water. Unless clean towels or other satisfactory hand-drying devices are provided, the benefits of frequent hand scrubbing are completely nullified.

PROHIBIT USE OF TOBACCO.- Smoking in food preparation, serving, or dishwashing areas is

Figure 1-1.-Good daily health habits for foodservice personnel.

prohibited. The use of tobacco while preparing or serving food may contaminate the fingers and hands with saliva and may promote spitting and coughing, which transmit disease organisms present in the saliva to food or food-contact surfaces. If smoking areas away from the galley are provided, personnel should use these designated areas, but thoroughly scrub hands before resuming work to prevent food contamination.

DEVELOP SANITARY WORK HABITS.- A wide range of communicable diseases and infections may be transmitted by food handlers to other personnel through contaminated food and careless practices.

Some of the desirable work habits that personnel should develop to prevent personal contamination areas follows:

Spoons, knives, and forks should be picked up or touched only by their handles.

0 Cups, glasses, and bowls should be handled so that fingers and thumb do not contact inside surfaces or lip-contact surfaces.

Portable- and fixed-food preparation equipment should be stored so that they require minimum handling by personnel. Improper storage ruins the effect of sanitizing, and excess handling will introduce contaminating material.

0 Disposable dinnerware must be handled and dispensed to prevent contamination of surfaces that come in contact with food or with the mouth of the user.

Tongs, picks, spatulas, scoops, dipping spoons, and other suitable utensils must be used in such a manner to keep manual contact with food at a minimum.

Figure 1-1 shows some of the good daily health habits for foodservice personnel.

REPORT PERSONAL ILLNESS AND ALL MINOR INFECTIONS.- Boils and sore throats are sources of bacteria that can cause severe food-borne diseases. When ill, report it and make arrangements to be relieved of duty. Sores, rashes of any kind, pimples, or other skin eruptions as well as cuts should be reported and medical aid solicited as soon as possible. Both supervisory personnel and operators are responsible for notifying medical personnel if a disease is suspected.

APPLY PROFESSIONAL TRAINING AND TECHNIQUES.- All personnel must be alert to the hazards associated with speedup methods and shortcuts to washing and sanitizing operations. Techniques of sanitizing-including times, temperatures, and routines-should be memorized and applied. The effectiveness of sanitation is directly related to the competence and cooperation of foodservice personnel.

COMPLY WITH SANITARY REGULATIONS.- Public health ordinances and regulations imposed by the Bureau of Medicine and Surgery (BUMED) must be observed in day-to-day foodservice operations. Recognized standards of sanitation embracing accepted public health principles are prescribed by these sources and administration of regulations at each activity will be enforced. figure 1-2 shows correct and safe work habits you should develop and practice.