Agricultural Workers as Vectors for Foodborne Illness

Occupational health and hygiene during the course of handling food items should be a top priority for food safety. However, agricultural workers and food handlers are potential vectors of foodborne illnesses when handling food items in the course of customary work practices. Many agricultural practices, such as harvesting, are labor-intensive operations involving direct human contact with fresh produce. In fact, humans and animals are major sources of pathogens in our food supply. Major pathogens such as E. coli 0157.H7, Salmonella spp., Shigella spp., Staphylococcus aureus, Giardia lamblia, and Cryptosporidium parvum can often be traced back to human or animal sources. Hepatitis A outbreaks have also occurred via food contaminated by infected food handlers in several areas worldwide (24-28).

Prevention is the mainstay to decrease morbidity from spread of transmissible diseases by food handlers. In the United States, food preparation and service regulations are issued by state health departments and may vary from state to state. For instance, routine hepatitis A vaccination of all food handlers is not recommended because their profession does not put them at higher risk for infection. However, local regulations mandating proof of vaccination for food handlers or offering tax credits for food service operators who provide hepatitis A vaccine to employees has been implemented in some areas. One economic analysis concluded that routine vaccination of all food handlers would not be economical from a societal or restaurant owner's perspective. However, the Centers for Disease Control and

Prevention (CDC) in the United States have supported use of the hepatitis A vaccine among dietary workers who may be at risk for contracting or spreading the disease (29-31).

The CDC has also supported screening for tuberculosis (TB) in high-risk groups such as foreign-born or recent immigrants from outside the United States. Screening of food handlers for TB has been found to be cost-effective in high-risk populations. However, this recommendation is to identify high-risk individuals who may be candidates for preventive treatment for latent TB and not to protect the public from contaminated food as Mycobacterium tuberculosis is not transmitted through food (32-35).

The WHO does not recommend routine medical and microbial screening of agricultural workers and food handlers. However, workers suffering from an illness that includes symptoms such as jaundice, diarrhea, vomiting, fever, sore throat, skin rash, or skin lesions such as boils or cuts should report this to their supervisor prior to starting work and should be temporarily excluded from activities requiring food handling (23,36).

Good worker hygiene practices during production, harvest, and food-handling activities can help prevent or minimize microbial contamination of food. Simple preventive practices such as teaching employees how to effectively wash their hands (i.e., wet the hands, use soap, rub hands together for at least 20 seconds to develop a lather, clean under fingernails, rinse, and dry with a paper towel) and when to wash hands (i.e., before starting to pack or process, after each break, after handling unsanitary items such as decayed produce, and after using the toilet facilities) are recommended. Other useful strategies include prohibiting workers from smoking or eating in the fields, where saliva could accidentally be sprayed on produce, and encouraging use of impermeable, nonlatex gloves when handling fresh produce. Multilingual signs and direct communication between supervisor and employee are also important (24).

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