The UK Food Standards Agency has published an essential document titled "Food Handlers: Fitness to Work", which serves as a regulatory guidance and best practice advice for food business operators. This article aims to provide a comprehensive overview of the document, highlighting key aspects that occupational health nurses and doctors should be aware of to maintain food safety in their respective establishments.

Regulatory Guidance and Best Practice Advice

The "Food Handlers: Fitness to Work" document offers regulatory guidance and best practice advice for food business operators. It outlines the critical measures that managers and staff must implement to prevent the spread of infections that could contaminate food or food contact surfaces. These infections are primarily caused by bacteria and viruses and can be transmitted through food, posing a significant risk to public health.

Preventing Infection Spread

People working around open food while suffering from certain infections can easily contaminate the food or surfaces the food may contact. This contamination can lead to the spread of infection to others through the food. To mitigate this risk, the guidance helps managers and staff by advising on which illnesses and symptoms should be reported and how managers should respond.

Key points include:

  • Main Symptoms: Diarrhoea and/or vomiting are the primary symptoms of illnesses that can be transmitted through food.
  • Reporting Symptoms: Staff handling food or working in a food handling area must report these symptoms to management immediately.
  • Exclusion from Work: Managers must exclude staff with these symptoms from working with or around open food, typically for 48 hours after symptoms cease naturally.

Definition of Food Handlers

The term 'food handler' primarily refers to people who directly touch open food as part of their work, including both employed and agency staff. However, it also encompasses anyone who may touch food contact surfaces or other surfaces in rooms where open food is handled. This broad definition ensures comprehensive coverage and emphasizes the importance of maintaining hygiene standards across all individuals involved in the food handling process.

Post-Illness Exclusion

After an illness, it is crucial to understand that bacteria and viruses can still be present in a person’s faeces even after symptoms have stopped. Therefore, managers must continue to exclude food handlers for a recommended period of 48 hours from the time symptoms cease. This period helps ensure that the risk of contamination is minimized.

For example, if symptoms end at 5 pm on Monday, the individual can safely resume work from 5 pm on Wednesday. If there is uncertainty about when the symptoms ended, managers can count from the time of the first normal stool to ensure safety.


Ensuring the fitness to work for food handlers is a critical component of food safety. The "Food Handlers: Fitness to Work" document by the UK Food Standards Agency provides invaluable guidance for managing and mitigating the risks associated with foodborne illnesses. By adhering to these guidelines, occupational health professionals can significantly contribute to maintaining a safe and healthy environment in food establishments.

While there are many international standards for diver medicals, the document "Medical Examination and Assessment of Working Divers" by HSE is one of the most commonly used standards worldwide. Similarly, the guidance provided by the Food Standards Agency is essential for ensuring the health and safety of food handlers and, by extension, the public.

For more information about this standard document or guidelines, please visit: UK Food Standards Agency