Manual of Naval Preventive Medicine
Chapter 1: Food Service Sanitation
VII: Health Standards for Food Service Personnel

1-53. Physical Examination (Medical Screening).

Department of the Navy
Bureau of Medicine and Surgery

1. All food service personnel including personnel employed by civilian contractors will be medically screened for evidence of communicable disease prior to initial assignment in food service. The health screening does not need to include a physical examination but it should be sufficient to detect evidence of diseases that may be transmitted by food, A tuberculin skin test is not routinely required. Subsequent health screening, e.g., annual evaluation, is not routinely required. The health screening may be conducted either by a physician or nonphysician health care provider, e.g., environmental health officers, nurse corps officers, preventive medicine technicians, independent duty corpsmen, civilian nurses and civilian environment health technicians. Civilian food service employees may be screened by local military medical departments or they must present documentary evidence, acceptable to the local medical authority, that a complete and thorough health screening has been accomplished.

2. All food service personnel who have been away from their duties for more than 30 days for nonmedical reasons must have a health screening prior to resumption of food service duty. All food service personnel who have been away from their duties for any period of time as a result of illness must receive authorization from the local medical authority prior to resumption of food service duty.

3. Food service personnel having open or draining lesions of the hands, face, or neck, or severe pustular acne of the face must be prohibited from performing food service duty. Lesions on other parts of the body must be evaluated by a medical department representative and a decision to prohibit or limit food service duties must be made on a case-by-case basis. Decisions to prohibit or limit food service duties should consider the location and type lesion, the amount of drainage, current therapy, and ability to cover the lesion, in addition to the food service duties the person performs.

4. During food service personnel pre-employment and resumption of food service personnel duties evaluations, specific tests and procedures, including tuberculin skin tests and chest X-rays, can be ordered at the discretion of the health care provider based on medical history, social history, and physical exam findings. Guidelines should be developed locally to assist health care providers in this screening process. Such guidelines should consider the medical and social history of the patient, the communicable disease (including tuberculosis) risk in the community. If justified by local conditions, e.g., certain outside continental United States locations, periodic health screening evaluations, including tuberculin skin tests may be a local requirement. Such requirements should be issued in local directives. The cognizant NAVENPVNTMEDU can provide assistance in developing guidelines. These requirements deal solely with assessing communicable disease risks. They should not be interpreted as limiting the scope or frequency of physical exams or health screening evaluations of food service personnel for other occupation-associated conditions, such as back injury or hearing conservation.