Food Protection Trends - January/February 2021 - 168

attempts by individuals to conceal symptoms (27) because
of unpaid or inadequate sick leave or fear of retribution for
missed work. Fever (body temperature >37.3°C) (74) is
not always present in COVID-19 patients, especially early in
the infection. The prevalence of fever as a symptom among
COVID-19 cases ranges greatly, with some estimates of
20% (30, 57). Gostic et al. (27) estimated that temperature
screening would fail to detect half of the COVID-19 cases
at airports, primarily because of asymptomatic carriage, but
these authors emphasized the need for effective and prompt
case contact tracing, another tool that should be applied to
exclude potentially infected workers from food processing
facilities. Thus, although temperature screening has poor
sensitivity, it may be valuable for identifying a portion of
infected employees.
Hygiene and sanitation
Personal hygiene and environmental sanitation are the
basis for prevention of food contamination and production
of safe food. Essential principles of food hygiene have been
outlined in many texts and have been published in the
General Principles of Food Hygiene (CXS1-1969) by the
Codex Alimentarius Commission (13). The Guidelines on the
Application of General Principles of Food Hygiene to the Control
of Viruses in Food (CAC/GL 79-2012) and other commodityspecific codes of practice from the Codex Alimentarius (14,
15) provide information applicable for the control of SARSCoV-2, although the focus of these documents is primarily
the protection of food from contamination. Because humans
can contaminate equipment, food contact surfaces, and
floors with SARS-CoV-2, the principles of cleaning and
sanitizing should be followed for the decontamination
of these items, thus reducing the potential of employees
contracting COVID-19 following contact with contaminated
surfaces. Care should be taken when undertaking cleaning
procedures, and particular attention should be paid to avoid
the generation of aerosols or dissemination of virus from
contaminated surfaces. Pressure washing in food facilities
can aerosolize and distribute contaminants for several
meters (67). Education and refresher training of employees
in appropriate hygiene and sanitation practices may lead to
improved compliance with best practices.
Because of the potential for self-inoculation with SARSCoV-2 by touching the face with a contaminated hand,
hand washing is critical and should be frequent, especially
after toileting, before eating, and any time after touching
potentially contaminated surfaces. However, hand washing
also may contribute to splash or cross-contamination from
sinks and the surrounding environment (22, 29). Fortunately,
SARS-CoV-2 has no unique resistance to disinfectants and is
susceptible to biocidal agents commonly used in the
food processing environment (37). Because of potential
contamination of the food production environment, cleaning
procedures may need to conducted more often (18).

168

Food Protection Trends January/February

Limitations
A hierarchy of interventions based on their effectiveness
for the control of occupational hazards has been proposed,
with elimination of pathogens from the work environment as
the most effective, structural (engineering) and operational
(administrative) controls as less effective, and the use
of personal protective equipment as the least effective
(65). However, this proposed ranking is not specific for
food processing environments and does not consider the
feasibility or practicality of proposed control measures.
Many of the strategies for COVID-19 control are based on
extrapolations of data on SARS-CoV-2 or similar organisms
but in other environments, such as the health care sector.
Limited data are available on the efficacy and practicality
or feasibility of these interventions in the food processing
environment. The experimental or epidemiological evidence
collected under different conditions are location independent
(e.g., efficacy of masks to prevent transmission from
patients) and are supported by sound scientific inference.
Application of similar interventions to the food processing
environment are thus predicted to be equally effective. Under
the conditions of food processing, mandatory mask wearing
and possibly face shields or eye protection may be one of the
most effective options based on feasibility and cost.
Food quality, food safety, economic, and sociobehavioral
considerations may preclude or limit the adoption of some
of the control measures suggested here. For example, high
humidity and low temperatures are required in meat coolers
for food safety and to prevent product desiccation. Increased
air filtration and disinfection may require investment in
equipment and structural changes to a facility. Improved
airflow and ventilation may require additional. may require
additional energy to cool incoming outside air. Physical
distancing of workers may require decreased line speeds or
product throughput. Enhanced or increased cleaning and
sanitation cycles require more person-hours. These expenses
should be viewed as investments in worker safety and
occupational health.
Company policies should not penalize employees who do not
report to work while sick and should not incentivize workers to
work when they are feeling ill. Training should be provided on
safe practices such as proper mask-wearing, physical distancing,
and sanitary practices. In many countries, food processing
jobs are filled by immigrants who may not be fluent in the first
language of the business. All employees must receive reliable
information and training about COVID-19 in formats and
languages that can be understood (49). Awareness, training,
and education are critical but must be followed by adoption of
preventive practices, that is, changes in management or behavior
required to prevent SARS-CoV-2 transmission.

Food Protection Trends - January/February 2021

Table of Contents for the Digital Edition of Food Protection Trends - January/February 2021