Top Food Code Standard – Worker Health

restaurant kitchen

The Critical FDA Food Code item #7 that is associated with an increased risk of food borne illness is discharge from the eyes, nose or mouth. We covered item #8, clean hands, in a previous blog post.

Food service workers should avoid working when they have discharge from the eyes, nose or mouth to prevent potential food borne illness and practice standards of common courtesy. Unfortunately, far too many food preparers and food servers work when marginally ill.

In a limited study reported by State and Federal Environmental Health Specialists reported in 2015, one-third of the restaurants’ policies don’t address when ill food workers should be not be allowed to work. Managers are often NOT actively involved in decisions about whether ill food workers should work.

  • Almost 70% of managers said they had worked while sick.
    • A third of managers felt obligated to work even when ill.
  • Food handlers reportedly work despite being ill because:
    • No one is available to replace them (26%), or
    • Their symptoms are mild or thought not contagious (19%), or
    • They had responsibilities no one else could fulfill (11%), or
    • They would not get paid if they did not work or,
    • The restaurant had no sick leave policy (5%).

The authors conclude, “Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill.”

During my practice of Emergency Medicine, I noticed many health care workers working while marginally ill. I understand the issues. It is a challenge to balance responsibility, work place needs, personal financial motives and good practice. But just like health care workers, food service workers are entrusted with the public health.

In reviewing our Dining Grades database of nearly 3 million health department scores, we have discovered national trends. A subset of that database is the distribution of FDA Food Code top violations. Discharge from the eyes, nose or mouth is a top trending violation. To see further reports, claim your restaurant listing.


Author: Dr. Harlan Stueven, MD

Harlan Stueven M.D. is a Board-Certified Emergency physician with sub-specialization in Environmental Toxicology and Board Certification in Medical Toxicology. Starting his career in the USAF, he served as a Flight Surgeon and Environmental Health Consultant Physician where one of his duties was monitoring food safety. In his nearly 40-year practice, he treated a range of medical, surgical and poisoning emergencies. He has been a Medical Director and/or Chairman of several hospital-based Emergency Medicine Departments, served as the President of Emergency and Environmental Medicine consulting group, a physician group Chief Financial Officer and sat on many national, state and local committees. Dr. Stueven founded Dining Grades and the Dining Safety Alliance to improve food safety by increasing awareness of food borne illness and the formation of partnerships within the food industry. He is a consultant to the Wisconsin Retail Food Establishment Grading Work Group; a Co-investigator in a CDC funded “Evaluation of Health Department Restaurant Inspection Programs” project. He has presented at several National, State and Regional conferences on restaurant grading and food safety. He is an accomplished leader, medical researcher, a champion of process improvement, author, and national and international speaker.

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