In Summary
- The faecal-oral route is the inadvertent transfer of microbes from the gut/faeces of one animal (including humans) to the mouth of another.
- Infected workers can contaminate fresh produce, which poses a potential risk to consumers if they contaminate equipment or product with contaminated faeces.
- To minimise these risks, hygiene facilities must be kept in satisfactory conditions, there must be enough toilets, and there must be sufficient facilities for cleaning and sanitising hands.
Most of the foodborne illness pathogens associated with fresh produce can be spread through the faecal-oral route (Julien-Javaux et al., 2019). The faecal-oral route describes the inadvertent transfer of microorganisms from the gut or faeces of one animal or human to the mouth of another animal or human. Faeces carrying the pathogen must either directly or indirectly contaminate the produce or contaminate soil, water, equipment or hands that subsequently comes into contact with the produce. It is not possible for a business to know if a worker is ill with a gut pathogen. The worker may choose to hide the fact they are ill, supress symptoms with medication, only have mild symptoms or even display no symptoms at all (known as asymptomatic infection); (Clayton et a., 2016). Harvest workers pose a potential risk to produce consumers if they inadvertently contaminate equipment or product with contaminated faeces. By definition, a pathogen in a worker's gut is capable of colonising a human gastrointestinal (GI) tract. In addition, the pathogen may be present at high concentrations in the faeces of an infected worker meaning that even small amounts of contamination could transmit illness to a consumer. The greatest risk of faecal contamination is from the hands of a worker shortly after they have defecated (Ceuppens et al., 2014). Hands contaminated with faeces containing Hepatitis A have been shown to be fomites (objects that spread contamination) for at least four hours (Mbithi et al., 1992). It is therefore important to make available:
- Toilets that are acceptably clean and sanitary (i. e. don’t contaminate users).
- Toilets that are near enough to the workers to be easily accessible.
- Adequate toilets for the number of workers.
- Facilities for cleaning and sanitising hands after using the toilet.
- Toilet facilities are culturally relevant to employed workforce e. g. squat latrines.
Recognising the importance of accessibility, the Codex Alimentarius Commission requires that facilities should be located in close proximity to the fields and indoor processing premises. The accepted maximum distance for locating toilet facilities from workers is 500m in GLOBALGAP and ¼ mile in US GAP standards. Historically, Red Tractor also stated 500m or less, but currently does not advise on a maximum distance, warning only that toilets should be far enough away from crops to prevent contamination of food. A maximum distance of around 500m is justified by the observations of Ceuppens et al. (2014) who determined that increasing distance from lettuce fields to toilet and hand wash facilities was significantly linked with increased concentrations of E. coli, coliforms and higher pathogen prevalence across all of a crop production area. It is important that toilets are regularly cleaned and sanitised. Monaghan and Hutchison (2016) report that internal field toilet door latches and toilet handles can harbour up to 1000 cfu/cm2 total aerobic mesophiles (bacteria that require oxygen and prefer moderate temperatures).
In some cases, for example where one person is working independently, toilets may be further away than 500m, providing there is reasonable and adequate transport to the toilet available to the worker. The UK Health and Safety Executive (HSE) provides guidance on the number of toilets and hand basins needed for workers (Table 1; HSE, 2007).
Table 1: HSE recommendations for the number of toilets and washbasins per staff numbers. Figures are for a mixed gender workforce (or for women only)
| Number of workers | Number of toilets | Number of hand basins |
|---|---|---|
| 1-5 | 1 | 1 |
| 6-25 | 2 | 2 |
| 26-50 | 3 | 3 |
The HSE guidance can be considered as broad and there is a different recommendation from the HSE if the workforce is exclusively male (Table 2). Similar advice of one field toilet for every seven workers without consideration of gender is provided in a different HSE document if the toilets are emptied on a weekly (or more frequent) basis.
Table 2: HSE recommendations for the number of toilets and urinals per staff numbers. Figures are for an exclusively male workforce.
| Number of workers | Number of toilets | Number of urinals |
|---|---|---|
| 1-15 | 1 | 1 |
| 16-30 | 2 | 1 |
| 31-45 | 2 | 2 |
| 46-60 | 3 | 2 |
| 61-75 | 3 | 3 |
| 76-90 | 4 | 3 |
| 91-100 | 4 | 4 |
The HSE recommendations are not a legal requirement of The Workplace (Health, Safety and Welfare) Regulations 1992 and so should be considered as best practice for crops that are assessed as exceptionally risky.
The number of toilets that are sufficient is not stated in most quality assurance schemes, although there is advice provided in the Red Tractor scheme that says there should be at least one toilet for every 20 workers and so is broadly similar to the HSE advice for a male workforce.
References
HSE (2007) Welfare at work. Guidance for employers on welfare provisions. 4 pp .
