Hepatitis B in food handlers

Summary of Transmission Risks

Hepatitis A (infectious hepatitis) and Hepatitis B (serum hepatitis) are distinct diseases with completely different transmission routes. While Hepatitis A is spread via the faecal-oral route, historical studies—such as those by John Neefe and co-workers—demonstrated that Hepatitis B cannot be transmitted through oral exposure to infected material, feces, or urine (1).

Modern epidemiology confirms that Hepatitis B virus (HBV) is not spread through food, water, shared utensils, or casual contact (2). Instead, it is limited to specific blood-to-blood routes, such as open wounds coming into direct contact or blood spills on broken skin.

Workplace Management & Hygiene

The risk of transmitting Hepatitis B in a standard workplace is minimal. Standard workplace hygiene practices are entirely sufficient to prevent transmission:

• Cover open wounds and sores.

• Clean any blood spills immediately using disinfectant or bleach.

• Do not share towels.

No extra or special precautions are required for employees living with Hepatitis B.

Legal and Regulatory Framework (New Zealand)

Under the Animal Products Act 1999, food and animal product handlers can only be excluded from work if they have a condition listed under Section A, Part 1, Schedule 1 of the Health Act.

• Hepatitis B is listed under Section B, meaning it cannot be used as a legal basis to exclude individuals from handling animal materials or food products.

• The Ministry of Health advises that only acute Hepatitis B is a notifiable disease, not chronic Hepatitis B.

• Employees with chronic Hepatitis B have no legal obligation to disclose their status to employers unless they work in high-risk medical roles (e.g., exposure-prone surgical procedures).

Conclusion and Recommendations

There is no justifiable medical or legal basis to exclude individuals with chronic Hepatitis B from food handling roles. Because of the persistent risk of uninformed workplace bias, we recommend that potential employees do not volunteer their Hepatitis B status. Furthermore, employers should not ask job applicants or staff members about their Hepatitis B status.

Authors

• Dr. Christopher Moyes (MA, MB, BChir, MRCP, MRACP, MD) – Clinician, Hepatitis Foundation of New Zealand

• Dr. Alex Lampen-Smith (MBBS, BPhty, MMedSci, FRACP) – Head of Gastroenterology, Bay of Plenty District Health Board & Clinician, Hepatitis Foundation of New Zealand Written October 2020

References

1. Neefe JR, Gellis SS, & Stokes J Jr. Homologous serum hepatitis and infectious (epidemic) hepatitis. Am J Med. 1946;1:3-22. doi: 10.1016/0002-9343(46)90017-4. PMID: 20989806.

2. Centers for Disease Control and Prevention. Hepatitis B Questions and Answers for Health Professionals. U.S. Dept. of Health and Human Services; 2019.