What Is a Carrier Screening Examination? Who Needs One?

Who is a carrier, and why is screening done?

A carrier is a person who carries an infectious micro-organism in their body without showing symptoms of disease and can pass it on to others. Bacteria and parasites excreted in faeces when hand hygiene after using the toilet is not followed, bacteria carried in the nose and throat, or an open wound on the hand can pass into food being prepared and from there to large numbers of people. The carrier screening examination is the name used in practice for the examination and laboratory tests aimed at detecting this “invisible carriage”.

In food production and mass catering, an agent carried by a single worker can affect hundreds of people in a single production batch. This is why food worker health screening is one of the workplace physician’s priorities from the point of view of both public health and worker health. The workplace physician’s duties expressly include preventing spread and immunisation work for the control of communicable diseases, hygiene training and ensuring that the necessary examinations and tests are carried out.

Legal basis: Law No. 1593 and the Regulation on Hygiene Training

The legal framework of carrier screening consists of three texts:

• Art. 126 of Public Hygiene Law No. 1593: In food production and sales premises, places of mass consumption and workplaces providing cleaning services in contact with the human body, those documented as having a communicable disease and those with a visible open wound or skin disease may not work, and may not be employed, until it is documented by a report that their disease has healed. Workers are obliged to inform the employer about their illnesses.
• Arts. 9 and 10 of the Regulation on Hygiene Training (Official Gazette 05.07.2013/28698): Persons who have a disease that can be transmitted through food or who are carriers of such a disease, those with diarrhoea, those with open or infected wounds or skin infections on visible parts of the body, and those who contract diseases such as tuberculosis may not work in these workplaces until they document by a physician’s or specialist physician’s report that they have recovered or are not infectious.
• Art. 15 of Law No. 6331 on Occupational Health and Safety: The employer ensures that workers are placed under health surveillance according to the risks of the work; health information is confidential and its cost may not be passed on to the worker.

The word “carrier” in the Regulation shows that carriage is not just a medical recommendation but a condition that prevents work. Compliance with the Regulation is inspected by the ministry or local authority that licenses the workplace.

Who needs a carrier screening examination?

Art. 2 of the Regulation on Hygiene Training sets out its scope. Mass catering falls within this scope: the Regulation’s definition of a retail establishment expressly includes ready-meal services, workplace and institutional canteens and restaurants.

Cosmetics production facilities are not listed separately in the Regulation’s scope. In these facilities, the workplace physician decides on screening, taking into account workers in direct contact with the product and the way the product is used. Personal care services such as hairdressers and beauty salons, on the other hand, are within scope.

Which tests does a carrier screening examination include?

The legislation does not set a fixed list of tests for carrier screening. The physician chooses according to the nature of the work, whether the product is eaten raw or cooked, and the worker’s duties. With diseases that can be transmitted through food in mind, the main tests the physician may use are:

• Stool culture: Investigates carriage of bacteria transmitted via the intestines, such as Salmonella and Shigella.
• Stool examination for parasites: Looks for eggs or cysts of intestinal parasites.
• Nose and throat culture: Investigates carriage of bacteria that can cause food poisoning, such as Staphylococcus aureus.
• Chest X-ray: Used to assess suspected tuberculosis.
• Hepatitis tests: Serological tests for infections such as hepatitis A and B where considered necessary.

Alongside the tests, the physical examination is also important: wounds, skin infections or nail infections on the hands and visible areas are often noticed before the laboratory result. We plan tests with authorised laboratories and health institutions; the results go into the worker’s health file together with the Annex 2 examination form.

How is the carrier screening frequency determined?

There is no fixed period in the legislation for carrier screening frequency. The periodic examination itself is carried out, according to the hazard class, at least every 5 years in less hazardous, every 3 years in hazardous and every year in very hazardous workplaces, and the workplace physician may shorten these periods. In work involving contact with food, the screening interval may be planned to be shorter than the periodic examination interval, according to the risk of the product. The factors determining the plan are:

1. Before starting work: Screening of a worker who will be in contact with food or customers is carried out together with the pre-employment examination.
2. Size of the risk: The interval is kept shorter for workers handling products eaten without further processing after cooking.
3. After illness: A worker who has been off work due to diarrhoea, vomiting, fever, jaundice or an infected wound is assessed before returning to work.
4. Outbreak or complaint: Screening is repeated when food poisoning is suspected or when more than one case occurs on the same line.

What happens to the worker if the result is positive?

A positive result does not mean the worker must be dismissed; in most cases it is a temporary condition that disappears with treatment. The process runs as follows:

1. The physician assesses the result. If necessary, the test is repeated and the worker is referred to the relevant physician for treatment.
2. The worker is temporarily removed from work involving contact with food. Under Art. 9 of the Regulation on Hygiene Training, the worker may not be employed in this work until documented by a report. The physician may propose a suitable duty without contact with the product; a change of duty is made with the employer’s approval.
3. Treatment and a follow-up test are carried out. A follow-up test is requested once treatment has been completed.
4. The worker returns with a recovery report. Under Art. 10 of the Regulation, the worker may work once they submit a physician’s or specialist physician’s report showing that they have recovered or are not infectious.
5. The source is investigated. Whether there are other carriers on the same shift, the hygiene of hand-washing stations and toilets, and the adequacy of soap and drying materials are reviewed.
6. Hygiene training is reinforced. Hand hygiene and the illness reporting rule are explained to the team again.

The greatest risk is a worker hiding their illness. To prevent a worker who comes in with diarrhoea or a fever from keeping quiet for fear of losing income, put the reporting rule in writing and announce clearly that anyone who reports will not face adverse consequences.

Checklist for the business

• All workers in scope hold a hygiene training certificate; for details, see our article on the hygiene training certificate.
• The pre-employment examination and screening are carried out before starting work involving contact with food.
• The screening plan, with the type and frequency of tests, has been set in writing by the workplace physician.
• The illness reporting rule is in writing and workers know it.
• The medical reports of temporary and subcontractor staff are checked.
• Hand-washing points, soap and drying materials are sufficient.
• Results are kept in the confidential health file and fitness decisions in the employer’s file.

The basic administrative fine for 2026 for failing to carry out health surveillance is 22,194 TL per worker; you can see the amount for your workplace in the administrative fines tool. For the general rules of periodic examinations, see our articles on periodic medical examinations and tests, for the pre-employment report, the pre-employment medical report, and for all of the physician’s duties, the duties of the workplace physician. We prepare the screening plan for food production and mass catering businesses in Bursa and neighbouring provinces within our health surveillance and workplace physician services; for sector notes, see our food sector page.

Frequently Asked Questions

Is a carrier screening examination mandatory?

The legislation does not provide for a fixed list of tests and frequency under the name “carrier screening examination”. However, the rule that a carrier of a disease transmissible through food may not work in these workplaces, together with the health surveillance obligation, makes screening a natural part of the risk assessment in this work.

Which tests does a carrier screening examination include?

Depending on the physician’s choice, stool culture, stool examination for parasites, nose and throat culture, a chest X-ray and, if considered necessary, hepatitis tests are carried out. Hand and skin findings are also assessed in the physical examination.

How often is a carrier screening examination carried out?

There is no fixed legal period. It is done on recruitment; the subsequent interval is set by the workplace physician according to the risk of the product, the worker’s duties and history of illness.

When can a worker with a positive result return to work?

After treatment and follow-up tests, they can return to their job involving contact with food once they submit a physician’s or specialist physician’s report showing that they have recovered or are not infectious. During this time the physician may propose a duty without contact with the product.