departments to make sure a complete and thorough physical examination has been done. Personnel having any open lesions, particularly on the  hands,  face,  or  neck  or  acne  on  the  face,  are prohibited  from  performing  foodservice  duty. Examination  of  personnel  with  questionable medical  or  social  histories  must  be  comprehensive including  X-ray  of  the  chest,  stool  and  urine examinations for parasite and bacterial pathogens, and other  such  determinations  as  may  be  indicated  by international  agreements. All  personnel  must  repeat  medical  tests  when  away from  duty  for  30  days  or  more.  All  personnel  must submit to laboratory examinations and other tests to detect and treat acute or chronic diseases and be relieved from duty if they are infected. Training All  foodservice  personnel  must  be  thoroughly indoctrinated  in  personal  hygiene  and  food  sanitation, as well as in the methods and importance of preventing food-borne illness. Temporary foodservice personnel must be indoctrinated as follows: All  foodservice  personnel  will  receive  a minimum of 6 hours’ initial training and 6 hours’ annual   refresher   training   in   foodservice sanitation  principles. All   foodservice   sanitation   training   will   be conducted  by  environmental  health  officers and/or preventive medicine technicians. In  those  cases  where  it  can  be  shown  that environmental  health  officers  or  preventive  medicine technicians are not available to perform such training, medical  department  representatives,  MSs  in  paygrade E-5  and  above,  or  civilian  foodservice  supervisors  who have  received  special  training  to  qualify  them  as foodservice  sanitation  instructors  maybe  used.  Special instructor certification training may be taken at either a Navy  environmental  and  preventive  medicine  unit  or naval  regional  medical  center  preventive  medicine service,   and   completion   of   training   must   be documented. Certified  instructors  must  use  and maintain up-to-date, standard Navy lesson plans in their training  programs.  Instructors  must  be  recertified  every 3 years and are authorized to sign the Foodservice Training  Certificate,  NAVMED  4061/1. Personal Hygiene The  group  of  principles  and  rules  designed  to promote personal health and cleanliness is known as personal  hygiene.  The  following  procedures  should  be used  to  ensure  personal  cleanliness. TAKE DAILY SHOWER OR BATH.— Maintain a high degree of cleanliness by thoroughly soaping and rinsing  the  body  to  remove  dirt,  perspiration,  and bacteria. This   practice   improves   circulation, appearance, and health, and is the foundation of personal hygiene. Frequent washing of hair is mandatory. Keep teeth  clean  by  brushing  at  least  twice  daily,  but preferably  after  each  meal. WEAR   CLEAN   GARMENTS.—   Wear   clean inner and outer garments. Germs are harbored in clothing as well as on skin surfaces, and diseases are likely to be transmitted. Caps (or hairnets for women) completely covering the hair must be worn at all times when working with food. Keep hair trimmed for neat appearance. Change clothing and aprons soon after soiling. WASH  HANDS  BEFORE  STARTING  AND AFTER FINISHING W O RK WITH FOOD.— Provide plenty of hot and cold running water under pressure.   Soap and paper towels with adequate waste receptacles must be available. Continuous rolled paper toweling that is sanitary may be used if it is approved by the National Sanitation Foundation Testing Laboratory  or  meets  equivalent  standards,  but  use  of such toweling must be supervised. Thorough washing of hands with hot soapy water to remove  soil  and  contamination  before  commencing work is mandatory. After each visit to the toilet, all food handlers are required to scrub hands and nails. When interruptions occur during routine duties in the galley, personnel  are  required  to  wash  their  hands  before resuming work. Frequent washing of soiled hands during work is also essential. Never wear an apron to the  toilet  or  washroom. Hands  are  probably  the  most  common  vehicle  for transmitting germs. Personnel should keep fingernails closely  clipped,  trimmed,  and  cleaned  underneath  and around cuticle. Cleaning is effective only with soaps or detergents and warm water. Unless clean towels or other  satisfactory  hand-drying  devices  are  provided,  the benefits of frequent hand scrubbing are completely nullified. PROHIBIT USE OF TOBACCO.—  Smoking  in food  preparation,  serving,  or  dishwashing  areas  is 1-5