FfW Bulgarian report (English language) - Fit for Work Europe

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Introduction 16 ‘Musculoskeletal diseases (MSDs) include impairment or injuries of muscles, bones, joints, ligaments and bursa, caused by occupational factors such as static work, heavy loads, monotonous work and vibration.’ With this definition being limited by the scope of the health issues addressed, as well as the factors contributing to those disorders, in 2008 an extensive list of occupational diseases was issued, linking international disease codes (ICD-10) to specific causal workplace factors such as vibration or working in awkward positions (NSSI, 2008). Examples of the diseases by cause are presented in Table 2.1 below Table 2.1. Selected occupational diseases in Bulgaria Causes within the work environment Condition ICD-10 code Local vibrations Carpal tunnel syndrome G56.0 Shoulder injuries M75 Lateral epicondylitis (tennis elbow) M77.1 Damage to soft issues of upper limbs M70 General vibrations Periarthritis of shoulder M75 Increased atmospheric pressure Physical overloading (working with heavy loads, repetitive and monotonous work, working at high speed, work posture etc) Trigger finger (Stenosing flexor tenosynovistis) M65.3 Myalgias M79.1 Neuralgias M79.2 Shoulder-hand syndrome M89.0 Achilles tendinitis M76.6 Chronic pain in neck-shoulder region M54.2 Low back pain M54.5 Source: NSSI, 2008 The new classification is more comprehensive compared to the systems used before, as it demonstrates an understanding of how the conditions in the workplace are directly linked to diseases. The use of international disease codes facilitates consistency of data collection and international comparisons. However, our brief review of official statistics on ill health in Bulgaria suggests that even with the definition of occupational diseases in existence, public bodies collecting data on prevalence and costs of MSDs do not always align their methods of data collection, which makes prevention and management of occupational diseases in Bulgaria a difficult task. Fit For Work?
2.5 Structure of the report Introduction In addition, the list still fails to address the fact that other conditions, such as RA, may affect work, although they are not directly caused by work. This suggests that the existing definition and categorisation of MSDs may be unhelpfully narrow as a reflection of MSD prevalence and impact specific to the Bulgarian population. This report is structured as follows: • Section 3 examines the extent of MSDs in Bulgaria and the impact they have on productivity and attendance at work, on labour market participation and on the wider Bulgarian economy. • Section 4 reviews the range of interventions, including vocational rehabilitation, which can improve job retention and labour market participation among those with MSDs. • Section 5 sets out our recommendations for employers, employees, GPs, occupational health professionals and for the Bulgarian government. • Appendix 3 provides a benchmarking grid in which a number of indicators covering the labour market, the welfare system and the health care system are presented for each of the countries involved in the Fit for Work project. Fit For Work? 17
Page 1 and 2: Fit For Work? Rosemary Thomas Kseni
Page 3 and 4: Contents 1. Executive summary 5 2.
Page 5 and 6: 1. Executive summary The ‘Fit for
Page 7 and 8: What can be done? Executive summary
Page 9 and 10: Executive summary We have found imp
Page 11 and 12: Increasing work intensity is a very
Page 13 and 14: 2.2 MSDs: The European context Intr
Page 15: 2.4 A note on definition Introducti
Page 19 and 20: Figure 3.1. Number of MSDs inpatien
Page 21 and 22: • Stamina and resilience; • Cog
Page 23 and 24: Work and MSDs in Bulgaria It is imp
Page 25 and 26: of RA and specific leukocyte antige
Page 27 and 28: injuries or back pain 15 ; Sieper,
Page 29 and 30: 2001). The study also found that fo
Page 31 and 32: • Local or whole-body exposure to
Page 33 and 34: workers of developing rheumatoid ar
Page 35 and 36: 3.4 The wider economic and social i
Page 37 and 38: Work and MSDs in Bulgaria Direct co
Page 39 and 40: presented in the Table 3.3 below. T
Page 41 and 42: 3.5 Summary Work and MSDs in Bulgar
Page 43 and 44: Job retention and return to work pr
Page 45 and 46: 4.2 The social security regime for
Page 47 and 48: Further indirect costs of disabilit
Page 49 and 50: 4.3 Conditionspecific interventions
Page 51 and 52: RA in Bulgaria who receive biologic
Page 53 and 54: Interventions Since it was first pr
Page 55 and 56: apart from norms of shift work. 43
Page 57 and 58: Box 2. Case Study - EPIQ Electronic
Page 59 and 60: the beliefs that both parties have
Page 61 and 62: 4.6 Summary 4.5.4 Improved employer
Page 63 and 64: 5.1 Recommendations for employers 5
Page 65 and 66: 5.3 Recommendations for GPs and spe
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Conclusions and recommendations •
Page 69 and 70:
Breen, A., Langworthy, J. and Bagus
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der Tempel, H. and van der Linden,
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Guzman, J., Esmail, R., Karjalainen
Page 75 and 76:
References Nachemson, A., Waddell,
Page 77 and 78:
Waddell, G. and Burton, A. K., (200
Page 79 and 80:
Appendix 2: Sample ‘Fit’ Note S
Page 81 and 82:
Sources: Eurostat Statistical Datab
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Sources: Parent-Thirion, Fernández
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Hourly labour costs 2007 Average ho
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% sickness absence due to health re
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Appendix 3: Benchmarking grid Refer
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The aim of the project is to stimul
Page 93 and 94:
Appendix 4: Fit for Work Europe Wha
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We provide: Research Advisory Consu
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