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

3. Work and MSDs in Bulgaria
3.1
An unclear
picture
18
This section sets out what we know about the impact of MSDs on people of working age in
Bulgaria. It uses data, research and interview evidence from Bulgarian sources where this is
available, and paints a picture of the challenges faced by both current and future Bulgarian
workers, their families, their employers and, ultimately, state agencies. It looks at four main
issues:
1. The inadequacy of the data on MSDs in Bulgaria and the consequences of this;
2. The impact that MSDs have on people’s ability to work;
3. The impact that work can have on MSDs;
4. The wider economic and social impact of MSDs in Bulgaria.
We begin by looking at data quality.
While there are a few major public bodies holding data on work-related MSDs in Bulgaria
(for example, the National Centre of Health Information, the National Centre of Public Health
Protection, the National Statistical Institute and the National Social Security Institute),
Gladicheva and Chengelova (2007) suggest that these sources are under-resourced, potentially
affecting the quality of available data. The lack of communication between those agencies is
also evident from the inconsistencies between data indicators available from those sources.
Despite the processing of data collection being in place, lack of resourcing and unavailability of
regular publications hinders the understanding of the impact of work-related MSDs in Bulgaria.
Figure 3.1 on the next page presents the growth of the number of patients discharged from
Bulgarian hospitals after undergoing treatment for MSDs.
This method of data collection provides only a narrow view of prevalence of MSDs in Bulgaria.
Because the prevalence of musculoskeletal diseases is estimated based on the numbers of
patients discharged from hospital with a particular diagnosis, this method does not take account
of those people with MSDs who were not hospitalised or of outpatients. Likewise it neglects
measuring the costs of MSDs beyond direct costs of treatments, for example, the rates of
unemployment and disability associated with MSDs.
It is particularly difficult to gain insight into the prevalence of conditions not included in the
occupational diseases list. For example, in the case of rheumatoid arthritis we have had to go
to sources external to Bulgaria to gain a picture of the prevalence of this disease. The same is
true for Ankylosing spondylitis (AS). Within Bulgaria the prevalence of these conditions is either
unreported, or – at best – is estimated based on membership figures in patient organisations.
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