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

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Work and MSDs in Bulgaria 30 existing policies, data and capacity in relation to physical health promotion between April – October 2011 with the intention of drafting a national action plan and implementing a national health strategy. 17 3.3.2 The impact of the workplace on MSDs Overall awareness of the health and safety risks related to their jobs is high amongst Bulgarian workers with 93 per cent saying that they felt very well-informed about the risks (EWCS, 2010). At the same time, only 40 per cent of workers felt that their health and safety was at risk because of work, and just over a third suggested that work negatively affected their health. Whilst this figure has decreased since 2005, when 48 per cent reported that work affected their health, it is still higher than the EU average (25 per cent). In terms of evidence and risk factors for the impact of work on MSDs a distinction needs to be made between ‘work-related’ disorders and ‘occupational’ disorders (Punnett and Wegman, 2004). Certain MSDs are recognised as occupational diseases by some European governments, such as wrist tenosynovitis, epicondylitis of the elbow, Raynaud’s syndrome or vibration white finger and carpal tunnel syndrome (Eurostat, 2004). Indeed, Bulgaria’s list of occupational diseases similarly includes many such occupational diseases, therefore demonstrating an understanding that work can cause and contribute to these conditions. The evidence linking non-occupational MSDs and work is not conclusive and attributing cause and effect between specific aspects of work and particular parts of the body is difficult. However, many of the established risk factors that may contribute to the development of non-specific MSDs can be encountered at work; even if work does not cause a condition it may have an impact on it. Moreover, if we consider risk factors beyond the physical, then the impact of the workplace on MSDs is likely to be much greater. The most frequently cited risk factors for MSDs encountered in the workplace include the following (Punnett and Wegman, 2004): • Rapid work pace and repetitive motion patterns; • Heavy lifting and forceful manual exertions; • Non-neutral body postures (dynamic or static), frequent bending and twisting; • Mechanical pressure concentrations; • Segmental or whole body vibrations; 17 See World Health Organisation http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/physicalactivity/news/news/2011/06/national-action-plan-on-physical-activity-in-bulgaria Fit For Work?
• Local or whole-body exposure to cold; • Insufficient recovery time (Punnett and Wegman, 2004). NSSI collects data on occupational diseases resulting from exposure of employees to factors in the work environment, however data are very scarce. For 2009 it reports only 116 cases of occupational diseases, with only 12 of them being MSDs (see Table 3.2). However it is worth noting that occupational accidents (adding up to 2,047 cases in the nine months of 2011), and resulting cases of MSDs do not fall into this classification. In comparison with previous records of occupational diseases produced by the National Centre of Public Health Protection (NCPHP n.d.), the number of cases seem to have decreased drastically (eg in 2003 the total number of MSDs was only 222); suggesting that before 2009 no distinction was made between occupational diseases and occupational accidents. Experts suggest that the drop in incidence may be associated with non-disclosure of illness in the context of recently worsened economic conditions and resulting fear of job loss. 18 Table 3.2. Registered cases of occupational diseases in 2009 Total number of diseases Of those caused by: • Local vibration • General vibration • Prolonged/frequent sitting • Pressure on wrist • Repetitive work with asymmetrical movements • Other repetitive/monotonous work • Use of tools in awkward manner (jerked movements) • Other cases of carrying or lifting heavy weights Total MDSs Of those: • Elbow osteoarthritis • Intervertebral disk damage • Shoulder periarthritis • Medial epicondylitis • Lateral epicondylitis (tennis elbow) Number of cases While this list provides a developed structure for collecting incidence data on specific MSDs caused by work, it is still not clear whether public bodies in Bulgaria manage to collect accurate and reliable data on work-related MSDs. The fact that so few cases of MSDs caused by work were recorded by NSSI may pose concerns over the methods of recording and classifying 18 Expert interview Work and MSDs in Bulgaria Fit For Work? 31 116 4 5 1 1 1 27 1 1 12 1 5 2 2 2 Source: NSSI, 2009
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 and 16: 2.4 A note on definition Introducti
Page 17 and 18: 2.5 Structure of the report Introdu
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: 2001). The study also found that fo
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
Page 67 and 68: Conclusions and recommendations •
Page 69 and 70: Breen, A., Langworthy, J. and Bagus
Page 71 and 72: der Tempel, H. and van der Linden,
Page 73 and 74: 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
Page 83 and 84:
Sources: Parent-Thirion, Fernández
Page 85 and 86:
Hourly labour costs 2007 Average ho
Page 87 and 88:
% sickness absence due to health re
Page 89 and 90:
Appendix 3: Benchmarking grid Refer
Page 91 and 92:
The aim of the project is to stimul
Page 93 and 94:
Appendix 4: Fit for Work Europe Wha
Page 96:
We provide: Research Advisory Consu
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