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

4. Interventions
4.1
The case
for early
intervention
42
The impact of MSDs, as we have seen, can be significant to the people living with them,
to employers and to society as a whole. Their impact on the workforce has recently started
to receive greater recognition. Whilst it is widely acknowledged that early intervention is an
essential part of addressing the onset of MSDs and absence caused by these conditions, there
is still some way to go before people with MSDs are given the best support possible to remain
in work or return to work. Long waiting times for care, certain employer’s lack of capacity to deal
with sickness, lack of employee awareness about conditions and their management, and mixed
messages on the effectiveness of various methods of workplace interventions or return to work
programmes are all barriers to making good and healthy work a reality for those with MSDs.
Improved health has been shown to have positive effect on overall economic growth. This
section looks at the kinds of interventions which are most likely to help workers with MSDs to
stay in work, to return to work, to remain productive, to derive health benefits from work and to
continue to make a contribution to society. In addition, Appendix 3 provides a wide number of
indicators that may help to identify both enablers and barriers to early intervention in Bulgaria
and to compare Bulgaria to countries with similar or different labour market, welfare and health
care systems.
Ensuring that workers who have MSDs get access to the appropriate treatment and support
as quickly as possible must be a top priority for employers and health care professionals.
Epidemiological studies of employees whose absence is caused by low back pain have shown
that the longer the sick leave, the more difficult it is to get the employee to return to work and
the higher the economic cost (Frank, Sinclair, Hogg-Johnson, Shannon, Bombardier et al. 1998;
Meijer, Sluiter, Heyma, Sadiraj, and Frings-Dresen, 2006). Sick leave has also been shown to
have a negative psychological impact on employees (Meijer, Sluiter, and Frings-Dresen, 2005).
Early intervention is therefore crucial to individual recovery and self-management, and may
contribute to reducing the number of working days lost and reduced productivity caused by
MSDs (although the evidence on the cost-effectiveness of specific return to work programmes is
inconclusive).
It is also in an employer’s best interests to act early if they are to minimise the costs to the
health of employees and to their business through absence. Based on a review of the available
evidence Breen, Langworthy and Bagust (2005) recommend that employees and employers
should discuss and adjust work within the first week. If employees have concerns about their
condition they should consult a health care professional and, following referral or diagnosis,
advice and planned action, a review should be conducted within four weeks.
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