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

1. Executive summary
The
‘Fit for Work?’
project
Following the economic downturn, Bulgaria is set to face the shrinking of its workforce. More
skilled workers than ever are leaving Bulgaria in search of better labour market conditions. The
skills gap is exacerbated by the growing number of those dropping out from work due to poor
health.
Acute conditions, such as cardiovascular disease, often grab the headlines in Bulgaria. Amid
the understandable concern about the number of working days lost to those conditions, one fact
seems to have become obscured. Musculoskeletal disorders (MSDs) such as back pain, arm
or neck strains or diseases of the joints are not only the third most common reason for absence
from work in Bulgaria, but further contribute to the shrinking of the labour market through
leading to a large number of disabilities and placing a significant burden on the welfare system.
Whilst government bodies in Bulgaria record the prevalence and impact of MSDs, the lack of
communication between various agencies, as well as a lack of standardisation in data collection
has increased the likelihood that the data misrepresents the societal burden of MSDs in
Bulgaria. Tackling the impact of MSDs has to become an immediate priority, and Bulgaria does
have the potential to manage the long-term impact of these conditions.
Bulgarian policy-makers, employers and health care professionals must recognise that a large
proportion of the inactive workforce in Bulgaria may in fact be fit enough to contribute their skills,
yet is discouraged from participating in the labour market as a result of stigma around disability.
There is overwhelming evidence that worklessness is, itself, bad for health. Job retention and
return to work can positively affect physical health, psychological well-being and raise people
out of poverty. In Bulgaria work has to become an outcome of treatment with better mechanisms
of diagnosis and management of diseases in place to increase individuals’ ability to remain in
and return to the labour market. Ultimately this will reduce the social burden of disease.
This project, part of a wider programme of work across 31 European and other countries,
has looked in some detail at the impact that MSDs have on the working lives of thousands of
Bulgarian workers, the adequacy of the treatment and support they receive, their experiences
at work, the effect of their condition on their family and colleagues, and the human and financial
costs involved. Specifically, we have looked at back pain, work-related upper limb disorders
(WRULDs) – two groups of conditions which are usually characterised by non-specific and short
episodes of pain and incapacity – and rheumatoid arthritis (RA) and spondyloarthropathy (SpA),
specific conditions that are often progressive and increasingly incapacitating. We conducted
a review of the recent academic and practitioner research on the relationship between these
MSDs and labour market participation, and conducted interviews with acknowledged experts in
this field. The full description of the programme can be found in Appendix 4.
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