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

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Interventions 58 Cont. 5) Prevention and monitoring Workers have been issued with personal protective equipment and preventive methods are reviewed continuously. Workers also benefit from health checks to monitor them for early diagnosis of diseases. 6) Physical activity EPIQ have provided their workers with opportunities to increase their physical activity through offering free tennis, table tennis and a gym. This approach to employee health and wellbeing, and in particular MSD prevention, is an example of best practice which will almost inevitably increase the productivity of workers as a result. Whilst the interventions implemented by EPIQ are commendable, it is not clear whether any baseline measures were made of employee health and how health and safety has improved health and wellbeing, productivity and costs. However, it is a good example that demonstrates that best practice for preventing work-related MSDs is known about within Bulgaria. 4.5.2 Intervention and adjustment of work demands Not only has evidence shown that work is good for you but returning to modified work can help recovery (Feuerstein, Shaw, Lincoln, Miller and Wood, 2003; van Duijn and Burdorf, 2008). Among occupational health specialists, the use of vocational rehabilitation has long been an accepted mechanism for ensuring that individuals with illness, injury or incapacity can return to work (even to perform adjusted work) as soon and as sustainably as possible. There have been concerns that rehabilitation is not well-integrated into mainstream clinical practice and that return to work is not seen by a sufficient proportion of clinicians as a valued outcome for the patient (Frank and Chamberlain, 2006). It is also important to stress that vocational rehabilitation is not the preserve of professionals. In practice effective management is as, if not more, important than formal rehabilitation. Yet, employers, if they think about this at all, invariably consider the physical job demands which need to be met by an employee with an MSD. The biopsychosocial model requires that the mental demands of the work are also considered as part of the return to work process. There is a growing body of work which shows that adjusting a variety of work demands can support successful return to work among those with a range of MSDs (Schultz, Stowell, Feuerstein and Gatchel, 2007; de Croon et al., 2004; Feuerstein, Shaw, Nicholas and Huang, 2004; Chorus, Miedema, Wevers and van der Linden, 2001). The success with which both employee and employer can manage the process of re-adjustment during return to work can also depend on Fit For Work?
the beliefs that both parties have about the extent to which the work itself is (at least in part) caused by or related to the incapacity. There are numerous types of work-based intervention for assisting those with MSDs, ranging from ergonomic adjustments to providing access to physiotherapy, modifying work programmes to cognitive behavioural therapy, or a combination of various strategies. Evidence on the success of these interventions at tackling non-specific MSDs is mixed (Meijer et al., 2005). 53 A systematic review of multidisciplinary treatments of patients with low back pain, for example, demonstrated that whilst the treatment improved function and decreased pain in individuals, it could not be demonstrated that this was linked to employees returning to work earlier than those who had not received it (Guzman, Esmail, Karjalainen, Malmivaara, Irvin et al., 2001). Whilst biomechanical or ergonomic factors may be related to the onset of back pain, evidence that interventions based on these principals will prevent re-occurrence or progression to chronicity is thin on the ground (Burton, 1997). In fact, it has proved virtually impossible to determine whether one treatment is significantly more effective than another (Ekberg, 1995). Even for specific conditions such as RA, the evidence for the effectiveness of vocational rehabilitation is slim (Backman, 2004; de Buck, Schoones, Allaire and Vliet Vlieland, 2002). There is nonetheless broad agreement on the principles for managing non-specific MSDs, particularly back pain, that are outlined in Box 3 below. This includes advice and a number of relatively simple measures for employees and employers to follow on how to deal with back pain. Box 3: Principles of managing non-specific MSDs 53 Findings from an evaluation of the effectiveness of return-to-work treatment programmes were inconsistent Interventions • Early treatment should be sought for back pain. • Most back pain is not due to a serious condition. • Simple back pain should be treated with basic pain killers and mobilisation. • It is important to keep active both to prevent and to treat back pain. • Getting back to work quickly helps prevent chronic back pain. • Adopt the correct posture while working. • All workplace equipment should be adjustable. • Take breaks from repetitive or prolonged tasks or postures. • Avoid manual handling and use lifting equipment where possible. • Clear information should be provided to employees about back care. • Health and safety policies should be implemented to cover all aspects of day-to-day work and should be reviewed regularly. Source: Health and Safety Executive (2002) Fit For Work? 59
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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 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: Box 2. Case Study - EPIQ Electronic
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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FfW Bulgarian report (English language) - Fit for Work Europe

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