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

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Executive summary 8 on the capacity rather than the incapacity of disabled people and review the current system of disability assessment to take into account both the physical and cognitive abilities of people with disabilities to support them in the labour market for longer. Organisations, such as The Bulgarian Organisation for Patients with Rheumatology Diseases should be supported in educating GPs and specialist consultants about the physical, social and psychological aspects of chronic diseases. • Think beyond legal compliance. Employers have to be aware of implications of ill health of employees on engagement and productivity. Simple interventions will help manage existing MSDs and prevent new cases of occupational diseases at the workplace. Managers should work together with employees in adjusting the ways work is organised to help prevent existing MSDs getting worse and to help people with MSD to stay in, or return to, work. They need to do this in a way which preserves job quality, avoids excessive or damaging job demands and takes heed of ergonomic good practice. • Assess the direct and indirect costs of MSDs. The quality of data on MSDs needs to be improved through monitoring the clinical and labour market impact of MSDs in a more ‘joined-up’ way. Currently the data on the costs and prevalence of MSDs in Bulgaria, their impact on sickness absence from work and lost productivity are not consistent, sufficiently comprehensive and reliable to allow good analysis or informed policy-making. A national register of occupational diseases would improve data quality considerably. • A national plan for MSDs. Such is the impact of MSDs on the working age population of Bulgaria we suggest that a national plan for the early diagnosis, treatment and rehabilitation of people with MSDs be established. This plan might establish national standards of diagnosis and treatment, support coordinated effort between local and state government and establish mechanisms which help GPs and employers to support job retention and return to work among people of working age with MSDs. Other countries (eg Ireland) have also appointed a National Clinical Director with oversight of such plans. We recommend that Bulgaria considers such an appointment. The evidence presented in this report illustrates that a large proportion of working age people in Bulgaria are, or will be, directly affected by musculoskeletal conditions (MSDs) in the coming years. This can have very significant social and economic consequences for these individuals and their families, it can impede the productive capacity of the total workforce and parts of Bulgarian industry and it can draw heavily on the resources of both the health system and the benefits regime. Fit For Work?
Executive summary We have found important clinical, epidemiological, psychological and economic evidence and expert opinion on the nature, extent and consequences of the MSD problem in Bulgaria. However, there still seems to be a lack of coherence or ‘joined-up’ thinking and action which focuses on the MSD patient as worker. While the number of advocates of the biopsychosocial model as it applies to all MSDs is growing, we noted that some of those who can have most impact on fulfilling the labour market participation of workers with MSDs have yet to embrace its principles as fully as they might. Fit For Work? 9
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: What can be done? Executive summary
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 and 58: Box 2. Case Study - EPIQ Electronic
Page 59 and 60:
the beliefs that both parties have
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4.6 Summary 4.5.4 Improved employer
Page 63 and 64:
5.1 Recommendations for employers 5
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5.3 Recommendations for GPs and spe
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Conclusions and recommendations •
Page 69 and 70:
Breen, A., Langworthy, J. and Bagus
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der Tempel, H. and van der Linden,
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Guzman, J., Esmail, R., Karjalainen
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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
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Sources: Eurostat Statistical Datab
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Sources: Parent-Thirion, Fernández
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Hourly labour costs 2007 Average ho
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% sickness absence due to health re
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Appendix 3: Benchmarking grid Refer
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The aim of the project is to stimul
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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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