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Part II: Health and safety issues

1. Introduction

The idea of this section of the survey was to get some idea of the reality on the shop floor - what do workers think are the major problems at the workplace - to give trade unions an idea of priorities and where to address their education and prevention policy efforts. Trying to put some kind of priority on osh/env issues is very important for trade unions. With limited resources, both in financial and in personnel terms, it is imperative that certain issues are tackled first rather than spreading resources thinly and achieving superficial results. How to allocate priorities? As it was not possible to go into detail, the questionnaire asked if listed issues were "no problem", a "minor problem" or a "serious problem". Although this may be a rather simplistic way around the issue at least it gives the national unions an idea of what concerns their members, and thus ensures support for their policies that are based on real issues.

Figure 9. Workplaces by the percentage of accidents recorded in 1997

2. Safety issues

Occupational accidents (not the causes) are discrete, visible happenings, unlike work-related illnesses which may be very subtle or confused with other symptoms such as the common cold or flu, or they may take years to develop, sometimes even after a worker has retired. For this reason, the survey asked for the number of accidents recorded in the workplace, believing that this would be a fairly easy-to-see indicator of general conditions of safety, or of the "dangerousness" of a particular workplace. It became obvious during the analysis of the survey, however, that this question turned out to be most unreliable. Leaving aside the arguments about definitions of accidents (number of days off work, etc.) and what does or does not get recorded, it may be that some respondents included recorded accidents from the whole company rather than just from their workplace - or there are some very dangerous workplaces in Bulgaria.

Some of the obviously unusable statistics then were disregarded for analysis. What remained was that 47% of the workplaces had no recorded accidents 1997. In 24.4% of the workplaces, a maximum of 5% of the employees had a recorded accident in 1997, that is between 1 and 5 accidents per 100 employees over the year; and 15% recorded an accident rate of at least 15.01% (See figure 9).

Figure 10 Safety issues that were experienced as problems in the workplaces

Fire risk, falls and being struck by objects were the three most common safety problems in the workplaces. 56.4% of the respondents considered the fire risk, 51.3% the falls and 48.2% the danger of being struck by objects as a safety problem of some degree - a minor or a serious problem. However, the three most common serious problems were fire risk, hot temperatures and cold temperatures. (See figure 10)

Not surprisingly, accidents were much more common in primary production and manufacturing than in other economic sectors. (Compare with European Union statistics for different industries, below:)

Table 2. Accidents at work in the European Union by type of activity (1994) per 100,000 employees

Many of the respondents were not able to assess by what percentage the number of accidents was underrepresentative. Only 49.6% of the respondents gave some figure. Most of these (54.3%) said that the number of accidents was underrepresentative by half (See figure 11), that is that the number of recorded accidents should have been double the figure actually recorded.

Figure 11. Workplaces by the percentage by which the figure on recorded accidents in 1997 was underrepresentative according to the respondents

Looking at which hazards were considered serious safety problems in different sectors the survey confirmed that the services sector is relatively "safe". It must be pointed out that all service activities were combined for this particular analysis, that is, that administration and banking, for example, were examined along with health service activities. It is well-known that lifting, and therefore musculoskeletal disorders, is a major problem in the health services sector, but the combination of data may account for the relatively low figure for lifting as a problem. The major safety problems in the service sector seem to be cold temperatures, humidity and the condition of floors (See table 3.).

Safety issues were considered as serious problems more often in primary production than in other economic sectors. In this sector, the most common serious problems were fire risk, being struck by objects, humidity, condition of floors, hand tools and falls.

In manufacturing, the most common serious problems were fire risk, hot temperatures, cold temperatures and condition of floors. Although fire risk and condition of floors were the major risks in manufacturing, Table 1. shows that they are less common than in the primary sector. Surprisingly, lack of machine guards (6.2%) and lighting (5.6%), which are fairly common hazards in manufacturing, were of very low concern in this survey, hopefully because machine guards are installed and lighting is adequate.

The construction and energy, electricity, gas and water supply gave few surprises: the most common serious problems were hot temperatures, being struck by objects, lifting, cold temperatures and falls, with transport of materials, welding and electrical hazards following closely behind.

Table 3. Safety issues that were experienced as serious problems in the workplaces of different industries

Energy means energy, electricity, gas and water supply

Figure 12. Health hazards that were experienced as problems in the workplaces

3. Health issues

The most common problems concerning health hazards in all sectors combined were noise, eye strain, irritants and dust and fumes. Noise was experienced as a problem of some degree - minor or serious - in 71.7% of workplaces, eye strain in 68.3%, irritants in 65% and dust and fumes in 63.7%. However, noise, dust and fumes and irritants were experienced more often than eye strain as serious problems.(See figure 12)

Whereas certain safety hazards were much more associated with some sectors rather than being common to all, it seems that health hazards such as noise, dust and fumes and irritants are common hazards in all sectors of activity (See table. 4)

Table 4. Health hazards that were experienced as serious problems in different industries

Energy means energy, electricity, gas and water supply

Noise, for example, was experienced as a serious problem in over 46% of manufacturing workplaces, 42.4% of primary production workplaces, in 31.9% of workplaces in the service sector, and 23.9% in construction and energy. This is not to say that the same levels of noise are experienced in all these workplaces, rather that the level of noise for the type of work required is perceived to be a problem. Thus, although it may be noisier on a construction site than in an office, the relatively low office noise may cause considerable stress for mental work and be considered a problem by office workers.

Another common finding is that biological hazards and radiation are low on the list of concerns across all sectors, although these are lowest for manufacturing at only 2.7%. Also contrary to the results for safety issues, concerning health issues the service sector is no longer perceived as "safer" than the construction and energy sector. Eye strain, noise, irritants, dust and fumes, uncomfortable work position and repetitive movements are all major problems in this sector and are mentioned as such in proportionately far more workplaces than in construction and energy (although similar to, or less than in, the primary sector or manufacturing.

In the primary production sector, the major problems cited were dust and fumes (mentioned by 51.5% of workplaces), irritants (42.4%), noise (42.4%), vibration (39.4%) and uncomfortable working position (38.2%), all of which are understandable in mining and agriculture.

Similar hazards were cited in manufacturing - noise in 46.7% of workplaces surveyed, dust and fumes in 38.3%, irritants in 34.7%, and eye strain in 33.1%. In the construction and energy industries, in addition to the noise, dust and fumes and irritant hazards experienced in other sectors, burns and uncomfortable work position were very prominent hazards.

Although only 25.2% of the respondents considered tobacco smoke as a health hazard that caused problems, 53.6% of the respondents considered tobacco smoking as a problem in the workplace. Although this difference can only be speculated on it may be that workers consider tobacco smoke as a nuisance, or that the act of smoking could give rise to safety problems, rather than actually causing health problems.

Figure 13. Organisational hazards that were experienced as problems in the workplaces

4. Organisational issues

Organisational issues can have an effect on safety, health and well-being - through stress from job insecurity, job dissatisfaction, style of supervision, or through fatigue from long work hours, shiftwork, etc. Work design, sanitary and eating facilities, housekeeping, storage, etc. can all have direct consequences on safety and health at work.

Over all sectors the most common organisational problems cited in the survey were job security, workplace design and sanitary facilities. 57.6% considered job security, 57% workplace design and 51.6% sanitary facilities as minor or serious problems. 23.9% said that sanitary facilities posed serious problems, 20.4% that workplace design was a serious problem and 20.2% job security (See figure 13).

Although job security comes in third position of serious problems, it is - like workplace design - a major consideration across all four sectors, and is the biggest perceived problem in primary production workplaces and in construction and energy. Workplace design, on the other hand, may be the second most serious problem in terms of the percentage of workplaces but this is because of the high proportion of manufacturing workplaces in the survey. It does not take such a prominent place in the other sectors. Of relatively little concern to respondents across all sectors were housekeeping (from 2.2% in construction and energy to 7.5% in services) and storage (from 4.3% in services to 11.8% in primary production).

Looking at the different industrial sectors, it appears that in addition to the problems posed by sanitary facilities and job insecurity, rest periods or a lack of adequate rest was a serious problem in primary production, but not so much in other sectors. Monotonous work was a serious problem in 24.2% of manufacturing workplaces, compared to 14.7% in primary production, 10.9% in services and 10.6% in construction and energy (See table 5)

Table 5. Organisational hazards that were experienced as serious problems in the workplaces of different industries

Energy means energy, electricity, gas and water supply

Eating facilities posed major problems for workers in the construction and energy industries, with 26.1% citing this as a serious problem, on a par with job insecurity (27.7%) and way above sanitary facilities (19.1%) and workplace design (15.2%).

Sanitary facilities (22.7%) and eating facilities (20%) were also major organisational problems in the service sector. The style of supervision and stress derived from this was not perceived as an overriding issue in the services sector.

Figure 14. Impact on the general environment that was experienced as a problem in the workplaces

5. Environmental issues

The most common workplace issues considered as problems in relation to their impact on the general environment were, in decreasing order, risk of major industrial accidents, noise, air pollution and dust. 57.5% of the respondents considered the risk of major industrial accident as a minor or serious problem, and 18.1% considered it a serious problem.. More than 15% of the respondents also considered noise, dust and air pollution as serious problems. Of little, or even least, concern in all sectors was the issue of radioactive waste (See figure 14).

Serious problems were much more common in primary production than in other sectors of industry. The risk of major industrial accident, for example, was considered as a serious problem in 38.2% of the primary production units. More than 20% of the primary production workplaces counted soil pollution, dust, over-exploitation of the environment, noise, bad smells and/or water pollution as serious problems. While primary production units - mining and quarrying and agriculture, fisheries and hunting - make up only 9.9% of the respondents they account, not surprisingly, for the vast majority of pesticide concerns and problems relating to over-exploitation of the environment. Primary production is also affected by more complaints of "medical waste" than even the services sector, which includes health care services, probably because of animal waste.

In manufacturing, the most common serious problems, in addition to the risk of major industrial accidents, were noise and waste of energy. In construction and energy, electricity, gas and water supply, the most common serious problems were waste of energy and air pollution. (See table 6)

Table 6. Impact of the workplace on the general environment that was experienced as a serious problem in the workplaces of different industries

Energy means energy, electricity, gas and water supply

6. Summary on issues perceived as problems

Table 7. Most common serious problems according to sector - round-up of priorities

Energy means energy, electricity, gas and water supply

Figure 15. Symptoms or diseases from which the workers were suffering sometimes or frequently

7. Symptoms and diseases

The most common symptoms from which workers were said to be suffering sometimes or frequently were tiredness, high blood pressure, headaches and backaches. Usually, workers suffered from the symptoms or diseases only sometimes rather than frequently, although certain symptoms and signs were mentioned as being frequent in over 30% of workplaces: e.g. tiredness in all sectors, high blood pressure in primary production, construction and energy and in the services sector (and almost 26% of workplaces in manufacturing). Backache was also a frequent problem in primary production units (47.1%) and in services (34.7%). (See figure 15). The frequency of symptoms and diseases were often related to the health hazards mentioned earlier:

• In 29.1% of those workplaces where noise was considered a serious problem, workers frequently suffered from deafness, and in 28.2% from ringing in the ears.
• In 22.8% of those workplaces where dust and fumes were considered a serious problem, workers suffered frequently from coughing, and in 18.6% from breathing difficulties.
• In 47.8% of those workplaces where chemicals were considered a serious problem, workers frequently suffered from allergies, and in 51.9% from skin irritation.
• In 26.7% of those workplaces where biological hazards were considered a serious problem, workers frequently suffered from gastro-intestinal disturbances, in 25.0% from cancer, in 33.3% from menstrual problems, in 28.6% from reproductive problems, and in 21.4% from birth defects in offspring.

The most common symptoms and signs of health problems mentioned are not, with the exception perhaps of high blood pressure, life-threatening ones - although they do detract from the overall quality of life and thus should not be discarded. High blood pressure is fairly common across all sectors and may reflect general levels of health in the country, rather than being work-related. Very serious issues such as reproductive problems, birth defects in offspring, cancer, asthma, etc. are fortunately on the bottom of the list of frequently reported symptoms and signs. But it must be pointed out that 6.1% of workplaces in the primary sector cited reproductive problems and birth defects as frequent happenings, and it would perhaps be worthwhile investigating this.

Relatively "new" symptoms are also becoming increasingly important in the Bulgarian sample, such as irritability (particularly important in the service sector), stress (common in primary production units and services), pain, tingling and numbness (common in the primary sector, probably from vibration from tools and equipment, and in services, probably from computer work). Deafness and ringing in the ears, both serious problems, are found predominantly in the primary and manufacturing sectors.

Looking at the individual sectors, it can be seen that workers in the primary sector suffer frequently from, in decreasing order, backaches, tiredness, stress, pain, tingling or numbness, ringing in the ears, cuts and bruises, and allergies. Although not experienced so much, several symptoms and signs stand out as being much more common in this sector than in others: visual changes, breathing difficulties, asthma, reproductive problems, and birth defects in offspring (See tables 8 and 9).

In manufacturing, the most common problems encountered were tiredness, headaches, high blood pressure, backache and irritability, although all these were common to at least one other sector also.

Workers in the construction and energy industries seem to be relatively healthy compared to workers in other sectors. Apart from tiredness, high blood pressure and headaches, common to other sector workplaces, these workers suffered from sore eyes and coughing. Of significance here is that only 1.1% of respondents cited "dizziness"as a problem (compared to 16.9% to 23.4% in other sectors) - perhaps a clear case of self-selection of construction workers. It is also surprising that there was no mention of allergies as a problem when cement eczema is usually a fairly common phenomenon in the construction industry.

Table 8. Symptoms or diseases from which the workers were suffering frequently in the workplaces of different industries

Energy means energy, electricity, gas and water supply

Table 9. Most frequently experienced symptoms and signs according to sector

In 86.4% of the workplaces surveyed, the workers consulted a doctor when they suffered from symptoms or diseases. In 40% of the workplaces, workers registered a complaint with the union.

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