Occupational Safety and Health in Bulgaria

Part IV: Occupational health services

As for monitoring, occupational health services are important, not to determine disease or injury in a worker and to arrange appropriate treatment, or to select for particular work activities, but to verify that controls are in place and working. If controls are adequate the workforce will not be in ill-health because of their work. There are different types of health examinations and different means of ensuring that workers do have health check ups. The aim of this section is to determine what is available in the way of occupational health services at the workplace in Bulgaria now.

Health examinations at the workplace are common practice in Bulgaria, being carried out in 77.7% of the workplaces surveyed. They were more common in privatized enterprises than in other property forms, more common in larger workplaces, and more common in workplaces with some degree of foreign ownership. Health examinations were carried out in all totally foreign-owned workplaces, and in 87% of the predominantly foreign owned workplaces.

In 82.1% of the workplaces, health examinations included a pre-employment check up. Check ups on leaving the company were carried out in only 0.8% of the workplaces - a case of relinquishing responsibility once a worker leaves a company? Continuing periodic health examinations are advisable for some work-related diseases and injuries and exposures known to be associated with disease, including those with long latency periods.

Usually, health examinations were carried out by a company doctor or nurse (in 72.3% of cases). In 32.1% the examinations were carried out by a union doctor or nurse. Occupational health services for a group of undertakings carried out the examinations in 22.6% of the workplaces, and private health professionals in 8.8% of the workplaces.

Occupational health services for a group of undertakings and company doctors or nurses who conducted the health examinations also checked the general hygiene of the workplace and advised workers on health issues more often than did private health professionals or union doctors or nurses who conducted the health examinations (See figure 18).

Figure 18. Workplaces where certain occupational health measures were conducted when the health examination was carried out by different health professionals

36.1% of the respondents said that improvements were made to the workplace after the results of health examinations. 46.4% said that improvements were not made and 17.5% did not know if improvements were made or not. Transferring the worker to another job after a health examination was quite common, 64.5% of the respondents saying individual workers were sometimes transferred, and 2.4% that they were sometimes fired after health examinations.

Transferring workers to other jobs was more common in manufacturing than in other sectors of industry, more common in private (privatized and new private) than in the public (public owned enterprises and budget sector) sector, more common in foreign than domestic owned enterprises, and more common in larger units. Firing was much more common in primary production than in other sectors of industry.

Results of health examinations were given to the worker concerned in 82.6% of the workplaces and to the union in 33% of the workplaces. It was more common that the union also received the results in the private sector (privatised and new private enterprises), and in workplaces with some degree of foreign ownership. 35.3% of those units with at least some degree of foreign ownership gave the results to the trade union, but this was the case for only 26.4% of purely domestically owned units

In 35.4% of the workplaces, workers were tested for alcohol and in 3.5% for illegal drugs Alcohol and substance abuse is a safety, health and productivity issue and as such should be an important part of trade union concerns.

63.1% of the companies kept health records but only 5.1% of the unions did. Record keeping by the company was much more common in workplaces with some degree of foreign ownership. It was also much more common in larger workplaces. In the service sector, record keeping by the company was much less common than in other sectors of industry.

According to the respondents, 46.8% of the workplaces reported work-related injuries and 36.4% work-related illnesses to the authorities at the national level. Reporting was much more common in workplaces with some degree of foreign ownership. In the service sector, reporting was much less common than in other sectors of industry. (The questionnaire did not distinguish between those injuries and diseases which had to be reported and other injuries and diseases.)

78.8% of the respondents said that their union has access to information which was reported to the authorities at the national level.


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