European semantic portal on workplace safety and occupational cancer prevention

The EuroWorksafe Service Impact on the Occupational Cancer

Prevention in Bulgaria

EWS Workshop “Prevention and EWS Workshop “Prevention and Occupational Cancer: Communication & IT”, Occupational Cancer: Communication & IT”,

February 14, 2008, Genoa, ItalyFebruary 14, 2008, Genoa, Italy

Dr. Ekaterina T. MirkovaDr. Ekaterina T. MirkovaElena Alexandrova, Nadezhda Elena Alexandrova, Nadezhda

TodorovaTodorovaNational Center of Public Helath National Center of Public Helath

Protection, Sofia, BulgariaProtection, Sofia, Bulgaria

NCPHP is a scientific and specialist organization of the Bulgarian Ministry of Health on public health protection and promotion. The NCPHP main activities refer to the research and development for prevention, diminishing or elimination the health risk related to the adverse effects of the environmental and occupational factors, food and nutrition and unhealthy lifestyle; education and dissemination of information in the field of public health protection, workplace and environmental health and safety and risk assessment, incl. cancer risk assessment and prevention; health promotion and integrated diseases prevention. 

Director of the NCPHP Prof.Dr.Lyubomir Ivanov, Ph.D., D.Sc

Professor Dr. Liubomir Atanasov Ivanov, DSc is the Director of the National Center of Public Health Protection (NCPHP).The Director of the NCPHP, Prof. Dr. Liubomir Ivanov, DSc is the National Consultant to the Ministry of Health on social medicine and health management, deputy chairman of the Higher Medical Council at the Ministry of Health.Prof. Ivanov has been working as WHO Advisor at the Ministry of Health of Georgia, special representative of the WHO Regional Director for Europe in Tadjikistan and chief coordinator of the UN on medical aid during the humanitarian campaign in Afghanistan.Prof. Ivanov is the author of more than 170 scientific publications in the field of public health care, including 16 monographs in English, French, Russian and Bulgarian. He has been cited in WHO editions, "Biosys" information system, Bulgarian, German, Hungarian and other international publications.

Cardio-vascular diseases

66.4%

Other 8%

Respiratory system’s diseases

3.7%

Cancer 15.6%

Digestive system’s diseases

2.8%

External causes of

morbidity and mortality 3.5%

Main Causes of Death in Bulgaria (2006)

OTHER SKIN 10.4%

PROSTATE 9.0%

COLON 7.4%

STOMACH 6.5%

RECTUM AND ANUS 6.2%

BLADDER 6.2%

LARYNX 3.5%

OTHER 30.8%

LUNG, TRACHEA AND BRON

19.2%

OTHER SKIN 10.4%

CORPUS 7.9%

CERVIX 7.3%

COLON 7.0%

OVARY ETC. 5.8%

RECTUM AND ANUS

4.7%

STOMACH 4.6%

OTHER 24.9%

LUNG, TRACHREA AND BRON

3.9%

BREAST 23.5%

PERCENTAGE DISTRIBUTION OF CANCER

INCIDENCE IN MALES BULGARIA 2004

PERCENTAGE DISTRIBUTION OF CANCER

INCIDENCE IN FEMALES BULGARIA 2004

Occupational Exposures to Carcinogens in Bulgaria in late

1980s

The transitional period with economic recession The transitional period with economic recession accompanied by insufficient resources for:accompanied by insufficient resources for: improving old technologiesimproving old technologies renovating worn-out equipmentrenovating worn-out equipment

Serious deterioration of OSH at work with Serious deterioration of OSH at work with carcinogens in high risk industrial sectors:carcinogens in high risk industrial sectors: mining; metallurgy; chemical and petroleum mining; metallurgy; chemical and petroleum

industry; rubber manufacturing; coke productionindustry; rubber manufacturing; coke production

Occupational Exposures to Carcinogens in Bulgaria (1990)

CarcinogensNumber of enterprises

with workplace carcinogen exposure to 50 > workers

Petroleum and petroleum products

139

Bensene 124Cr and Cr compounds 57Ni and Ni compounds 41Aromatic amines 36Vinyl chloride 35Polyaromatic hydrocarbons 29Azo dyes 26Cd and Cd compounds 25Asbestos 20As and As compounds 14Acrylnitrile 12Al and Al compounds 9Hydrazine 3

CarcinogensNumber of exposed workers

Workplace air concentrations (mg/m3)

OEL(TWA, 8h)

Maximum air concentrations

As and inorganic As compounds

2167 0.02 5

Benzo(a)pyrene 2306 0.00015 0.02Gasoline 35717 300 6000Bensene 12573 5 1333Vinyl chloride 3562 2.5 300Cd 3989 0.05 10Inorganic lead compounds 29585 0.05 100Cr, hexavalent 3680 0.5 406

Occupational Exposures to Carcinogens in Bulgaria (1990)

Occupational Exposures to Chemical Carcinogens in Bulgaria (1990)

Highly increased levels of workplace exposure to Highly increased levels of workplace exposure to human carcinogens – Group 1 (IARC); Cat.1 (EU)human carcinogens – Group 1 (IARC); Cat.1 (EU) In 65% of chemical industry enterprises air In 65% of chemical industry enterprises air

concentrations of carcinogens (TWA, 8hr) exceeded concentrations of carcinogens (TWA, 8hr) exceeded the respective national OEL Values (in times):the respective national OEL Values (in times):

100 100 Cr, hexavalent; lead; vinyl chloride; Cr, hexavalent; lead; vinyl chloride; 10 10 benzene; Cd; benzene; Cd; up to 10 up to 10 benzo(a)pyrene; Al. benzo(a)pyrene; Al.

Data on occupational exposure to carcinogens not Data on occupational exposure to carcinogens not systematically collectedsystematically collected

Bulgarian Ministry of HealthNational Health Strategy, 2001

“Better Health for Better Future of Bulgaria”

Action Plan in the health strategy’s key thematic Action Plan in the health strategy’s key thematic area: “Cancer”area: “Cancer”

Portfolio of measures to minimise by 25% up to Portfolio of measures to minimise by 25% up to 2010 the premature cancer death rates in the age 2010 the premature cancer death rates in the age group <60 yrs, incl.group <60 yrs, incl.

implementation of effective OSH measures to prevent and implementation of effective OSH measures to prevent and minimise workplace-related cancer risksminimise workplace-related cancer risks..

National Legislation on Protection of Workers from Risks Related to Exposure to Carcinogens and Mutagens at Work

Transposition of the Council Carcinogens Directives Transposition of the Council Carcinogens Directives 90/394/EEC, 97/42/EC and 1999/38/EC into the national law:90/394/EEC, 97/42/EC and 1999/38/EC into the national law: Ordinance No 10 of 26 September 2003 on the protection of Ordinance No 10 of 26 September 2003 on the protection of

workers from risks related to exposure to carcinogens and workers from risks related to exposure to carcinogens and mutagens at workmutagens at work

Council Carcinogens Directive 2004/37/EC Council Carcinogens Directive 2004/37/EC is notis not transposed into the national lawtransposed into the national law

Transposition of the Council Asbestos Directives Transposition of the Council Asbestos Directives 83/477/EEC, 91/382/EEC and 2003/18/EC into the national 83/477/EEC, 91/382/EEC and 2003/18/EC into the national law:law: Ordinance No 9 of 04.08.2006 on the protection of workers Ordinance No 9 of 04.08.2006 on the protection of workers

from risks related to exposure to asbestos at workfrom risks related to exposure to asbestos at work

National Legislation on Carcinogens (Cont’d)

Transposition of the Council Chemical Agents Transposition of the Council Chemical Agents Directive 98/24/EC into the national law:Directive 98/24/EC into the national law:

Ordinance No 13 of 30.12.2003 on the protection of Ordinance No 13 of 30.12.2003 on the protection of workers from risks related to exposure to chemical workers from risks related to exposure to chemical agents at workagents at work

OELVs set up for 27 occupational carcinogens of Cat.1 OELVs set up for 27 occupational carcinogens of Cat.1 and 2and 2

manufacture and industrial use of 4 aromatic amines manufacture and industrial use of 4 aromatic amines banned (2 NAPH, benzidine, 4 aminobiphenyl and banned (2 NAPH, benzidine, 4 aminobiphenyl and their salts; 4 nitrobiphenyl)their salts; 4 nitrobiphenyl)

biological limit values set up for 5 occupational biological limit values set up for 5 occupational chemical human carcinogens (benzene, vinyl chloride, chemical human carcinogens (benzene, vinyl chloride, Ni, Pb, Cr)Ni, Pb, Cr)

Bulgarian Industrial Enterprises and Workforce (2002)

Industrial Enterprises

99,7%

0,3%

SME

Large companies

Workforce Employed

66,9%

33.1%

SME

Large companies

Occupational Exposures to Carcinogens in Bulgaria

(2000-2003) Manufacture of carcinogens in BulgariaManufacture of carcinogens in Bulgaria

~ 189000 tonnes/yr of chemical carcinogens (benzene, ~ 189000 tonnes/yr of chemical carcinogens (benzene, bitumen, ethylene oxide, formaldehyde, acrylnitrile, bitumen, ethylene oxide, formaldehyde, acrylnitrile, divinyl, styrene etc.divinyl, styrene etc.

~ 60 tonnes/yr of asbestos~ 60 tonnes/yr of asbestos

Industrial use of carcinogens in BulgariaIndustrial use of carcinogens in Bulgaria 82000 tonnes/yr of chemical carcinogens82000 tonnes/yr of chemical carcinogens 50 tonnes/yr asbestos50 tonnes/yr asbestos

1155 enterprises of high OSH risk at work with 1155 enterprises of high OSH risk at work with dangerous substances, incl. carcinogensdangerous substances, incl. carcinogens

3880 employees with workplace exposure to chemical 3880 employees with workplace exposure to chemical carcinogens and asbestos dustcarcinogens and asbestos dust

Regulatory Control of Compliance with Provisions of the National Legislation on OHS at Work with

Carcinogens and Mutagens: The Executive Agency “Chief Labour Inspectorate” 7 national inspection campaigns for OSH at work with 7 national inspection campaigns for OSH at work with

dangerous substances, incl. carcinogens and mutagens dangerous substances, incl. carcinogens and mutagens carried out in industry sectors at risk (chemical industry, carried out in industry sectors at risk (chemical industry, metallurgy), 2000-2003:metallurgy), 2000-2003:

Positive trend observed in implementation of good practices Positive trend observed in implementation of good practices for workplace carcinogen exposure prevention and reduction for workplace carcinogen exposure prevention and reduction in some large companies:in some large companies:

Cessation of chemical carcinogens manufacture Cessation of chemical carcinogens manufacture benzene, vinyl chloride, azo dyes;benzene, vinyl chloride, azo dyes; antioxidant Neoson “D” use in the rubber industry antioxidant Neoson “D” use in the rubber industry

ceased;ceased;

Cessation of asbestos production and use, manufacture of Cessation of asbestos production and use, manufacture of asbestos-cement, asbestos-textile products and asbestos asbestos-cement, asbestos-textile products and asbestos insulations; asbestos-containing friction goods’ insulations; asbestos-containing friction goods’ manufacture substantially reducedmanufacture substantially reduced

Regulatory Control of Occupational Carcinogens: The Chief Labour Inspectorate Activities (Cont’d)

Major shortcomings observed in complying with Major shortcomings observed in complying with essential employers’ duties under the national essential employers’ duties under the national OHS legislation on carcinogens, particularly in OHS legislation on carcinogens, particularly in SME, as regards:SME, as regards: occupational cancer risk assessment, prevention, occupational cancer risk assessment, prevention,

risk management and intervention;risk management and intervention; effective OHS policy implementation at work with effective OHS policy implementation at work with

carcinogens.carcinogens.

Substantially increased levels of workplace Substantially increased levels of workplace exposure to carcinogens, exceeding national exposure to carcinogens, exceeding national OELVs recorded (benzene, formaldehyde etc.)OELVs recorded (benzene, formaldehyde etc.)

Regulatory Control of Occupational Carcinogens: The Chief Labour Inspectorate Activities (Cont’d)

The main reason for low levels of legislation The main reason for low levels of legislation compliance in SMEcompliance in SME :: lack of knowledge of occupational cancer risks and lack of knowledge of occupational cancer risks and

applicable regulations, due toapplicable regulations, due to lack of specific and comprehensive information and lack of specific and comprehensive information and

guidanceguidance

poor skills in occupational cancer risk management poor skills in occupational cancer risk management and implementation of risk intervention and implementation of risk intervention programmesprogrammes

lack of adequate occupational training of managers lack of adequate occupational training of managers and workers in workplace-related cancer risks and workers in workplace-related cancer risks prevention and workers protectionprevention and workers protection

NCPHP Final EWS Service Validation Trials

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3,013,023,033,04

3,053,063,073,083,093,103,11

3,123,133,143,15

Evaluation criteria

No opinionI disagreeI agree

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.013.023.033.043.053.063.073.083.093.103.113.123.133.143.15

Evaluation criteria

No opinion

I disagree

I agree

NCPHP Final EWS Service Validation Trials: Scientific Users

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.013.023.033.043.053.063.073.083.093.103.113.123.133.143.15

Evaluation criteria

No opinion

I disagree

I agree

NCPHP Final EWS Service Validation Trials: Industrial Users

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues

Promotes the development and implementation of Promotes the development and implementation of a national strategy for occupational cancer a national strategy for occupational cancer preventionprevention

Guarantees proper implementation of the EU Guarantees proper implementation of the EU legislation on carcinogens in the national lawlegislation on carcinogens in the national law

ensure updating of existing national OHS legislation on ensure updating of existing national OHS legislation on carcinogens and enhance its implementation in carcinogens and enhance its implementation in practicepractice

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues

(Cont’d) Offers a comprehensive information of:Offers a comprehensive information of:

EU Carcinogens Directives and adopted EU Carcinogens Directives and adopted amendments;amendments;

EU Member States Regulations on carcinogens and EU Member States Regulations on carcinogens and OHS legislation on workers protection from OHS legislation on workers protection from occupational cancer risks;occupational cancer risks;

Guidances to practical implementation of the Guidances to practical implementation of the carcinogens legislation in force and of the new EU carcinogens legislation in force and of the new EU chemicals legislation REACH and GHS as related to chemicals legislation REACH and GHS as related to regulation of carcinogens;regulation of carcinogens;

EU and EU Member States OELVs for control of EU and EU Member States OELVs for control of workplace carcinogen exposures;workplace carcinogen exposures;

Guidance to setting OELVs for carcinogens.Guidance to setting OELVs for carcinogens.

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues

(Cont’d)

Supports defining national priorities for intervention Supports defining national priorities for intervention strategies to prevent and minimise occupational strategies to prevent and minimise occupational exposure to carcinogens and reduce future burden exposure to carcinogens and reduce future burden of occupational cancer in Bulgaria, promoting:of occupational cancer in Bulgaria, promoting:

National profiling exercise forNational profiling exercise for::

the nature and extent of use of, andthe nature and extent of use of, and workplace exposure to chemical carcinogens, andworkplace exposure to chemical carcinogens, and management of risks from exposure to chemical management of risks from exposure to chemical

carcinogens in current workplaces in Bulgaria, in order carcinogens in current workplaces in Bulgaria, in order toto

target the sectors and companies at increased target the sectors and companies at increased workplace-related cancer risksworkplace-related cancer risks

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues

(Cont’d)

Supports mainstreaming of occupational Supports mainstreaming of occupational cancer prevention policy in other national cancer prevention policy in other national policy areas:policy areas:

EducationEducation

better information, raising occupational cancer better information, raising occupational cancer risks and prevention awareness;risks and prevention awareness;

improved occupational training for more effective improved occupational training for more effective workers protection from workplace-related cancer workers protection from workplace-related cancer risks.risks.

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues

(Cont’d)

ResearchResearch setting joint priorities for national public health and setting joint priorities for national public health and

research institutes to include key OHS issues of work research institutes to include key OHS issues of work with carcinogens and mutagens in their research with carcinogens and mutagens in their research programmesprogrammes

Supports the development of national Supports the development of national occupational cancer prevention promotion occupational cancer prevention promotion campaignscampaigns

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Industry

Cover the industry needs for:Cover the industry needs for:

specific and comprehensive information and specific and comprehensive information and guidance on all key areas of workplace-related guidance on all key areas of workplace-related cancer risk assessment; prevention and risk cancer risk assessment; prevention and risk management, as well as for,management, as well as for,

easy access to specific, sector and workplace-easy access to specific, sector and workplace-oriented, professional advise and quality oriented, professional advise and quality consultancy on-demandconsultancy on-demand

with a view of closing the know-how gap andwith a view of closing the know-how gap and providing companies with well-adapted practical providing companies with well-adapted practical

occupational cancer risks prevention and risk occupational cancer risks prevention and risk management solutionsmanagement solutions

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: SME

Supports SME in the implementation of:Supports SME in the implementation of:

the national OHS legislation on carcinogens in force the national OHS legislation on carcinogens in force and its established prevention practices, ensuring and its established prevention practices, ensuring high levels of compliance for adequate workers high levels of compliance for adequate workers protection by,protection by,

the provision of up-to date specific, easy to the provision of up-to date specific, easy to understand and apply information and guidance on understand and apply information and guidance on how to introduce systematic workplace-related how to introduce systematic workplace-related cancer risk assessment, prevention and risk cancer risk assessment, prevention and risk managementmanagement

Guidances on occupational cancer risk prevention and management

Good practices;Good practices;

Guidelines on assessment of occupational Guidelines on assessment of occupational exposures to carcinogens;exposures to carcinogens;

Guidance documents on cancer risk Guidance documents on cancer risk assessment for different occupations;assessment for different occupations;

Recommendations for developing risk Recommendations for developing risk intervention programmesintervention programmes..

The EWS Service Impact on Occupational Cancer

Prevention in Bulgaria: SME (Cont’d) Supports SME in:Supports SME in:

the implementation of the OHS policy at work with the implementation of the OHS policy at work with carcinogens aimed atcarcinogens aimed at

encouraging employers to adopt health-focused encouraging employers to adopt health-focused preventive approaches andpreventive approaches and

promoting healthy attitudes among employeespromoting healthy attitudes among employees

Supports occupational cancer prevention Supports occupational cancer prevention promotion campaigns, incl.:promotion campaigns, incl.:

occupational cancer risk awareness-rising occupational cancer risk awareness-rising campaigns in specific risk industry sectors to campaigns in specific risk industry sectors to promote OHS management at work with promote OHS management at work with carcinogens in high-risk SME.carcinogens in high-risk SME.

The EWS Service Impact on Occupational Cancer Prevention in Bulgaria:

Meeting the Specific Information and Consultancy Needs of Industrial Users

Provision of guidances, professional advice and Provision of guidances, professional advice and on-demand consultancy to help stakeholders on-demand consultancy to help stakeholders understand their task and fulfill their duties under understand their task and fulfill their duties under the new EU chemicals regulation “REACH”the new EU chemicals regulation “REACH”

Guidance to successful REACH implementationGuidance to successful REACH implementation

REACHing the workplace: industry obligations;REACHing the workplace: industry obligations; risk assessment in REACH and in workers risk assessment in REACH and in workers

protection legislation;protection legislation; substitution in REACH authorisationsubstitution in REACH authorisation..

The EWS Service Impact on REACH Implementation in Bulgaria

REACH: Challenge for IndustryREACH: Challenge for Industry

Technical Guidance Documents and supporting Technical Guidance Documents and supporting IT tools providedIT tools provided

Authorisation applications concerning the control Authorisation applications concerning the control of risks from SVHC, incl. liable to workplace of risks from SVHC, incl. liable to workplace exposure control Carcinogens and Mutagens exposure control Carcinogens and Mutagens Cat.1 and 2, and their safe replacementCat.1 and 2, and their safe replacement

The EWS Service Impact on GHS Implementation in Bulgaria

Guidance documents on: GHS Regulation (re-Guidance documents on: GHS Regulation (re-classification)classification)

Assessment of differences between current system Assessment of differences between current system of classification and labeling of hazardous of classification and labeling of hazardous chemicals, incl. carcinogens and mutagens and chemicals, incl. carcinogens and mutagens and GHS;GHS;

Analysis of the GHS compatibility with REACH Analysis of the GHS compatibility with REACH requirements.requirements.

The EWS Service Meeting Specific Information Needs of Industrial Users

EMF and Human Health: CancerEMF and Human Health: Cancer

The EWS provides evidence-based information on The EWS provides evidence-based information on possible cancer risks from exposure to:possible cancer risks from exposure to:

RFR – wireless communications (mobile phones, base RFR – wireless communications (mobile phones, base stations) stations)

ELF – ELF – high voltage power lines; increased risk high voltage power lines; increased risk of of childhood leukaemiachildhood leukaemia (IARC, 2B Gr.)(IARC, 2B Gr.)

IF – IF – increasing exposure due to new and increasing exposure due to new and emerging emerging technologies; need of proper cancer technologies; need of proper cancer risk risk assessmentassessment

Static magnetic fields – occupational exposure to MRI Static magnetic fields – occupational exposure to MRI equipment personnel equipment personnel

and needand need of cancer risk of cancer risk assessmentassessment

EMF and Cancer: From Science to Safer Workplaces

The EWS provides guidances to The EWS provides guidances to implementation of OHS regulations of implementation of OHS regulations of exposure to EMF and workers protectionexposure to EMF and workers protection

Guidelines for the assessment, measurement Guidelines for the assessment, measurement and calculation of workers exposure to EMS and calculation of workers exposure to EMS and risk assessment;and risk assessment;

EMF exposure monitoring and compliance EMF exposure monitoring and compliance measurements; occupational exposure limits;measurements; occupational exposure limits;

EMF risk communication strategies and risk EMF risk communication strategies and risk management.management.

Thank you for your attention Thank you for your attention !!

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www.euroworksafe.euwww.euroworksafe.eu