1. 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 Occupational Cancer: Communication & IT”, February 14, 2008, Genoa, Italy Dr. Ekaterina T. Mirkova Elena Alexandrova, Nadezhda Todorova National Center of Public Helath Protection, Sofia, Bulgaria

3. 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

4. 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.

5. Main Causes of Death in Bulgaria (2006)

8. PERCENTAGE DISTRIBUTION OF CANCER INCIDENCE IN MALES BULGARIA 2004 PERCENTAGE DISTRIBUTION OF CANCER INCIDENCE IN FEMALES BULGARIA 2004

9. Occupational Exposures to Carcinogens in Bulgaria in late 1980s  The transitional period with economic recession accompanied by insufficient resources for: improving old technologies improving old technologies renovating worn-out equipment renovating worn-out equipment  Serious deterioration of OSH at work with carcinogens in high risk industrial sectors: mining; metallurgy; chemical and petroleum industry; rubber manufacturing; coke production mining; metallurgy; chemical and petroleum industry; rubber manufacturing; coke production

10. Occupational Exposures to Carcinogens in Bulgaria (1990) Carcinogens Number of enterprises with workplace carcinogen exposure to 50 > workers Petroleum and petroleum products139 Bensene124 Cr and Cr compounds57 Ni and Ni compounds41 Aromatic amines36 Vinyl chloride35 Polyaromatic hydrocarbons29 Azo dyes26 Cd and Cd compounds25 Asbestos20 As and As compounds14 Acrylnitrile12 Al and Al compounds9 Hydrazine3

11. Carcinogens Number of exposed workers Workplace air concentrations (mg/m 3 ) OEL (TWA, 8h) Maximum air concentrations As and inorganic As compounds21670.025 Benzo(a)pyrene23060.000150.02 Gasoline357173006000 Bensene1257351333 Vinyl chloride35622.5300 Cd39890.0510 Inorganic lead compounds295850.05100 Cr, hexavalent36800.5406 Occupational Exposures to Carcinogens in Bulgaria (1990)

12. Occupational Exposures to Chemical Carcinogens in Bulgaria (1990)  Highly increased levels of workplace exposure to human carcinogens – Group 1 (IARC); Cat.1 (EU) In 65% of chemical industry enterprises air concentrations of carcinogens (TWA, 8hr) exceeded the respective national OEL Values (in times): In 65% of chemical industry enterprises air concentrations of carcinogens (TWA, 8hr) exceeded the respective national OEL Values (in times):  100  Cr, hexavalent; lead; vinyl chloride;  10  benzene; Cd;  up to 10  benzo(a)pyrene; Al.  Data on occupational exposure to carcinogens not systematically collected

13. Bulgarian Ministry of Health National Health Strategy, 2001 “Better Health for Better Future of Bulgaria”  Action Plan in the health strategy’s key thematic area: “Cancer” Portfolio of measures to minimise by 25% up to 2010 the premature cancer death rates in the age group <60 yrs, incl. Portfolio of measures to minimise by 25% up to 2010 the premature cancer death rates in the age group <60 yrs, incl.  implementation of effective OSH measures to prevent and minimise workplace-related cancer risks.

14. National Legislation on Protection of Workers from Risks Related to Exposure to Carcinogens and Mutagens at Work  Transposition of the Council Carcinogens Directives 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 workers from risks related to exposure to carcinogens and mutagens at work Ordinance No 10 of 26 September 2003 on the protection of workers from risks related to exposure to carcinogens and mutagens at work  Council Carcinogens Directive 2004/37/EC is not transposed into the national law  Transposition of the Council Asbestos Directives 83/477/EEC, 91/382/EEC and 2003/18/EC into the national law: Ordinance No 9 of 04.08.2006 on the protection of workers from risks related to exposure to asbestos at work Ordinance No 9 of 04.08.2006 on the protection of workers from risks related to exposure to asbestos at work

15. National Legislation on Carcinogens (Cont’d)  Transposition of the Council Chemical Agents Directive 98/24/EC into the national law: Ordinance No 13 of 30.12.2003 on the protection of workers from risks related to exposure to chemical agents at work Ordinance No 13 of 30.12.2003 on the protection of workers from risks related to exposure to chemical agents at work  OELVs set up for 27 occupational carcinogens of Cat.1 and 2  manufacture and industrial use of 4 aromatic amines banned (2 NAPH, benzidine, 4 aminobiphenyl and their salts; 4 nitrobiphenyl)  biological limit values set up for 5 occupational chemical human carcinogens (benzene, vinyl chloride, Ni, Pb, Cr)

16. Bulgarian Industrial Enterprises and Workforce (2002)

17. Occupational Exposures to Carcinogens in Bulgaria (2000-2003)  Manufacture of carcinogens in Bulgaria ~ 189000 tonnes/yr of chemical carcinogens (benzene, bitumen, ethylene oxide, formaldehyde, acrylnitrile, divinyl, styrene etc. ~ 189000 tonnes/yr of chemical carcinogens (benzene, bitumen, ethylene oxide, formaldehyde, acrylnitrile, divinyl, styrene etc. ~ 60 tonnes/yr of asbestos ~ 60 tonnes/yr of asbestos  Industrial use of carcinogens in Bulgaria 82000 tonnes/yr of chemical carcinogens 82000 tonnes/yr of chemical carcinogens 50 tonnes/yr asbestos 50 tonnes/yr asbestos  1155 enterprises of high OSH risk at work with dangerous substances, incl. carcinogens  3880 employees with workplace exposure to chemical carcinogens and asbestos dust

18. 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 dangerous substances, incl. carcinogens and mutagens carried out in industry sectors at risk (chemical industry, metallurgy), 2000-2003: Positive trend observed in implementation of good practices for workplace carcinogen exposure prevention and reduction in some large companies: Positive trend observed in implementation of good practices for workplace carcinogen exposure prevention and reduction in some large companies:  Cessation of chemical carcinogens manufacture  benzene, vinyl chloride, azo dyes;  antioxidant Neoson “D” use in the rubber industry ceased;  Cessation of asbestos production and use, manufacture of asbestos-cement, asbestos-textile products and asbestos insulations; asbestos-containing friction goods’ manufacture substantially reduced

19. Regulatory Control of Occupational Carcinogens: The Chief Labour Inspectorate Activities (Cont’d)  Major shortcomings observed in complying with essential employers’ duties under the national OHS legislation on carcinogens, particularly in SME, as regards: occupational cancer risk assessment, prevention, risk management and intervention; occupational cancer risk assessment, prevention, risk management and intervention; effective OHS policy implementation at work with carcinogens. effective OHS policy implementation at work with carcinogens.  Substantially increased levels of workplace exposure to carcinogens, exceeding national OELVs recorded (benzene, formaldehyde etc.)

20. Regulatory Control of Occupational Carcinogens: The Chief Labour Inspectorate Activities (Cont’d)  The main reason for low levels of legislation compliance in SME : lack of knowledge of occupational cancer risks and applicable regulations, due to lack of knowledge of occupational cancer risks and applicable regulations, due to  lack of specific and comprehensive information and guidance poor skills in occupational cancer risk management and implementation of risk intervention programmes poor skills in occupational cancer risk management and implementation of risk intervention programmes lack of adequate occupational training of managers and workers in workplace-related cancer risks prevention and workers protection lack of adequate occupational training of managers and workers in workplace-related cancer risks prevention and workers protection

21. NCPHP Final EWS Service Validation Trials

22. NCPHP Final EWS Service Validation Trials: Scientific Users

23. NCPHP Final EWS Service Validation Trials: Industrial Users

24. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues  Promotes the development and implementation of a national strategy for occupational cancer prevention Guarantees proper implementation of the EU legislation on carcinogens in the national law Guarantees proper implementation of the EU legislation on carcinogens in the national law  ensure updating of existing national OHS legislation on carcinogens and enhance its implementation in practice

25. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues (Cont’d)  Offers a comprehensive information of: EU Carcinogens Directives and adopted amendments; EU Carcinogens Directives and adopted amendments; EU Member States Regulations on carcinogens and OHS legislation on workers protection from occupational cancer risks; EU Member States Regulations on carcinogens and OHS legislation on workers protection from occupational cancer risks; Guidances to practical implementation of the carcinogens legislation in force and of the new EU chemicals legislation REACH and GHS as related to regulation of carcinogens; Guidances to practical implementation of the carcinogens legislation in force and of the new EU chemicals legislation REACH and GHS as related to regulation of carcinogens; EU and EU Member States OELVs for control of workplace carcinogen exposures; EU and EU Member States OELVs for control of workplace carcinogen exposures; Guidance to setting OELVs for carcinogens. Guidance to setting OELVs for carcinogens.

26. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues (Cont’d)  Supports defining national priorities for intervention strategies to prevent and minimise occupational exposure to carcinogens and reduce future burden of occupational cancer in Bulgaria, promoting: National profiling exercise for: National profiling exercise for:  the nature and extent of use of, and  workplace exposure to chemical carcinogens, and  management of risks from exposure to chemical carcinogens in current workplaces in Bulgaria, in order to  target the sectors and companies at increased workplace-related cancer risks

27. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues (Cont’d)  Supports mainstreaming of occupational cancer prevention policy in other national policy areas: Education Education  better information, raising occupational cancer risks and prevention awareness;  improved occupational training for more effective workers protection from workplace-related cancer risks.

28. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Key Issues (Cont’d) Research Research  setting joint priorities for national public health and research institutes to include key OHS issues of work with carcinogens and mutagens in their research programmes Supports the development of national occupational cancer prevention promotion campaigns

29. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: Industry  Cover the industry needs for: specific and comprehensive information and guidance on all key areas of workplace-related cancer risk assessment; prevention and risk management, as well as for, specific and comprehensive information and guidance on all key areas of workplace-related cancer risk assessment; prevention and risk management, as well as for, easy access to specific, sector and workplace- oriented, professional advise and quality consultancy on-demand easy access to specific, sector and workplace- oriented, professional advise and quality consultancy on-demand  with a view of closing the know-how gap and  providing companies with well-adapted practical occupational cancer risks prevention and risk management solutions

30. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: SME  Supports SME in the implementation of: the national OHS legislation on carcinogens in force and its established prevention practices, ensuring high levels of compliance for adequate workers protection by, the national OHS legislation on carcinogens in force and its established prevention practices, ensuring high levels of compliance for adequate workers protection by,  the provision of up-to date specific, easy to understand and apply information and guidance on how to introduce systematic workplace-related cancer risk assessment, prevention and risk management

31. Guidances on occupational cancer risk prevention and management Good practices; Good practices; Guidelines on assessment of occupational exposures to carcinogens; Guidelines on assessment of occupational exposures to carcinogens; Guidance documents on cancer risk assessment for different occupations; Guidance documents on cancer risk assessment for different occupations; Recommendations for developing risk intervention programmes. Recommendations for developing risk intervention programmes.

32. The EWS Service Impact on Occupational Cancer Prevention in Bulgaria: SME (Cont’d)  Supports SME in: the implementation of the OHS policy at work with carcinogens aimed at the implementation of the OHS policy at work with carcinogens aimed at  encouraging employers to adopt health-focused preventive approaches and  promoting healthy attitudes among employees  Supports occupational cancer prevention promotion campaigns, incl.: occupational cancer risk awareness-rising campaigns in specific risk industry sectors to promote OHS management at work with carcinogens in high-risk SME. occupational cancer risk awareness-rising campaigns in specific risk industry sectors to promote OHS management at work with carcinogens in high-risk SME.

33. 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 on- demand consultancy to help stakeholders understand their task and fulfill their duties under the new EU chemicals regulation “REACH” Guidance to successful REACH implementation Guidance to successful REACH implementation  REACHing the workplace: industry obligations;  risk assessment in REACH and in workers protection legislation;  substitution in REACH authorisation.

34. The EWS Service Impact on REACH Implementation in Bulgaria  REACH: Challenge for Industry Technical Guidance Documents and supporting IT tools provided Technical Guidance Documents and supporting IT tools provided  Authorisation applications concerning the control of risks from SVHC, incl. liable to workplace exposure control Carcinogens and Mutagens Cat.1 and 2, and their safe replacement

35. The EWS Service Impact on GHS Implementation in Bulgaria  Guidance documents on: GHS Regulation (re- classification) Assessment of differences between current system of classification and labeling of hazardous chemicals, incl. carcinogens and mutagens and GHS; Assessment of differences between current system of classification and labeling of hazardous chemicals, incl. carcinogens and mutagens and GHS; Analysis of the GHS compatibility with REACH requirements. Analysis of the GHS compatibility with REACH requirements.

36. The EWS Service Meeting Specific Information Needs of Industrial Users  EMF and Human Health: Cancer The EWS provides evidence-based information on possible cancer risks from exposure to: The EWS provides evidence-based information on possible cancer risks from exposure to:  RFR – wireless communications (mobile phones, base stations)  ELF – high voltage power lines; increased risk of childhood leukaemia (IARC, 2B Gr.)  IF – increasing exposure due to new and emerging technologies; need of proper cancer risk assessment  Static magnetic fields – occupational exposure to MRI equipment personnel and need of cancer risk assessment

37. EMF and Cancer: From Science to Safer Workplaces  The EWS provides guidances to implementation of OHS regulations of exposure to EMF and workers protection Guidelines for the assessment, measurement and calculation of workers exposure to EMS and risk assessment; Guidelines for the assessment, measurement and calculation of workers exposure to EMS and risk assessment; EMF exposure monitoring and compliance measurements; occupational exposure limits; EMF exposure monitoring and compliance measurements; occupational exposure limits; EMF risk communication strategies and risk management. EMF risk communication strategies and risk management.

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