1. INFORMED AND HEALTHY
Project BG051PO001-5.3.01 “Informed and
Healthy” is implemented within the 2007 – 2013
Human Resource Development Operational
Program, Priority Axis 5 “Social Inclusion and
Promotion of Social Economy”, Operation 5.3.
“Employability through Better Health”

2. • Total project amount: BGN 4,692,754.30
• Project duration: 48 months; launched on 21
May 2009 and planned to end until 21 May
2013
• The project general goal is to enhance the
population’s employability, extend its active
labor life and maintain healthy workforce by
enhancing the knowledge, skills and
motivation needed for healthy lifestyles.

3. Project specific goals include:
1. Enhance the awareness, especially
among vulnerable groups, about
behavioral risk factors related to
excessive table salt intake, psychotropic
drug abuse among young people,
smoking, occupational, everyday and
transport traumatism.

4. 2. Incept a change in behavior in relation
to the aforementioned risk factors by
enhancing the knowledge of healthy
lifestyles and opportunities for curbing
traumatism among target groups.

5. Forthcoming Activities:
• Compile handbooks and manuals of
good practices:
• Methodological manual of successful
approaches and good practices to be
used by practitioners in the area of
psychotropic drug abuse prevention;

6. • Manual of good practices for medical
specialists on risk assessment and
control for smokers;
• Manual of good practices for medical
specialists on risk assessment and
control of occupational traumatism;

7. • Methodological manual of successful
approaches and good practices for
producers of low-salt foods.
• National health information campaigns
aiming to curb:

8. - table salt intake
- psychotropic drugs abuse among
young people
- smoking
- occupational traumatism
- everyday traumatism
- transport traumatism

9. - Conduct a final study of knowledge,
attitudes toward behavior change and
healthy lifestyle skills and
opportunities for curbing the risks of
occupational, everyday and transport
traumatism among target groups.

10. • Expected results include:
- quality of human capital improved
through an improved health status and
curbed unhealthy habits;
- expanded knowledge, skills and
attitudes toward healthy lifestyles and
curbing the risks of occupational,
everyday and transport traumatism;

11. - established new values of responsible
behavior to people’s own health, other
people and the environment;
- The project is managed and
administered by the Ministry of Health.

12. ANALYSIS
The global prevalence of chronic non-
infectious diseases, the various
mortality reasons and their
development models in the individual
countries prove that people’s living
conditions, their attitude toward their
own health, habits and behavior can
prevent their appearance or accelerate
the process of high morbidity rate.

13. Social chronic non-infectious disease
morbidity in the Republic of Bulgaria
shows a growth tendency which will
probably persist in the following
decades of this century. One reason for
that is the nation’s demographic
status: the long-term negative
population growth and the ageing of
the population.

14. A significant part of our country’s population
is a bearer of serious behavioral risk factors
corresponding mostly to blood circulation
organ diseases, respiratory system diseases,
cancer neoplasm, traumas, etc. In 2006, the
WHO presented a new strategy for health
improvement and enhancement and
countering chronic non-infectious diseases
based on the theses below:

15. • Each widely spread social disease is caused
(completely or partially) by social and
behavioral processes that can facilitate its
dissemination and treatment.
• All behavioral and social processes are
subject to potential change.
• Successful interventions aiming to bring
about social and behavioral changes can
alleviate significantly the global burden of
diseases, disability and premature death.

16. This strategy finds its implementation
in health promotion methods including
enhancement of individuals’ health
awareness and self-motivation for
control of their own health behavior as
a chance for better health.

17. • Health in all its aspects is a cross-
cutting point for solving problems like
life expectancy and quality,
employability, healthy offspring,
economic prosperity, etc. These are
also the reasons why health related
issues and the bridling of some risk
behavior factors are in the spotlight of
INFORMED AND HEALTHY project
activities.

18. Research, Analyses and Campaigns
Conducted over the Past Three Years
• Cardiovascular diseases rank among
Bulgaria’s number one reasons for morbidity
and mortality. Bulgaria is one of the
countries in Europe with the highest
morbidity and mortality rates caused by
cardiovascular diseases which show a
tendency to increase or persist, unlike
Western European countries’ tendency to
curb this rate.

19. • According to National Statistical
Institute data, the main mortality
reason among Bulgaria’s population
are blood-circulation organ diseases -
66.4% of overall mortality in 2006 and
65.8% in 2007. The high cardiovascular
mortality rate in Bulgaria corresponds
to the high arterial hypertension rate in
our country – 40.1% of people aged 25
– 64 years; and 50.3% of people aged
45+.

20. • Arterial hypertension is a paramount
and highly widespread risk factor for
cardiovascular and kidney diseases,
including stroke, coronary disease,
cardiac and kidney disorders, and
ranks as a mortality risk factor number
one globally.

21. • The excessive table salt (sodium chloride)
intake increases arterial pressure values.
• The reduced table salt intake at the
population level contributes to the reduction
of cardiovascular morbidity and mortality
rates, thus resulting in significant saving of
health expenses. The World Health
Organization and the World Cancer Research
Fund recommend a daily salt intake of 5 g.

22. • Main sources of salt in the diet of
Bulgaria’s population include:
industrially processed food – bread
and bakery products, meat products,
cheese and ready to cook food (soups,
broths, etc.).

23. • The excessive salt intake affects more
than 70% of Bulgaria’s population.
• The excessive table salt intake
correlates to the high rates of arterial
hypertension, myocardial infarction
and brain stroke in our country.

24. • The “2006 Recommendations for
Healthy Diet of the Population” include
a recommended daily sodium intake of
less than 2,000 g which can be found in
5 g of salt – a quantity that complies
with the WHO recommendation;
practical approaches to reducing salt
intake are also proposed.

25. DISSEMINATION OF DRUGS
Over the past three years, research and
analyses were conducted on the issue
of dissemination of drugs among both
active age population (18 – 65 years)
and school goers.

26. • Cannabis is the most commonly used
illegal drug.
• The second largest group of illegal
drugs is the group of stimulants,
including synthetic ones
(amphetamines, ecstasy, cocaine).
• The comparatively common use of
sleeping drugs and tranquilizers,
mostly by the more elderly population,
is also alarming.

27. Summing up, we need to say that in 2007
33.2% (one-third) of Bulgaria’s 9th to 12th
graders had tried at least once in their lives
some type of illegal drug. Translated into
absolute numbers, this means that about
115,000 – 120,000 of today’s secondary
school students have some experience in
using illegal drugs.

28. The same research employed indicators for
tracing the influence of 3 main aspects of
young people’s lives: family, school and
friends. Some elements were identified that
could be defined as risk factors at the social
level. Within the family, these include for
example insufficient contacts with parents
and control by parents (different from total
or police-like control).

29. Data show that the percentage of
young people, who have used some
kind of drugs in their lives and almost
never spend their free time with their
parents on off-school days, is almost
three times higher than the same
percentage among school goers who
frequently share their leisure time with
their families.

30. As to the school, young people’s
dissatisfaction with studying and the
lack of understanding with their
teachers can qualify as such risk
factors; for example, the percentage of
young people who have used some
drugs and say that studying is useless
is two times and a half higher than the
same number among school goers who
do not share the same opinion.

31. In friends’ circles, the most influential
risk factor is the use of psychoactive
drugs by friends – for example, the
percentage of school goers who have
tried some drug is six times higher
among those whose friends smoke
marijuana.

32. SMOKING
Smoking has unique significance
because of its present and
prognosticated future influence on
global mortality rates. If the current
ascending tendency persists, the
number of smoking victims will grow
several times and will reach 10 million
per year.

33. Smoking is a behavioral factor causing extremely
unfavorable health consequences. Accumulated
scientific information indicates that smoking and
passive smoking are a direct or indirect factor for
morbidity and mortality caused by more than 25
types of diseases. It is essential for the origin and
the graver course of the most serious and widely
spread diseases of social significance like:
• oncologic diseases and in particular lung, mouth,
mouth cavity, pharynx, esophagus, larynx, trachea
and bronchial cancer;

34. • cardiovascular diseases: hypertension,
ischemic heart disease, brain vascular
disease and atherosclerosis. The risk
of heart diseases among smokers is 1.5
– 3 times higher and brain stroke
incidence among smokers is 2 – 4
times higher. The risk gets higher as
smoking intensity increases;

35. • chronic non-specific lung diseases
(chronic bronchitis, chronic obstructive
lung disease, asthma, etc.) and
emphysema where smoking causes
75% of morbidity rates and 80% of all
lethal cases associated with these
diseases.

36. • Smoking causes economic losses for
both smokers and their families and
society as a whole. The percentage of
lethal cases among men caused by all
smoking factors is highest at the age of
45 – 64 years and accounts for 44%.

37. • Quitting smoking results in longer life
expectancy in good health which gives
vital importance to all programs and
activities in support of smokers’ efforts
to quit smoking.

39. OCCUPATIONAL TRAUMATISM
Occupational traumatism is a combination of
occupational traumas resulting from employment
injuries that can cause temporary incapacity for
work, disability or death. As per Article 55 of the
Social Insurance Code “employment injury is any
sudden impairment of health occurred during and
in connection with or because of the work
performed, as well as during any work performed
in the interest of the enterprise where the said
impairment has resulted in incapacity for work or
death”.

40. Employment injury shall furthermore be any injury
of a person insured under Article 4 (1) and (2)
herein during the usual commuting to or from the
working place to: 1. the principal place of
residence or to another additional place of
residence of a permanent nature; 2. the place
where the insured person customarily takes his or
her meals during the working day; 3. the place
where a remuneration is received. Employment
injury shall not be the case where the insured
person has deliberately impaired his or her health.
Occupational traumatism causes human suffering,
material and social losses affecting not only
injured persons but also their employers and
society as a whole.

41. • The reasons for occupational traumatism are
numerous: technical (e.g. lack of fencing of
rotating and moving parts, machine and
equipment failure); technological (using
dangerous technology or dangerous work
practices); organizational (lack of company
policy on health and safety at work, inadequate
organization of work, lack of technical safety
training and control;

42. insufficient in-house risk control; lack or
inadequate use of protective means and
gear; work performed by unauthorized
persons; lack of established and clear
instructions on safety at work; lacking or
insufficient safety and security instructions
and training; poor maintenance of
workplaces).

43. Information materials – with the support
of the Working Conditions Fund, a
number of brochures on safe and
healthy working conditions in
construction were published: “Safety
and Security Coordinator in
Construction”; “Openings and
Contours: Working up High”; Risk of
Falling from Height. Protection”;
“Movable Scaffolding”; “Roof Works”;
“Wheel Loaders, Dumpers and Dump
Trucks”; “Loading and Unloading
Works”.

44. There is a separate group of
occupational traumatism related to
people with impaired hearing and
disabled people.

45. ROAD TRAFFIC
Road traffic is a process incorporating at any
time the driver, the vehicle and the road
infrastructure. Each one of these elements has
certain influence on road traffic safety, the
dominating one, at a certain stage, being the
behavior of road traffic participants which is also
reflected by the statistics on road traffic
accidents and their consequences. People of all
ages, mostly young people in good health, die as
a result of road traffic accidents.

46. In 2008, 74 (7%) children aged up to 18
years, 187 (17.6%) young people aged 18 –
24, 601 (56.6%) people aged 25 – 64 and
199 (18.8%) elderly people aged 65+ died
because of road accidents. The number of
children victims – 48 killed and 655 heavily
injured – is the highest. 521 children, of
whom 12 dead, were injured as
pedestrians. 14 drivers were killed and 209
were injured.

47. More than 92% of young people aged 18 –
24 injured in road accidents were drivers
of and passengers in motor vehicles. 601
people aged 25 – 64 years died because
of road accidents. Of the 199 dead people
aged 65+, pedestrians account for 129
(64.8%), passengers – 44 (22.1%) and
drivers – 26 (13.1%).

48. Reasons for Road Accidents:
• More than 94% of road accidents are
caused by motor vehicle drivers and
high and inappropriate speed.
• Incapable and unauthorized drivers.

49. • Other factors influencing drivers’
capability of adequate driving: fatigue,
depression, various health disorders,
natural disasters, etc.

50. • Insufficient usage of safety tools
(seatbelts, helmets and children’s car
seats) by passengers and drivers
injured in road accidents.
• Pedestrian traumatism levels – among
the highest in European countries.
• Road accidents during the dark part of
the day.

51. The gravest road accidents occur due
to front crashes caused by unsafe
overtaking and entry in the opposite
lane resulting from loss of car control
due to insufficient qualification or
falling asleep, entry in the opposite
lane horizontal curves because of
higher speed, etc.

52. Road traffic traumatism is a serious
public health problem because it
results in premature death, permanent
disability and long-term illness of
healthy people.

53. TRAUMATISM
Traumatism in Europe is the third most
significant reason for death after cardio-
vascular and oncologic diseases.
Traditionally, everyday trauma is
classified according to the intention
factor. The main reasons for
unintentional trauma include falling,
poisoning, drowning, burning, etc.

54. • Reasons for intentional trauma include some
types of violence (e.g. threat). Violence is defined
as an intentional use of physical power or threat
against people’s own lives (suicide or self-injury)
or against other persons (interpersonal – violence
of children, partners, elderly people,
acquaintances, strangers), groups or communities
of people which leads to physical or psychological
trauma, death, developmental deviation or
deprivation.