OCCUPATIONAL HANDICAP-FREE LIFE EXPECTANCY IN BULGARIA 1976-1992 BASED ON THE DATA OF THE MEDICAL EXPERT COMMISSIONS

This article presents health expectancy calculations from Bulgaria for 1976-1992. The calculations are based on mortality statistics and dat a from a national information system from the Expert Medical Commissio ns on Working Capacity about loss of working capacity. Following inter nationally accepted terminology, the most appropriate term for the hea lth expectancies presented here is 'occupational handicap-free life ex pectancy' (OHFLE). Life expectancies were calculated as partial life e xpectancies from ages 16 to 59. Health expectancy calculations followe d Sullivan's cross-sectional method with age and sex specific prevalen ce data on occupational handicap. Around 1985 a three- to four-fold in crease in these prevalences occurred. The distribution of occupational handicaps over sexes, age groups and severity levels, however, remain ed fairly constant. The results show a decrease both in partial life e xpectancy within the age range 16-59 and in OHFLE at the age of 16 for men. For women a more or less stable partial life expectancy and a de crease in OHFLE at the age of 16 was found around 1985. The introducti on of more incentives for people who successfully registered probably caused the decrease around 1985. Major social changes may have acted a s confounding factors for the fluctuations after 1985. On the other ha nd the findings may reflect real changes in population health due to a n increasing incidence in some major disease categories. The nation-wi de system for assessment and registration of health related working in capacity has proved a useful source for an attempt to calculate OHFLE. Given uncertainties about the population health underlying these chan ges in OHFLE, however, it is recommended that health interview and hea lth examination surveys should be considered as alternative routes for achieving a more comprehensive picture of population health in Bulgar ia. Copyright (C) 1996 Elsevier Science Ltd