AIM: Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. METHODS: A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupational diseases and possible awarding compensations to the patients. RESULTS: In 13 countries out of the 23 countries studied, LBPD caused by overload can be recognized as occupational, providing that the diagnosis is sufficiently proven and exposure criteria and/or listed occupation are met and duration of exposure is confirmed (Belgium, Denmark, France, Germany, Hungary, Italy, Lithuania, Macedonia, Netherlands, Romania, Slovakia, Sweden, and Switzerland). LBPD due to vibrations can be also recognized as occupational in 14 countries. In 8 countries LBPD are not accepted as occupational unless they are caused by an injury at work. Specific criteria to evaluate occupational exposure of patients with LBPD were set in Belgium, Denmark, France, Germany, Lithuania, Macedonia, Netherlands, and Slovakia. In other countries, the evaluation is done at an individual basis. CONCLUSIONS: In practice, the assessment of occupational overload and its contribution to the development of LBPD as well as its inclusion in the compensation system are important for several reasons. Firstly, it may be considered essentially preventable. Secondly, cases with a significant contribution of occupational aetiology may be viewed as occupational diseases for which compensation may be claimed, as it is the case in many European countries. Importantly, inclusion of LBPD in the list of occupational diseases or another system of compensation may be viewed as a preventive measure as it increases the visibility of this problem not only for the workers, but especially for the employers.

Centre for Environment and Health KU Leuven Leuven Belgium

Department of Medicine Epidemiology and Occupational Hygiene INAIL Rome Italy

Department of Neurology Regional Hospital in Pardubice Pardubice Czech Republic

Department of Occupational Medicine 1st Medical Faculty Charles University and General University Hospital Prague Czech Republic

Department of Occupational Medicine and Toxicology Faculty of Medicine Comenius University Bratislava Slovak Republic

Department of Occupational Medicine Faculty of Medicine and Dentistry Palacký University in Olomouc and University Hospital Olomouc Czech Republic

Department of Radiodiagnostics 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Czech Republic

Department of Statistics Swiss Accident Insurance Trust Lucerne Switzerland

GETA Centre v v i Prague Czech Republic

IDEWE External Service for Prevention and Protection at Work Heverlee Belgium

National Institute of Public Health Prague Czech Republic

Netherlands Centre for Occupational Diseases Coronel Institute of Occupational Health Academic Medical Centre University of Amsterdam Netherlands

Occupational and Environmental Diseases Centre Grenoble Teaching Hospital Grenoble France

Occupational Medicine Department University of Medicine and Pharmacy of Targu Mures Targu Mures Romania

Public Health Institut RM UKIM Medical Faculty Skopje Macedonia

Swedish Social Insurance Inspectorate and Institute of Environmental Medicine Unit of Occupational Medicine Karolinska Institute Stockholm Sweden

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