Cent Eur J Public Health 2015, 23(3):244-251 | DOI: 10.21101/cejph.a4185

Low-back Pain Disorders as Occupational Diseases in the Czech Republic and 22 European Countries: Comparison of National Systems, Related Diagnoses and Evaluation Criteria

Andrea Laštovková¹, Marie Nakládalová², Zdenka Fenclová^1,3, Pavel Urban^1,3, Petr Gaďourek⁴, Tomáš Lebeda³, Edvard Ehler⁵, Petr Ridzoň¹, Jana Hlávková³, Alena Boriková², P. Paul F. M. Kuijer⁶, Igor Bátora⁷, Stefan M. Scholz-Odermatt⁸, Horatiu Moldovan⁹, Lode Godderis^10,11, Ola Leijon¹², Giuseppe Campo¹³, Manuela Vaněčková¹⁴, Vincent Bonneterre¹⁵, Elisaveta Jasna Stikova¹⁶, Daniela Pelclová¹

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

² Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacký University in Olomouc and University Hospital, Olomouc, Czech Republic

³ National Institute of Public Health, Prague, Czech Republic

⁴ GETA Centre, v.v.i., Prague, Czech Republic

⁵ Department of Neurology, Regional Hospital in Pardubice, Pardubice, Czech Republic

⁶ Netherlands Centre for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Netherlands

⁷ Department of Occupational Medicine and Toxicology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic

⁸ Department of Statistics, Swiss Accident Insurance Trust (Suva), Lucerne, Switzerland

⁹ Occupational Medicine Department, University of Medicine and Pharmacy of Targu-Mures, Targu-Mures, Romania

¹⁰ Centre for Environment and Health, KU Leuven, Leuven, Belgium

¹¹ IDEWE External Service for Prevention and Protection at Work, Heverlee, Belgium

¹² Swedish Social Insurance Inspectorate, and Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden

¹³ Department of Medicine, Epidemiology and Occupational Hygiene, INAIL, Rome, Italy

¹⁴ Department of Radiodiagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic

¹⁵ Occupational and Environmental Diseases Centre, Grenoble Teaching Hospital, Grenoble, France

¹⁶ Public Health Institut RM, UKIM, Medical Faculty, Skopje, Macedonia

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.

Keywords: low-back pain diseases, heavy-weight lifting, overload, occupational disease, criteria, compensation

Received: November 14, 2014; Revised: June 16, 2015; Accepted: June 16, 2015; Published: September 1, 2015  Show citation