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pain is 14% (Nachemson, 2004; NRC-IOM, 2001; Schneider and Irastorza, 2010; Shekelle, 1997).
Other surveys have estimated that LBP has an annual incidence in the adult population in the
industrialized countries that ranges from about 1.4 to 4.9% (Op de Beek and Hermans, 2000;
Shekelle, 1997) or between 19% and 56% (NRC-IOM, 2001). The NRC-IOM (2001) reported that
the National Health Interview Survey estimated at 17.6% (or 22.4 million people) the prevalence
of suffer from LBP the entire U.S. population on 1988, while for the U.K. it was estimated at 39%
on 1999 and for the Netherlands it was found to be 46% for men and 52% for women on 1999
(Op de Beek and Hermans, 2000).
A comparative analytical report compiled by Eurofound, based on national surveys and European
Working Conditions Surveys carried out by Eurostat, showed that WRMSD are the major source of
occupational morbidity in EU accounting for the majority of the occupational diseases, with an
estimated prevalence rate of over 2.5% among employees, the equivalent of more than four million
employees (Giaccone, 2007), with work-related low back pain (WRLBP) the most prevalent. Even
if in practice it is often impossible to distinguish between WRLBP and that of uncertain origin (Op
de Beek and Hermans, 2000) or between WRMSD and MSD as there is not a comparative estimates
of the incidence in the non-working general population (NRC-IOM, 2001), surveys among the
EU workers reported that millions of workers across EU are affected by WRMSD throughout their
labour tasks, a fact that designate WRMSD as the major source (∼39%) of occupational morbidity
within EU member states, with the WRLBP (24.7% of the workers) and myalgia (22.8% of the
workers) to be the most prevalent (Parent-Thirion et al., 2007).
Besides the health concern, the WRMSD have also a great financial cost to society, which for the
U.S. in 1995 it was estimated that had been yielded to $215 billion (Praemer, Furner, and Rice,
1999) and for the Europe up to 2% of the gross domestic product annually with a total cost due to
sickness absence of about £254 billion (Bevan et al., 2007; Lancet, 2009). The European annual
cost of WRLBP is about €12 billion (Bevan et al., 2007) and for the U.S, a conservative cost
estimation is about $50 billion annually in work-related costs (NRC-IOM, 2001).
Global Burden
It seems that the global burden of LBP has been underestimated in the Global Burden Disease (GBD)
reports compiled previously to 2010 due to methodological issues of the measurements (Hoy et al.,
2010). By using disability adjusted life year (DALY) metric as a measure to quantify the burden
of disease from morbidity, where one DALY equals one lost year of healthy life from mortality
and disability (Fig. 1.3), the last GBD released in 2010 reported that MSD and LBP are among
the non-communicable diseases that most increased between 1990-2010. The high ranking of
LBP (Fig. 1.4) is partly due to the undertaken method that took into consideration the functional
loss and disability that is caused by LBP, contrary to previous GBD reports where prevalence
estimations of LBP were based on case definitions that correlated poorly with functional disability
and also limited the available data of the epidemiologic studies that were aligned with the used
definition (Hoy et al., 2010). The 2010 GBD report estimated LBP as the seventh cause of disability
worldwide (Fig. 1.5a), while neck pain and other MSD also listed in the top-25 ranking. For the
western industrialized countries LBP ranks as second cause of disability (Fig. 1.5b), while other