Each year 15-20% of Americans report back pain, resulting in over 100 million workdays lost and more than 10 million physician visits. National Health Interview survey data estimates that two-thirds of all low back pain cases are attributable to occupational activities. The cost of back pain is also disproportionate, as it represents about 20% of workers’ compensation claims, but nearly 40% of the costs. In 2003, 3.2% of the total U.S. workforce experienced a loss in productive time due to back pain. The total cost of this productive time lost to back pain is estimated to be in excess of $19.8 billion dollars.

Hospitalizations for work-related back disorders have serious and costly effects including: high direct medical costs, significant functional impairment and disability, high absenteeism, reduced work performance, and lost productivity. Well-recognized prevention efforts can be implemented for high risk job activities and reduce the burden of work-related low back disorders.


Hospital discharge records are only available for non-federal, acute care hospitals. Many individuals with work-related injuries do not file for workers’ compensation or fail to recognize work as the cause of their injury. Additionally, self-employed individuals such as farmers and independent contractors, federal employees, railroad or longshore and maritime workers are not covered by state workers’ compensation systems. The expected payer on hospital discharge records may not be accurate and reflect the actual payer. Data between states may not be comparable due to differences in benefit adequacy in states’ workers’ compensation programs. Trends in the use of outpatient surgical centers may limit the interpretation of this indicator. The indicator utilizes only the first seven diagnosis and four procedure code fields to include and exclude cases. Many states have more diagnosis and procedure code fields that could be used to include and exclude cases. The indicator excludes patients hospitalized outside their state of residence.