A total of 915 subjects with lumbar spine disease of the multicenter case-control study EPILIFT were clinically described in detail. Of the 915 subjects, 43% had a motor or sensomotor lumbar spine syndrome, 38% a sensitive lumbar spine syndrome, and 19% a local lumbar spine syndrome. The arithmetic mean (± standard deviation) for the pain intensity on a visual scale (range 1-10) was 7.4±1.9, which demonstrates the relatively high level of pain experienced by the subjects. Also, the Oswestry score is compatible with high limitations in patient's everyday life. In 96.0% of the 915 EPILIFT subjects, the radiological findings showed disc-related damage in at least one segment either in the form of disc herniation or disc narrowing (chondrosis) of the lower lumbar spine in segment L4/L5 and/or L5/S1. In only 4.0% of the cases was the upper and/or the middle part of the lumbar spine (segment L1/L2 - L3/L4) damaged. A nearly identical distribution of the localization of the radiologically diagnosed disc damage was found in 87 EPILIFT cases with a total dose according to the Mainz-Dortmund dose (MDD) model of at least 25 MNh in men or 17 MNh in women as well as in the 228 cases with a total dose of at least 12.5 MNh according to the BSG ruling from 30 October 2007 (No. B 2 U 4/06 R). About every third subject of the 915 EPILIFT cases showed monosegmental, bisegmental or polyseg-mental radiologically diagnosed damage of the lumbar spine. In addition, the 87 EPILIFT cases with a total MDD dose of at least 25 MNh in men or 17 MNh in women as well as the 228 highly exposed cases with a total dose of at least 12.5 MNh according the above mentioned BSG ruling did not have a different distribution. In all, 64 of the 915 EPILIFT cases (7.0%) showed accompanying spondylosis in accordance with the consensus criteria. EPILIFT cases with an accompanying spondylosis are substantially older and showed a higher prevalence of male sex and adipositas than those without. Furthermore, the prevalence of accompanying spondylosis in men with pronounced chondrosis (case group 3) with 26.8% is much higher than in the other case groups (0-6.5%). The prevalence of accompanying spondylosis in the 87 cases with a total MDD dose of at least 25 MNh in men or 17 MNh in women was 10.3% and slightly higher than in lower exposed cases (6.6%). The 228 highly exposed cases with a total dose of at least 12.5 MNh calculated according to the BSG ruling did not show, at 9.2%, a substantially higher prevalence of an accompanying spondylosis in comparison with cases with lower exposure (6.3%). Taken together, the results are not in concordance with the opinion that accompanying spondylosis and polysegmental radiologically diagnosed damage of the lumbar spine are typical signs of an exposure-related form of lumbar disc disease according occupational disease 2108. Therefore, the consensus report for expert opinions concerning occupational disease 2108 (Bolm-Audorff et al. 2005) should reassessed. A total of 49 of the 915 EPILIFT cases (5.4%) showed stronger or equally strong definite cervical spine damage compared with the lumbar spine and 35 case subjects (3.9%) had a lower damage in the cervical spine compared to the lumbar spine. In contrast, the prevalence of stronger or equally strong defi nite damage of the cervical spine in comparison with the lumbar spine in 87 EPILIFT cases with a total MDD dose of at least 25 MNh in men or 17 MNh in women was with 10.3% higher than in the 687 cases with a dose <12.5 MNh according to the above mentioned ruling with 5.5%. Overall, nonoccupation-related competing causes were rarely found. The most common competing causes among the 915 EPILIFT cases were asymmetric lumbosacral transitional vertebrae which occurred in 15 cases, followed by deep lumbar scoliosis with an angular degree of at least 10° according to Cobb which occurred in 9 EPILIFT cases. The fact that almost all cases with confirmed nonprofession-related, competing causes had a total MDD dose, according to the BSG ruling, of less than 12.5 MNh proves that those cases with a confirmed nonprofession-related competing cause more likely do not have occupational disease No. 2108. Limiting the evaluation to the 228 highly exposed EPILIFT cases with a total dose of at least 12.5 MNh according to the BSG ruling when defining extreme exposure by MDD, the most common constellation according consensus criteria was constellation B2 with 154 cases (67.5%), followed by constellation B3 with 21 cases (9.2%), and B1 with 14 cases (6.1%).