Occupational diseases

Occupational diseases are illnesses that insured persons suffer as a result of their work and which are listed in the Occupational Diseases Ordinance (BKV) and can be caused by a wide variety of harmful effects. In particular, certain chemicals, physical effects such as pressure, vibrations or carrying heavy loads and working in noisy or dusty conditions can be considered. However, not every illness can be recognized as an occupational disease. Only those illnesses which, according to the findings of medical science, are caused by specific agents can be considered as occupational illnesses. Certain groups of people must be exposed to these effects through their work to a significantly greater degree than the rest of the population. The occupational diseases currently eligible for recognition can be found in Annex 1 to the BKV (list of occupational diseases).

Diseases caused by chemical exposure

• 11 Metals and metalloids
• 1101 Diseases caused by lead or its compounds
• 1102 Diseases caused by mercury or its compounds
• 1103 Diseases caused by chromium or its compounds
• 1104 Diseases caused by cadmium or its compounds
• 1105 Diseases caused by manganese or its compounds
• 1106 Diseases caused by thallium or its compounds
• 1107 Diseases caused by vanadium or its compounds
• 1108 Diseases caused by arsenic or its compounds
• 1109 Diseases caused by phosphorus or its inorganic compounds
• 1110 Diseases caused by beryllium or its compounds
• 12 Asphyxiating gases
• 1201 Diseases caused by carbon monoxide
• 1202 Diseases caused by hydrogen sulfide
• 13 Solvents, pesticides and other chemical substances
• 1301 Changes to the mucous membranes, cancer or other

neoplasms of the urinary tract caused by aromatic amines

• 1302 Diseases caused by halogenated hydrocarbons
• 1303 Diseases caused by benzene, its homologs or styrene
• 1304 Diseases caused by nitro or amino compounds of benzene or its homologs or their derivatives
• 1305 Diseases caused by carbon disulphide
• 1306 Diseases caused by methyl alcohol (methanol)
• 1307 Diseases caused by organic phosphorus compounds
• 1308 Diseases caused by fluorine or its compounds
• 1309 Diseases caused by nitric acid esters
• 1310 Diseases caused by halogenated alkyl, aryl or alkylaryl oxides
• 1311 Diseases caused by halogenated alkyl, aryl or alkylaryl sulfides
• 1312 Diseases of the teeth caused by acids
• 1313 Corneal damage of the eye caused by benzoquinone
• 1314 Diseases caused by para-tertiary butylphenol
• 1315 Diseases caused by isocyanates
• 1316 Diseases of the liver caused by dimethylformamide
• 1317 Polyneuropathy or encephalopathy caused by organic solvents or their mixtures
• 1318 Diseases of the blood, hematopoietic and lymphatic systems caused by benzene
• 1319 Laryngeal carcinoma due to intensive and long-term exposure to aerosols containing sulphuric acid
• 1320 Chronic myeloid or chronic lymphocytic leukemia due to 1,3-butadiene with evidence of exposure to a cumulative dose of at least 180 butadiene-years (ppm x years)
• 1321 Changes in mucous membranes, cancer or other neoplasms of the urinary tract caused by polycyclic aromatic hydrocarbons if exposure to a cumulative dose of at least 80 benzo(a)pyrene-years [(µg/m3) x years] is proven

Re numbers 1101 to 1110, 1201 and 1202, 1303 to 1309 and 1315: Skin diseases are excluded. These are only regarded as diseases within the meaning of this Annex insofar as they are manifestations of a general disease caused by absorption of the harmful substances into the body or are to be compensated in accordance with number 5101.

Illnesses caused by physical agents

• 21 Mechanical effects
• 2101 Severe or recurrent diseases of the tendon sheaths or tendon sheaths and tendon or muscle attachments
• 2102 Meniscus damage after several years of continuous or frequently recurring activities that place above-average strain on the knee joints
• 2103 Diseases caused by vibration when working with pneumatic tools or similar tools or machines
• 2104 Vibration-induced circulatory disorders of the hands
• 2105 Chronic diseases of the bursa due to constant pressure
• 2106 Pressure damage to the nerves
• 2107 Avulsion fractures of the vertebral processes
• 2108 Disc-related diseases of the lumbar spine due to many years of lifting or carrying heavy loads or many years of working in an extremely bent posture, which have led to chronic or chronically recurring complaints and functional limitations (of the lumbar spine)
• 2109 Disc-related diseases of the cervical spine due to many years of carrying heavy loads on the shoulder, which have led to chronic or chronic-recurrent complaints and functional limitations (of the cervical spine)
• 2110 Disc-related diseases of the lumbar spine due to long-term, predominantly vertical exposure to whole-body vibrations while sitting, which have led to chronic or chronic-recurrent complaints and functional limitations (of the lumbar spine)
• 2111 Increased tooth abrasion due to several years of quartz dust exposure
• 2112 Gonarthrosis due to kneeling or comparable knee strain with a cumulative exposure time during working life of at least 13,000 hours and a minimum total exposure time of one hour per shift
• 2113 Pressure damage to the median nerve in the carpal tunnel (carpal tunnel syndrome) due to repetitive manual activities involving flexion and extension of the wrists, increased force exerted by the hands or hand-arm vibrations
• 2114 Vascular damage to the hand due to impact-like force (hypothenar hammer syndrome and thenar hammer syndrome)
• 2115 Focal dystonia as a disease of the central nervous system in instrumental musicians due to high-intensity fine motor activity
• 2116 Coxarthrosis due to load handling with a cumulative dose of at least 9,500 tons of loads handled during working life with a load weight of at least 20 kg handled at least ten times per day
• 22 Compressed air
• 2201 Illnesses caused by working in compressed air
• 23 Noise
• 2301 Noise-induced hearing loss
• 24 Radiation
• 2401 Cataracts due to heat radiation
• 2402 Diseases caused by ionizing radiation
• Diseases caused by infectious agents or parasites and tropical diseases
• 3101 Infectious diseases if the insured person worked in the health service, in charity work or in a laboratory or was particularly exposed to the risk of infection to a similar extent through another activity
• 3102 Diseases transmissible from animals to humans
• 3103 Worm diseases of miners caused by Ankylostoma duodenale or Strongyloides stercoralis
• 3104 Tropical diseases, typhus
• Diseases of the respiratory tract and lungs, pleura and peritoneum and ovaries
• 41 Diseases caused by inorganic dusts
• 4101 Silica dust lung disease (silicosis)
• 4102 Quartz dust lung disease associated with active pulmonary tuberculosis (silico-tuberculosis)
• 4103 Asbestos dust lung disease (asbestosis) or diseases of the pleura caused by asbestos dust
• 4104 Lung cancer, laryngeal cancer or ovarian cancer
  • in connection with asbestos dust lung disease (asbestosis)
  • in connection with pleural disease caused by asbestos dust or
  • with evidence of exposure to a cumulative dose of asbestos fiber dust in the workplace of at least 25 fiber-years (25 x 10(high)6 ((fibers/cbm) X years))
• 4105 Mesothelioma of the pleura, peritoneum or pericardium caused by asbestos
• 4106 Diseases of the deep respiratory tract and lungs caused by aluminum or its compounds
• 4107 Pulmonary fibrosis caused by metal dusts from the manufacture or processing of hard metals
• 4108 Diseases of the lower respiratory tract and lungs caused by Thomas flour (Thomas phosphate)
• 4109 Malignant neoplasms of the respiratory tract and lungs caused by nickel or its compounds
• 4110 Malignant neoplasms of the respiratory tract and lungs due to coke oven crude gases
• 4111 Chronic obstructive bronchitis or emphysema in underground coal miners with evidence of exposure to a cumulative dose of generally 100 particulate matter years ((mg/cbm) X years)
• 4112 Lung cancer due to exposure to crystalline silica (SiO(deep)2) with proven quartz dust lung disease (silicosis or silico-tuberculosis)
• 4113 Lung cancer or laryngeal cancer caused by polycyclic aromatic hydrocarbons with evidence of exposure to a cumulative dose of at least 100 benzo[a]pyrene years [(µg/m3) x years]
• 4114 Lung cancer caused by the interaction of asbestos fiber dust and polycyclic aromatic hydrocarbons if there is evidence of exposure to a cumulative dose corresponding to a causation probability of at least 50 percent according to Annex 2
• 4115 Pulmonary fibrosis due to extreme and long-term exposure to welding fumes and welding gases - (siderofibrosis)
• 4116 Lung cancer following long-term and intensive exposure to secondhand smoke at the workplace in insured persons who have never actively smoked themselves or have smoked a maximum of 400 cigarette equivalents
• 42 Diseases caused by organic dusts
• 4201 Exogenous allergic alveolitis
• 4202 Diseases of the lower respiratory tract and lungs caused by raw cotton, raw flax or raw hemp dust (byssinosis)
• 4203 Adenocarcinomas of the nasal cavity and paranasal sinuses caused by dust from oak or beech wood
• 43 Obstructive respiratory diseases
• 4301 Obstructive respiratory diseases caused by allergenic substances (including rhinopathy)
• 4302 Obstructive respiratory diseases caused by chemical-irritant or toxic substances

Skin diseases

• 5101 Severe or recurrent skin diseases
• 5102 Skin cancer or cancer-prone skin lesions caused by soot, crude kerosene, tar, anthracene, pitch or similar substances
• 5103 Squamous cell carcinoma or multiple actinic keratoses of the skin caused by natural UV radiation

Diseases of other causes

• 6101 Eye tremors in miners

1. Source reference: https://www.gesetze-im-internet.de/bkv/anlage_1.html