The different occupational health systems and legislations in the countries across Europe makes it difficult for one to sketch a detailed picture for the whole continent. Reporting bias and selection bias have a considerable impact on the perceived prevalence and incidence, while reliable data are hard to extract from official registries. Data from one region in Germany will serve as an example. Comparison with data from other sources yields an estimate of 0.7 to 1.5 cases per 1,000 per year as a gross average, while the problem in specific occupational groups is more pronounced. Reliable data on social and economic impact are very scarce.