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To investigate the costs of low-back pain associated sick leave of workers in the Netherlands from 2015 to 2017. We used longitudinal data form a large occupational health service regarding sick leave (registered by occupational physicians). Costs of sick leave due to low-back pain were estimated using the human capital approach, considering society and company perspectives. A total of 7901 low-back pain episodes from 7161 unique workers were analyzed. We estimated an average episode of low-back pain sick leave was 129.42 days in durat