Introduction. Surgical treatment for a herniated disc (HDO) was chosen as an indicator of spinal pathology to determine the association between HDO and occupational activity and the role of occupational activity in the development of this condition. Methods. Patients were selected from regional databases of the Medical Information Systems Program (PMSI) based on the following criteria: age 20 to 59 years, a record of HDO surgery, in 2002–2003 at the Nantes University Hospital for the pilot study, and in 2007–2008 at all surgical centers in the Pays de la Loire region for the regional study. Medical and occupational history was collected via a self-administered postal questionnaire. The age-adjusted relative risk (RR) was used to estimate the association between HDO and occupational activity. The contribution of occupational sectors and professions to the risk of HDO was quantified by the fraction of risk attributable to occupational factors in the population (Frap) and by the fraction of risk attributable among those exposed (Frae). Results. The pilot study included 146 respondents to the self-administered questionnaire among the 272 eligible patients. The regional study included 1,870 respondents among the 3,135 patients who underwent surgery in 2007–2008. The RR for HDO was 5.1 [2.6–10.1] among men in transportation and, among women, 2.7 [1.6–4.5] in healthcare and 10.2 [4.4–23.3] in hospitality and food services. The highest attributable risk fractions were associated with the hospitality and food service sector among women (Frap = 19%, Frae = 90%). The high-risk occupations among men were drivers (Frap = 12%, Frae = 79%) and unskilled industrial workers (Frap = 17%, Frae = 80%), and, among women, civil servants (Frap = 18%, Frae = 66%). Discussion and conclusion. These studies confirmed the value of HDO surveillance based on the PMSI and identified occupations at risk for HDO in the general population. (R.A.)