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Introduction: Individual prevention (IP) of work-related musculoskeletal disorders involves targeted interventions that address individual health risks in the workplace. The primary objective is to identify work-related health hazards at an early stage and prevent the onset or progression of occupational diseases by implementing tailored measures. This approach is particularly relevant for individuals displaying early symptoms or at elevated risk of diseases affecting the lumbar spine, knees, shoulders, or hips.

Methods: Well-established IP programmes currently exist in Germany for the lumbar spine and knee joints. These were developed and evaluated by three accident insurance institutions (UVT). However, the introduction of new national occupational diseases such as OD 2117 (rotator cuff lesion) and OD 2116 (hip osteoarthritis due to manual handling of loads), and the removal of the cessation requirement, highlight the need for additional IP programmes. Consequently, an umbrella review was initiated by the German Social accident insurance (DGUV) to identify and assess the effectiveness of existing international IP programmes or evidence-based modules for shoulder and hip conditions. Additionally, a survey of the UVTs was conducted in 2024 to identify key areas for further development.

Results: The national IP programmes have a modular structure, beginning with a (partially) inpatient core phase and continuing with follow-up interventions. Consisting of ten standardised components, the programmes include sports therapy, physiotherapy, ergonomics, and psychological training. The modular structure is defined in the DGUV guideline IP MSE (IFA report 5/2023), which aims to ensure consistent programme development and transparent access. Access to IP programmes is available through multiple pathways, including following the recognition of an occupational disease or during occupational medical health examinations. Evaluations of the national IP programmes for the knee and lumbar spine show significant short-term improvements in pain symptoms, functional capacity, and work-related behaviour after the inpatient phase. Long-term benefits are observed when follow-up measures such as sports training are consistently maintained. Preliminary findings from the umbrella review indicate that international IP programmes using multimodal approaches are generally effective. Sports therapy, physiotherapy, and manual therapy demonstrate positive outcomes, whereas purely physical modalities appear to be less effective. However, the methodological quality of the studies is often limited. The 2024 UVT survey identified areas in need of further development, such as expanding the ergonomics module to address a wider range of occupational groups and exposure types and creating outpatient programme formats.

Conclusion: The evidence-based, modular DGUV’s IP approach provides a robust framework to reduce occupational diseases. In the future, this approach must adapt to scientific evidence, changing demands and new requirements to remain effective to support employees’ long-term health.