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Background: Musculoskeletal disorders (MSDs) remain among the leading causes of work-related disability and absenteeism in Germany. In response, the national Occupational Medicine Rule AMR 13.2 – based on the national Ordinance on Occupational Health Care (ArbMedVV) – provides a structured framework for preventive health care related to physical workloads associated with musculoskeletal health risks.

Methods: AMR 13.2 defines six types of physical workload: manual lifting, holding, and carrying of loads; manual pulling and pushing; repetitive manual tasks; application of whole-body forces; locomotion under load; and constrained body postures. These exposures are closely linked to regional musculoskeletal complaints and diseases, including those affecting the cervical and lumbar spine as well as upper and lower limbs.

The guideline introduces a four-level risk model (ranging from 1 (low) to 4 (high)) to standardize risk assessment. It recommends a clear assessment strategy: starting with basic screening tools, proceeding to advanced screening methods, and incorporating expert-based assessments or biomechanical measurements for complex exposure scenarios.

Results: Depending on the assessed risk level, preventive actions range from ergonomic workplace redesign to mandatory occupational medical examinations (required for risk levels 3 and 4). AMR 13.2 emphasizes the primacy of preventive measures according to the TOP principle (Technical, Organizational, Personal) and promotes a holistic, participatory health care approach.

Additionally, mandatory occupational health care in response to exposure to whole-body and hand-arm vibrations is also regulated in the ArbMedVV and supplemented by the Noise and Vibration Occupational Safety Ordinance (LärmVibrationsArbSchV) when defined action values are exceeded.

Conclusion: Germany’s AMR 13.2 presents a comprehensive, scientifically grounded framework for managing physical workload-related health risks in the workplace. By integrating risk-based screening, exposure-specific assessment tools, and graded preventive action, it supports both individual health protection and organizational risk management in occupational settings.