Further development of the G 46 occupational medical examination for the musculoskeletal system

Project No. IFA 4196


completed 01/2014


Within the "Further development of the G 46 occupational medical examination" project (FF-FP0293), funded by the DGUV, the Institute of Occupational Medicine at the RWTH Aachen conducted intensive functional diagnoses in accordance with the Fokus method and assessments of psychosocial risks on approximately 400 industrial mechanists in eleven metalworking companies. The IFA, which is a partner in the study, was tasked with conducting intensive risk assessments of the physical back workloads. The physical and psychosocial exposure data were to be correlated with the results of the surveys of disorders and of the functional diagnoses in order for strategies to be identified for improving occupational medical prophylaxis in accordance with G 46.

The focus of the IFA project described here lies upon recording and analysis of the physical stress data.


The test subjects in the study comprised 410 workers in machining (373 male, 37 female) in eleven companies and eight task areas. The Standardized Nordic Questionnaire was used to record the subjective disorders in the lumbar and cervical spine. A sub-group of 78 test subjects (73 male, 5 female) from all task areas was selected for the performance of measurements of the spinal stresses over a shift. Body posture and manipulation of loads were recorded by means of the CUELA personal measurement system. Cumulative doses were calculated for the angle of forward trunk inclination, manipulated load weights, lumbar torques and intervertebral disk compression forces on the lowest intervertebral disk at L5/S1. Correlations and odds ratios were calculated in order to determine the relationship between the subjective disorders of the lumbar and cervical spine and the cumulative work stresses.


The stress dose values varied strongly between the different task groups. Mean cumulative angles of trunk inclination of 160000±90000 °s, load manipulations of 28000±22000 kgs, lumbar torques of 200±80 Nmh and lumbar compression forces of 3.9±2 kNh per day were measured. A significant correlation with an OR of 2.07 (CI: 1.08 – 3.98) was observed for the highest versus the lowest exposure quintile for the relationship between the cumulative angles of trunk inclination and the subjective lumbar and cervical spine disorders. This permits formulation of a defined guideline value for risk assessment of work performed in a constrained trunk posture which can be referenced as a selection criterion for the G 46 study. Esposure/disorder characteristics for other forms of workloads were frequently U-shaped.

Last Update:

20 Nov 2014


Financed by:
  • Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)
Research institution(s):
  • Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung (IFA)
  • RWTH Aachen Institut für Arbeitsmedizin

metal working

Type of hazard:

muliple exposures multiple strain, handling of loads, mental stress factors


ergonomics, occupational medical prevention, musculoskeletal disorders (except cancer)

Description, key words:

G 46 occupational medical prophylaxis, risk assessment of physical and mental stresses, musculoskeletal system, milling machine operator, metalworking industry


Further information

R. Winkler, J Lang, J Bechmann, R Ellegast, T Kraus, E Ochsmann (2012, November). Prädiktiver Einfluss psychosozialer Faktoren auf akute Beschwerden des Lendenwirbelsäulenbereichs und Nackens – erste Ergebnisse. Vortrag auf dem 16. Symposium Arbeitsmedizin und Arbeitswissenschaft für Nachwuchswissenschaftler des Forums Arbeitspsychologie der DGAUM, Bad Münder.