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    Exoskeletons

    Occupational exoskeletons are portable external devices that fit onto the worker’s body to assist, support, or amplify their physical capabilities while performing tasks. Their purpose is to reduce the load on certain musculoskeletal structures, such as the lower back, shoulders, or limbs, during manual handling of loads , overhead work, sustained postures, or repetitive efforts. According to INSST Technical Prevention Note 1162, they are classified as active, which incorporate electric or pneumatic actuators that provide energy for movement, and passive, which use springs or elastic materials to store and release the energy of the movement itself and are the most widespread in the workplace. They are also distinguished by the body area they assist (trunk and lower back, upper limbs, lower limbs, or full body) and by their rigid or flexible structure. Its regulatory classification is not unique: exoskeletons for medical purposes are governed by the regulations for medical devices, active devices with moving parts can be considered machines subject to Royal Decree 1644/2008 and, from January 20, 2027, to Regulation (EU) 2023/1230, and their classification as personal protective equipment under Regulation (EU) 2016/425 is not generally resolved. Both the INSST in NTP 1162 and 1163 and the European Agency for Safety and Health at Work agree that the exoskeleton does not replace the elimination, design and organization measures provided for in Law 31/1995 and Royal Decree 487/1997, but is a complementary option to consider when those have been exhausted and the risk is still not sufficiently controlled, and always after a selection, a pilot test and monitoring with the participation of the users.

    In short

    External portable devices assist the worker’s body in reducing strain on the lower back, shoulders, or limbs during handling tasks, awkward postures, or work with arms raised. They are classified as passive (springs and elastic elements) and active (with actuators), and by the body area they assist. They can reduce the load in the assisted region, but also redistribute it, alter balance, or generate other effects. They do not replace the elimination, design, and organizational measures of Law 31/1995 and Royal Decree 487/1997. The INSST (NTP 1162 and 1163) and EU-OSHA recommend considering them as a complementary measure, with selection, pilot testing, voluntary use, and monitoring.

    Content
    1. Types and applications
    2. Benefits, risks and regulatory fit
    3. Selection and integration criteria (NTP 1163)
    4. Organizational application: how to introduce exoskeletons into the company
    5. Limits and common mistakes
    6. Practical example
    7. Regulatory and reference framework
    8. Related concepts
    9. References

    A–Z dictionary →

    Types and applications

    • Passive exoskeletons. Without an external power source; they store the energy of movement using springs or elastic elements and return it to assist the lumbar region, shoulders or legs; lightweight and the most widely used in industry and logistics.
    • Active exoskeletons. With electric, pneumatic, or hydraulic actuators that provide force to movement; greater assistance capacity, but also greater weight, complexity, need for maintenance, and potential risks from unforeseen movements.
    • By body area. Trunk and lumbar area for lifting and bending; upper limbs for work with arms raised; lower limbs for prolonged squatting or standing postures; and full body.
    • By structure. Rigid, with a frame that transmits the loads, or flexible and textile, lighter and with less restriction of movement.
    • Typical applications. Automotive and aerospace assembly, logistics and picking, construction, agriculture, healthcare and care, and maintenance tasks where job redesign is difficult.
    • State of standardization. There are standards under development on requirements and testing of exoskeletons, but no consolidated certification framework, which requires evaluating each device in its context.

    Benefits, risks and regulatory fit

    The available evidence, compiled by the European Agency for Safety and Health at Work in its 2019 consultation document and by the INSST in NTP 1162, shows that exoskeletons can reduce muscle activity and perceived load in the assisted area, especially in the lumbar region and shoulders, with results that depend on the type of device, the task, and the individual. At the same time, risks and undesirable effects have been described: redistribution of the load to other areas of the body, impaired balance and gait, difficulty reacting to a fall, cardiovascular overload due to the added weight, pressure points and skin irritation at contact points, possible muscle atrophy from prolonged use, interference with other protective equipment and the environment, and a lack of data on long-term effects. Therefore, both organizations place exoskeletons at the bottom of the hierarchy of measures, after elimination, technical redesign, and organizational measures.

    Regarding the regulatory framework, the INSST (National Institute for Safety and Health at Work) points out that exoskeletons intended for medical purposes are regulated as medical devices, that active exoskeletons with moving parts may fall under the scope of machinery regulations, and that their classification as personal protective equipment is not generally established. In any case, their use in the workplace is governed by the general obligation under Law 31/1995 to assess risks and adopt the most effective measures, by Royal Decree 487/1997 on manual handling of loads, which prioritizes elimination and mechanization, and by Royal Decree 1215/1997 on work equipment when the device is considered as such.

    Selection and integration criteria (NTP 1163)

    • Determine the need. Verify that elimination, design, and organizational measures have been implemented and that the risk persists; only then consider the exoskeleton as a complementary measure.
    • Analyze the task. Precisely define the movements, postures, loads, frequencies, and environment, and verify that the type of exoskeleton is suitable for them and does not interfere with other tasks in the job.
    • Select and test. Evaluate various devices with volunteers, assess usability, comfort, fit, compatibility with PPE and performance, and conduct a pilot test under real-world conditions.
    • Integrate gradually. Short periods of use that gradually increase, training in adjustment and use, user participation, and voluntary use.
    • Monitor and adjust. Track discomfort, health, incidents and acceptance, with tailored health monitoring and decision review.
    • Maintain and document. Maintenance, cleaning, inspection of elastic elements or actuators, registration of users, hours of use and results.

    Organizational application: how to introduce exoskeletons into the company

    1. Start with the ergonomic assessment of the workstation and verify that the elimination, technical redesign and organizational measures have been applied and that the risk persists.
    2. Define the task and the physical demands that are intended to be assisted, and select the type of exoskeleton (body area, passive or active, rigid or flexible) consistent with them.
    3. Clarify the regulatory fit of the chosen device (machine, medical device, work equipment) and the manufacturer’s documentation, including instructions and limitations of use.
    4. Conduct a pilot test with volunteers, using pre-established evaluation criteria (comfort, fit, usability, compatibility with PPE, performance, discomfort) and with the participation of worker representatives.
    5. Provide training on fitting, use, limitations and warning signs, and integrate use progressively and voluntarily.
    6. Establish follow-up: health surveillance, recording of discomfort and incidents, usage and acceptance indicators, and periodic review of the decision.
    7. Document the assessment, selection, pilot testing, training, and follow-up as part of preventive planning.

    Preventive management software allows linking the exoskeleton to the evaluated jobs and tasks, recording the pilot test and its results, managing training and delivery to each person, scheduling maintenance and health monitoring, collecting reports of discomfort, and analyzing the evolution of musculoskeletal disorders in the assisted jobs.

    Limits and common mistakes

    1. Adopt the exoskeleton as a first measure instead of eliminating or redesigning the task.
    2. Choosing the device without analyzing the actual task means that the assistance does not match the movements that generate the load.
    3. Imposing its use without a pilot test, without participation or voluntary nature, leads to rejection and abandonment.
    4. Ignoring load redistribution to other areas, balance, pressure points, and compatibility with other PPE and the environment.
    5. Do not provide training on adjustment and limitations, nor establish progressive periods of use.
    6. Not to monitor health, discomfort and incidents, nor to review the decision with the data obtained.

    Evidence on long-term effects is still limited and the decision should be made on a case-by-case basis with ergonomic advice; this fact sheet is for informational purposes only.

    Practical example

    Situation: An industrial vehicle assembly plant with underbody bolting tasks, with arms above the head for much of the shift, registers recurring shoulder discomfort on a line that cannot be redesigned in the short term.

    • Prior assessment. The prevention service confirms that rotation, low torque tools and supports have already been applied, that line elevation is not immediately feasible and that the shoulder risk persists, so the upper limb exoskeleton is considered as a complementary measure.
    • Selection and pilot test. Two passive shoulder models are tested with eight volunteers for four weeks, with increasing periods of use, comfort and perceived effort questionnaires, observation of postures and verification of compatibility with glasses, gloves and space under the body.
    • Integration. The highest-rated model is adopted, with training on adjustment and limitations, voluntary use, scheduled maintenance of elastic elements, and registration of users and hours.
    • Follow-up. Health monitoring and discomfort records are reviewed quarterly; if a lower back problem associated with the fit is detected in a person, it is corrected, and the line elevation is maintained in the planning as a priority design measure.

    Regulatory and reference framework

    The regulatory classification of each exoskeleton (machine, medical device, work equipment or, where applicable, personal protective equipment) must be verified with the manufacturer’s documentation and the corresponding technical advice.

    Related concepts

    References

    1. National Institute for Occupational Safety and Health. NTP 1162: Exoskeletons I: definition and classification. 2021. Official source
    2. National Institute for Occupational Safety and Health. NTP 1163: Exoskeletons II: Criteria for selection and integration in the company. 2021. Official source
    3. European Agency for Safety and Health at Work. Peters, M. and Wischniewski, S. Impact of the use of exoskeletons on safety and health at work. Reference document. 2019. Official source
    4. Official State Gazette. Law 31/1995, of November 8, on Occupational Risk Prevention. 1995, current consolidated text. Official source
    5. Official State Gazette. Royal Decree 487/1997, of April 14, on minimum health and safety requirements for the manual handling of loads that pose risks, particularly to the lower back, for workers. 1997, current consolidated text. Official source
    6. Official State Gazette. Royal Decree 1215/1997, of July 18, establishing the minimum health and safety requirements for the use of work equipment by workers. 1997, current consolidated text. Official source
    7. Official State Gazette. Royal Decree 1644/2008, of October 10, establishing the regulations for the marketing and commissioning of machinery. 2008, current consolidated text. Official source
    8. European Union. Regulation (EU) 2023/1230 of the European Parliament and of the Council of 14 June 2023 on machinery. 2023. Official source

    Editorial information

    Publication date: August 30, 2026 .

    Editorial Manager: Sabentis Editorial Team .

    Editorial review by Pablo Rodríguez LinkedIn

    Executive Vice President of the ORP International Foundation and Chief Financial Officer of Sabentis.

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