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Background and Importance Manual compounding of aseptic preparations in hospital pharmacies may involve repetitive movements and physical workloads that may affect staff health. Despite technological advancements, many preparations are still performed manually, highlighting the need to identify ergonomic risks and assess staff perceptions related to this activity.Aim and Objectives To collect feedback from pharmacy staff regarding ergonomic challenges, health concerns, and perceptions of automation in aseptic compounding.Material and Methods A cross-sectional survey was conducted among KIRO-Oncology and Kiro-Isolator users. The questionnaire collected demographic data (age, gender), occupational information (professional category, time dedicated to manual compounding), and self-reported physical health aspects related to work. Additional compounding-related variables included syringe size, final container type, and medicines considered difficult to compound manually or preferred for robotic preparation.Results We received 37 responses from hospital pharmacy professionals, all of them used to combine manual and automated compounding with KIRO-Oncology or Kiro-Isolator robots across six countries: Spain (15), France (11), Latvia (5), Finland (3), Ireland (2), and Poland (1).Among respondents, 39.3% were aged 18–30 years and 46.4% were 31–41 years; nearly 80% were women; 65% were pharmacy technicians, 27% pharmacists, and the remainder nurses. 73% spent over half of their working time on manual compounding.95% reported discomfort or pain during compounding, mainly in the hands, cervical region, and fingers (>15% each). 19% had taken sick leave due to musculoskeletal disorders, with half notifying to the occupational health service. In two-thirds of these cases, medical leave or reassignment exceeded 1 month.41% identified the infuser as the most resistant container, followed by the cassette (27%) and prefilled bags (24%). The 50 mL syringe was most frequently used (50%). The drugs considered most difficult to prepare manually were paclitaxel (35%), fluorouracil (13%), and cyclophosphamide (12%), while those preferred for robotic compounding were cyclophosphamide (27%), paclitaxel (24%), fluorouracil (8.2%), carboplatin (7%), and doxorubicin (6%). Participants expressed a preference for using robotic systems for preparations involving large volumes, reconstitutions, elastomers and cassettes, highly contaminating drugs, and those requiring 50 mL syringes. 95% believed robotic compounding could help reduce repetitive stress injuries. Conclusion and Relevance Manual compounding frequently leads to musculoskeletal discomfort among pharmacy personnel. Implementing ergonomic strategies and expanding robotic compounding for high risk or physically demanding preparations could potentially enhance staff safety and well-being.References and/or Acknowledgements Clàudia Sabaté Martinez (Kiro-Grifols)Conflict of Interest No conflict of interest