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Background and Importance Manual compounding of sterile preparations may involve repeated manipulations and physical force, particularly during syringe withdrawal and injection, which could contribute to repetitive stress injuries. Measuring these forces may provide objective evidence of the process’s physical demands.Aim and Objectives To identify the most ergonomically demanding manual preparations by measuring withdrawal and dilution forces, supporting prioritisation for robotic compounding.Material and Methods The study was conducted in three hospitals combining manual and automated compounding with the Kiro Oncology robot. Preparations were selected by drug, dose, density and final container.Two manual movements were assessed: withdrawal (pulling the syringe plunger to aspirate drug from the vial) and insertion (pushing the plunger to transfer the solution into the final container).Additional tests used saline (NS), water for injection (WFI), and 5% dextrose (D5W) with syringes from 1 to 50 mL, to assess force across sizes and solutions.A dynamometer with a custom adapter on the syringe plunger was used. Reference force values and risk levels were defined according to UNE-EN1005-3:2002+A1. The maximum reduced isometric force for withdrawal and insertion was 1.83 kg with tasks over 0.92 kg considered ergonomic risks. Measurements were done by trained staff under standardised conditions (syringe with closed system transfer devices).Results Nine technicians participated, three from each hospital, (67% women, mean age 43±13years), three repetitions/participant (27 measurements): Vial Dose (mg) Volume (mL) Syringe (mL) Final container Withdrawal force (Kg) (SD) Insertion force (Kg) (SD) Oxaliplatin (100 mg/20 mL) 200 40 50 IV bag 4.22 (1.60) 5.80 (2.71) Oxaliplatin (100 mg/20 mL) 85 17 20 IV bag 1.81 (0.58) 3.22 (1.75) Paclitaxel (300 mg/50 mL) 300 50 50 IV bag 4.77 (1.55) 5.43 (1.21) Paclitaxel (300 mg/50 mL) 100 16.7 20 IV bag 2.62 (0.48) 3.64 (0.90) Fluorouracil (5000 mg/100 mL) 4000 80 50 Infuser 4.20 (1.68) 9.40 (1.96) Fluorouracil (5000 mg/100 mL) 4000 80 50 Cassette 4.20 (1.68) 6.77 (4.00) All manual preparations exceeded the recommended force limit, with no significant differences between aqueous (oxaliplatin) and viscous (paclitaxel) drugs. Force differences were mostly related to syringe volume and final container, with the highest forces recorded during infuser insertion. For NS, WFI, and D5W, only syringes >10 mL exceeded risk thresholds.Conclusion and Relevance Manual compounding frequently exceeds ergonomic limits, especially with large volumes (>20 mL) and infuser transfers. These data support prioritising such tasks for robotic compounding (if available) to reduce musculoskeletal risk.References and/or Acknowledgements Clàudia Sabaté Martinez (Kiro-Grifols)Conflict of Interest No conflict of interest