For the prevention of musculoskeletal disorders (MSD), the evaluation of manual materials handling (MMH) is important. Cumulative loading can be used to quantify exposure, but there is little applied research on its effectiveness in risk assessment. Therefore, this publication presents an analysis of whether cumulative loading estimates can be used to assess the occupational risk of MSD. Five methods for estimating cumulative spine loads from time-varying data are compared based on real collective exposure data of MMH associated with both high and low incidences of MSD. Results show that cumulative loading estimates can be used to assess the occupational risk of MSD. Still, it should be noted that assessment results are substantially influenced by the recorded level of detail of the exposure data and do not allow for reliable conclusions regarding physiological demands. Further research is needed regarding the inclusion of physiological responses and task sequences. Relevance to industryThe findings can be applied to ergonomic risk assessment in occupational practice. By becoming more aware of the differences between calculation methods and the influence of the level of detail of the exposure data, the planning and implementation of the ergonomic risk assessment can be facilitated.