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Screening tools provide occupational physicians the ability to inform employees about their alcohol consumption, and the possibility to take preventive measures. In addition, the occupational physician can detect risky and harmful alcohol use. So far, clear screening guidelines to deal with alcohol misuse in occupational health setting are lacking.Between June 2016 and March 2017, we organised four World Cafés with a motivated group of occupational physicians. The World Café method is a Large Scale Intervention and an evidence-based approach in which stakeholders actively participate. The different screening tools were discussed and the guideline was concretized.The Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) was selected as the most adequate and feasible instrument to screen workers. This shortened version of the AUDIT (the first 3 of 10 questions focuses on the consumption of alcohol) is a brief, validated screening instrument for risky drinking and alcohol misuse. The working group advised to organise targeted screening during individual medical examinations (i.e. pre-recruitment medical examination, periodic medical examination, occupational aptitude test, return to work screening and consultations with workers showing deteriorated job performances). We made flowcharts for each type of examination, with an overview of the possible initiatives of occupational physicians based on the score of the screening test, i.e. brief interventions. The guideline also stipulated in which circumstances additional biomarkers are required. Finally, the use of AUDIT-C for health promotion initiatives was concretized. In that case, results will be analysed on a company level and may thus form the basis for prevention measures.This consensus guideline is the first guideline for occupational physicians. It will now be submitted for validation, subsequently followed by its implementation.