Bridges are vital parts of public road networks. They are maintained through the execution of maintenance interventions to ensure they continuously provide service to society. These interventions, however, should be executed in a way that results in the lowest overall negative impacts, i.e. the most sustainable work programs should be followed. A challenge in the determination of these work programs is that only some impacts are attributable to elements. Others, are only attributable to the bridge as a whole and require more modelling effort than what is currently done in many bridge management systems, and, therefore, require a different methodology to be used. In this paper, a methodology is proposed to determine the most sustainable work programs that systematically takes into account both element level and structure level impacts. The proposed methodology is demonstrated using it to determine the most sustainable work program for an example bridge. The advantages and disadvantages of the methodology, as well as possible future research directions, are discussed.