{
  "abstract": "Background Occupational physical activity (OPA) during pregnancy has been linked to adverse pregnancy outcomes, but crude exposure assessment remains an issue in causal inference. We aimed to develop a quantitative trimester-specific job exposure matrix (JEM) for standing, walking, and forward bending, among pregnant workers.Methods Accelerometer measurements from 403 female workers within 109 DISCO-08 job codes were obtained between January 2023 and June 2024 in Denmark. Full workdays were measured during two weeks in pregnant workers and one week in non-pregnant workers. To estimate exposure levels of occupational standing, walking and forward bending for all 1171 DISCO-08 codes, we included expert ratings, age and trimester as fixed effects, and job codes and workers as random effects in linear mixed-effects models.Results The between-job variances relative to total variances were 56% for standing, 51% for walking and 45% for forward bending. The fixed effects age and trimester reduced standing time with 0.02 hours/year, and 0.38 hours during 3rd trimester, respectively whereas no differences were observed for walking or forward bending. Including expert ratings in the final models reduced between-job variances with 50% for standing and forward bending, and 17% for walking. Based on the trimester-specific JEM for standing, bakers had the highest exposure (range 5.41-5.03 hours). For walking and forward bending, the highest exposed jobs were waiters (1.76 hours) and livestock/dairy producers (1.24 hours), respectively.Conclusion The JEM enhances independent objective exposure assessment in epidemiological studies of OPA and pregnancy outcomes and may advance guidelines and potentially prevent adverse pregnancy outcomes.",
  "authors": [
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Hannah Nørtoft Frankel"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Esben Meulengracht Flachs"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Camilla Sandal Sejbaek"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Jonathan Aavang Petersen"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Jens Peter Bonde"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Ingrid Sivesind Mehlum"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Mette Korshøj"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Susan Peters"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Magnus Svartengren"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Pasan Hettiarachchi"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Peter J Johansson"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Alex Burdorf"
    },
    {
      "affiliations": [
        "Bispebjerg and Frederiksberg, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. National Institute of Occupational Heath (STAMI), Oslo, Norway. Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark. Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. Department of Public Health, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Luise Mølenberg Begtrup"
    }
  ],
  "title": "8238616 Development of a quantitative job exposure matrix for standing, walking, and bending for pregnant workers",
  "uid": "234e61a6-a430-5c84-887b-5ad40ce674d4"
}