PRECISE - Objective Measures and Observations of Physical Exposures Among Pregnant Employees in the Danish Workforce

Background and impact In the Scandinavian countries, 75-80% of women are a part of the workforce and many of these are of reproductive age.(2) Physical workloads are a recurring issue in risk assessment and counselling of pregnant women regarding work. Epidemiological studies have indicated an association with preterm birth and foetal death, (3-9) but have been based on self-report mostly with a retrospective design with obvious limitations regarding recall bias, crude and no time specific exposure assessments. Few studies have applied Job Exposure Matrices (JEMs) for exposure assessments, but these studies have been small and/or based on self-report or expert assessment.(4, 10-14) Overall, previous studies have been limited by misclassification of exposures and a lack of exposure contrast with few highly exposed pregnant women.

Pregnancy discomforts are common and often reason for absence during pregnancy.(15-16) Since pregnancy discomforts only in extreme cases involve hospital contacts and thereby entry in the Danish registries, studies rely on self-report. To be able to prevent absence or other negative consequences, we need more knowledge on the importance of physical workloads in relation to development or aggravation of pregnancy discomforts.

Results from PRECISE will help improve current knowledge on physical workloads during pregnancy and advance national guidelines, which potentially can prevent negative outcomes in pregnancies and reduce worries and absence among pregnant employees. Further, the construction of trimester-specific JEMs based on objective exposure assessments will expand and support research in occupational reproduction and enable future investigations of associations with other outcomes in pregnancy and offspring.

Qualifications and previous related activities of the applicant PRECISE is a natural extension of the applicant Luise Mølenberg Begtrup´s commitment to secure safe working environments for mothers and offspring. In both her research and clinical practice Dr. Begtrup continously strive to improve guidance of healthcare professionals, employers and decision makers and provide information, advice and work planning for pregnant women. She is PI for projects focusing on the wellbeing of pregnant women and their retention at workplaces and was pivotal in the establishment of the nationwide occupational generation cohort DOC*X-G, and in research of night work and pregnancy outcomes. Dr. Begtrup has been involved in the National Board of Health´s update for maternal care, and recently finished a review to the Danish Working Environment Authority about work-related ergonomic exposures and pregnancy.

Research plan The project period of four years is organized in six interrelated work packages (WP1-WP6). The PhD-student covered by this application is planned to start 01/03/2023 and will be recruited through postings through the Capital Region of Denmark and the University of Copenhagen.