{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:16:06Z","timestamp":1767993366043,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,2,5]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify the biomechanical and organisational constraints that influence pregnancy outcomes and define the exposure levels at which the risks for pregnancy become significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>We applied a consensus method (Delphi) consisting of a literature review followed by expert opinions on exposure levels. The group of experts was made up of 12 people from different medical specialities and working in various structures in France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The studied variables were: (1) exposure: night work\/shift work, weekly hours at work, lifting of heavy loads, prolonged standing and multiple exposure and (2) pregnancy outcomes: prematurity, low birth weight and spontaneous miscarriages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The consensus method resulted in the following recommendations. The time spent working must not exceed 40 hours\/week; in the absence of a consensus on the level of exposure, night and\/or shift work must be avoided; prolonged standing must not exceed 3 hours\/day; lifting must be limited to carrying loads &lt;11 kg, with a daily load &lt;100 kg; multiple exposure must be avoided, in particular: vibration, night work\/shift work, time spent working exceeding 40 hours\/week, prolonged standing and lifting of heavy loads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results could help the occupational physician to address the question of whether an exposed employee should remain at work, considering her individual characteristics (medical history, family situation, socioeconomic level, etc) in consultation with pregnancy specialists (obstetricians, midwives).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-052474","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T11:51:07Z","timestamp":1646740267000},"page":"e052474","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Biomechanical and organisational constraints of pregnant women at work: definition of exposure levels using a consensus method (Delphi)"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8699-0022","authenticated-orcid":false,"given":"Thomas","family":"Certenais","sequence":"first","affiliation":[{"name":"Department of Occupational Medicine, University Hospital Centre Bordeaux, Bordeaux, France"},{"name":"Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, University Hospital Centre Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rapha\u00eblle","family":"Teysseire","sequence":"additional","affiliation":[{"name":"Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, University Hospital Centre Bordeaux, Bordeaux, France"},{"name":"Inserm UMR1219-EPICENE, Bordeaux Population Health Research Centre, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan","family":"Garlantezec","sequence":"additional","affiliation":[{"name":"Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085, IRSET, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Brochard","sequence":"additional","affiliation":[{"name":"Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, University Hospital Centre Bordeaux, Bordeaux, France"},{"name":"Inserm UMR1219-EPICENE, Bordeaux Population Health Research Centre, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guyguy","family":"Manangama","sequence":"additional","affiliation":[{"name":"Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, University Hospital Centre Bordeaux, Bordeaux, France"},{"name":"Inserm UMR1219-EPICENE, Bordeaux Population Health Research Centre, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5594-5405","authenticated-orcid":false,"given":"Fleur","family":"Delva","sequence":"additional","affiliation":[{"name":"Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, University Hospital Centre Bordeaux, Bordeaux, France"},{"name":"Inserm UMR1219-EPICENE, Bordeaux Population Health Research Centre, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"2025121222084055000_12.3.e052474.1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.13-1-75"},{"key":"2025121222084055000_12.3.e052474.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-013-0924-3"},{"key":"2025121222084055000_12.3.e052474.3","doi-asserted-by":"crossref","first-page":"862","DOI":"10.2460\/javma.250.8.862","article-title":"Review of hazards to female reproductive health in veterinary practice","volume":"250","author":"Scheftel","year":"2017","journal-title":"J Am Vet Med Assoc"},{"key":"2025121222084055000_12.3.e052474.4","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2012-101032"},{"key":"2025121222084055000_12.3.e052474.5","unstructured":"Carbone P , Granata O , Mantovani A , et al . EUROCAT special report : primary prevention of congenital anomalies in european countries [Internet]. Northern Ireland, 2013. Available: https:\/\/eu-rd-platform.jrc.ec.europa.eu\/sites\/default\/files\/EUROCAT-Special-Report-Primary-Preventions-of-CA.pdf [Accessed 21 May 2020]."},{"key":"2025121222084055000_12.3.e052474.6","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2008.041772"},{"key":"2025121222084055000_12.3.e052474.7","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ejogrb.2016.12.035","article-title":"Prevention of spontaneous preterm birth: guidelines for clinical practice from the French College of gynaecologists and obstetricians (CNGOF)","volume":"210","author":"Sentilhes","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025121222084055000_12.3.e052474.8","unstructured":"Delva F , Manangama G , Brochard P , et al . The ARTEMIS center: an environmental health prevention platform dedicated to reproduction. Available: www.mdpi.com\/journal\/ijerph [Accessed 30 Jun 2020]."},{"key":"2025121222084055000_12.3.e052474.9","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.admp.2019.09.004","article-title":"Exposures to occupational reproductive hazards | Expositions des facteurs de risque sur la reproduction en milieu professionnel","volume":"80","author":"Certenais","year":"2019","journal-title":"Archives des Maladies Professionnelles et de l\u2019Environnement"},{"key":"2025121222084055000_12.3.e052474.10","unstructured":"French Agency for Food, Environmental and Occupational Health & Safety . Assessment of the health risks for professionals exposed to atypical working hours, especially night work. ANSES opinion. collective expert report. scientific edition, 2016."},{"key":"2025121222084055000_12.3.e052474.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-014-0934-9"},{"key":"2025121222084055000_12.3.e052474.12","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3337"},{"key":"2025121222084055000_12.3.e052474.13","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2006.026872"},{"key":"2025121222084055000_12.3.e052474.14","unstructured":"RCP . Physical and shift work during pregnancy: occupational aspects of management. A national guideline, 2009."},{"key":"2025121222084055000_12.3.e052474.15","unstructured":"Lafon D , Abadia G , Basile S , et al . Grossesse et travail. Quels sont les risques pour l\u2019enfant na\u00eetre ? Avis d\u2019experts [Internet]. Paris: EDP Scienc, 2010: 568. https:\/\/u-bordeaux-scholarvox-com.docelec.u-bordeaux.fr\/reader\/docid\/88802633\/page\/512?searchterm=Grossesse et travail"},{"key":"2025121222084055000_12.3.e052474.16","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2000.01567.x"},{"key":"2025121222084055000_12.3.e052474.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7001.376"},{"key":"2025121222084055000_12.3.e052474.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0215748","article-title":"Night work during pregnancy and preterm birth-A large register-based cohort study","volume":"14","author":"Specht","year":"2019","journal-title":"PLoS One"},{"key":"2025121222084055000_12.3.e052474.19","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e318253b192"},{"key":"2025121222084055000_12.3.e052474.20","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm171"},{"key":"2025121222084055000_12.3.e052474.21","unstructured":"Croteau A . Effets de la charge globale de travail sur La grossesse, synth\u00e8se syst\u00e9matique avec m\u00e9ta-analyse et m\u00e9ta-r\u00e9gression. Qu\u00e9bec, 2015."},{"key":"2025121222084055000_12.3.e052474.22","unstructured":"Croteau A . L\u2019horaire de travail et ses effets sur le r\u00e9sultat de la grossesse. M\u00e9ta-analyse et m\u00e9ta-r\u00e9gression [Internet]. Qu\u00e9bec: Inspq, 2007. https:\/\/www.google.com\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=2ahUKEwiwiKar-KHhAhUG1BoKHVyoAYgQFjAAegQIARAC&url=https%3A%2F%2Fwww.inspq.qc.ca%2Fpdf%2Fpublications%2F677-HoraireTravailGrossesse.pdf&usg=AOvVaw0AtfiwByHaZCNuzyX-w8ee"},{"key":"2025121222084055000_12.3.e052474.23","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1158\/1055-9965.936.13.6","article-title":"Epidemiology of urinary melatonin in women and its relation to other hormones and night work","volume":"13","author":"Schernhammer","year":"2004","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025121222084055000_12.3.e052474.24","first-page":"251","article-title":"Physiological effects of shift work on hospital nurses","volume":"30","author":"Yamauchi","year":"2001","journal-title":"J Hum Ergol"},{"key":"2025121222084055000_12.3.e052474.25","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt054"},{"key":"2025121222084055000_12.3.e052474.26","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105592"},{"key":"2025121222084055000_12.3.e052474.27","unstructured":"Yousuf M . The Delphi Technique. Essays in Education [Internet], 2007. Available: https:\/\/openriver.winona.edu\/eie\/vol20\/iss1\/8 [Accessed 26 Jun 2020]."},{"key":"2025121222084055000_12.3.e052474.28","unstructured":"Laughlin L . Maternity Leave and Employment Patterns of First-Time Mothers: 1961-2008 Current Population Reports [Internet], 2011. Available: www.census.gov\/population [Accessed 05 Dec 2020]."},{"key":"2025121222084055000_12.3.e052474.29","unstructured":"Groupe scientifique maternit\u00e9 et travail - INSPQ [Internet]. Available: https:\/\/www.inspq.qc.ca\/maternite-et-travail\/groupe-scientifique-maternite-et-travail [Accessed 03 Jul 2020]."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-052474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:08:49Z","timestamp":1765606129000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-052474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,8]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/bmjopen-2021-052474"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-052474","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}