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Date of filling in this questionnaire or last update: 17/01/2026
1. IDENTIFICATION & BASIC DESCRIPTION
Cohort name
  DOC*X
Country
 

  • Denmark
Name
  Esben Meulengracht Flachs
Institution
  Bispebjerg and Frederiksberg Hospital, University of Copenhagen
Email
  esben.meulengracht.flachs@regionh.dk
Do you want to add another Principal Investigator of the Cohort
 

  • Add another Principal Investigator of the cohort
Name
  Camilla Sandal Sejbæk
Institution
  Bispebjerg and Frederiksberg Hospital, University of Copenhagen
Email
  camilla.sandal.sejbaek@regionh.dk
Website
 

  • www.doc-x.dk
Name of committee
  Danish National Committee on Health Research Ethics
Or provide website
 

  • www.doc-x.dk
Contact Principal Investigator (name)
  Esben Meulengracht Flachs
Data access policy (briefly describe)
  Data is available through collaboration with a participating institution with affiliation to the Research Server at Statistics Denmark
Is this cohort part of a consortium? (name consortium)
  The European Occupational Exposome and Health Cohort Consortium
Participation in pooled analyses
 

  • The cohort is potentially interested in participating in pooled analyses of (European) occupational cohort studies (note pooled analyses also includes remote decentralized analyses that would not require any transfer of primary data as well as meta-analyses).
Main aim of cohort, please briefly describe the main objectives of the cohort
  A large nationwide database that can integrate prospective data on occupational exposures with data on health, work participation and labour market exit
Study design (please select as many as appropriate)
 

  • Prospective cohort
Source population (please select as many as appropriate)
 

  • General population: National
  • Mother-child cohort
  • Generation (parents-children) study
Comparators (please select as many as appropriate)
 

  • Internal study population
  • External comparison of workers with other exposure
Inclusion criteria
  Persons aged at least 16 years who were gainfully employed and living in Denmark in 1970 or from 1976 to 2022
Enrollment
  Ongoing
Age range at entry (main cohort)
 

Minimum Maximum Mean
16 105 35

Men at enrollment
  2,984,000
Women at enrollment
  2,414,000
Children (<18 years) at enrollment
  2,460,000
Men at last follow-up
  2,984,000
Women at last follow-up
  2,414,000
Children (<18 years) at last follow-up
  2,460,000
Participation rate at enrollment (if known)
  95
Comments
  In 2015 the cohort included 6,399,000 individuals - 2,984,000 men and 2,414,000 women.
JEM based exposures in the database:
- Psychosocial exposures (permission needed from JEM owners)
- Shoulder exposures (upper arm elevation, repetitive shoulder movements, forceful shoulder exertions)
- Lower body exposures (total load lifted, standing/walking, sitting, kneeling/squatting)
- Physical exertion and body position (score based on sitting, standing/walking, kneeling, repetition, twisted back, lifted arms, lifting/carrying, pushing/pulling)
- Noise
- Vibration
- Particulate airborne exposures (mineral dust, organic dust, fumes and vapour) (permission needed from JEM owners)
- Wood and endotoxin
- Chemical agents (permission needed from JEM owners)
- Lifestyle (tobacco smoking, body mass index, alcohol consumption, leisure-time physical activity, fruit/vegetables consumption)
- Wet hands and gloves
2. OUTCOME FOLLOW-UP
Type of data for outcome follow-up (please select as many as appropriate)
 

  • Death certificate
  • Disease incidence records
  • Hospital / physician diagnoses
  • Use of registers (specify)
Death certificate (specify)
 

  • Access to Cause of Death register
Disease incidence records (specify)
 

  • Access to the Danish Patient Registry
Hospital / Physician diagnoses (specify)
 

  • ICD-8 or ICD-10 codes
First follow-up period (provide year)
  1976
Last follow-up period (provide year)
  2022
Number of follow-ups after baseline (provide number)
  Once per year
Participation at last follow-up (if known)
  95
Comments
  The generational part of the DOC*X cohort, DO*X-G, contains:
Women with at least one pregnancy: 1,414,000
Men with at least one child: 1,244,305
3,433,000 pregnancy outcomes of women in the cohort, includes both induced and spontaneous abortions, still- and liveborn children.
3. OCCUPATIONAL EXPOSURES
Source of exposure data collected (please select as many as appropriate)
 

  • Job-employment records
Occupational history/time frame
  Follow-up period
Occupational coding performed
  Yes
Occupation (specify coding system used)
 

  • DISCO-88 (Danish version of ISCO-88)
Industry (specify coding system used)
 

  • DB-07 (Danish version of NACE v.2)
Methods for exposure assessment (please select as many as appropriate)
 

  • Job Exposure Matrix
 

  • ALOHA+ JEM
Please insert reference/further information
  Permission needed from owners
 

  • BEN-JEM
 

  • Endotoxin QJEM
 

  • Lifestyle JEM (DK)
 

  • Light JEM (DK)
 

  • NOCCA JEM
 

  • Noise JEM (DK)
 

  • Psyk JEM
 

  • SYN-JEM
 

  • Wood DUST QJEM
Main categories
 

  • Dusts and fibres
  • Solvents
  • Pesticides
  • Metals and metal oxides
  • Other chemicals
  • Biological factors
  • Ergonomics, physical workload, and injury related
  • Psychosocial domains
4. OUTCOMES EVALUATED
Baseline - type of outcome data collected (select more than one if applicable)
 

  • Death certificates
  • Medical records
  • Registry-based
Registry-based
 

  • Birth register
  • Disease specific clinical database
  • Hospital discharge
  • Mortality register
  • Migration
Follow-up - type of outcome data collected (select more than one if applicable)
 

  • Death certificates
  • Medical records
  • Registry-based
Registry-based
 

  • Birth register
  • Employment status
  • Hospital discharge
  • Mortality register
  • Migration
Outcome type (please select as many as appropriate)
 

  • Mortality
  • Morbidity
  • Disability
Diagnostic groups based on ICD10
 

  • A Bacterial infectious disease, type of microorganisms*
  • B Viral infections, type of microorganisms*
  • B99 Other and unspecified infectious diseases, type of microorganisms*
  • C + D Neoplasms
  • D Diseases of blood and blood-forming organs excl. leukemia
  • E Endocrinological disease
  • E Malnutrition and obesity
  • E Metabolism disease
  • F Mental disorders
  • G Disease in the nervous system
  • H Disorders of the eye
  • H Disorders of the ear
  • I Heart disease
  • I Cerebrovascular diseases
  • J Respiratory disease
  • K Diseases of oral cavity, salivary glands and jaws
  • K Diseases of oesophagus, stomach, duodenum and appendix
  • K Hernia, colon and intestine disease
  • K Diseases of peritoneum, liver
  • L Skin, nail and hair disorders
  • M Arthritis, arthrosis, systemic connective disorders, spine disorders
  • M Disorders of muscles, bones, synovialis, bursa, cartilage
  • N Kidney, renal pelvis disease
  • N Male and female related disorders
  • O+P Pregnancy and labour
  • Q After birth – child disorders
  • S Injuries
Other health related outcomes
 

  • Work participation
6. Other Information
 

  • Alcohol
  • Demographics
  • Diet
  • Education
  • Medical history
  • Physical exercise
  • Residential history
  • Socioeconomic status
  • Smoking
Possibility for linkage to data registries/data enrichment via data linkage
 

  • Birth register
  • Employment status
  • Hospital discharge
  • Migration
  • Mortality register
Please describe plans that are funded or most likely to be funded
  Exposure to air pollution
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