Objectives This study explored the association between biomarkers of type I collagen metabolism and exposure to physical workload. Methods In a prospective cohort study, serum concentrations of markers of type I collagen synthesis and degradation were assessed monthly for student nurses who worked as nurses for a period of 6 months and compared with those of a reference group. The number of patient-handling activities was estimated from observations at the workplace. Linear generalized

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... g equations were used to analyze differences in the serum concentrations of the biomarkers between the exposed group and reference group, as well as to analyze whether the number of patient-handling activities was associated with serum concentrations of the biomarkers. Results Serum concentrations of the biomarkers were found to differ between the groups. The biomarkers reflected a higher anabolism of type I collagen in the exposed group when compared with that of the reference group. An analysis of the effect of the number of patient-handling activities revealed that a higher exposure was associated with higher effective type I collagen synthesis within the exposed group. Conclusions These results indicate that serum concentrations of these biomarkers of type I collagen metabolism can reflect differences in exposure between contrasting groups, and also varying levels of exposure between persons within an occupation.