Briggs Andrew M, Bragge Peter, Smith Anne J, Govil Dhruv, Straker Leon M
School of Physiotherapy, Curtin University of Technology, Perth, Australia.
J Occup Health. 2009;51(3):177-92. doi: 10.1539/joh.k8007. Epub 2009 Apr 1.
Spinal pain is a significant occupational health issue. Whilst neck pain and low back pain have received considerable attention, thoracic spinal pain (TSP) has not. The objective of this study was to systematically identify and report the evidence describing the prevalence and correlates of TSP within occupational groups.
This literature review systematically searched for reports of TSP prevalence and associated factors for TSP in working adult cohorts using nine electronic databases. Studies were evaluated for level of evidence and epidemiologic data were narratively synthesised.
52 studies were identified describing 65 cohorts covering manual labourers, office workers, health professionals, manufacturing and industrial workers, drivers, military personnel and performing artists. Prevalence varied with occupational group and time period. One year prevalence of TSP ranged from 3.0-55.0%, with most occupational groups having medians around 30%. Significant odds ratios for individual (concurrent musculoskeletal disorders, exercising, pre-menstrual tension and female gender), general work-related (high work load, high work intensity, perceiving ergonomic problems in the workplace, working in some specialised areas, performing boring/tedious work tasks, certain year levels of study, employment duration, driving specialised vehicles, and a high number of flying hours), physical work-related (manual physiotherapy tasks, climbing stairs and high physical stress) and psychosocial work-related (perceived risk of injury and high mental pressure) factors were reported.
The high median prevalence rates suggest TSP may be a significant occupational health problem. The multiple domains of associated factors point to the need for prospective research encompassing these domains to inform targeted occupational interventions.
脊柱疼痛是一个重大的职业健康问题。虽然颈部疼痛和下背部疼痛已受到相当多的关注,但胸椎疼痛(TSP)却未得到重视。本研究的目的是系统地识别和报告描述职业群体中TSP患病率及其相关因素的证据。
本系统文献综述使用九个电子数据库,系统检索了在职成年人群中TSP患病率及相关因素的报告。对研究的证据水平进行评估,并对流行病学数据进行叙述性综合分析。
共识别出52项研究,描述了65个队列,涵盖体力劳动者、办公室职员、卫生专业人员、制造业和产业工人、司机、军事人员和表演艺术家。患病率因职业群体和时间段而异。TSP的一年患病率在3.0%-55.0%之间,大多数职业群体的中位数约为30%。报告了个体(并发肌肉骨骼疾病、运动、经前紧张和女性性别)、一般工作相关(高工作负荷、高工作强度、感知工作场所的人体工程学问题、在某些特定领域工作、执行枯燥/繁琐的工作任务、特定学年水平、就业时长、驾驶特种车辆以及飞行小时数较多)、体力工作相关(手动物理治疗任务、爬楼梯和高体力压力)和心理社会工作相关(感知受伤风险和高精神压力)因素的显著优势比。
较高的中位数患病率表明TSP可能是一个重大的职业健康问题。相关因素的多个领域表明需要进行前瞻性研究,涵盖这些领域以为有针对性的职业干预提供依据。