title: Prevalence and associated factors for thoracic spine pain in the adult working population: a literature review.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Physiotherapy, Curtin University of Technology, Perth, Australia.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Briggs
authors.forename: Peter
authors.initials: P
authors.lastname: Bragge
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Smith
authors.forename: Dhruv
authors.initials: D
authors.lastname: Govil
authors.forename: Leon M
authors.initials: LM
authors.lastname: Straker