Jan. 23, 2002 -- Concerns about children's backpacks are gaining new weight in the wake of the death of a child in Hong Kong, a parents' crusade for school involvement, and the call for a ban by a leading orthopedic researcher.
The issue took a a tragic twist in Hong Kong, where earlier this month a 9-year old boy fell 20 floors to his death after his heavy backpack pulled him over the safety rail of a building. Officials suspect the bag moved forward as the boy leaned to look at something, pushing him over the railing.
And physicians say they are beginning to see some symptoms of back problems stemming from carrying heavy packs.
For example, a study in the January issue of the journal Spine shows that carrying backpacks that weigh an average of 20 pounds is likely to cause back pain in children.
Pain in the Back
Dr. Lonnie Zeltzer, director of the pediatric pain program at UCLA, has treated a growing number of children with symptoms such as back, neck, shoulder and head pain caused by carrying heavy backpacks.
"I don't think the backpacks are causing permanent damage, but they place a strain on certain muscles that cause kids to hold their bodies in certain ways and creates muscle and ligament pain," Zeltzer says.
Other experts even speculate that carrying heavy packs may increase a child's risk of developing spinal disorders, though more research is needed.
"This is a very important area to study. These children may be causing some increased risks of arthritis to their backs, but this has not been conclusively proven," says Dr. Jeffrey Wang, chief of the spine service at UCLA.
Dr. Jonathan Schaffer, an orthopaedic surgeon at the Cleveland Clinic Foundation, also points out that previous studies have shown that children's hearts and lungs can be affected by the weight of the backpack. His own daughter's backpack weighed in at around 45 pounds recently.
More and more parents and medical researchers are now seeking solutions to the problem of young children doing potentially permanent damage to their spines by carrying overloaded backpacks.
In fact, one man has made it his mission to lighten the load that kids are carrying. With the support of the local school board, Mark Lorenzoni, a father of four from Charlottesville, Va., has started a task force to address the backpack issue.
"This all started when I went to move my fifth grader's backpack off the floor one night," he explains. "I kicked it and it barely moved, it was so heavy. My son was 60 pounds at the time, and his backpack weighed 20 pounds. Backpacks should only weigh 10 to 15 percent of a child's weight."
The Charlottesville task force has suggested implementing a five-minute "backpack planning period" for younger students before the final school bell sounds, which would help kids reduce the weight of their backpacks before sending them home. They also recommend schools provide students with two sets of textbooks, one that stays at home and the other that is kept in the classroom.
Placerita Junior High School in Newhall, Calif., has already implemented such a program. The school's principal, Rob Gapper, recently weighed the backpacks of two students, and was surprised by what he found.
"It's incredible how much things weigh, I had no idea. The student planner alone weighs a pound. I was amazed that just a notebook weighs anywhere from a half a pound to three quarters of a pound," he says.
Jody Liss-Monteleone, a counselor at the school, says even without textbooks, many of the backpacks are still too heavy.
"The backpacks seemed to be about 11 to 15 pounds, without textbooks, which is fine unless you're an 86 pound girl. The multiple notebooks, the gym clothes, the lunch, and various other supplies create a heavy backpack."
Some go so far as to suggest we find a way to get rid of backpacks altogether.
"I think it is important that schools work out ways to substitute electronic access to resource information and to arrange schedules so that the weights carried throughout the day are smaller," argues Dr. Donlin Long of Johns Hopkins, a leader in the field of back pain and founding editor of Spine.
Another, less drastic, way to prevent aching backs could be for children to use backpacks on wheels. But some say this alternative carries with it a lot of baggage.
"The rolling backpacks solve the weight issue, but they are difficult to maneuver in crowded hallways, says Monteleone. "Also, in many schools, they are 'uncool' and most students would rather injure their backs than be seen as 'uncool.'"
If your child must carry a heavy pack, experts say even the simplest advice could help ease the burden.
"When shopping for a backpack, choose one that is comfortable and the correct size for your child," advises Dr. Bernard Pfiefer, an orthopedist at the Lahey Clinic in Burlington, Mass. "Make sure the pack has padded shoulder straps and a hip belt for support."
And teach your kids how to handle the weight properly.
"To pick up a heavy pack safely," Pfiefer adds, "place it on the table or desk with the shoulder straps on top. Face backwards, bend the knees, and then lift the pack up onto your back."