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Backpacks represent a common consumer product in our modern school system. However, their use may not always be without some adverse health effects. Every year school age children make more than 10 000 backpack related office or emergency room visits in the United States. 1 In a study of 11-13 year old children, Pascoe et al showed that the daily physical stresses associated with carrying book bags on one shoulder significantly altered children's posture and gait. 2 While schoolchildren carry these heavy, one size fits all backpacks, it is uncertain that all the items would be needed on the days the backpacks are carried to school. Yet, one wonders how many parents ever take the time to check the weights or contents of these backpacks. We designed this study to assess parental knowledge of the weight and contents of their elementary schoolchild's backpack.
SUBJECTS AND METHODS
Subjects included 188 students in grades K-5 attending three elementary schools in Central Texas, who carried backpacks that weighed 10% or more of their body weights. The study was approved by our Institutional Review Board. Area school principals were contacted to solicit their school's participation. All students enrolled at three schools whose principals consented to participate by approval letters were included. However, only 4th and 5th graders participated in school B. Of 1327 students enrolled in the three schools, parents of 745 (56.1%) provided written consent. Data were collected on predesignated days blinded to the students.
The weight and height of each child, who returned a written parental consent, were determined along with their backpack weight, demographic data, and type of backpack. Students whose backpacks weighed 10% or more of their body weights were surveyed further to obtain additional information, including backpack contents and whether any parent had ever weighed their backpack or checked its contents. To assure quality, the survey instrument was pretested, only calibrated...