In Hong Kong recently, 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 over to look at something, pushing him over the railing.

Physicians say they are beginning to see symptoms of back problems in kids, caused by heavy backpacks. 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.

Dr. Lonnie Zeltzer, director of the pediatric pain program at UCLA, has treated a 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,? he says.

Other experts say that carrying heavy packs may increase a child?s risk of developing spinal disorders. ?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, says previous studies have shown that children?s hearts and lungs can be affected by the weight of the backpack. He checked his daughter?s backpack and found it weighed 45 pounds.

Mark Lorenzoni, a father of four from Charlottesville, Virginia, has started a task force that has suggested implementing a five-minute ?backpack planning period? for younger students before the final school bell, 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. ?This all started when I went to move my fifth grader?s backpack off the floor one night,? he says. ?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.?

Placerita Junior High School in Newhall, Calif., already has such a program. It started when Rob Gapper, the principal, weighed the backpacks of two students. ?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 critics say we should 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,? says Dr. Donlin Long of Johns Hopkins, a leader in the field of back pain.

Kids could also put their backpacks on wheels. ?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.??

?When shopping for a backpack, choose one that is comfortable and the correct size for your child,? says 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. To pick up a heavy pack safely, 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.?

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