Child Health

Backpack Injuries In Children—Not What You May Think

Do Night Lights Cause Nearsightedness?

Backpack Injuries In Children—Not What You May Think

Backpacks have become the major way children carry books and other items to and around school, and there has been growing concern among health care professionals, parents, and educators that backpacks may injure the growing child’s back. Even though many orthopedic surgeons report seeing very few children who have back pain due specifically to backpacks, many people cite federal data that describe frequent injuries associated with backpacks. Indeed, in 1999 and 2000, the U.S. Consumer Product Safety Commission (CPSC) reported that backpacks were associated with over 12,000 injuries. However, pediatric orthopedic surgeons in Michigan and Ohio had seen very few acute back injuries in children that seemed to be caused by backpacks, so they decided to carefully study just what kind of injuries the CPSC had in its files.

When the researchers excluded injuries from infant carriers and camping backpacks, and then looked only at school-age children (ages 6-18 years), the more than 12,000 reports came down to 247. They then examined these in detail, and instead of finding back injury to be the most common problem blamed on school-type backpacks, the authors found that these injuries accounted for only 11% of the total. The other 89% of backpack injuries involved other parts of the body, most often the head or face followed by hand, wrist or elbow, shoulder, and foot or ankle.

Rather than backpacks injuring children’s backs from excessive weight putting strain on their backs, the CPSC data revealed that the most common way injuries occurred was from tripping over the backpack or being hit with it (often when it was being used as a weapon). Even among back injuries, only 59% were blamed on actually carrying a backpack. The authors urge that "public health officials should expand their backpack safety initiatives to cover injuries caused by tripping over a backpack and being hit by a backpack." (Weirsema BM et al: Pediatrics, January, 2003, pp. 163-166)

COMMENT: We admit to being surprised by these results, since we—like many others—have become very concerned about the extreme weight that many children carry around to and from school and between classes. Carrying heavy weight might be more likely to cause chronic back problems, not the kinds of acute back injuries that the CPSC study collected, so the case might not be closed on whether carrying heavy packs is bad for children’s backs. On the other hand, this new report does provide convincing evidence that backpacks can be harmful to children in ways that most of us hadn’t considered.

Web Resource: For handouts on backpack safety, see http://www. sesameworkshop.org/parents/advice/article.php?contentId=64101, and http://www.aap.org/advocacy/releases/septschool.htm. r

Do Night Lights Cause Nearsightedness?

Last May, researchers from the University of Pennsylvania found that myopia (nearsightedness) was more common among children who slept with a night light on than it was among children who slept in the dark. Though these researchers acknowledged that there were problems with their study, they nonetheless urged that "infants and young children (should) sleep at night without artificial lightng in the bedroom, while the present findings are evaluated more comprehensively." Two other studies have done just that, and it appears that the alarm created by the Pennsylvania report was probably unnecessary.

One study involved 1,220 children of various ethnic groups. The researchers looked at what percent of children had myopia according to whether they slept in the dark, slept with a nightlight before age two, or slept with full room lights on. They found that myopia was no more common among the night light or full-light group than it was in the group that slept in the dark, and they conclude that "our results indicate that myopia is unlikely to develop in children as a result of exposure to night-time lighting as infants." (Zadnik K et al: Nature, March 9, 2000, pp. 143-144)

In a second report, researchers studied 223 subjects whose average age was 11 years; they asked their parents about whether the children used night lights as infants, and they, too, found no differences in the frequency of myopia according to whether a night light had been used. (Gwiazda J et al: Nature, March 9, 2000, p.144)

COMMENT. The report of almost a year ago raised concern among a lot of parents, and the results of the newer studies are most welcome. Unfortunately, the first study was not well done and the authors too quickly assumed that night lights caused myopia and then recommended that parents change behaviors without waiting until their results could be evaluated by others. This experience reinforces the view that a single study's results should almost never be taken as fact, and before we change behaviors we need to see that early findings are proven correct.© April 2000 Child Health Alert