He may, but the injury isn't likely to be in the obvious place: his back. Rather, he's more likely to get hurt falling over a backpack than he is by carrying one, new research shows.
Surprisingly, carrying a backpack is not even a shoo-in for the second most common way to be hurt with a backpack. There are two sources vying for second place as the cause of backpack-related injuries. One is carrying the backpack, but being the victim of someone throwing one your way is just as likely to result in injury.
The researchers decided to study this issue because they realized that carrying a heavy backpack often made the news as a potential source of injury. In their experience in the emergency room and doctors' offices, however, "rarely were there ever any injuries to the back from the backpack," says one of the researchers, Dr. Brent Wiersema, a resident in orthopedics at the Bi-County Community Hospital in Warren, Mich.
In the January issue of Pediatrics, the researchers analyzed data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission National Injury Information Clearinghouse. All children aged 6 to 18 recorded as having an injury related to a backpack were included.
There were 247 children with backpack-related injuries in the data from 1999 to 2000.
Most injuries (28 percent) were due to tripping over a backpack, followed by wearing one (13 percent) and getting hit by one (also 13 percent). Other reasons for injury included being cut accidentally while reaching into the backpack.
Most common areas of injury related to the backpack were the head and face (22 percent), followed by the hand (14 percent), wrist or elbow (13 percent), shoulder (12 percent), and ankle or foot (12 percent).
Injuries to the back ranked only sixth, at 11 percent. However, when back injuries were reported, the majority of such injuries (58 percent) were related to carrying the backpack.
Since falling over a backpack was the main reason for backpack-related injury, the main parts of the body hurt by this kind of accident were the ankle and foot or wrist and elbow. Combined, those two areas accounted for one quarter of backpack-related injuries.
Children hit by a backpack were usually the intended victim of someone using their backpack as a weapon or throwing it around in play, and the face and head was the area most commonly injured by this type of assault.
"I think we anticipated that we would show the most common injury wasn't going to be the back," Wiersema says. They expected that the cause of backpack-related injuries wasn't going to be the result of carrying the backpack, either. "It was more children misbehaving, kids goofing around with the backpack," he says.
Dr. Ronald Maio is head of the injury research center at the University of Michigan Health System in Ann Arbor, and has worked in emergency rooms for more than 20 years. He cannot recall ever having seen an injury related to backpacks, but says this study suggests "wearing a backpack is not as harmful as we think."
He remembers being a student and trying to hit friends with his book bag, and, later, as a parent, frequently telling his own daughter to watch where she put her school bag, concerned that someone would trip over it.
"This study suggests that most acute injuries are not due to how the backpack is worn but other ways the backpack is used," Maio says. Wearing one "is not quite as dangerous as we think."
Teaching children how to carry a backpack correctly and to carry a lighter load than many do might reduce as much as 23 percent of the injuries in the study. However, the researchers say that telling them to leave their backpack in a safe place and not use it as a weapon could eliminate more than 40 percent of backpack-related injuries presenting in emergency departments.
"Time and energy shouldn't necessarily be on how to wear a backpack," Wiersema concludes, "but more on proper care. Where to set it and not to swing it."
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