Aim: The aims of this paper were: to establish the efficacy of an educational intervention in reducing school backpack weight and, possibly, back pain; to verify the content of backpacks and the social importance of the problem; to confirm existing data in the literature.
Design: controlled prospective educational intervention.
Participants: the entire Year 6 population (402 pupils) of 2 randomly chosen rural school districts of the province of Mantua (Italy); of these, we took 108 (selected according to position in the class register): 82.4% completed the study; 402 parents and 124 teachers entered the study, 77.1% and 37.1% respectively completed it.
Intervention: instructive meeting and written material for teachers, and a leaflet for parents on backpack management.
Main outcome measures: backpack weight and content; back pain; subjective perceptions of backpack load; packing and carrying methods; backpack load: importance, management and education; backpack characteristics.
Results: We obtained a statistically significant reduction in the backpack weight in each of the groups (study 11.2%; control 7.9% - not a statistically significant difference); 90.1% of the material carried is necessary. Backpacks are considered a problem by 95.1% of parents, 73% of teachers, and 60.3% of pupils. Backpack weight: 8.75+/-1.26 kg (19.9+/-5.3% of body weight); fatigue during backpack carrying: 72.7%; back pain life prevalence: 58.4%; fatigue during backpack carrying and considering backpacks a problem were associated with back pain (odds ratios 4.4 and 5).
Conclusions: Educational intervention is not the answer to the problem and solutions, like the clear legal limits established for adults, need to be found.