According to a recent study conducted to identify the most common mechanisms and sites of injury associated with book backpacks in school-aged children, backpack injuries did not involve the back. Researchers from Bi-County Community Hospital, Michigan, USA studied children between 6 and 18 years old who were recorded in the NEISS (The National Electronic Injury Surveillance System) database with a backpack-related injury. One hundred emergency departments throughout the United States participate in NEISS data collection. Patients were identified by review of the NEISS data from 1999–2000 and separated by age, sex, location of injury, and mechanism of injury. There were 247 children with backpack injuries. The mean age was 11.8 years, and 50% were male. The most common injury location was the head/face followed by the hand, wrist/elbow, shoulder, and foot/ankle. The back ranked sixth. Of these back injuries, 59% were associated with carrying a backpack. The most common mechanism for injury was tripping over the backpack, followed by wearing, and getting hit by the backpack. Although the CPSC (Consumer Product Safety Commission) data on backpack injuries is frequently quoted in articles relating backpacks with back injury, 89% of backpack injuries in this study did not involve the back. The study does not support the hypothesis that back injury is the major problem with book backpacks in the emergency department setting.

Pediatrics January 2003, Vol. 111 (1)