{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:04:03Z","timestamp":1767650643501,"version":"3.40.5"},"reference-count":17,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,1,1]]},"abstract":"<jats:p>Objective. To identify the most common mechanisms and sites of injury associated with book backpacks in school-aged children, who present to the emergency department. This should help with the development of backpack injury prevention strategies.<\/jats:p><jats:p>Design. A descriptive analysis of The National Electronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission (CPSC) National Injury Information Clearinghouse data on backpacks.<\/jats:p><jats:p>Setting. One hundred emergency department departments throughout the United States that participate in NEISS data collection served as the setting.<\/jats:p><jats:p>Participants. All children between 6 and 18 years old who were recorded in the NEISS database with a backpack-related injury were studied.<\/jats:p><jats:p>Methods. Patients were identified by review of the NEISS data from 1999\u20132000. We separated patient data by age, sex, location of injury, and mechanism of injury.<\/jats:p><jats:p>Results. 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 (22%) followed by the hand (14%), wrist\/elbow (13%), shoulder (12%), and foot\/ankle (12%). The back ranked sixth (11%). Of these back injuries, 59% were associated with carrying a backpack. The most common mechanism for injury was tripping over the backpack (28%), followed by wearing (13%), and getting hit by the backpack (13%).<\/jats:p><jats:p>Conclusions. Although the CPSC data on backpack injuries is frequently quoted in articles relating backpacks with back injury, 89% of backpack injuries in our study do not involve the back. Our study does not support the hypothesis that back injury is the major problem with book backpacks in the emergency department setting.<\/jats:p>","DOI":"10.1542\/peds.111.1.163","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"163-166","source":"Crossref","is-referenced-by-count":25,"title":["Acute Backpack Injuries in Children"],"prefix":"10.1542","volume":"111","author":[{"given":"Brent M.","family":"Wiersema","sequence":"first","affiliation":[{"name":"Bi-County Community Hospital, Department of Orthopaedic Surgery, Warren, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Wall","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital, Department of Pediatric Orthopaedic Surgery, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L.","family":"Foad","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital, Department of Pediatric Orthopaedic Surgery, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2003,1,1]]},"reference":[{"key":"2021120821110014500_R1","doi-asserted-by":"crossref","unstructured":"Iyer SR. Musculoskeletal pain in school children. In: Proceedings of the International Ergonomics Association 2000; Human Factors Ergonomics Society; Congress, pp. 5.419\u20135.422. Washington, DC: 2000","DOI":"10.1177\/154193120004403005"},{"key":"2021120821110014500_R2","unstructured":"Smith I. Schooling on backpacks. Time.2001158"},{"key":"2021120821110014500_R3","unstructured":"Kids and backpacks. Available at: www.aaos.org Accessed August 12, 2002"},{"key":"2021120821110014500_R4","doi-asserted-by":"crossref","unstructured":"Troussier B, Davoine P, de Gaudemaris R, Fauconnier J, Phelip X. Back pain in school children. A study among 1178 pupils. Scand J Rehabil Med.1994;26:143\u2013146","DOI":"10.2340\/165019771994263143146"},{"key":"2021120821110014500_R5","unstructured":"Spears JD, Wall EJ, Mehlman CT, Crawford AH. Backpacks and back pain: where\u2019s the epidemic? Presented at the American Academy of Pediatrics Annual Meeting; October 20\u201324, 2001; San Francisco, CA. J Pediatr Orthop.In press"},{"key":"2021120821110014500_R6","doi-asserted-by":"crossref","unstructured":"Grimmer K, Williams M. Gender-age environmental associates of adolescent low back pain. Appl Ergon.2000;31:343\u2013360","DOI":"10.1016\/S0003-6870(00)00002-8"},{"key":"2021120821110014500_R7","unstructured":"Kruse RW, Sheir-Neiss GI, Rahman T, Jacobsen L, Pelli J. Backpack use as a risk factor in children\u2019s back pain. Presented at the American Academy of Orthopaedic Surgeons Annual Meeting; 2002; Dallas, TX. Poster No. 264"},{"key":"2021120821110014500_R8","unstructured":"Skaags DL, D\u2019Ambra P, Early SD, Tolo VT. Association of backpack and scoliosis with carrying a backpack in 1,020 children. Presented at the Scoliosis Research Society Annual Meeting; September 18\u201321, 2000; Cairnes, Australia. Paper No. 47"},{"key":"2021120821110014500_R9","unstructured":"Skaags DL, Early SD, D\u2019Ambra P, Tolo VT. The association of back pain and carrying a backpack in school children. Presented at the Pediatric Orthopaedic Society of North America Annual Meeting; May 2\u20135, 2001; Cancun, Mexico. Paper No. 21"},{"key":"2021120821110014500_R10","unstructured":"Viry P, Creveuil C, Marcelli, C. Nonspecific back pain in children. A search for associated factors in 14-year-old schoolchildren. Rev Rhum Engl Ed.1999;66:381\u2013388"},{"key":"2021120821110014500_R11","unstructured":"National Electronic Injury Surveillance System. Washington, DC: US Consumer Product Safety Commission; 2000"},{"key":"2021120821110014500_R12","unstructured":"National Electronic Injury Surveillance System. Washington, DC: US Consumer Reports Product Safety Commission; 2001"},{"key":"2021120821110014500_R13","unstructured":"Backpacks on a roll. Available at: http:\/\/www.consumerreports.com Accessed August 12, 2002"},{"key":"2021120821110014500_R14","unstructured":"National Electronic Injury Information Clearinghouse Reported Incidents: Book Bags or Bag Carriers: 1999\u20132000. Washington, DC: US Consumer Product Safety Commission; 2001"},{"key":"2021120821110014500_R15","doi-asserted-by":"crossref","unstructured":"Pascoe DD, Pascoe DE, Wang YT, Shim DM. Kim CK. Influence of carrying book bags on gait cycle and posture of youths. Ergonomics.1997;40:631\u2013641","DOI":"10.1080\/001401397187928"},{"key":"2021120821110014500_R16","doi-asserted-by":"crossref","unstructured":"Whitfield J, Legg S, Hedderley D. The weight and use of schoolbags in New Zealand secondary schools. Ergonomics.2001;44:819\u2013824","DOI":"10.1080\/00140130117881"},{"key":"2021120821110014500_R17","doi-asserted-by":"crossref","unstructured":"Vacheron JJ, Poumarat G, Chandezon R, Vanneuville G. The effect of loads carried on the shoulders. 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