Back pain arising from schoolbag usage among primary schoolchildren

• Primary schoolchildren's responses about back pain from surveys are reliable.
• Reliability of children's responses is not significantly associated with age.
• Prepubescent children's awareness about back pain increases with age.
• Heavy schoolbags affect children's posture, physiology and perception of pain.
• Younger children are more exposed to back pain from backpack usage.

This study employed multifactorial variables to determine the effect of schoolbag weight on the occurrence of back pain among primary schoolchildren and also determined the reliability and factorability of their survey responses. A total of 615 prepubescent children aged between 7 and 12 years with a boy to girl ratio of 2:3 participated in the study. Of these children, 205 were also selected for a test–retest to determine the reliability of the questionnaire. The kappa coefficient was used to analyze dichotomous and nominal variables, and the intraclass correlation coefficient (ICC) was used for the categorical variables. Correlation techniques were also used to investigate backpack-induced back pain problems. The test–retest revealed that dichotomous and demographic (k = 0.7–1.0), psychosocial perception of pain (ICC = 0.6–0.72) and backpack culture (ICC = 0.6–0.78) variables all demonstrated good and high reliability. Variables associated with multiple responses, however, recorded low reliability value. The exploratory factor analysis also reveals six factors, of which only psychosocial perception of pain, individual rating ability and backpack culture accounted for more than 70% of the variance explained during the analysis. Both the subjective and objective variables revealed the significant effect of the children's heavy bag on their degree of feeling back pain (F(2,612) = 3.72, p = 0.02), neck inclination (F(2,166.15) = 54.8, p < 0.0001), back inclination (F(2,183.9) = 60.92, p < 0.0001), pulse rate (F(2,155.31) = 4.07, p = 0.019) and saturated oxygen (F(2,152.83) = 5.95, p = 0.003) were significantly associated with the weight of their schoolbags. The significant effect of age was also identified as the measuring variables were all negatively correlated with the children's age. Backpack–back pain intervention and awareness are still needed especially among the younger primary schoolchildren who are at greater risk of back pain from backpack usage.Relevance to industryThis research demonstrated that information about prepubescent children's perception and rating of pain are equally reliable as other objective measuring instruments. Younger children who carry greater loads face greater risk of back pain than older children.