This fall, more than 40 million American school children will once again be carrying heavy loads back and forth to school each day. Experts say about half these kids will be carrying too much weight. The result could be a lifetime of chronic back, neck and shoulder pain stemming from carrying too much, too young. But according to experts, the issue is more than just backpacks—it's school ergonomics and the impact that ill-conceived physical environments in schools are having on the physical health of our kids. Julee Newberger interviewed Karen Jacobs, past president of the American Occupational Therapy Association and Boston University professor.

Audio Excerpt Karen Jacobs describes the field of occupational therapy. [1] (:26) Need Real Player [2]?

The American Occupational Therapy Association is sponsoring a day of awareness about the dangers of heavy backpacks. Why are children's backpacks a cause for concern?

The backpack is really the tip of the iceberg. We're concerned about ergonomics and youth in general. We see a trend in kids complaining about musculoskeletal problems such as, my shoulders hurt, my neck hurts, my back hurts, and if we look at tasks that children do during the day, they're carrying their backpacks to and from school, they're sitting at a desk with a typical static posture, they're in front of computers at school and at home. But we're starting here because we can all relate to children carrying backpacks.

What are some alternatives to kids carrying heavy books to and from school?

One possible solution is for teachers to talk to each other about when they give their assignments. We're not as worried with elementary school because we see that children are in typically the same classroom, and we don't see books as heavy and large in elementary school as we do in middle school. Say the middle school teacher in math talks to the social studies teacher and the science teacher, who all have very heavy books, and they decide that Monday social studies will give homework using the text book, and Wednesday it might be math, so that all the text books are not always going home together. Another is scanning pages and putting homework assignments online. Now we do know that not every child can get online, but libraries have computers too and children may use that as an alternative as well. E-books are another solution. Books on CD-ROM as well.

Audio Excerpt

More from Karen Jacobs about books on CD-ROM. [3] (:28) Need Real Player [4]?

For a child that has to take home a few heavy books, we tell them to put that heaviest book closest to their back, so they're packing and carrying a backpack with a better distribution of weight. And there's nothing wrong with taking out that second heavy book and carrying it in front of you, cradling it ... Wheeled backpacks are another alternative.

How can parents help?

The key thing that we tell parents is to take back the control in the selection of a backpack and how you wear it. Work with your child. Check what's inside that backpack. Do they need to take five gallons of water with them? It's not like they're going to a desert island every day. Do they need that heavy stuffed animal or their CD player? There are issues that can be easily addressed. It's really being more active in our children's lives, which is what we should do anyhow.

What type of activities do you have planned for National Backpack Awareness Day?

Right now we have 65 events around the U.S. in 25 states and it is growing daily. In some cases it's individual classrooms, in some it's whole schools, some in community centers and YMCAs [Occupational therapists] will be setting up scales, and the children will put their backpacks on the scales in the morning and at the end of day (because backpacks are typically loaded at that time). They'll weigh the backpack, record it on a piece of paper, and then they'll weigh themselves to determine the percentage of that backpack to their body weight. We highly recommend that a backpack be no more than 15 percent of child's body weight. We've invited parents and teachers to come to different events where we'll go over better awareness of wearing a backpack.

What are some of the issues you see with ergonomics in schools?

Many schools buy one size chair and one size desk. It's okay if you're that average person that chair was designed for but if you're short, it's uncomfortable. We're making suggestions of how to make a better match between the tasks and the tools kids use in their daily activities. So instead of having a child's feet dangling, get an old copy of the Yellow Pages and use it as a footrest. Get a towel and roll it so that you have a little lumbar support ... Schools could consider getting adjustable chairs and desks, desks and chairs in different sizes, or consider raising and lowering them.

I love technology, and I think it's great that schools are making a commitment to getting computers, but they have to also think about where the computer goes and where the kids are sitting. If they can afford to make any investment at all, I ask them to get adjustable keyboard trays. Research shows that if you put the tray in a negative tilt about 7 - 15 degrees, that tilt keeps wrist in neutral position, which helps prevent carpal tunnel.

What about in the home?

The solutions that I mentioned can be easily applied in the home environment, being very mindful of a couple of things. One is, as a parent bringing a computer into the home, they need to make a commitment to be in charge of the computer. Don't put it up in your kids' bedroom. Put it in a space that can be easily monitored, where you can walk by and see what your kids are doing—your kitchen, your family room—somewhere you can say, hey John, you've been on for a long time, take a break. Or Sally, your brother was just there, he's so much taller than you, why don't you think about lowering the monitor.

In the home environment, where there are multiple users, I'd suggest parents get an adjustable chair if possible, and a keyboard tray. I think that all parents care about their kids and they want to do right by them. And schools care about kids' that's their business and so it's just working together, looking at the occupational therapists as their resource.

Learn more about National Backpack Awareness Day and school ergonomics from the American Occupational Therapy Association [5].

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Julee Newberger is a former managing editor of Connect for Kids.