Ibrahim Hasan Mustafa, Sangar Muhammad Ahmed, Jawdat Mamand Alhagbaker, Namir Al-Tawil


Background: A heavy schoolbag is one of the most common health problems worldwide among school aged children. Frequently using the heavy schoolbag and using it incorrectly during school days may cause risk of musculoskeletal symptoms (involving pains in neck, both shoulders, back, waist, elbow, hand and wrist, thigh, knee, and foot), and can be a risk factor for other health problems including a change in body posture and spinal cord deformity. The study objectives were to investigate the association between the weight of schoolbags and the occurrence of neck, lower back, and shoulders and hand/wrist symptoms among primary school children.

Material & Methods: A descriptive (cross-sectional) design was carried out in public schools in Erbil city, during the academic year 2022-2023. Epi Info 7 (produced by CDC) computer program was used for sample size estimation. The sample involved 624 students aged 6 to 12 years from 12 primary schools in Erbil city.

Results: The majority (79.6%) of the students were using risky (heavy) weight schoolbag. The prevalence of pain (in one or more sites) was 41.3%. There was significant association between prevalence of pain and hand type of schoolbag (p=0.022), weight of bag (p=0.011), and ratio of weight of bag/body weight of more than 10% (p=0.020). Prevalence of pain was higher among students aged ≥10 years, who were using hand type bag, and who used to carry risky weight bag. Regression analysis showed that the following factors were associated with pain: age (≥10 years), lifting heavy weight, not practicing exercise.

Conclusion: In conclusion the prevalence of Musculo-skeletal pain was relatively high, which was multi-factorial.


Primary school student; Schoolbag weight; Back pain; Musculoskeletal; Children back pain.

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