title: Children at risk: risk factors for low back pain in the elementary school environment.
abstract: METHODS
  A prevalence survey of 101 randomly selected elementary schools in the Israel Central District.
  
  
  OBJECTIVE
  To identify and describe risk factors for low back pain that exist in the elementary school environment.
  
  
  BACKGROUND
  Recent surveys report a high prevalence of low back pain in children and adolescents that increases with age, with a correlation between low back pain in adolescence and that experienced in adulthood. Environmental risk factors have been associated with the development of low back pain in children. Because of the significant amount of time children spend in their school environment, risk factors need to be identified in this environment.
  
  
  METHODS
  A questionnaire, completed by school nurses, measured risk factors among 10,000 children in elementary schools in Israel. These included backpack and student weight, the availability of storage facilities, the appropriateness of chair and desk height to student height, seating arrangements during frontal lessons, and physical activity at recess.
  
  
  RESULTS
  Between 30% and 54% of students carried >15% of their body weight. Nearly 15% of the first graders and 20% of sixth graders had inappropriate chairs. In 74% of the classes, students sat with their side facing the teacher and in 35% students sat with their backs. In 6% of schools, no physical activity is offered at recess.
  
  
  CONCLUSIONS
  Shortcomings were found in all areas investigated. There is an urgent need for health promotion programs to increase awareness and reduce risks in the school environment.
authors.affiliation: Petach Tikva Area Ministry of Health, Petach Tikva, Israel. limonfamily@hotmail.com
authors.forename: Susan
authors.initials: S
authors.lastname: Limon
authors.forename: Liora J
authors.initials: LJ
authors.lastname: Valinsky
authors.forename: Yael
authors.initials: Y
authors.lastname: Ben-Shalom
mesh_terms: D001835:Body Weight; D002648:Child; D006804:Ergonomics; D005260:Female; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D007374:Interior Design and Furnishings; D007557:Israel; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D009043:Motor Activity; D011187:Posture; D015995:Prevalence; D012307:Risk Factors; D012574:Schools / Q000145:classification / Q000706:statistics & numerical data*; D013334:Students; D011795:Surveys and Questionnaires; D016474:Weight-Bearing