Is school furniture design a contributing factor to low back pain in adolescents?

Abstract

Abstract Background Recent evidence showed that low back pain (LBP) is frequent among youth. Individual etiologic factors are most often associated with musculoskeletal overuse and altered postural control. This study aimed to evaluate the association between school furniture design and LBP in school-adolescents. Methods A cross-sectional study was conducted using a self-reported questionnaire distributed to school-adolescents aged 12-18 years, in Southern Tunisia, 2018. We performed a stratified three-step sample to obtain a representative sample of 1400 subjects. Results The response rate was 87.2% (1221 students). The mean schoolbag weight was 3±1.3 kg. The schoolbag to body weight ratio was 0.05±0.03. The main method of carrying a schoolbag was on both shoulders (57.2%). During the last 3 months, LBP was reported in 391 cases (32%). Multivariate analysis using logistic regression showed that high-school grade was independently associated with LBP (Adjusted Odds Ratio (AOR)=2.7;95% CI = [1.9-3.7];p<0.001). Classroom furniture and layout design independently associated with LBP included too low seat backrest (AOR=1.4;95% CI = [1.12-1.87];p=0.005), too far seat to black(board) distance (AOR=1.5;95% CI = [1.1-2.2];p=0.041), schoolbag to body weight ratio ≥10% (AOR=1.7;95% CI = [1.2-2.4]; p = 0.002) and carrying schoolbag for 30-60 minutes (AOR=1.48;95% CI = [1.1-2.1]; p = 0.029). Otherwise, carrying school bag by hand (AOR=0.25; 95% CI = [0.07-0.89]; p = 0.033) was found to be independently associated with lower prevalence of LBP complaints. Conclusions Current design of school furniture is not compatible with the adequate purposed dimensions in students. It increased substantially the risk of LBP, which emphasizes the need for multi-disciplinary approach involving teachers, policy makers and health care professionals. Key messages School related LBP may threaten the physical performance and the social life of adolescents. Revising school environments and radical ergonomic interventions are mandatory.