School bags - health issue

By Edward Arambewala

Daily News online edition: http://www.dailynews.lk/2011/01/10/fea29.asp

An epidemiological research was carried out in a representative district of Sri Lanka with the participation of 1,607 school children on Ergonomic factors in the educational environment and their influence on school-going early adolescents.

This was stated by Family Health Bureau Health Schoolbag project coordinator and Consultant community physician Dr Kapila Jayaratne when speaking to Daily News Health Watch.

Research findings

Many children experienced discomfort due to sub-standard seating arrangements in the classroom. A significant proportion had to turn their necks to see the blackboard. Seating locations were not changed for many children.

There is wide-spread incompatibilities of classroom furniture with anthropometric dimensions of children Majority of children perceived discomfort due to mismatched furniture There were gross deficiencies with regard to carrying school bags. Deficiencies were noted in weight, model, ergonomic features and the carrying behaviour.

Children experienced several negative effects, such as muscular-skeletal pain, attributable to mismatched ergonomic factors Research outcomes further revealed that a majority of children carried bags with unhealthy features and they were too heavy according to international standards. Text books and other writing books accounted for more than two thirds of the school bag weight. Bag behaviour was not healthy. Many children reported negative health consequences. It is evident that a 'big health issue' exists in Sri Lankan schools with regard to carriage of school bags. These findings necessitated formulation of feasible solutions with the involvement of major stakeholders.

We considered it important to translate research findings into action.

We adopted three strategies

• Dissemination of research findings
• Provision of feasible solutions
• Advocacy

Research findings necessitated identification of priority areas and formulation of feasible solutions to improve the current status. Taking into account, several factors including feasibility of implementation and acceptability by the adolescents and their parents, it was considered that issues related to schoolbags should be a priority area for intervention.
Solutions were contemplated on - strategies for bag-weight reduction, introduction of a model healthy bag and bag behaviour changes.

The main conclusions were shared with Education Ministry and other stakeholders. Dissemination of research findings through multitude of mass media sensitized students, teachers, parents, general public and administrators of health and education sectors.
Research outcomes were even shared at international forums to obtain further inputs and update good practice evidence. Solutions were contemplated on; strategies for bag weight reduction, introduction of a model healthy bag and bag behaviour change.
When findings and recommended solutions were shared with the Education Ministry for education authorities themselves to find solutions to heavy schoolbag. Education Publication Department Commissioner W M N J Pushpakumara took the lead role. He initiated another research project to be undertaken to explore strategies to lighten the schoolbag. Text books were split in to several volumes. Only page-80 exercise books were recommended.

Introduction of the model school bag

The need for modelling a healthy schoolbag was imperative. Inputs were obtained from the International Ergonomic Association and from consultations with experts. Healthy bags designed ergonomically in other countries were also studied.
School Health Unit of FHB, for their role, initiated designing a model school bag. Dr Kapila Jayaratne, being a member of the Technical Committee of International Ergonomic Association on Ergonomics for Child Educational Environments (ECEE), consulted several international ergonomic experts on healthy features of a bag.
Several bag models were studied and a sample schoolbag with ergonomic features was manufactured to suit Sri Lankan contexts.

The model bag was evaluated by a team of experts including Paediatricians, Orthopaedic Surgeons, Community Physicians, Psycho-ergonomic consultants and Physiotherapists. It was field-tested at a Colombo suburb school and children, teachers and principals responded on local adaptability.

Our bag

A healthy schoolbag adapted for Sri Lankan children was modelled according to ergonomic standards. This sample bag was locally manufactured based on an ergonomically designed healthy bags approved by the Australian Chiropractic Association.

Once the sample bag was evaluated by experts and children, recommendations were sent to the Education Ministry. Sri Lanka Standards Institute was consulted for physical quality assurance.
Registration of bag manufacturers
Bag manufacturers were registered by the Education Ministry and they were educated on the healthy bag concept.
A successful awareness program for bag manufacturers on healthy schoolbag was held. More than 400 manufacturers from all over Sri Lanka on participated at this meeting. Dr. Kapila Jayaratne, described the research background: focusing on burden of the problem, why the ergonomic features are essential to safeguard health of children and what is expected from local manufacturers. Sri Lanka Standards Institute Chamari Geeganage explained physical quality aspects and the process of developing standards on schoolbag. Mr. Tissa Vitana of Ministry of Education elaborated on registration procedure, evaluation of bags by the National Advisory Committee on Schoolbag, the process of awarding logo of the 'healthy schoolbag' and post-market surveillance system for quality assurance.

The project was pioneered under the supervisory guidance of Prof Dulitha Fernando.