This study was designed as a cross-sectional questionnaire-based survey of low back pain (LBP) in 13- to 16-year-old Danish school children. The cohort consisted of 671 boys and 718 girls in eighth and ninth grade in 46 municipal schools in three counties of Sealand. All the pupils filled in a questionnaire with LBP as the main topic and were at the same time examined by the school doctors. The first part of the questionnaire contained questions about leisure time sports activity, TV watching, PC use, job in leisure time and smoking. The second part dealt with LBP in relation to frequency and severity, influence on daily living and use of the health system. The school doctor measured body height and weight, (BMI), degree of hypermobility and the tightness of the hamstring muscles. The results showed a cumulative life-time prevalence of LBP of 58.9%, a 1-year prevalence of 50.8% and an increase in LBP prevalence of 6.4% from 14 to 15 years of age, independent of gender. Fourteen percent (141 F, 54 M) fulfilled the criteria for general hypermobility and 12.2% (45 F, 124 M) had tightness of hamstring muscles of more than 40 degrees. Recurrent/continuous LBP in a moderate to severe degree was recorded in 19.4% of children (182 F, 88 M). This was positively correlated to female gender, BMI more than 25 kg/m(2), competitive sport for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system and reduced life quality. Stepwise logistic regression analysis indicates that female gender, daily smoking and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We don't know yet whether these factors are of any causal importance in the development of severe LBP.

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Several studies indicate that the ISO standards for school furniture seem to be inappropriate, and there is increasing evidence that the inclination of the seat should be forward and that it should be possible to adjust the table-top to a certain non-horizontal angle. However, these studies have predominantly used objective measurement methods on adult subjects for short-term experiments in rather artificial surroundings. By means of structured interviews registering the school children's perception of ergonomic comfort, the present study has compared three types of school furniture-the original ISO-standard type, and two different new types characterized by forward slanting seats and tiltable desk-tops, the main difference between the two being approximately 15 cm in the height of the chair as well as the table. The study showed that the highest of the two tilting types was perceived to be significantly better than the two others in terms of table height, chair height, reading position, back-rest, and global assessment. Likewise, the feature of a tiltable table-top was considered overwhelmingly positive independently of the height of the furniture. It is recommended that school authorities, producers of school furniture, and relevant medical personnel consider these results for alternative designs of school furniture. It should be kept in mind, however, that school furniture is only one among many factors in the multifactorial field of the back health of school children.