LCQ14: Safeguarding spinal health of students
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Question:
There are views pointing out that there has been an upward trend of Hong Kong students suffering from varying degree of spinal problems (e.g. round upper back, forward head posture and scoliosis) in recent years and such patients have become increasingly younger. Earlier on, departments such as the National Health Commission have issued the "'Five Health' Promotion Action Plan for Children and Adolescents (2026-2030)", which calls for increased attention to the health problems of children and adolescents, including their bone health. In this connection, will the Government inform this Council:
(1) whether it has analysed the reasons for the year-on-year increase in the proportion of students required further spinal assessment after receiving scoliosis screening at the Student Health Service Centres (SHSCs) of the Department of Health (DH) over the past three school years; of the respective annual numbers of students referred by DH to specialists for following up on their spinal problems over the past three school years, as well as the average waiting time of such cases;
(2) given that spinal assessment is not currently included in the annual assessment provided by SHSCs, and that SHSCs will only provide spinal assessment for Secondary Four to Six students as and when necessary, whether the authorities will consider providing regular spinal assessment services to students from all grades so as to achieve the effects of "early detection, early identification and early support";
(3) as there are views that overweight school bag is one of the major causes leading to students developing round upper back and spinal compression, whether the authorities have considered allocating additional resources to subsidise the comprehensive provision of additional lockers in schools, so that students can make good use of storage facilities and alleviate the problems arising from overweight school bags;
(4) whether the authorities will promote multilateral co-operation among professional bodies, healthcare professionals, families and schools by regularly organising spinal health seminars and workshops, so as to enhance the awareness and understanding of primary and secondary school teachers across the territory as well as parents regarding students' improper sitting postures and early signs of scoliosis; and
(5) whether it will explore incorporating contents such as spine care and core muscle training into the curriculum of regular physical education lessons of primary and secondary schools or formulating school programmes relating to spine protection, so as to assist students in building the habit of maintaining good posture?
Reply:
President,
The Student Health Service (SHS) under the Department of Health (DH) provides health promotion and preventive healthcare programmes for primary and secondary school students according to their needs at various stages of development. It aims to safeguard the physical and psychological health of school children, and enable them to gain the maximum benefit from the education system and to develop their potentials.
To attain this objective, the DH's SHS provides free annual health assessment services for primary and secondary school students, which include growth monitoring, vision and hearing screening, health assessment questionnaires. If health or behavioural problems are identified, healthcare professionals of the DH will provide health counselling and relevant information, and refer the students to the Special Assessment Service under the SHS, specialist clinics under the Hospital Authority, or other appropriate institutions for further suitable assessment and treatment.
In consultation with the Education Bureau (EDB) and the DH, the consolidated reply to the question raised by the Hon Vincent Cheng is as follows:
(1) According to data of the DH, the percentage of students requiring further spinal assessment and the annual number of students referred by the DH to specialists for further spinal assessment across the ten school years from 2015/16 to 2024/25 are tabulated below:
| School year | 2015/16 | 2016/17 | 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022/23 | 2023/24 | 2024/25 |
| Number of students referred by the DH to specialists for further spinal assessment | 3 044 | 2 721 | 2 677 | 2 684 | 1 447 | 1 079 | 1 885 | 3 350 | 4 191 | 2 665 |
| Percentage of students requiring further spinal assessment | 17.2% | 16.5% | 15.2% | 15.2% | 15.6% | 20.8% | 16.3% | 13.7% | 16.5% | 17.4% |
Regarding the past three school years mentioned in the question, the percentage of students requiring further spinal assessment ranged from 13.7 per cent to 17.4 per cent. This is consistent with the variations observed within the data range of the past ten years (13.7 per cent to 20.8 per cent), within the normal range, and not representing a year-on-year increase. Although the annual number of students referred by the DH to specialists over the past ten years fluctuated from year to year, it still remained relatively stable. The increases in the number of students during the 2022/23 and 2023/24 school years were mainly due to a decrease in the number of students receiving assessments during the COVID-19 pandemic. This resulted in an increase in both the number of students receiving assessments and requiring referrals during the two school years following the return to normalcy (i.e. the 2022/23 and 2023/24 school years). The figure has already declined substantially in the 2024/25 school year. Depending on actual circumstances such as the appointment time chosen by the students, students undergoing further spinal assessment by the DH can generally receive an assessment appointment within a few weeks.
(2) When considering disease screening, the DH takes into account several medical principles for an overall assessment. For example, a concerned disease must have an identifiable incubation period or early symptomatic period, effective treatments with medical evidence, and significant demonstrated improvement in treatment outcome through early intervention. Moreover, a screening test must be accurate, simple, safe, and acceptable to the target population. The cost of the screening program must be balanced with the overall need of medical resources.
According to clinical evidence, the peak incidence of scoliosis in adolescents mainly occurs in the age group of 10 and 14 (i.e. Primary 5 level to Secondary 3 level) during the puberty development period. Screening during this period is the most effective way to identify at-risk cases early before skeletal maturity of students, which enables timely referrals and treatment. In view of the aforementioned medical principles, the DH's SHS pays special attention to the skeletal growth of students aged 10 to 14 when providing free annual health assessment services, and arranges examinations to be conducted by healthcare professionals either annually or on alternate years depending on the circumstances.
When students reach the stage of Secondary 4 to Secondary 6 (i.e. aged 15 or above), their skeletal growth has gradually matured and stabilised. The clinical risk of rapid deterioration of scoliosis decreases significantly. Therefore, the current mechanism, which arranges spinal assessments for Secondary 4 to Secondary 6 students based on clinical needs, aligns with the aforementioned medical principles and the practice to balance the cost-effectiveness of public resource utilisation.
(3) The EDB attaches great importance to students' health and reminds schools to provide a learning environment that promotes students' physical and mental health. The EDB has all along advised schools to adopt feasible measures to reduce the weight of students' school bags through various channels, such as circulars, guidelines, letters to school heads, featured articles, online promotional resources, and the annually distributed parent leaflets. The EDB Circular No. 17/2015 on "Guidelines on Reducing the Weight of School Bags" clearly spells out a range of measures recommended for schools to reduce the weight of school bags. For example, schools should, according to their financial budget and available space, provide storage facilities for students as far as possible, and help students develop the habit of making good use of storage facilities. Student lockers have been the standard provision of new schools for the last 20 years, and schools may make flexible use of the recurrent subvention provided by the EDB to procure storage facilities for students having regard to school-based circumstances and students' needs.
(4) and (5) The DH has been collaborating with schools and community organisations to jointly promote relevant health messages. The DH will distribute leaflets on good posture, core muscle exercises and scoliosis to students at Primary 5 level and above participating in the service and their parents. The objective is to deepen their awareness and understanding of poor sitting posture and early signs of scoliosis. The EDB will also co-ordinate with the DH in disseminating relevant materials to schools for further publicity and education.
Content related to spinal care has been incorporated into relevant school subjects, including Primary Humanities, Primary Science, Biology (Secondary 4 - 6). These curricula cover learning contents on spinal protection, helping students learn the proper standing and sitting postures, and the proper postures when reading, carrying school bags and using electronic devices. The curricula also help students develop good habits of protecting their spines. Meanwhile, the emphasis for Physical Education is on cultivating a healthy lifestyle for students.
Ends/Wednesday, June 10, 2026
Issued at HKT 15:27
Issued at HKT 15:27
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