A new study analyzing national emergency room data has shown that the number of injuries related to cell phone use, including facial cuts, bruises, and fractures, has risen "steeply" over the last 20 years.
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According to the study, which was published yesterday in JAMA Otolaryngology-Head & Neck Surgery, the incidence of these head injuries spiked around the year 2007, when the first iPhone was introduced.
Most of the injuries occurred among people aged between 13 and 29 years and were due to being distracted by cell phones whilst driving, walking, and texting.
The research was led by a facial plastic surgeon Boris Paskhover at Rutgers New Jersey Medical School, who says his experience treating patients with cell phone injuries prompted him to investigate the problem.
The smarter phones got, the more dangerous they became
Paskhover and team say that as cell phones became smarter, they also became marginally more dangerous to people who are easily distracted by them. Before phones became loaded with news alerts, Twitter pings, and read receipts, they posed less of a risk to their users, the researchers say.
"This study's findings suggest that growing dependence on cell phones in modern life may require that steps be taken to educate and promote safe practices for using these devices," they write.
The authors say their study is the first to investigate injuries to the face and neck rather than the entire body. Their analysis of 20 years of emergency room data showed that such injuries were infrequent up until 2007, when Apple introduced the first iPhone, and the injury rate has risen dramatically since.
"Although mobile telephones were gaining popularity prior to that time point, their functions were limited, and they were, therefore, less likely to be major distractions when compared to modern-day smartphones," the authors wrote.
Two categories of injury
Cell phone injuries fall into two categories: direct mechanical injuries (such as someone dropping their phone on their face or being hit by a thrown phone) and cell phone use-associated injuries, such as tripping over whilst texting and walking at the same time.
The study found that while some injuries fell into the first category, many were caused by distracted use, and it is these injuries that Paskhover finds the most concerning. He says ninety of the injuries he has looked occurred while people were distracted by Pokémon Go.
"People stopped being aware of their surroundings"
"The phone went from being a phone to being a mobile platform," says Paskhover. Old-school phones did not distract people to the point that they tripped and cut their eyelids. Smartphones, though, do: "People stopped being aware of their surroundings."
Most injuries were not very serious, and, generally, patients did not require hospitalization. Almost 95% of people were either treated at an emergency department and immediately sent home or were sent home without treatment.
However, the researchers say the problem should still be taken seriously.
I think it's severely underreported. If someone is walking down the street and they trip and fall, they're not going to say that they were being a schmuck and looking at their phone. They just say they tripped and fell."
Boris Paskhover, Rutgers New Jersey Medical School
What did the study involve?
For the study, the researchers pulled data from a U.S. Consumer Product Safety Commission database that collects information on emergency room visits from about 100 hospitals. They analyzed data available for 2,500 patients who sustained cell phone-related injuries to the head and neck between 1998 and 2017.
The team then used that information to estimate the overall incidence of cell phone-related injuries across the country.
They estimated that, nationwide, about 76,000 people were injured during that time. The annual estimated number of cases until 2006 was fewer than 2,000, but the number steeply increased after that.
About 40% of the people injured were aged 13 to 29 years, and many were hurt whilst walking, texting, or driving. Children under the age of 13 were the most likely to sustain direct injuries, which accounted for 82% of the injuries in that age group. Older adults aged over 50 years, on the other hand, were more likely to incur use-associated injuries.
Cell phone use and repetitive strain injury
Studies have also shown that cell phone is associated with repetitive strain injuries in the hands, upper back, and neck. For every inch, the head is tilted forward from a neutral position, the pressure placed on the spine doubles, which can pull it out of alignment.
Tom DiAngelis, former president of the American Physical Therapy Association's Private Practice Section, has previously likened this to bending a finger all the way back and holding it there for an hour: "As you stretch the tissue for a long period of time, it gets sore, it gets inflamed," he says… "The real question ... is: 'What are the long-term effects going to be?' "
Avoiding injury requires some common sense
Paskhover says he would like to see fewer cases where patients visiting his office have already been injured and need the damage to their faces fixed.
"I love my smartphone," he says, but he added that it is easy to get too absorbed and that people need to use common sense to avoid injury:
"Clearly people wouldn't read a magazine while they're walking, but they'd read an article on their phone. People are crossing Park Avenue in New York City without looking. They're going to get hit," he warns… "Be careful."
The team concludes that their findings suggest a need for patient education about injury prevention and the dangers of activity while using these devices.
Povolotskiy, R. et al. (2019). Head and neck injuries associated with cell phone use. JAMA Otolaryngol Head Neck Surg. https://doi.org/10.1001/jamaoto.2019.3678