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Original Investigation
December 5, 2019

Head and Neck Injuries Associated With Cell Phone Use

Author Affiliations
  • 1Department of Otolaryngology–Head & Neck Surgery, Rutgers New Jersey Medical School, Newark
JAMA Otolaryngol Head Neck Surg. 2020;146(2):122-127. doi:10.1001/jamaoto.2019.3678
Key Points

Question  Is increasing cell phone use associated with the number of head and neck injuries in the United States?

Findings  In this cross-sectional study based on a sample of 2501 reported cases from a national database (76 043 estimated weighted cases), the number of head and neck injuries related to cell phone use was found to have increased steadily over a recent 20-year period.

Meaning  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.


Importance  As cell phones gain more influence in daily life, they also become potentially more hazardous. Injuries resulting from cell phone use have long been reported largely in the context of driving-related incidents, but other mechanisms of injury have been underreported.

Objective  To assess the incidence, types, and mechanisms of head and neck injuries associated with cell phone use.

Design, Setting, and Participants  Retrospective cross-sectional study using data from a national database of individuals with head and neck injuries related to cell phone use who presented to emergency departments in the United States between January 1998 and December 2017.

Main Outcomes and Measures  Incidence, types, and mechanisms of injury related to cell phone use in the US population.

Results  A reported total of 2501 patients (1129 [55.0%] female, 795 [38.8%] white, and 772 [37.6%] aged 13-29 years) presented with injuries of the head and neck related to cell phone use; the estimated weighted national total was 76 043 patients (42 846 females [56.3%], 34 894 [45.9%] white, and 29 956 [39.4%] aged 13-29 years). The most commonly reported subsites of injuries in the head and neck region included the head (33.1% of estimated total); face, including eyelid, eye area, and nose (32.7%); and neck (12.5%). The most common injury diagnoses included laceration (26.3% of estimated total), contusion/abrasion (24.5%), and internal organ injury (18.4%). Age group distributions showed that most injuries associated with cell phone user distraction occurred among individuals aged 13 to 29 years (60.3%; Cramer V = 0.29). In addition, those younger than 13 years were significantly more likely to sustain direct mechanical injury from a cell phone (82.1%) than to have a cell phone use–associated injury (17.9%) (Cramer V = 0.305), whereas a cell phone use–associated injury was more likely than a direct mechanical injury to occur among those aged 50 to 64 years (68.2% vs 31.8%; Cramer V = 0.11) and those older than 65 years (90.3% vs 9.7%; Cramer V = 0.29).

Conclusions and Relevance  Cell phone–related injuries to the head and neck have increased steeply over the recent 20-year period, with many cases resulting from distraction. Although the disposition of most cases is simple, some injuries bear a risk of long-term complications. Many of these injuries occurred among those aged 13 to 29 years and were associated with common activities, such as texting while walking. These findings suggest a need for patient education about injury prevention and the dangers of activity while using these devices.

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