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Jairia Dela Cruz
08 Jan 2019

Technology use, especially of smartphones, is highly prevalent in Singaporean adolescents, and high smartphone users are at increased risk of developing musculoskeletal and visual symptoms, according to a study.

“This study has revealed substantial total technology use of 8.9 hours/day (537 mins/day across the whole week) by adolescents and dominance of smartphone use among all the devices,” the investigators said.

In a representative sample of 1,884 adolescents (mean age 13.3 years; 50.4 percent female; 73.1 percent Chinese) who commonly reported musculoskeletal discomfort and visual symptoms, the mean duration of smartphone use was 264 minutes/day. Patterns of use, including multitasking and bout length, varied by gender, school level, type of device and activities. [Ergonomics 2018;doi:10.1080/00140139.2018.1562107]

Relative to tablet, laptop and desktop, smartphone use dominated for each type of activity: homework, social, videos, games and general use. Girls used the smartphone mainly for messaging and social media. In comparison, games accounted for the greater use of the device in boys.

Smartphones were frequently used in multitasking (69.4 percent). The frequency increased with the school level, from 53.2 percent in primary 5 to 70.4 percent in secondary 1 and remaining high thereafter.

The mean bout length of smartphone use (191 vs 101 mins for TV, 100 min for laptop and 69 min for tablet) increased from primary 5 (118 min) to secondary 3 (239 min) and then decreased considerably in junior college 1 (128 min).

In adjusted logistic regression models, every hour increase in smartphone use per day was associated with up to a 7-percent increase in the risk of discomfort in neck/shoulders (odds ratio [OR], 1.04; p<0.05), upper back (OR, 1.07; p<0.001), arms (OR, 1.04; p<0.01) and wrist/hand (OR, 1.04; p<0.05), as well as a 5-percent increase in the risk of visual symptoms such as eye strain, tiredness of eyes and dry eyes (OR, 1.05; p<0.001).

“In contrast to the generally held belief that greater technology use can lead to vision problems, a higher amount of smartphone use was related to decreased risk of having myopia [OR, 0.97; 95 percent CI, 0.94–0.99; p<0.05] in this study,” the investigators noted.

“However, the causality in this association is not known due to the cross-sectional design of this study. It might be that adolescents who had myopia used smartphones less to prevent worsening of their eyesight,” they continued.

Meanwhile, there were no significant associations observed for tablet use, with the prevalence and amount of use of this particular device being lower than that of smartphone. The investigators attributed this to the much lower tablet ownership and, from anecdotal evidence, the device being mostly shared among the family.

Continuous use of mobile touch screen devices (MTSDs) may promote musculoskeletal symptoms through muscle overloading or awkward postures. Similarly, it may increase the risk of having visual symptoms as a result of prolonged near vision work, impaired blink reflex and blue light emitted from screens. [Appl Ergon 2018;70:232-239; Workplace Health Saf 2018;66:56-60]

“The high MTSD exposures are therefore a cause for concern, and further research on the implications of its use among adolescents are warranted,” the investigators said.

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