Cell phone use

Impact of Cell Phone Use on Safe Street Crossing

Dr Hirsch is a clinical instructor of pediatrics at New York Presbyterian Hospital, Weill Cornell Medical Center in New York City. She is also a medical editor for Dr Pohl is professor of pediatrics and associate dean of student affairs and career counseling at Jefferson Medical College in Philadelphia.

On a virtual street, kids who crossed while on the phone got hit more often.

The time when anticipatory guidance for an 11-year-old patient consisted of reminding him or her to wear a seat belt and drink milk is long past. Over the years, we have begun to discuss drugs, alcohol, safe sex, and tobacco avoidance at earlier and earlier ages. In addition, as times have changed, new hazards have made their way into our patients’ lives, causing us to make further adjustments to these discussions.

A recent study in Pediatrics by Stavrinos and colleagues1 highlights one of the latest potentially dangerous situations to be encountered by our patients: the use of a cell phone while crossing the street. More and more children and preteens are using cell phones—for conversations, text messaging, and surfing the Internet. In addition, they frequently use their cell phones while they are in transit, whether that be riding in a car or walking along the street. However, the complex act of safely crossing a street requires assessment of distances, speeds, and acceleration and can be difficult for a preteen even without any distractions.

Although several recent studies have examined the risks of driving while using a cell phone, less research has been done on pedestrian use of phones. Stavrinos and colleagues investigated the effects of cell phone use on virtual street crossing in 77 children aged 10 to 11 years. They used an interactive virtual environment that had been previously validated as representative of realworld experience. The environment consisted of monitors in a semicircle in front of the child, showing a crosswalk and moving traffic; the child heard traffic noise and ambient sounds, and the view changed as the child stepped off the curb into the crosswalk.

The children observed a research assistant first successfully crossing the street and then being “hit” by a car on a second attempt. Each child had 10 familiarization trials, from which the data were discarded. Then, after completing tasks that measured attention, each child crossed the street 12 times. Half of the children received a cell phone call from a research assistant during the first crossing, and half received a call during the seventh crossing. Each phone call lasted for 6 crossings, which resulted in half the children being on the phone during the first half of their experience and half being on the phone during the second half of their experience.

The authors measured how long a child waited to leave the curb after a car passed, how soon the next car came after the child reached the opposite side, how many “hits” and close calls a child had, and how many times he looked left and right before crossing relative to the waiting time. Data were also collected from the parents for factors such as the child’s cell phone use, attention capacity, and pedestrian experience.

The children were found to engage in riskier behaviors when talking on the cell phone, regardless of their prior use of cell phones, experience with crossing streets, or history of being highly attentive. They were less likely to look both ways before crossing the street when they were on the phone. They were more likely to be hit or have a close call when they were on the phone at the beginning of the experience compared with when they were not distracted or when they received the phone call later in the experiment.

The Stavrinos study is limited by its small sample size and by the artificial nature of receiving a phone call from an unfamiliar person in a virtual environment. However, this study provides us with initial evidence of the dangers of a habit that has become second nature to our patients. The effects of cell phone use, as well as text messaging and Internet use, on pedestrian safety certainly warrant further study.

Although cell phones can be an aid to child safety, by providing a way to contact parents or call for help, they need to be used safely. We should inform families of the dangers of talking on the phone while crossing the street and encourage our patients to end calls when they need to step into traffic.