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1.1 Physical health

A range of physical health risks has been shown to be linked to mobile phone use. Many studies have suggested a possible link between mobile phone RF effects, the incidence of brain tumours, and sleep disturbance. For example, it is generally recommended that mobile phones are not left to charge in the bedroom [10].

A recent publication by Mobile Wise, a group whose aim is to help young people use phones more safely, reported more than 200 scientific studies linking children’s mobile phone use to serious health problems [10]. Children are potentially more susceptible than adults to the RF effects of mobile phone radiation because their brains have a higher fluid content, their skulls are thinner with skull thickness continuing to increase until they are about 18 years old [11]. As a result, the specific absorption rate (SAR) can be considerably higher for a child than for an adult [12]. It was found that Magnetic Resonance Imaging (MRI) scans of children aged 5 and 8 showed two times the SAR rate of adults [12]. Other studies have shown the same [13].

A meta-analysis of long-term mobile phone use found an association with ipsilateral glioma and acoustic neuroma. [14]. An ipsilateral glioma is a tumour on the same side of the head that the phone is used on. The risk of leukaemia [15,16] and parotid gland tumours in ipsilateral mobile phone users [17,18] has been suggested and there is also concern that the thyroid gland might be affected [19].

An Independent Expert Group first raised concerns about the potential vulnerability of children in 2000 [20]. Discussion continued, and in 2004 the World Health Organization held an expert workshop. The RF effects were considered not only for children but also for the pre-natal development of the embryo and the foetus as some studies have found a genotoxic effect. A meta-analysis of 101 publications of RF radiation showed that 49 reported a genotoxic effect while 42 did not [21]. In a comprehensive review of published scientific literature, an Environmental Working Group found 10 human studies that had identified a variety of changes in sperm exposed to cell phone radiation. In the findings, men who carried their phones in a pocket or on a belt were more likely to have lower sperm counts and/or more inactive or less mobile sperm [10].

Other possible health effects include: high frequency hearing loss [22]; eyestrain and blurred vision [23-25] and reduced fertility [26]. Musculoskeletal effects have also been identified in users adopting unnatural postures. Symptoms include upper back and neck problems, flexed neck and right and left hand pain [27].

1.2. Cognitive health

Research has suggested that radio frequency radiation (RFR) might affect cognitive functioning. The results of computerised psychometric tests on mobile phone users aged 11-14 have shown impaired cognitive function [28]. Slower reaction to stimuli was associated with higher mobile phone use with reference to texting and voice calls. However, other studies have shown no cognitive effects [29, 30].

The Study of Cognition, Adolescents and Mobile Phones (SCAMP) commissioned by the UK Department of Health is currently assessing the cognitive abilities of 2,500 children, aged 11-12 in outer London [31]. The children will carry out computerised tasks designed to measure cognitive abilities such as memory and attention. The experiments of Hyman et al. [32] showed that attention was affected when students were walking and using their phones at the same time. It was found that mobile phone users were less than half as likely to notice an unusual activity (a uni-cycling clown) and it was suggested that inattentional blindness occurred as a result of a simple activity that required few cognitive resources. It took students 83 seconds to cross the campus area if they were on their phone compared to 79 seconds if they were not. Thus, the cognitive implications of mobile phone use are also important when users carry out a secondary task, such as driving or walking while texting, talking on the phone or listening to music.

1.3. Social health

Advantageous aspects of improved social communication from the use of the mobile phone have been well documented [33,34]. Users can gain a sense of freedom as a result of their ability to be contacted anywhere, any time. However, there have been negative health effects reported when voice calls and texts disrupt social interaction [35,36] or disturb sleep [37]. In extreme cases, mental distress and disruption of family and social relationships [38], stress and even addiction may occur [39]. Many users feel compelled to reply to texts and emails, constantly checking for the arrival of a message. Some of this seems to be an appropriate affordant of the nature of the technology but the level of compulsion and attachment can become problematic. Descriptions of mobile phone use from a study in Australia [40] that used criteria developed from Brown’s behavioural addiction components [41,42] revealed symptoms of behavioural addiction. For example, many users were troubled by cognitive salience, occurring when the mobile phone overrides other thought processes such that, when trying to focus on one activity, they cannot stop thinking about their mobile.

Other social issues to do with mobile phones, particularly important for children, involve cyber-bullying and security. There are ways that parents can help their children in terms of internet safety, but unknown callers can contact children simply by ringing or texting them.

Notwithstanding possible health risks, the mobile phone has been described as “permanently changing the way we work, live and love” [43, p.1]. It has also been claimed that mobile phones are “redefining careers, the family unit and social intercourse” [44, p.1]. This is thought to be due to its portability, multi-functionality and the affordance of constant accessibility and reachability. The latter has led to the employment of terms such as “always on” [34] and “perpetual contact” [45] as a way of describing the way users interact with this technology. Although this has created cognitive and social expansion, some health impacts have led to cognitive and social problems as well as physical ones. The aim of this paper is to identify any physical, cognitive or social health concerns provoked by mobile phone use in young users aged between 8 and 14.

2. Methods and materials

Questionnaire booklets about mobile phone use were developed and presented to young users to find out how they use mobile phones. Participants were 8-11 year-olds (n=168) and 11-14 year-olds (n=136). Boys and girls completed the questionnaires in small groups across six year groups in 11 schools in the South West of England. It took around 20 minutes to complete each questionnaire.

The questions included in the questionnaires are shown in Appendix 1.

It was decided to use questionnaires in order to gather data from a large sample of participants. A literature survey provided the background and several studies influenced the choice of questions [7,8,34,45]. These were adapted for the age of participants and a pilot study (unpublished) was carried out. Some questions were changed following the pilot study to make sure the 8-11 year-olds could fully understand the terminology. For example, technological gadget was changed to electronic gadget. The children themselves suggested this.

The questionnaires for 8-11 year-olds had only minor (but essential) differences from those designed for the 11-14 year-olds. For example, when asked what they used their mobile phone for, the 8-11 version made no reference to social networking sites like Facebook (because of the consent age for using Facebook) but these were mentioned in the version for 11-14 year-olds. The questionnaires included open-ended and multiple choice questions.

Interviews elicited in-depth information from participants. Interview questions are outlined in Appendix 2. The interviews were designed to encourage open-ended, undirected responses but it was also hoped that participants might give an indication of any physical discomfort they experienced as a result of using their phones. Children were interviewed in groups of three in order to create a sense of safety. This group size was also large enough to facilitate dynamic interaction between the participants but small enough for each individual’s voice to be heard. The groups were facilitated by the researchers to ensure each child participated in the interviews.

Ethical procedures were followed; approval was given by the University of Bristol Ethics Committee. Participants could decide to leave the study at any point if they did not wish to continue. Information letters were also given to parents/carers of all participants and parental/carer approval was gained with a signed consent form. Respondents had the opportunity to ask questions at any time and parents also had the opportunity to ask any questions they wished to the researchers.

3. Results and discussion

Descriptive statistics show that 95% of 8-11 year-olds have access to a mobile phone and that 66% own one. In the 11-14 age group, all but one participant owned a mobile phone (99%).

On average the 8-11 year-old participants make three to four calls a day (M=3.5, SD=5.8) with a range from 0 to 50. They send about 12 texts a day (M=12.1, SD=29.0) with a range from 0 to 201.

Results show that 11-14 year-olds make on average 21 calls a day (M=3.4, SD=6.0) with a range of 0 to 53. The 11-14 age group send about 50 texts a day (M=49.6, SD=87) with a range of 0 to 502.

4. Summary

The mobile phone has had a significant impact on the ways in which people communicate and organise their lives. This research study has demonstrated the high involvement and investment of time in mobiles by this 8-14 age group. When matched against the literature on health hazards, the research shows that there are a number of physical, cognitive and social health concerns associated with young people’s use of mobile phones. This suggests that young users should be cautious about heavy use, especially with voice calls. Further, many of the long-term effects are not currently known. This study did not ask specifically about the length of time young users spend on mobile phones, although some evidence was gained in the interviews. Redmayne’s study [26] did gather information about the length of time young users spent on voice calls and concluded that if usage continued at the reported rate, many would be at risk of specific brain tumours by their mid-teens. As the multi-purpose function of the mobile phone continues to proliferate, an analysis of time spent on voice calls and other mobile functions could provide useful research data and guidance for the future.

An awareness of the health consequences of mobile phone use is paramount for increasing our knowledge and understanding. It should be noted that mobile phones now carry a UK Government health warning that highlights the scientific uncertainties concerning the long-term health effects of mobile use. Current government recommendations for children advise young users not to hold their mobile near their heads if they are making a voice call. It suggests texting, or using the mobile on speaker [51]. Advice also says young people should never leave their phones by their beds or under their pillows and never to keep them in their pockets. However, most young users, schools and parents are unaware of these guidelines.

Recommendations for further research could include finding out whether young users are taking advantage of opportunities to use hands-free equipment. Using mobile phones with headsets would ensure that they are kept away from children’s heads when talking on their mobiles, thus reducing the possible health risks from RF radiation. Another area of research could involve assessing the level of awareness of health-related issues with mobile phones amongst children, parents and schools. Active promotion and application, particularly of government recommendations for mobile phone use, are necessary to encourage educational awareness and understanding, and to prevent harm.