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Title: Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life : a cross-sectional study
Authors: Tsang, SMH 
Cheing, GLY 
Lam, AKC 
Siu, AMH
Pang, PCK 
Yip, KC
Chan, JWK 
Jensen, MP
Issue Date: 2023
Source: Frontiers in public health, 2023, v. 11, 1178769
Abstract: Objective: Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary.
Materials and methods: This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4–5 and Secondary 1–4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured.
Results: 1,058 children and adolescents aged 9–17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ’s = 0.28–0.33, P’s < 0.001), visual symptoms (ρ’s = 0.33–0.35, P’s < 0.001), and poorer device use-related psychosocial health (ρ’s = 0.38–0.47, P’s < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students.
Conclusion: Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.
Keywords: Children and adolescents
Electronic device
Musculoskeletal symptoms
Psychosocial health
Quality of life
Visual symptoms
Publisher: Frontiers Research Foundation
Journal: Frontiers in public health 
EISSN: 2296-2565
DOI: 10.3389/fpubh.2023.1178769
Rights: © 2023 Tsang, Cheing, Lam, Siu, Pang, Yip, Chan and Jensen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
The following publication Tsang SMH, Cheing GLY, Lam AKC, Siu AMH, Pang PCK, Yip K-C, Chan JWK and Jensen MP (2023) Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study. Front. Public Health. 11:1178769 is available at https://doi.org/10.3389/fpubh.2023.1178769.
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