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Ergonomics. 2018 Dec 21:1-16. doi: 10.1080/00140139.2018.1562107. [Epub ahead of print]

Mobile touch screen device use and associations with musculoskeletal symptoms and visual health in a nationally representative sample of Singaporean adolescents.

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a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia.
b Physiotherapy Department , KK Women's and Children's Hospital , Singapore.
c Department of Public and Occupational Health, Amsterdam Public Health Research Institute , VU University Medical Center , Amsterdam , the Netherlands.
d Department of Health Human Performance and Recreation , University of Arkansas , Fayetteville , Arkansas, USA.
e Physical Education and Sports Science , National Institute of Education, Nanyang Technological University , Singapore.
f Lions Eye Institute, Centre for Ophthalmology and Vision Science , University of Western Australia , Perth , Australia.


This study aimed to describe contemporary technology use, especially smartphones and tablets (mobile touch screen devices), and examine associations with musculoskeletal symptoms and visual health among adolescents in Singapore. A representative sample of 1884 adolescents (50.4% girls) from grades primary 5 to post-secondary (10-18 years old), recruited from 13 schools, completed an online questionnaire in class. Total technology use was high, with smartphone duration being highest (mean = 264 [SD = 243] min/day). Patterns of use, including multitasking and bout length, were influenced by gender, school level, type of device and activities. Musculoskeletal discomfort and visual symptoms were commonly reported. After adjusting for potential confounders, more hours/day of smartphone use was associated with increased risk of neck/shoulders, upper back, arms and wrist/hand discomfort (OR = 1.04[95%CI = 1.01-1.07] to 1.07[1.03-1.10]) and visual symptoms (OR = 1.05[1.02-1.08]), but was associated with decreased odds of myopia (OR = 0.97[0.94-0.99]). No significant associations were found for tablet use. Practitioner Summary: 1884 adolescents in Singapore completed an in-depth questionnaire regarding their use of technology. The smartphone was the device with the highest usage, and greater smartphone use was associated with increased odds of musculoskeletal and visual symptoms. High use of smartphones has physical health implications for adolescents.


Mobile touch screen devices; musculoskeletal symptoms; smartphone; tablet; visual symptoms

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