Previous research has confirmed the danger posed when people are distracted by cell phone use. Now, new findings published in JAMA Otolaryngology—Head & Neck Surgery show that folks are more prone to head and neck injuries if they fiddle with their phones as they stroll or drive, reports Rutgers Today.

For the study, researchers at Rutgers New Jersey Medical School in Newark assessed 2,501 ER patients (about 40% of them ages 13 to 29) who sustained head and neck injuries as a result of cell phone use between 1998 and 2017. Injuries ranged from cuts and bruises to abrasions and internal injuries, particularly around the eyes and nose.

Researchers used their data to estimate that a national total of 76,043 people sustained similar injuries. Their investigation highlighted a steady rise in injuries during the nearly 20-year period—with some notable spikes. What’s more, a third of injuries were to the head and neck area, and another third were to the face. Lacerations (26.3% of estimated total), contusions or abrasions (24.5%) and internal organ injury (18.4%) accounted for the most injuries.

While 41% of these injuries occurred in the home, were minor and required little to no treatment, 50% stemmed from distracted driving and one third from distracted walking.

Kids under 13 years old were much more likely to suffer injuries as a result of a cell phone battery exploding or parents dropping a cell phone on them; these youngsters also sometimes hit themselves in the face with a phone.

Investigators noted that these upticks in head and neck injuries coincided with the 2007 release of the iPhone and the 2016 release of Pokémon Go—an augmented-reality video game in which players track animated characters on their phones in real locations. (While the game was reported to increase physical activity among Americans, it also resulted in robberies, car accidents and  even deaths.)

“Injuries from cell phone use have mainly been reported from incidences during driving, but other types of injuries have gone largely underreported,” said Boris Paskhover, MD, a surgeon and assistant professor at Rutgers New Jersey Medical School and the study’s author. “We hypothesize that distractions caused by cell phones were the biggest reason for injury and mainly affected people aged 13 to 29.”

Paskhover suggested that the findings show the need to educate young people about the risks of cell phone use and distracted behavior while driving, walking or being engaged in other activities.

For related coverage, read “Addiction to Smartphones and the Internet May Pose Risk to Teens’ and Mental Health.”