A review of pedestrian injuries and deaths from crashes with trains and motor vehicles in the United States where the victim was wearing headphones finds that incidents of serious injury have more than tripled in the last six years. The reviewers conclude that pedestrians who use headphones while walking about near traffic may be putting themselves at risk and they urge this be investigated further.

The lead author of the review is Dr Richard Lichenstein, associate professor of pediatrics at the University of Maryland School of Medicine and director of pediatric emergency medicine research at the University of Maryland Medical Center, in Baltimore. He and his colleagues write about their findings in the 16 January online issue of the journal Injury Prevention.

They found that the majority of incidents involved young men under the age of 30 and occurred in urban counties. More than half of the crashes were with trains, not motor vehicles, and many of them sounded their horns before the crash, which the victim most likely did not hear because they were wearing headphones.

In their background information the authors explained they carried out the research because while we know a lot about the link between cell phone use while driving and the risk of death to drivers and passengers, we know very little about the risk posed by using headphones while walking near traffic.

Lichenstein also said in a statement that he wanted to do the study after reviewing the tragic case of a local teenager who died crossing a railroad track. It was alleged the boy had been wearing headphones and did not hear the train coming, despite it making warning sounds. On further investigation he found similar examples were occurring in other states.

“As a pediatric emergency physician and someone interested in safety and prevention I saw this as an opportunity to — at a minimum — alert parents of teens and young adults of the potential risk of wearing headphones where moving vehicles are present,” he said.

For their review Lichenstein and colleagues searched a number of sources to find reports published between 2004 and 2011 of crashes between pedestrians and motor vehicles or trains where pedestrian use of headphones was mentioned.

The sources they searched include the US National Electronic Injury Surveillance System and the US Consumer Product Safety Commission databases, plus Google News Archives and the Westlaw Campus Research records.

The reviewers extracted and summarized all the cases and graded each into one of three categories according to the information in the report or article, as to the likelihood of headphone use (eg reports that mentioned the pedestrian was wearing headphones at the time of the crash were in the top category).

They also noted other things, such as whether the record mentioned that a warning was sounded before the crash.

They found:

  • 116 reports of death or injury of pedestrians wearing headphones.

  • More than two-thirds of the victims were male (68%).

  • More than two-thirds were under the age of 30 (67%).

  • More than half the vehicles involved were trains (55%).

  • The vast majority of the crashes occurred in urban counties (89%).

  • Nearly three quarters of the reports mentioned that the victim was wearing headphones at the time of the crash (74%).

  • Over a quarter of the reports mentioned that a warning was sounded before the crash (29%).

The reviewers conclude:

“The use of headphones with handheld devices may pose a safety risk to pedestrians, especially in environments with moving vehicles. Further research is needed to determine if and how headphone use compromises pedestrian safety.”

They also found over the six year period they studied, there was a tripling in the number of cases of serious injury to pedestrians who were wearing headphones when the crash occurred, according to a statement from University of Maryland Medical Center.

Lichenstein said in the statement:

“Everybody is aware of the risk of cell phones and texting in automobiles, but I see more and more teens distracted with the latest devices and headphones in their ears.”

“Unfortunately as we make more and more enticing devices, the risk of injury from distraction and blocking out other sounds increases,” he warned.

He and his colleagues remarked on two phenomena that most likely contributed to the injuries and deaths they reviewed: distraction and sensory deprivation.

Being distracted while using an electronic device has also been termed “inattentional blindness”, where, on being confronted with such an array of stimuli, the brain divides its mental resource allocation.

In the case of pedestrians wearing headphones, this distraction is further intensified by sensory deprivation, where the ability to sense an external stimulus, such as hearing a warning sound or car horn, is diminished because of the sounds made by the portable device and headphones.

Written by Catharine Paddock PhD