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Mobile phone usage pattern and its health effects among medical students in north Karnataka: an observational study

Background: The mobile phone is viewed as an important communication tool and is an integral part of the human society in the present era. Medical students use smart phones for note taking, imaging, web browsing, text books, question banks etc. Excessive mobile phone use has been found to be associated with health problems such as impaired concentration, headache, fatigue, thermal sensations in and around ear, stress, sleep disturbances and frustration. Objective was to explore the mobile phone usage pattern and its health effects among medical students. Methods: An observational study was conducted among medical students of Belagavi. The calculated sample size was 277 after taking the prevalence of mobile phone usage pattern of 76.4%. The questionnaire consists of sociodemographic characteristics, pattern of mobile phone usage like mode of use, time of maximum use etc. and the health effect variables like headache, restlessness, neck pain, painful fingers etc. Statistical analysis was done using MS-Excel 2007 and SPSS v 22, proportion and chi-square test was applied and p<0.05 was considered significant. Results: 98.19% were using smart phone and 85.56% were having single phone. Maximum were using for 2-4 years (42.60%). Internet was used for academic purpose in 89.89%. Majority of them experienced eyes symptoms (55.23%) followed by sleep deprivation (46.21%) and headache (42.60%). Conclusions: Even though mobile phone has positive role in our daily lives, its overuse leads to negative impact on health, sleep, and academic performance of students.

Mobile phone excessive use has been found to be associated with health problems such as impaired concentration, headache, dizziness, fatigue, thermal sensations in and around ear, facial dermatitis, stress, sleep disturbances owing to night time use, and frustration. 6 Hence the study was conducted to know the usage pattern of mobile phones and the health effects among medical students.

METHODS
An observational study was conducted among the medical students of BIMS, Belagavi. The calculated sample size was 277 by taking 76.4% usage pattern of smart phone from a study conducted by Gupta et al with 95% confidence interval and 5% absolute error. 9 It was two months study from August 2018 to September 2018. The study was conducted after the Ethical clearance from IEC of BIMS, Belagavi. All the medical students were included in the sampling frame except the first year as they were on post university exam leave and they were explained about the purpose of the research. The questionnaires were distributed to the respondents and were asked to fill it up after giving the informed consent. It was a self-administered, pre-designed, pre-tested semistructured questionnaire. The questionnaire comprised of socio-demographic characteristics, pattern of mobile phone usage (mode of use, time of maximum use, etc.), behavioural pattern (midnight checking of mobile, early morning checking, restroom usage), their opinion on mobile phones and the health effect variables experienced like headache, restlessness, fatigue, neck pain, painful fingers etc.

Inclusion criteria
All the medical students were included to participate in the study.

Exclusion criteria
Students who did not give informed written consent.

Statistical analysis
Data was analysed using MS-Excel 2007 and SPSS v 22, proportion and Chi-square test was applied and p value <0.05 was considered significant. Results were presented in form of tables and figures.

RESULTS
Out of a total of 277 student participants, 62.09% were males and 37.91% were females. Majority of them were in the age group of 21-23 years (51.99%) as shown in the ( Table 1).
85.56% (237) had one mobile phone and only 5.42% (15) were having three mobile phones and 98.19% were having smart phones and both keypad and smartphone was owned by 1.44% of them. Among them 11.55% were using mobile phone for more than six years and 42.60% were using since 2 to 4 years. As far as the behavioural pattern is concerned 23.83% of study participants kept the mobile under the pillow while sleeping, only 7.58% of them switched off their phone during sleep, 21.30% of them check the mobile for any missed calls or messages at midnight and 65.70% of them were checking the mobile as soon they get up from the bed. The usage of mobile phone among medical students in the classroom during the break time was 48.43%, 6.86% driving and 91.70% were using for study purpose (Table 2). Sleep and academic disturbances were more common in participants who were using mobile phones more than five hours compared to participants using for less than five hours and their association was highly significant (p<0.005) ( Table 5).      The association of health problems experienced with the duration of mobile phone was significant (p<0.005) ( Table 6).

DISCUSSION
At present there are no much studies or information about the mobile phone usage pattern and its health impact. In our study 62.09% were male and 37.91% were female participants where as a study conducted by Unnikrishnan et al in Coastal South India 56% were male and 44% were female students. 16 In South India, Subha et al found that 39.7% were keeping their phone in ringing mode and 60% were keeping in vibrating or silent mode which was almost similar to our study. 15 The result of our study shows that 51.21% were using the mobile phone for more than five hours. A study conducted by Susila et al among medicals students of Chennai found that 29% spent more than three hours/day on mobile and 17.8% by Gupta et al in Punjab were using for more than three hours. 6,9 The use of internet for entertainment, academics and social networking was higher in the present study. The present study found that mobile phone was used for more than five hours by most of the students, and almost everyone was using for academic purpose, entertainment and social networking and they had experienced health problems. So, the students should be educated regarding the health problems owing to the over usage of mobile phones, prohibition of usage of mobile phones in the college campus should be implemented and strictly followed by the administrative authority. Prevalence of Internet Addiction and its association with mental health among college going students in