Associations between excessive screen time and school and out-of-school injuries among adolescents: A population-based study

•Over 80 % of adolescents have elevated screen time and a high risk of various school and out-of-school injuries (risk up to 4.45 times).•Behavioral and health difficulties (BHDs) explain up to 39 % of the injury risk.•These SBHDs included substance use, suffered violence, sexual abuse, poor family-peer support, sleep difficulty, depressive symptoms, and suicide attempt.•The frequency of subjects without BHDs steadily decreased with time since age 10 more quickly among the subjects with TDST≥7 and at least one injury than among the other subjects.•Our findings may inform healthcare providers, parents, schools, and public policy that prevention to reduce elevated screen time would be efficient to prevent injuries, in addition to BHDs. Most adolescents spend excessive screen time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) which may impact the occurring of various types of school and out-of-school injuries. We assessed their associations and potential confounding factors among 1559 middle-school students from north-eastern France (mean age=13.5 ± 1.3). Participants completed a questionnaire including socioeconomic features, daily screen time for various screen-based activities (coded 1=