How many crashes does cellphone use contribute to? Population attributable risk of cellphone use while driving

•Cellphone distraction accounts for 8% of overall crashes in the United States.•Young drivers are more susceptible to the influence of cellphone distraction compared to middle-aged drivers.•Visual-Manual distraction accounts for the majority (87.5%) of the cellphone-related crashes. Background: Cellphone distraction is a major contributing factor for traffic crashes, a leading cause of death worldwide. The novel naturalistic driving study (NDS) study with continuously collected in situ driving videos provides an opportunity to accurately estimate the safety impact of cellphone distraction. Methods: We apply a case-cohort study design to the Second Strategic Highway Research Program NDS, the largest NDS up-to-date with more than 3400 participants. The data include with 842 level 1–3 crashes and 19,338 randomly selected control driving segments. We propose a partial Population Attributable Risk (PAR) estimator that provides consistent and stable estimation over time and across different driving behaviors. Results: The US population-adjusted PAR show that 8% of crashes (PAR = 0.08, 95 %CI: [0.06, 0.19]) can be reduced if cellphone distraction were switched to sober, alert, and attentive driving behavior. Young adults (age 20–29 years) and middle-aged drivers (age 30–64 years) each contribute 39% of the population level PAR. Within each age group, the PARs vary substantially from 18% for young adult drivers to 5% for middle-aged drivers. The contribution of cellphone visual-manual tasks to crashes is more than 4 times larger than cellphone talking and accounts for 87.5% of cellphone-related crashes (PAR = 0.07). Conclusions: Cellphone distraction contributes to a considerable part of crashes. Young drivers are more susceptible to the influence of cellphone distraction and visual-manual distraction accounts for the majority of cellphone-related crashes.