title: The 'selfie' phenomenon: reducing the risk of harm while using smartphones during international travel.
abstract: BACKGROUND
  Photography is an integral component of the international travel experience. Self-photography is becoming a mainstream behaviour in society and it has implications for the practice of travel medicine. Travellers who take selfies, including with the use of selfie sticks, may be subject to traumatic injuries associated with this activity. This review article is the first in the medical literature to address this emerging phenomenon.
  
  
  METHODS
  Articles indexed on PubMed and Scopus databases through 2015 were retrieved, using the search terms 'travel', combined with 'selfie', 'self-photography', 'smartphone', 'mobile phone' and 'social media'. The reference lists of articles were manually searched for additional publications, and published media reports of travel-related self-photography were examined.
  
  
  RESULTS
  The lack of situational awareness and temporary distraction inherent in selfie-taking exposes the traveller to potential hazards. A diverse group of selfie injuries has been reported, including injury and death secondary to selfie-related falls, attacks from wild animals, electrocution, lightning strikes, trauma at sporting events, road traffic and pedestrian accidents. Public health measures adopted by the Russian Federation in response to over 100 reported selfie injuries in 2015 alone are presented. The review also discusses the potential for direct trauma from the use of selfie sticks. Travel-related scenarios where selfies should be avoided include photographs taken from a height, on a bridge, in the vicinity of vehicular traffic, during thunderstorms, at sporting events, and where wild animals are in the background. Recommendations exist which discourage use of mobile phones in drivers and pedestrians.
  
  
  CONCLUSIONS
  The travel medicine practitioner should routinely counsel travellers about responsible self-photography during international travel and should include this advice in printed material given to the patient. The travel and mobile phone industries should reinforce these health promotion messages. Future research should offer greater insights into traveller selfie-taking behaviour.
authors: School of Medicine, National University of Ireland Galway, Galway, Ireland and School of Medicine, International Medical University, Kuala Lumpur, Malaysia gerard.flaherty@nuigalway.ie.
authors: Gerard T
authors: GT
authors: Flaherty
authors: School of Medicine, National University of Ireland Galway, Galway, Ireland and.
authors: Joonkoo
authors: J
authors: Choi
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D040421:Cell Phone; D006801:Humans; D012309:Risk-Taking; D057236:Travel Medicine
keywords: Selfie; injury; mobile phone; smartphone; social media; travel