This study qualitatively analyzed 25 websites on distracted driving using Google as a search engine. The findings of this analysis demonstrate notable differences between the way distracted driving is portrayed on the internet versus reality. For example, the results of this study show that death was the most common consequence of distracted driving presented on the websites. In addition, 15 (60%) websites cited a fatality as an outcome, compared to injuries that were reported on 11 (44%) of the sites. Depending on the source, current data available on road traffic accidents resulting from distracted driving proves that injuries outnumber death as a consequence, with a ratio of 60-113 to 1 [14,15].

The study also demonstrated discrepancies between the online and actual representations of various driving distractions. Mobile phones and texting, discussed in 17 (68%) of the sites, were shown to be the most common distracting activities. However, a report by Erie Insurance completed using data from the Fatality Analysis Reporting System lists daydreaming as the number one distraction involved in 61% of fatal MVCs and ranked mobile phones second at 14% [16]. Another report from the NHTSA indicates that talking with a passenger is the most common distracting activity, responsible for 57% of distracted driving collisions, while combined phone use accounted for 11% [17].

The fact that texting is the most common type of distraction described is not surprising. Gallup [18] reported that texting is now the preferred form of communication among Americans under the age of 50 years and that the prevalence of texting is higher among younger people in the United States. The Centers for Disease Control and Prevention found that drivers aged 16-19 years are at highest risk of being involved in MVCs [19], and the NHTSA reported that the same age group also had the highest percentage of distracted drivers involved in fatal MVCs [1]. This could be the basis of why websites for distracted driving have focused on mobile phone use so heavily.

As expected, government agencies publish the majority of information available to the public concerning distracted driving. This finding is encouraging, as it suggests that government authorities are actively working to address this problem.

Although many websites provided statistics and consequences and 11 websites mentioned generic injuries, it is worrisome that only one website cited orthopedic injuries resulting from distracted driving. The Canadian National Trauma Registry reports that 79% of the major injuries in hospitalized patients are musculoskeletal in nature and that car crashes are the number one cause of major injuries [20]. Considering that at least 16% of all injuries sustained in an MVC are distraction related [14], it is logical to assume that orthopedic injuries would make up the majority of these injuries. Unfortunately, this outcome of distracted driving is massively ignored by these websites.

Many of the reviewed websites offered guidance on how to prevent distracted driving. However, all of these invoked driver self-discipline and other active mechanisms to enforce behavior modification (eg, “Just Drive”). Likely, decreasing distracted driving will be a combination of education, cultural shift, and passive restraints, for example, mobile phone apps restricting phone use while driving [21], collision avoidance, and self-driving technology in vehicles.

The main limitation of this study is that little is publicized about the algorithm for the google.com/ncr search; thus, it is unknown exactly how website hits are generated on Google. However, by using a nonregional Google search, we attempted to collect as many websites as possible without the bias of regional preferences. Therefore, it is likely that our search results represent what the average information seeker would find without any filters set. Additionally, the primary strength of this study is that it examines a contemporary public safety issue using the most popular search engine.

According to the World Health Organization, almost 1.35 million people die in MVCs every year, and for every one of those traffic fatalities, 60 people get injured [15,22]. Distracted driving is a considerable contributor to these figures and continues to be a common practice among the drivers despite attempts by many organizations to control this pervasive behavior through education. It seems to be especially widespread among the younger drivers [23-25], as it has become the leading cause of death for teenagers [26].

Many North American jurisdictions passed antidistracted driving laws to curb this problem. Unfortunately, despite introducing new legislation, distracted driving remains rampant today. The Alberta Government in Canada released data that show no decrease in distracted driving convictions in the 4 years since the distracted driving legislation was passed (n=25,958 in 2012 and n=27,281 in 2016) [27]. Moreover, in Ontario, apart from 2012, distracted driving has been the leading cause of MVC fatalities since 2009, when legislation prohibiting the use of handheld devices was first introduced [28]. The NHTSA also continues to report an alarming number of collisions due to distracted driving, with no signs of this problem ending: 885,000 crashes in 2015 compared with 826,000 in 2011 [14].

Google is the most visited website globally [11], and with 92.37% of the market share and more than 5.6 billion queries a day, it is the most popular search engine in the world [13,29]. It is available in 149 different languages [30] and operates in more than 200 countries, making it a particularly useful tool when researching topics of interest online. Studies have examined Google’s increasing involvement in the search for medical information online and have found that despite some deficiencies, it can be an effective medium [31]. Research looking into the information on various medical issues available on the internet using Google as a search engine includes subjects such as views on vaccination [32], psychoactive agents [33], fractures [34], and skin cancer [35].

Although distracted driving has become increasingly common, and interest on this subject is high, there is limited research on the information available online regarding this issue. To our knowledge, so far, there have not been any publications concerning information on the internet on distracted driving, which are accessible through Google. A recent study [36] completed at the authors’ home institution, which is currently in preprint, has examined the messages represented in distracted driving videos on YouTube with similar findings.

Distracted driving is becoming more prevalent, and with it, so are the injuries and loss of lives associated with this problem. Our Google search project found that little to no specific information is available to the general public regarding types of injuries, including the potential disability resulting from them. Conversely, death due to distracted driving, which, in reality, occurs much less often than injuries, is the most commonly presented outcome in these websites. Unfortunately, websites focusing mainly on fatality secondarily to distracted driving eclipses the reality of millions of people surviving distraction-related MVCs who continue to live with chronic pain, disabilities, decreased quality of life, and increased financial burden. Furthermore, the sites mostly focus on mobile phones as potential distractions and largely neglect other more common forms of distracted driving. Although the general public recognizes that distracted driving is dangerous, in principle, the lack of specific information on the consequences of this behavior may be contributing to its continued practice.