Cuts, broken bones, severed limbs, genetic mutations, cosmic burns, deadly toxins, and alien parasites are a few of the grim risks video gamers must assess and manage virtually. But real physical dangers exist too, such as gamer’s thumb, carpal tunnel syndrome, and tennis elbow. Add to these hearing loss and tinnitus. Game over?

Given the obvious dangers of volume ramped up to match game adrenalin levels, there is a relative scarcity of studies looking at the auditory effects of the voluntary recreational exposure to high-intensity sounds involved in gaming. The World Health Organisation does, however, list these unsafe listening activities as an “important modifiable risk factor of hearing loss”.

Gaming is one of the most popular leisure activities worldwide, with an online source estimating there were over 3 billion gamers worldwide in 2022, points out the British Medical Journal in a recently published systematic scoping review on Risk of sound-induced hearing loss from exposure to video gaming or esports. The authors claim this is the the first article to comprehensively review whether gaming might be a source of unsafe listening.

And after analysing five peer-reviewed studies that evaluated associations or correlations of gaming with hearing loss or tinnitus, the authors counted that four reported significant associations or correlations with gaming and hearing loss or tinnitus.

Although limited, the evidence suggests that “gaming may be a common source of unsafe listening, which could place many individuals worldwide at risk of permanent hearing loss and/or tinnitus”.

The longer you play a video game, the higher the risk to your hearing

Within the research, the reviewers led by audiologist and epidemiologist Dr. Lauren Dillard, first author, found that “those who game regularly, as compared to those who do not, are more likely to experience tinnitus, measured high-frequency hearing loss, and self-perceived difficulties hearing”.

“One study showed that individuals who play video games for longer times are at higher risk of developing hearing loss or tinnitus,” points out Dr. Dillard, of the Medical University of South Carolina.

Bang, bang…you’re deaf! Impulse sounds may have an unmeasured impact

Studies of hearing loss risk, such as in occupational settings, often rely on average sound intensity levels (eg, 80 decibels over a period of time—for example, a 40-hour working week). But the authors of this study in the BMJ point out that potential damage from impulse sounds – common sounds in gaming such as gunshot or explosions, consisting of bursts lasting less than one second and with peak levels at least 15 dB higher than the background sound – is not necessarily captured by average sound intensity levels. One study reported that impulse sounds reached levels as high as 119 dB(C) during game play.

More research on video gaming noise – and protection policy – needed

The study concludes: Results suggest that additional research on these relationships is needed, including identifying populations of gamers at high risk of unsafe listening. These would help to inform and refine interventions that can prevent hearing loss and/or tinnitus among gamers. An important intervention could be the development and implementation of policy to promote safe listening among gamers.

Source: BMJ