ACROSS AMERICA — Parents who think their kids spend too much time playing video games have a new tool in their arsenal: Immersing themselves in the intense, pulsating action playing out on the screeen could cause irreversible hearing damage.
A new report from a team of doctors and scientists from the United States, Australia, China and Switzerland warns gamers could be severely damaging their hearing, or sentencing themselves to the effects of tinnitus — persistent ringing, buzzing or roaring sounds deep in the inner ear — often without knowing it.
A systematic global review of scientific literature on hearing risks associated with gaming suggests sound levels reported in the studies of more than 53,000 gamers often exceeded safe, permissible levels. They also reported playing for hours at a stretch, according to the review of 14 global studies on the subject published Tuesday in the journal BMJ Public Health.
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Even a one-time exposure to an extremely loud sound can overwork and kill the sensitive hair cells and membranes in the cochlea, the part of the inner ear that houses the Corti, the organ that produces nerve impulses in response to sound vibrations.
But, the World Health Organization and University of South Carolina, warned in their report, “Gamers who are listening at high-intensity sound levels and for long periods may be at risk of permanent sound-induced hearing loss and/or tinnitus.”
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It has long been known that gaming can have both psychological and physiological effects. Emotions can range from euphoria to frustration to anger. Physical symptoms can include everything from wrist, neck and elbow pain to obesity, neuropathy to blood clots. And the link between hearing damage and loud music venues, headphones and earbuds also has been clearly established.
However, evidence-based research on hearing loss and tinnitus associated with gaming is limited, the researchers pointed out. The findings encapsulated in their report “suggest that there may be a need to prioritize interventions, such as initiatives focused on education and awareness of the potential risks of gaming, that can help promote safe listening among gamers,” the researchers said.
The issue becomes more urgent with the exponential growth of the gaming industry. An estimated 300 billion gamers worldwide have turned what was a niche hobby into one of the fastest-growing sectors in the entertainment industry. Gaming industry revenue grew from about $242.5 billion in 2018 to about $406.2 billion, according to the data platform Statista. By 2028, revenues could reach $625.64 billion.
Additional data from Statista shows about 36 percent of U.S. gamers are young adults between the ages of 18-34, and about 24 percent are under the age of 18. Slightly more males than females, 53 percent versus 46 percent, are regular gamers, according to Statista.
If It Doesn’t Hurt, How Bad Can It Be?
Too many times, gamers scoff at the risks, Julie Hyland, a clinical audiologist and professor at the University of Tulsa, told Patch.
“There’s risk involved there,” said Hyland, who was not involved in the study. “There are a lot of myths associated with noise-induced hearing loss.”
Among the most common is, “If it’s not hurting my ears and it’s not uncomfortable, it’s not damaging my hearing,” she said.
For many gamers, she said, the louder the volume, the better.
“As humans, we like to immerse ourselves in the experience, to be there ‘in person,’” Hyland said. “When we’re immersed in the virtual world, we want to feel the power of the explosion and whatever else is going on.”
The researchers found that, on average, noise levels in video games are often at permissible levels or higher, but noted impulse sounds — for example those from gunfire or explosions — can be much louder and aren’t necessarily factored in when determining safe levels.
But what is a safe noise level? It depends on how many hours a week gamers are at the console or in front of their devices, and their age. For comparison purposes, normal conversation is usually around 60 to 70 decibels. It’s exposure to noise levels of 85 decibels or higher — the impulse sounds on video games, but also leaf blowers, chainsaws, gunshots and ambulance sirens — that can cause damage.
“Permissible” noise levels for adults are around 83 decibels for 20 hours a week, 86 decibels for 10 hours and 92 decibels for 2.5 hours. At 98 decibels, the safe listening time is just 38 minutes a week, the researchers pointed out.
For Children, The Risk Is Greater
The threshold is much lower for children — 75 decibels for 40 hours a week, 83 decibels for 6.5 hours a week, 86 decibels for 3.25 hours, 92 decibels for 45 minutes and 98 decibels for just 12 minutes a week.
In a policy statement last fall, the American Academy of Pediatrics said excessive noise exposure is a serious public health hazard that goes largely unnoticed.
“Children have smaller ear canals than adults, which intensifies higher frequency sounds,” Dr. Sophie Balk, past chair of the organization’s Council on Environmental Health and Climate Change, said in the statement. “And the concern is not only with volume but how long and how often children are exposed to noise.”
It’s possible to enjoy the thrill of immersion in an experience and still be safe, according to Dr. Janet Choi, an assistant professor of clinical otolaryngology-head and neck surgery with the University of Southern California’s Keck School of Medicine and an otolaryngologist with Keck Medicine of USC.
“The most important thing is to be aware of the gaming sound level and the duration of exposure to loud noise,” Choi told Patch. “I recommend keeping the volume at a safe level — loud enough to enjoy the game, but not so loud that it causes discomfort.”
One way is by using noise-canceling headphones to avoid turning up the volume in a noisy environment. Also, maintain a reasonable distance from speakers and consider installing noise meter apps on smartphones to make sure video game sounds remain at safe levels.
“If you were exposed to a loud noise unexpectedly, take a break for at least five to 10 minutes,” Choi said.
Take A Break
The University of Tulsa’s Hyland recommends the “60/60” rule of thumb. In other words, “don’t exceed 60 percent of the maximum volume of whatever device you’re using for 60 minutes,” she said. “Then you take a break. Duration and intensity work together, and that cuts the exposure.”
Even the most mindful of parents who monitor their children’s gaming and screen time can be lulled into a false sense of security if they don’t hear sounds coming from their earbuds or noise-canceling headphones, Hyland said. That’s often more indicative of how well the device seals off the ear canal, she said, adding that on devices providing very tight seals, intensity levels may way be damaging a child’s hearing.
Gamers who notice changes in hearing or tinnitus should immediately seek medical attention, Choi said. At that point, though, the damage may already have occurred.
“It absolutely can happen before you realize it,” Marquitta Merkison, the associate director of audiology professional practices at the American Speech-Language-Hearing Association, told Patch. “Once you lose hearing, it does not come back.”
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Importantly, she said, noise-induced hearing loss, or NIHL, is the only type of hearing loss that is 100 percent preventable by adopting safe listening practices.
“It is not necessary to turn your headphones up to dangerous levels,” she said. “You wouldn’t dream of driving without a seatbelt or not using sunscreen. It’s in your control.”
Merkison said she was gratified to see the World Health Organization and other health groups give such attention to the issue of gaming-related hearing damage.
“It’s really great to see safe listening prioritized,” she said. “It’s something we all can do, and it doesn’t cost any money. It’s a great thing that is totally within our control.”
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