According to the latest review, players should play loudly and for extended periods of time, going over safe thresholds.
According to the article, this may aggravate tinnitus, an ongoing ringing in the ears, or cause irreversible hearing loss.
The review, which was published in BMJ Public Health, examined 14 studies with a combined sample size of over 50,000 participants.
In the same way that public health campaigns have raised awareness of live music and headphones, the researchers call for increased efforts to address the concerns that gamers face.
Gamers could, of course, lower the volume while playing to reduce the risk, but the study indicates that prolonged exposure to loud noises may contribute to the issue.
For instance, adults can safely be exposed to 80 decibels (dB), or about the noise level of a doorbell, for 40 hours a week, according to the World Health Organization (WHO).
However, the safe threshold for noise exposure quickly drops below that point.
The WHO recommends that adults only listen to noise levels of 85 dB for four hours per week and 90 dB for one hour and fifteen minutes per week. The cutoff points are even lower for kids.
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In four shooting games, the average headphone noise levels in one of the studies the researchers reviewed ranged from 88.5 to 91.2 dB.
According to a different study, impulse sounds—brief, intense bursts of sound like gunfire—can reach 119 dB.
The study also discovered that boys were observed to play video games more frequently than girls, for longer periods of time, and at higher volumes in three different investigations.
While some research connected gaming to hearing loss, others connected the activity to tinnitus. They assessed hearing using a mix of hearing tests and self-reported information.
The authors agree that additional studies are necessary to prove a more substantial connection between gaming and hearing loss.
They also state that further research should be done on the effects of e-sports, age, sex, and geography.
A few of the research they examined were from the 1990s, a time when the gaming industry was very different from what it is today.
Just two studies that were released in the previous ten years measured the sound levels of video games or gaming centers—which are similar to arcade games and are common in Asia.
However, the authors draw the conclusion that “gaming may be a common source of unsafe listening, given the limited available evidence.”
According to them: “The findings suggest that there may be a need to prioritise interventions, such as initiatives focused on education and awareness of the potential risks of gaming, that can help promote safe listening among gamers.”
The association for the gaming industry, Ukie, stated that it still promotes headphones use at safe levels but declined to comment further on the results of the recent investigation.