Video gamers worldwide may be risking irreversible hearing loss and/or tinnitus—persistent ringing/buzzing in the ears—finds a systematic review of the available evidence, published in the open access journal BMJ Public Health.

What evidence there is suggests that the sound levels reported in studies of more than 50,000 people often near, or exceed, permissible safe limits, conclude the researchers.

And given the popularity of these games, greater public health efforts are needed to raise awareness of the potential risks, they urge.

While headphones, earbuds, and music venues have been recognized as sources of potentially unsafe sound levels, relatively little attention has been paid to the effects of video games, including e-sports, on hearing loss, say the researchers.