Hearing Health in Video Games

[Music] good afternoon note to self don't schedule yourself AC opposite Destiny so this is Patrick zidell Patrick zidell is a former professional uh Esports athlete Esports player um he's retired about a year ago he's 23 now I think and and when he was playing he realized wow sometimes my ears ring a lot and then they started ringing more then they started ringing more and he did some Googling and he realized I have tinius which is a constant ringing in his ear and now the ringing doesn't go away so he's now got permanent tenius and after some more Googling he kind of realized I think I gave this to myself so Patrick's game was a tactical five on five shooter

where hearing footsteps is his paycheck so in order to hear those really really quiet footsteps that are you know ASM totically logarithmically soft away far away he would crank the volume like insanely loud levels so he could hear those quietest footsteps but of course when the flashbang grenade goes off next to him it was really really loud so combination of playing really really loud because that's what his paycheck depended on and the fact that he plays for long hours he practices he plays um he realized he gave himself tenus I met Patrick uh in Geneva uh this last summer at the World Health Organization U I started doing some Pro boner work for them last May or June because they're more very interested in video games as a potential source of hearing health problems um and they've created something called their make listening safe

initiative to look at hearing health for the population in general and it it's a big problem hearing Health uh you know the inability to hear well has all sorts of Downstream Health ramifications from increased risk of Alzheimer's depression not to mention of course the fact that we aren't a people are not able to enjoy the work that we all create here so um who here either has an iPhone or an Android yeah 100% go up I don't you you'd ask have to ask that question um has anybody with an Apple Watch ever had this pop up yep handles go up um so a couple of years ago uh the um World Health Organization in conjunct working with apple working with Google and working with the itu actually created something a specification for hearing safety on these sorts of devices right people listen to music with their earbuds in they listen to for you know too loud for

too long uh they've got their you know watches to tell them things and they implemented What's called the I Whit t870 spec guidelines for safe listening devices and systems it first came out in 2019 it was updated recently in 2022 here's the uh World Health Organization version of the uh the spec here is the little bit more button up itu version of the spec I kind of like that one better but what it does is it specifies amongst other things under what circumstances should devices that play music to your ears you know either provide some warnings or notifications to the user to The Listener or uh perhaps automatically lower the volume down which uh will do in some cases as well so that was a very very successful initiative right they got something into devices that virtually every person uh carries through this

htu Whit t870 spec through their make listening sa safe initiative so what are they doing now they deliberately left video games off of the itu h70 spec they just felt they didn't know the space well enough they wanted to get something out right you what feature you going to cut in order to ship they cut uh video game systems and devices so they are in the middle right now now of writing a there's no number to for it yet or anything but writing an analogous specification for us in the video game industry um again the it so they started the itu who Global safe standard for listening in video game and Esports initiatives as part of the um make listening safe campaign so a goal is to create a spec kind of analogous to the one adopted by Google and Android Google and Apple

another is that they do have an awareness campaign they just published a article uh got picked up by most of the press in January about hearing safety in general so there's uh Community awareness going on and also they started reaching out to the development Community which is kind of how I got involved um you know again to help them better understand how people play games how people make games how game systems work and so on so that's kind of what they're doing and like I said part of what they're going to likely you know working on are what would analogous features to what we have on our iPhones and apple eye watches and so on what sorts of things would we put into things like game consoles or gaming devices and so on so that's part of what they're doing we're not going to talk really too much about that except that if you are interested in that I'll have some contact information at the end um let me know by all means we would love you to be part of the

conversation so of the things they also did want to do was reach out to to us to game developers particularly those on the audio side of things and uh towards that for example at game sound con this last October uh by pure happen stance the head of this initiative at the wh Dr s Chata happened to be in Los Angeles and she actually took an Uber I invited her to become part of my opening remarks at gam soundc con this year and literally she took an hour hour and a half Uber from Southern La up to Burbank where she spoke for 10 minutes and then went back to doing the business that she did so they're very very uh passionate about this particular thing um and her big point is that this is a this is a very real threat there she who estimates that three billion human beings will have significant hearing damage in their life um if things don't change on their current course and for us in games it's kind of an interesting

thing there's nothing necessarily more you know about games that makes games more damaging you're hearing them say watching a movie or something like that but we do kind of have a bit of a triple threat here um one is that if we are successful people play our games a lot um you know I think Ballers gate is about a 120 hour playthrough um I certainly know people um very very close family members who play many many hours a week tens of hours a week um so that's one of the problems not problems it's a success of us but it's a potential thing to worry about that people play our games for a long periods of time they play it Loud volumes um many people play games pretty loudly and they're playing with headphones by the way that's a chat GPT image the uh the guy with the sound waves coming out of his ears we got we got more um

so and studies show and in talking with some of the you Publishers and so on that about half of our customers about half of our players play with headphones on that's up a you know significant amount you know from a dozen years ago or so in fact so much so that a lot of us mix our games with headphones on as well as with uh speakers I was um I had uh coffee with u Emily Ridgeway at valve and she's got this wonderful tree of headphones that because they all sound so different she wanted to figure out oh what do these different headphones sound like what sounds sound good in them so headphone listening is definitely a very very big thing um and uh to be frank biology is going against us um it's fun to listen loud um this is another chat GPT image this is um make me a realistic picture of somebody rocking out loudly while playing a video game uh not super

careful on how they count hands but um but it so it turns out that there's a part of our uh it's not we don't use it for hearing but it's still part of our auditory system called the sacculus the sacculus is in the in the inner ear that is particularly sensitive to low frequencies at high DB levels again we don't use it for hearing but it does sort of activate at about 90 DB and it's got a connection to the hypothalamus and yeah that's the part of the brain that deals with Hunger sex and sort of hedonistic responses to things um so it literally is more pleasurable to us to experience loud anybody who's played in a band or been at a concert or loves mer that brass is blaring it's just some yeah something that's really cool so it's something that we are definitely fighting against it's we we kind of want to turn ourselves up to this is the first meme I ever made so uh for this talk here all right right

um so how does this uh you know super super bit on the biology this is what it looks like inside our ears I'm sure we've all heard that we have hair cells in our ears we actually have two different sets of hair cells those top hair cells are called the inner hair cells those are the only hair cells that are actually connected to nerves so those are the ones we actually use to hear those bottom hair cells those three rows they're called the outer hair cells and they um their job is simply to mechanically amplify sounds we'll get to that in just a second but uh it's really that top line that is the the thing that changes vibrating air molecules to you know transducing through the three bones in our inner ear to liquid in our CA that wiggle these hairs um this is how we hear and of course if we listen for a little bit too loudly for too long this is what happens um in fact those the hairs stay bent over over and our body

determines that they are dead and that they don't regrow um instead actually literally like a scab forms over where they used to be which is why there's empty space not sort of you don't see the dead hair cells there so those outer hair cells are really really important without our outer hair cells this would be our limit of our hearing so we we literally would hear nothing below 60 DB if we did not have those outer hair cells the outer hair cells act as a nonlinear amplifier for and this is the curve that represents the amplification it's a mechanical amplification that the outer hair cells do that bring the level of the vibrations up to the point where our inner hair cells can actually detect move enough so that we detect sound um and uh if in the audio world this is an upward compressor

um so literally mechanically we're providing variable gain at very very soft levels we're providing lots of gain at higher levels we our Auto hair cells provide little no extra gain and this is why by the way if somebody is hard of hearing you don't shout at them because the upper range of their hearing is normal like anybody else it is just that the softer sounds are not Amplified up to the range where our inner here ha cells hair cells can actually detect sound so this is why hearing damage is so Insidious um right they say an ounce ounce of prevention is worth a pound of cure except in our case there's no cure so it's kind of problematic so the thing that you want to track if we're talking about either our own hearing health or our players's hearing health is dosage over time right it's like a Geer counter you can be exposed to so much radiation for a certain number of times minutes if you're exposed to twice as

much radi radiation you better be in the room half as long and it's just like that with sound as well and this is called the equal energy principle right if I listen for four hours at 80 DB on Monday and two on Sunday that's the same as if I had um listened for six hours in one day and here's an example by the way of some L's output from a couple of different games um the second one little bit more steady very very high levels where the D dynamic range of the first one uh gives a lot more opportunity for our ears sort of to breathe and so on so the who uh and international standards have have come up with what are safe listening levels how loudly can we listen for how long in a recreational setting there are different numbers for occupational settings right where there's a a factory stamping machine going 24 hours a day uh

for recreational listening what they have settled upon is 80 DB a weighted DBA for 40 hours a week and every three DB of increased listening level is H haves the amount of safe listening time so at 86 DB it's not 40 hours a week that is safe it is only 10 hours a week that is safe and at 100 DB uh right it's like 5 minutes 6 minutes uh that is that is safe so the wh did a survey and also a survey of literature kind of to kick this thing off um and one thing that they found was people when they are playing games are playing louder than 80 DB and they're playing for in some cases you know more than 10 hours a week so people generally are listening at unsafe levels um certain certain subsets of our

players are playing loud and plain for long periods of time the uh they do set different levels for children versus adults that's what the uh mode two was is the same thing but for kids um so it's definitely a little bit of a problem um so some of the other results of their surveys were people did not perceive themselves as being susceptible to hearing loss that makes sense gamers are for the most part kind of young and young people kind of feel pretty princible in general much less for something where slow dosages over a period of decades will result in hearing loss when they're 75 or 80 so that kind of makes sense um they do believe that reducing volume would Li limit gameing enjoyment a year ago I would have rejoiced at that statement um but it is something we need to keep in mind like I said we're fighting against the sacculus and the fact that it's more fun to listen loud um that said half of the response to the survey said that they

were interested in learning more about this thing because it's sort of like smoking people do not want lung cancer so they realize they shouldn't smoke um and so yeah I kind of want to know more about that um so uh yeah this is what they kind of the survey of the um results there now some listening habits that they have uh these were done on Windows systems and the average volume setting was 56% 56% % on Windows system volume is about I measured it just the other day I think it's about minus 8 DB um from Peak so they're down a little bit um 21% listen at high or very high volume settings where were high was def defined as the system volume was greater than 60% or very high greater than 80% so one in five people system volumes while they're playing games are pretty loud um of course one thing that was kind of

cool is you know three out of four said they believe that sounds are either extremely or very important that's yay us again so that's good um but it is it is problematic um right time spent G with gaming is associated with higher odds of hearing loss that was one of the findings of the survey people who game more um tend to start to have some hearing problems Gamers who played more frequently were more likely to game at higher volume so that's that double whammy of dosage right time at a certain volume times the level at which you are actually listening and um you know four or five and 10 reported having heard ringing in their ears after playing a game session at least once so there's definitely some stuff that you know some things to look at here from a safety perspective so as game develop velers you know are there

things that we can do to make the game people play the games we have we want them to play long periods of time we want them to hear our stuff uh but are there anything we can do and to be Frank this is a open question this is one of the things we're trying to figure out this is a new topic for us um right we haven't thought of this another chat GPT image except I did Photoshop um the wise mastering plugin into the thought bubble there so yeah this is not some I don't know about you I had never really given this a second thought so it's not something we had thought about the exception being Rob Bridget who has thought about this of course because Rob Bridget has thought about everything um but it does seem kind of close to some things that we have worked on so accessibility um loudness standards we boy I remember being at at the Fairmont talking about uh loudness standards at GDC uh listening environments like nighttime mode audio customizability Advan audio settings these sorts of

things and again you know several years ago uh Sony Microsoft kind of joined forces to help create the um mixed recommendations the standard minus 23 lefts we're kind of at right now a lot of games have very cool audio options with headphone base boosts and different kinds of custom customizability um this is from is this from God of War Ragnarok I think it is um yeah of course somebody here knows that uh so yeah different levels of dynamic range right so that if I don't want my gunshots to be quite so loud maybe I can play my game at a more limited dynamic range uh some devices actually do Implement some of these warning features already this is the manual from I forgot if it's Oculus go or Oculus Quest but um you know to prevent hearing loss do not listen at high volumes that's warning in the manual and actually you will get a Visual Alert if you've been listening in this VR experience in some VR experience for too loud for too long now there obviously are a lot of

challenges um right there is the biggest is the last mile problem it's all of good for us to talk about you know the how we create our games and the volume levels we set we don't know what the person's headset is Right an 80 ohm headset versus a 30 ohm headset versus a 250 ohm headset are going to be massively you know like orders of magnitude different SP levels to the eardrums so who is fully cognizant of that there some initiatives to try and deal with that that are kind of fun for us long term like headphones that tell you the exact SPL level that are going to the ears which we can then do things like you know flet your months and compensated listening it's volume controls and things like that so those are a little bit down the road but their idea is that we can make a meaningful impact while working on a bit longer term solution so what we have here or ravor is a sort of a call to action um the idea of this talk it's a a 30 minute talk so it's a quick one is just to sort

of introduce the topic to the industry a little bit we had a little bit of a panel at game sound Con on it continuing it here at GDC so part one is just if you're interested in being part of the conversation come join and be part of the conversation we'd love to get your input on this topic in general um consider hearing Health in the same way you might consider accessibility or those sorts of things where it's a something maybe we can start thinking about how might we change a little bit of the way we make our games not to diminish the content we want to make the emotional content we want to make but with just something like this in mind I think also being aware of how our players are listening to our games could be really helpful there's a lot of not we have a lot of opaque areas where we're not really quite sure what's going on so Telemetry data audio audio analytics right um have your games report back to you back to home base what people's volume slider settings are at or what

their system settings at and things like that play testing of trying things out to see how it affects how loudly people listen and so on um and the kinds of telemetry days Telemetry data we might want to collect are you listening on a headphone or speakers what options are people set again this is non-intrusive stuff this is stuff you can just get by calling apis um USB versus analog what's the level of chat versus game versus sound effects versus music and so on game volume settings system volume setting things like that um so another interesting call to action might be thinking about what kind of features might we want you want to implement in your game that could lead to a lower sound pressure level experience for the player right less loudness at the headset um without compromising our experiences um loudness setups more granal audio sliders uh you know back to Patrick when he realized that he was you know he had literally damaged his hearing he wrote A Little Piece of Windows

software he's he's a programmer too and what this piece of Windows software did again the game he did was a five on five tactical shooter um which means that unless you win there are long periods of the game where you're just spectating right you die you're out of this round until the next round um and he realized hey when I'm spectating after I've been killed I'm still hearing the game at this full volume and so he simply wrote a piece of software that detects when he is dead and it literally reached into the window system volume and lowered the Windows system volume by like 15 or 20 DB and then when it his software would detect that he was no longer dead and active in the game it would bring it back up again so things like that might be some you know that was something he implemented so that he could practice uh right he can't use that kind of software in a tournament but when he was practicing he would use the software such that he could still get the experience but only

when he wanted it he didn't need that high volume dose when he wasn't even active in the game so things like that um if you are an educator definitely call to action for you all there's lots of lots of areas we could you know we could sit down and think of 15 to 20 M under either undergrad or Master's thesis uh like projects things like listening habit studies and the effects of L level on in sspl and you know what if we make our logo screens louder or softer how does that affect how loudly people play their games um user behavior for different all sorts of studies that kind of could be done um so if you're an educator and you have students who are interested in hey I might want to publish a paper that you know how we call this talk how to get a paper referenced by The Who in three easy steps just make you about hearing health and video games I can't guarantee anything but boy that will be read by The Who within days of it being published

um another call to action be nice to your own years um what this graph is is uh what's called TTS or temporary threshold Chef shift so when we expose ourselves to loud sounds like I I remember being 22 years old and mixing my band in the studio and it was cranked up and it was rock and rolling it was really fun um after Loud exp loud exposure to sounds drastically changes our free the frequency response of our ears so this is 115 DBA which is pretty loud that's that's a loud band at a club but for just 20 minutes after that you've got a 50 deel Notch at 3 khz which totally is going to screw up your mixes and even 24 hours later that top green one even 24 hours later You' still got six or eight or almost 10

DB of a notch in your hearing a full 24 hours after like going to a concert um so yeah long sound design mixing sessions excessive levels will distort your hearing so take care of your own hearing I know you know many mixers and so on never go anywhere without earplugs um right right you mix you're really loud in your mixing session the next morning you come and listen to your mix like why is it so bright well it's bright because while you were mixing at the end of the night you had a giant notch in U in your high mids there so if you are interested in this topic um drop me an email this goes straight to my inbox hearing at gamesoundcon tocom and with that I'll open it up to any questions anybody might have yes uh please walk up to the microphone so that the folks at um home um can have a chance and we've got like four minutes for questions before we

take it to the walkup room yes hi um thanks so much for putting on this presentation um I'm just curious with regards to VR headsets like the quest 3 um the in head or in headset speakers uh it's it's going to be very difficult for them to produce uh low frequency information um and as we discussed today or as you discussed today uh Gamers like to hear Everyone likes to hear that frequency information to make it feel good um how what would be the um best practice to uh help reduce the chances of harm from players trying to boost the volume on their headset uh speakers to get that sensation yeah that is a great question and my guess is I saw Scott cell phone out here my guess is there is like half of a team at meta working on that very Pro yeah getting low frequencies out of small transduc is challenging and we do want to try and make sure our systems

aren't designed such that people overcompensate um for not having the low end by just cranking it up really loud uh there have been some attempts to work at this one is you know use of things like Max based Technologies you know missing fundamental phenomena and so on but yeah there there's no perfect solution for for that right now um so yeah yeah it's a great it's a great question it's a creative challenge that we need to solve okay thanks a lot again thank you so much for um all of this information gathered in one place I'm curious what you or the whho might be doing with Esports uh tournament organizers or leagues who will put um often put on a secondary set of headphones on top of the in years that a lot of the um the competitors are using for communications or in game sound in order to play to blast um white noise or pink noise at them to mute the audience basically yeah that's a great question if you're in an Esports tournament um

not only first of all you're probably wearing deep inear monitors over the top of which you're wearing acoustically um you know minus 30 DB things to which they sometimes pipe in white noise so that the gamers don't get an advantage by listening to the shoutcasters the the you know the announcers announcing the thing uh that is definitely something the is looking at trying to have some more safety standards around for players because is it's not healthy for players now the the only mitigating factor is that that is a pretty small scenario it does not happen in in the context of numbers of human beings playing video games at loud volumes it's it's a very very small thing but it's definitely one of the things that they're working on and it's probably one of the reason Patrick karing got as bad as it was I think I got time for one more question before we take it up to the the uh the wrapup room yes hi um I from from what I remember uh the

monitoring uh standard for um speakers is around uh 85 DB uh at least for uh film and TV yep um and I'm not sure three is one for uh headphones but um I was just wondering if um in order to uh protect your own hearing and um make sure that your um mixes are as good as possible without um the effects of um losing um like like like having that Notch effect that that you were talking about um would you recommend um a revision to that uh standard um and or a different uh um behavioral change in terms of uh when you're mixing like um uh doing like a

onh hour session here and there ra rather than um a two-hour session like like would would spacing it out um help um uh any long-term effects during during the week when you're working on um a project yeah it's a great question I I definitely would not go as far as tell the entire audio industry that they should change their mixing level standards um uh that said you know taking breaks is an important part of the mixing process again it gives your ears a chance to rest um the 80 you from a so 80 Deb is the recreational 85 is actually the the occupational so if you're working and that said again You're when we mix to 85 that's kind of you know where dialogue level we want to have it's not like you're listening to Pink noise at 85 DB for eight hours in a mixing session or or again you know you're not on a factory floor where the ambient noise level is 85 DB and literally all day long you are listening

to that so the fact that yeah we're you know I suppose if you were a you know heavy metal mixer that just did nothing but mix heavy metal albums 12 hours a day that could be problematic but yeah just taking breaks and the natural EB and flow of most media um you know has enough softs versus louds that I I don't see that as probably being an issue as long as you take breaks yeah you you need to give your ears a rest not just for your hearing but for your profession so that you're we're not making mixing decisions based upon um the colorization based of that because of TTS it's temporary threshold shift it's called so thanks so much uh thanks for showing up and being interest in this topic [Applause] [Music]