# Prevalence of voice problems and associated risk factors in electronic sports players

## TL;DR

This study found that about 20% of esports players experience voice problems, likely due to long gaming hours and poor environmental and lifestyle factors.

## Contribution

The first investigation into voice disorders among esports players, identifying risk factors like prolonged gameplay and poor air quality.

## Key findings

- 20.7% of esports players had voice problems based on the VHI-10-TR cutoff score.
- Longer daily speaking time during gameplay and weekly gaming hours over 21 were significantly associated with voice problems.
- Poor air quality and frequent spicy/fatty food consumption were lifestyle-related risk factors for voice issues.

## Abstract

Electronic sports (esports) has rapidly emerged as a global phenomenon, engaging millions of players and viewers. Previous research has extensively examined health concerns in this population, including musculoskeletal disorders, ocular fatigue, sleep disturbances, and cardiometabolic risks. However, despite the intensive and prolonged vocal use required during team-based gaming communication, voice disorders have not been investigated in esports players. This study aimed to examine the prevalence of voice problems and associated risk factors in this population.

A cross-sectional survey was conducted with 87 esports players aged 18–32 years in Türkiye. Data were collected using a researcher-developed questionnaire that addressed vocal symptoms, phonotraumatic behaviors, lifestyle, and health-related factors. In addition, the Voice Handicap Index-10 (VHI-10-TR) was administered. A cutoff score of ≥ 7 on the VHI-10-TR was used to identify players at risk for voice disorders. Descriptive statistics, chi-square tests, and logistic regression analyses were performed.

Based on the VHI-10-TR cutoff score (≥ 7), 20.7% of the participants were classified as having voice problems. Significant associations were found between voice problems and longer daily speaking time during gameplay (p = .009) as well as weekly gaming hours exceeding 21 (p = .009). Commonly reported symptoms included throat dryness (49.4%), vocal fatigue (35.6%), and throat discomfort (26.4%). Poor air quality in gaming environments (p = .036) and frequent consumption of spicy/fatty foods (p = .037) were significant lifestyle-related risk factors. Difficulty hearing conversational speech was also associated with increased likelihood of voice problems (p = .045). Logistic regression indicated that unadjusted odds of reporting voice problems were three to five times higher in relation to these factors, though none remained significant in the adjusted model.

Approximately one in five esports players reported voice problems, highlighting their potential vulnerability as a risk group. Environmental and lifestyle conditions, alongside prolonged gaming and communication, contribute to vocal strain. Preventive strategies focusing on vocal hygiene, gaming environment improvement, and early screening may help safeguard vocal health in this population.

The online version contains supplementary material available at 10.1186/s13102-026-01536-9.