The 20-something man walked into Stanford Health Care’s emergency department suffering from a common injury with an uncommon — but growing — cause: He broke his hand while flailing around in a virtual world.
Wearing a virtual-reality headset that immersed him in a computer-generated environment, the man had “gotten a little too enthusiastic” and punched a wall, said Dr. Ryan Ribeira, assistant medical director of the Stanford Emergency Department, who treated the patient.
“There are a number of VR games where you end up swinging your arms around a bit,” Ribeira said. “When you’re in VR, things feel real. There are experiences where a spider might jump out at you. It can be that you’re fighting zombies in VR and they’re jumping out at you. You may have to jump away or fall on the ground.”
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Little data exists on how many people are injuring themselves in VR worlds, but recent research suggests the numbers are climbing, Ribeira said. And while VR technology is still struggling for mass appeal, the $271 million spent in the U.S. on VR headsets in October and November, according to CNBC, suggests many may have ended up as gifts for Bay Area residents and others this holiday season.
“There are going to be a bunch of people,” Ribeira said, “that are going to be putting on a VR headset for the first time.”
A paper published earlier this year by Dignity Health researchers in Arizona analyzed U.S. emergency-room data and reported that the first recorded VR injury occurred in 2017, and by 2021, there were some 1,336 reported injuries from using the technology.
“VR devices are operated with the user’s full physical engagement, which may involve walking, kicking, arm swinging, neck movements, bending, and other maneuvers,” the paper’s authors wrote. “As with any physical activity, there is a risk of injury, and because the devices are primarily used within a confined space indoors, there are additional hazards that may endanger VR users.”
Broken bones were the most common reported injury, followed by cuts, contusions and sprains. Ribeira noted that people in virtual reality can get hurt when they become dizzy from head movement, and “just fall down.”
Since 2021, the number of VR injuries across the country has probably climbed to a few thousand a year, Ribeira said, adding that many additional injuries no doubt occur but do not require medical care. Still, the technology has yet to hit the mass market, and many doctors and nurses have yet to treat their first case of virtual reality injury. “We’re not seeing it,” said Christopher Brown, spokesman for El Camino Health, which has emergency rooms at its hospitals in Mountain View and Los Gatos. Sutter Health said it was not seeing such cases at its Bay Area emergency rooms.
The U.S. Consumer Product Safety Commission in a March letter to product-certification company Underwriters Laboratories raised concerns that the effect of VR use on children’s developing visual and musculoskeletal system “has not adequately been addressed” and that neck strain could also affect users. Tripping over objects poses another risk, according to a 2021 paper by United Kingdom researchers.
A number of law firms are trolling online for clients injured while in virtual worlds. Silicon Valley Law Group is not one of them, but one of its attorneys, Stephen Wu, formerly represented companies like Firestone and the R.J. Reynolds Tobacco Company in major product-liability cases. With virtual reality, legal claims could arise over alleged design defects, or failure to warn consumers about risks, Wu said.
Leading VR headsets include Meta’s Quest products, formerly branded as Oculus, Sony’s PlayStationVR, and HTC’s VIVE.
Major companies selling VR headsets provide warnings about how to use the products safely, and recommend keeping small children from using them. Ribeira, who founded SimX, a startup providing VR-based training for doctors, nurses and paramedics, also provided recommendations to keep VR users from colliding painfully with the real world and ending up in his emergency room.
Among the key safety recommendations from Ribeira and headset makers are to play in the center of a safe, clear space that also has a buffer zone empty of objects or hazards that extends beyond the virtual boundaries you set, and to avoid passing by the boundaries when they appear in your world.
“Virtual reality injuries are something to prepare for but are really preventable,” Ribeira said.