FIFA World Cup event. Half a million international supporters

are expected to converge on South Africa for the historic event, to be hosted in Africa for the first time. Spectators will be greeted by a distinctively African sporting spectacle uniquely characterised by sounds produced by sports fans blowing the horn-like instrument known as the vuvuzela.1 Cherished by local supporters, the vuvuzela produces a characteristically loud, reverberant sound that can be heard for miles around the stadium. In the recent 2009 Confederations Cup held in South Africa, the international football community noticed this phenomenon.1 Despite complaints from international teams, spectators and commentators about the uninterrupted loudness of the vuvuzela, FIFA approved it as part of the signature 2010 World Cup to be held in Africa.1,2 The actual sound output created by the vuvuzela was recently reported to reach dangerously high levels, averaging 131 dB(A) at the horn opening and 113 dB(A) at a 2-metre distance from the vuvuzela.2 These values exceed international directives on exposure limits in occupational settings. Although there is significant variability in individual susceptibility, prolonged or regular exposure poses a significant risk for noise-induced hearing loss.3-5 Recreational activities with excessively loud sound levels are an increasingly important public health care concern for developing permanent sensorineural hearing loss.5-8 We aimed to determine (i) noise exposure levels of spectators at a FIFA 2010 designated training stadium during a premier soccer league match; and (ii) changes in auditory functioning soon after the match. Methods Ethical clearance was received from the University of Pretoria (September 2009), and we obtained permission from the City of Tshwane to conduct the study at the specific stadium. Each participant signed an informed consent form. Study population Spectators at a South African premier soccer league match hel