It's not just damage to hearing that clubbers should worry about

Experts writing in the Thorax detail four cases where loud music fans experienced the condition, known as a pneumothorax.

One man was driving when he experienced a pneumothorax, characterised by breathlessness and chest pain.

Doctors linked it to a 1,000 watt "bass box" fitted to his car to boost the power of his stereo.

A pneumothorax occurs when air gets into the space between the lung and the membrane that covers it when small breaks occur in the lung wall.

It is thought the intense pulses of low-frequency, high-energy sound causes the lung to rupture because air and tissue respond differently to sound.

We're flagging this up so that doctors can ask the right questions.

Dr John Harvey, Southmead Hospital

In a minority of cases, the oxygen supply to the vital organs is seriously diminished and the patient's life can be put at risk.

A pneumothorax is treated by inserting a tube called a chest drain to allow air to escape from the chest cavity.

Concerts

In a second case detailed in Thorax, a 25-year-old smoker saw doctors after experiencing a sudden severe pain in the left side of this chest while standing next to a loud speaker in a club.

A third man, a 23-year-old non-smoker, experienced a collapsed lung while attending a pop concert, where he was standing quietly near to several large loud speakers.

In the final case outlined in the journal, a 23-year-old regular smoker had suffered pneumothorax on several occasions.

During a follow-up consultation, where doctors were talking to him about what could have led up to each incident, he revealed that on two of the four occasions, he had been attending a heavy metal concert when he became ill.

Dr John Harvey, of Southmead Hospital in Bristol, who wrote the Thorax report, with colleagues from Belgium, told BBC News Online: "I don't think we'll stop people going to clubs, but we may be able to advise them not to stand next to loud speakers or put a bass box into their car."

Dr Harvey added: "A typical district hospital might see about 50 patients a year in casualty.

"We can't estimate how common loud music is as a cause, but it is probably quite significant.

"The condition is three times commoner in men than in women, and a proportion of sufferers may have been clubbing or standing next to a bass box at a pop concert."

Dr Harvey added: "Both my Belgian colleagues and I have seen cases and the more we mention it, the more people say 'I had a case like that'.

"So we're flagging it up so that doctors can ask the right questions."