Ever since the advent of the full-face helmet back in the 1960s, there has been a debate about whether it is the most effective form of head protection. Indeed, some observers suggest helmets, in general, may contribute to certain injuries, such as concussions and neck trauma. There is also an argument that post-crash airway management may also be more difficult on a rider wearing a full-face motorcycle helmet because performance of CPR or airway clearance is required, and helmet removal may risk worsening cervical spine injury if done improperly. Others argue that full-face helmets are inconvenient, too heavy, too restrictive, or too hot.
The counterpoint is that helmet design innovations are available to counter those problems. For example, helmets that offer full-face coverage, but have flip-up or removable chin bars instead of one-piece construction, eliminate the need to remove the helmet for emergencies. Other options are also available, such as removable cheek pads in the helmet to allow much easier helmet removal—a common feature of premium motorcycle helmets.
The lack of objective data is part of the problem with sorting fact from fiction regarding this issue. There has been one study in particular that may help: Are full-face helmets the most effective in preventing head and neck injury in motorcycle accidents? A meta-analysis. It was published in May 2020 and authored by Soramon Chaichan and 13 associates. Most of the authors, including Chaichan, are from the Faculty of Medicine at Khon Kaen University in Thailand, which is rated in the top five percent of universities in the world by QS World University Rankings.
The study uses crash incident and outcome data to assess the effectiveness of full-face, open-face (three-quarters coverage), and half-helmets based on data from Taiwan (2011 and 2015), Malaysia (2014), Japan (2004), and Brazil (two independent 2014 studies). The authors reviewed 702 studies and found six that qualified for inclusion in the analysis. The six selected studies included 6,529 participants.
Because this meta-analysis included data from four countries and the foundation studies it is based on had some variations in data extraction and definitions of injuries, some degree of interpretation is required in the outcome data. Also, the actual performance quality and safety certification of the helmets involved in each incident is unknown, and there is no indication of how many of the full-face helmets were modular designs or models with a removable chin bar. Also, the mechanism of injury and circ*mstances of each accident across 6,529 incidents introduce a nearly infinite number of variables that may affect the outcomes.
Despite those data limitations, this study’s findings provide new insights into an old question. The findings quantify, in general terms, the differences in the effectiveness of three familiar helmet types. Usually, discussions about helmet pros and cons among helmet users revolve around anecdotes or unusual one-off cases. The Khon Kaen University study allows a more objective, quantitative assessment. Studies where helmet type and use data was not documented were excluded.
Regarding neck injuries and helmet use, the University of Wisconsin recently completed a large study. It showed that helmets do not cause or contribute to neck injuries. Additionally, helmeted riders suffered significantly fewer neck injuries due to crashes than riders not using a helmet. The Khon Kaen University study found that head injuries, at 41.4 percent, were the most common type of injury among autopsied motorcycle crash victims.
This summarizes the Khon Kaen University study results: “The main finding of this review is that full-face helmets were better than other types of helmet at preventing head and cervical kinds of injury in motorcycle accidents. The risk of head and cervical injuries for riders who used full-face helmets was 64 percent lower compared with those who used half-coverage helmets, 36 percent lower than in those who used open helmets, and 57 percent lower when compared with both those who used half-coverage helmets and those who used open helmets.”
At the end of the day, the choice of which helmet style with which set of features, or even whether to wear a helmet at all (depending on applicable laws) is up to each rider. However, the data shows that a full-face motorcycle helmet cuts the risk of head and cervical injuries by over half compared to open-face and half-helmets.
