Accident statistics - head/neck injuries

[Freewheel]

I've been pondering workplace safety and am interested in whether anybody can point me towards statistics for the cause of death for pilots in accidents - pilots only at this point. I'm looking to put together an outlay/outcome analysis for the company.

There is clear evidence that wearing fire resistant clothing and a helmet reduces the danger from an accident. I'm looking for what's next.

I have the impression that spinal / basal skull fractures are the next most significant group, but no more than that. Does anybody know of anything available?

[SASless]

Helmets and Nomex work for some crashes....but anti-gravity suits would be better yet.

http://www.kpho.com/2007/0727/13772039.jpg

[JimL]

The best way to acquaint yourself with this subject is to google "helicopter head injuries" and then search down the list for the relevant papers (leave individual reports to one side; they may be interesting but summaries are more important).

Three to start with (not necessarily the best):

Flight Safety (http://www.flightsafety.org/hs/hs_nov_dec98.pdf)

Analysis of Injuries among Pilots Killed in Fatal Helicopter Accidents (http://www.ingentaconnect.com/content/asma/asem/2003/00000074/00000004/art00007?crawler=true)

Pilots killed in Fatal Helicopter Accidents (http://dind.nic.in/iab/t07/i2/iabt07i2p48.pdf)

Jim

[Madbob]

Freewheel

You might like to look at the BoI / accident report of the mid-air collision in January 2007 at RAF Ternhill involving two Squirrels.

The QFI in ZJ263 was sadly killed but the "stude" survived with serious head injuries and there is no doubt that wearing a helmet saved his life....The other crew of two also survived, albeit with less severe/minor injuries

Ministry of Defence | About Defence | Corporate Publications | Boards of Inquiry (http://www.mod.uk/DefenceInternet/AboutDefence/CorporatePublications/BoardsOfInquiry/BoardsOfInquirybois.htm)

Many moons ago I knew an RAF Medical Officer (Wg Cdr David Anton) who must have retired some time ago but he was an aviation pathologist and an expert in accident investigation where aircrew injuries were being assessed. Apart from identifying cause of death:( in fatal accidents he had the happier task in others of seeing first hand how improvements in crash-worthiness, fire mitigation, aircrew clothing/helments etc. actually worked.:)

I haven't a clue where his is now but I am sure he is very well known in av med circles. Martin Baker may be another source worth contacting, apart from making ejection seats they also design and manufacture crash-worthy seats for both FW and RW ac. (Thankfully I have never had recourse to use either apart from a one-off "ejection" up the gantry rig then at North Luffenham before the joys :bored: of being let loose with a JP at Linton!)

MB

[mickjoebill]

I would be very interested to hear if wearing neck collars would reduce injuries in heli accidents and have considered wearing one myself after F1 introduced the HANS system, where a rigid support is worn over the shoulders to which the helmet is strapped.
HANS wouldn't work in a heli as I think it would restrict head movement too much.

But, priced at under $30 the basic foam wrap around collar types aren't expensive and the racing car driver collars come covered in fire resistant materials.
Neck Collars (http://www.jegs.com/webapp/wcs/stores/servlet/category_10001_10002_10501_-1_10481)


Pros and cons of wearing one?

Mickjoebill

[HELOFAN]

Maybe some military stats would be handy too.
Not sure who would provide any info though.

Was reading some stories about Mil guys and early NVG's.
They were really heavy & pilots were suffering broken necks after hard landings due to the excess weight.

Also know of a Apache pilot that is off due to fractured vertibrates due to wearing lots of lovely body armor,being hunched over & lots of vibrations.
Turns out this isnt uncommon.

Though they are mil pilots, they are not 2 way rifle range related incidents.

HF

[JimEli]

a neck collar is virtually worthless.

[R44-pilot]

"a neck collar is virtually worthless."

Gotta agree, thats horizontal impact, should think most spinal injurys are due to the vertical impact.

Might work ok with planes...... :bored:

[Freewheel]

Thanks everybody so far.

I'm taking a multi-pronged approach so an aeromedical guy is rustling up some academic sources for me. I've contacted my local accident authority also.

I managed to google around a brazilian sites for lawyers and sites giving statistics relating to fatal/serious/minor injury classifications, but none I found gave me the injury types. There's also information here, but nothing as specific as I'm hoping for.

I hadn't thought of M-B. Will get in touch.

The HANS device was partially the inspiration behind the project. I had seen it around for years in motorsport and also didn't think it allowed enough movement until I was given a passenger ride in a touring car recently and was allowed to try the driver's spare. I thought it was a little restrictive for some types of operation but had much potential. I've found a paper on the known circumstances of use for various HANS devices and the G numbers are shocking.

What I've found so far is that lower spinal injuries (lumbar) tend to be from vertical compression loads such as rotary accidents and centre around where the spine has bent and the vertebrae have come into contact. Keeping the torso in place and supported during an accident event is most helpful there (ie sitting properly in a well designed seat and having your harness done up). Upper spinal injuries, (cervical) which tend to be more debilitating, tend to come from the unrestrained movement of the head and neck, the movement of which is relatively similar in vertical and horizontal accidents due to the anchoring of the movement in the torso. This is what I'm interested in, as well as those injuries that occur through the head striking an object and forming an axis, creating a severe bending moment on the spine or a Basilar Skull Fracture. I don't think a collar is of much value due to the compression of the material. Better than nothing, perhaps, but nowhere near as good as it needs to be.

What I'm really looking for is enough information to determine whether this injury type is common enough to get a return for further research.

[SASless]

sitting properly in a well designed seat and having your harness done up)

Well Sir.....that rules out helicopters then!

Name me one helicopter that has a "well designed seat"....just one!

[Freewheel]

SAS,

According to the certification requirements, the Guimbal Cabri G2 has a seat designed well enough to pass the tests. Never having sat in one, I can't vouch for it's comfort. There is still footage of the tests around somewhere.


Stroking seats are a substantial improvement in many respects, but allow the torso closer to the controls and any pedestal where fitted.Whether this may bring an increase in facial/skull injuries I'm not sure, but if so, they could certainly be reduced by restraining head movement.

The EC120 seats are reasonably comfortable, but I've never spent more than around 3 hours of a day in one. Others may have more information.

The AS350 can be bought new or retrofitted with seats similar (or identical?) to the EC120 seats, but I've never sat in one which had them. I believe most of the Eurocopter range has similar seating.

Nick - the S92? Are the seats designed for crush or are the wheels expected to accomodate this movement?

The MD900 has supposedly crashworthy seats, can anybody confirm?

I suppose I need to know whether anybody has had experience of these or any other seat in preventing/reducing/exacerbating/doing absolutely nothing for a back/neck or head injury in an accident.


PM if you prefer, all responses remain confidential. The information if used will be adjusted to remove as much identifying material as possible.

[garsr1]

We used to have a A109E and have been operating the A109S. It has the new crash worthy seats I will look up the specs. and repost the benefits over the old seats. The most obvious difference between the Power and the Grand seat is that the Grand seat sits higher and you have room for compression. Also the head rest can not be removed and is attaced to the seat back and allowed a little for and aft movment. All of the passenger seats also have the new crash worthy seats.

[John Eacott]

Re neck restraints, BMW Motorrad have developed and currently markets a neck brace (http://www.bmw-motorrad.com/com/en/index.html?content=http://www.bmw-motorrad.com/com/en/equipment/rider_equipment/index.jsp) for motorcyclists. Review here, (http://www.gizmag.com/go/6500/) maybe this is the sort of system that could be developed for use with helmets in high risk areas?

http://www.bmw-motorrad.com/dbimages/fap/product_images/86_A0070615_medium.jpg

[garsr1]

This subject will also bring up another question. How well will we be able to move our heads to check for obsticals or traffic. I have never wore a hans device so I dont know how restictive it is. I know a that there can be thousands of risk vs. need camparison for something like this.:ugh:

[Benjamin James]

Motorcross riders use them, so surely it can adapted to helicopter use.

WK8W9h0dOgE


I'd happily where a heli specific device if it could save me on the rare occasion the crash suits such a device, but I get the feeling I'm in the minority.

[John Eacott]

What I've found so far is that lower spinal injuries (lumbar) tend to be from vertical compression loads such as rotary accidents and centre around where the spine has bent and the vertebrae have come into contact. Keeping the torso in place and supported during an accident event is most helpful there (ie sitting properly in a well designed seat and having your harness done up).

FW,

From personal experience: I have compression fractures of L3 and L4 vertebrae from a vertical impact following a wirestrike. Bell 206L, with the early (poxy) seat base, which was next to useless for a <80kg such as myself. Thrown around and also knocked out (no helmet, last time ever that happened!) but: the director in the left front seat was a 100+kg fellow, and his weight actually broke his seat frame which absorbed most of the impact :ooh: As a result, he had severe bruising, but no major injury, and walked away :)

Early design parameter crashworthy Bell seats, as long as you're on the heavy side they'll work for you :p

[Freewheel]

John, who would have thought being a fat b@stard would be a health benefit....


The Leatt Brace is the best thing I've seen so far - prevents cervical movement in 360 degrees very well without restricting normal head movement - however;

Helicopter helmets typically go no lower than required to get the earcup over the ears. Motorsport helmets cover the entire skull, jawline and then some. In a downward or forward accident, the head will naturally tend to travel downward and forwards. The likelihood of the jaw being the item that stops travel of the head is therefore high.

Gentex offer a maxillofacial shield for the HGU-56P helmet, but I doubt it's designed to accept such a load.

I wonder (and I'm shuddering at the cost) if a specific brace compatible helicopter helmet may be required, since we probably won't get the features we look for in aviating, not to mention looking a bit silly wearing motorcross helmets.... (not that it's ever stopped me before).

[PurplePitot]

When you've finished that study can you start another one that involves strapping a pair of NVG on to the front and a 600gm weight onto the back of your head - I suspect you'd lose the lot, head and all.... :eek::eek::eek:

[Freewheel]

PP,

The selfish bit is that I'm looking to see what can be done for our specific operation, but I'm trying to keep in mind the wider industry. It will definitely have relevance for those who spend a minority of their time inside the shaded area of the H-V diagram....

With NVG's, a tether (HANS type) device will probably suffer more than a brace device I suspect, but only a properly instrumented test will determine that. One thing's for sure, with an extra 1-1.5 kilos on your head, something's better than nothing....

[topendtorque]

Interesting
can't comment on the heavy NVG gear, but thoughts of velcro or detonating attach bolts comes to mind. Heh Heh.:E
A bit like the brief we give to shooters, "If'n there's silence just throw that damn thing out the window first, got it?"

Re Neck breaks, I cannot recall one. I would place a preference on mobility and vision perepheral far above a neck brace.

The upper back seems to be the most common in the R22, I assume because of the lower intera blades not always availing themselves of the opportunity of zero forward airspeed. Particularly that trait combined with lap sach harness is bad news. The spine will curve under forward deceleration.

The 47's seemed to have the lower back injuries much more often. i have noticed that the 47 guys get up and walk more often and sooner than the R22 guys. Having bumped a '47 once I was very thankful of the full harness, felt just like a bad fall from a horse.

The Hillers I recall, had a couple of nasty full on, engine xmon the lot straight onto the luckless driver in the centre seat whenever a heavy forward airspeed bump arrived.

The bump I had in a R22, left me to crawl away from it, (three cracked vertabrae upper back) and unable to carry a full jerry can in one hand for 18 months, but i clould carry two inside twelve months.

I agree that light weight people seem to suffer more. a recent case was extraordinary.

The crew member "Left hand seat in an R22" suffered quite badly in the upper back, not quite breaking the spinal chord. It appears, - we think - that on the second contact which was the left hand skid at still about ten knots, which broke the forward port cluster, that at the same time the M/R blade contacted the ground heavily port side, thus throwing the xmon and associated framework forwards and pushing the firewall forward right behind where his back was being firmly pushed by his feet.
(a breaking cluster always means that there is severe stress to be shared around, mostly by the person closest to it to help absorb.)

Sort of a rabbit chop if you like. He didn't even have seat belt bruising. he was a light weight extremely fit, very good ex pro bull rider, young man. The driver stepped out with light bruising. The cabin virtually unmarked ecept for the fire wall bump.

We have long lamented the abscence of full harness in R22's but I maintain that the discipline of teaching zero forward airspeed touchdowns is by far the most important at ab initio stage for any person down in the grey shaded area.
tet

[Hover Bovver]

A hans device would not work in an aircraft, as to make the system work properly it needs specific belts to hold you and it in place,none of which will be certified of course - and then you also need the helmet to go with it . It is also rather awkward to get on and off, and generally is left connected to the helmet and the 2 are put on together. You also need a seat which is specifically shaped for the Hans , otherwise it feels uncomfortable sitting in a normal seat .

[mickjoebill]

For those in light utility helicopters where the seat back is easily removed a custom seat back could be made to accommodate the hans.
Given the appalling design of most seats pre year 2000 there is room for improvement in the seat back in any case.



Mickjoebill

[KNIEVEL77]

Madbob states in his post that an inquiry into a helicopter crash stated that 'the helmet clearly save his life'.........without doubt the best £500 that guy has ever spent, i'm off to order one now!

[Runway101]

I couple of months ago I flew with an old fella in his 206 from Switzerland. He's the owner/engineer/pilot/everything of a small company with an H300, 206 and Lama. He flies a lot of concrete for construction, but occasionally does give instructions and also flies VIPs to their favorite ski resort.

He insisted on a helmet and it was the first time I used one. Unfortunately the helmet was a bit too large for me, but I could definitely get used to it if you give me a recent model.

He made a point that he flew once with two guys in his H300 (were you are basically sitting on top of each other) and he had to do an emergency landing because of some mechanical failure (drive train if I recall correctly). He was the only one wearing a helmet. On touch down the Hughes 300 almost flipped over and he hit his head on the door post REALLY hard. With his one eye he saw the right passenger open the door and getting ready to jump out, while the ship was still almost flipping and the pilot was afraid his rotor would strike the ground or boom anytime soon. With his right arm he just grabbed that young guy who wanted to jump out and told him to stay put.

The point is, without his helmet he would probably have been unconscious, which could have resulted in lots of different endings of this story. He now also insists on passengers wearing the helmet, "even if it's Michael Schuhmacher".

[KNIEVEL77]

Runway 101,

Great story........but why do you think they are not compulsory for ALL helicopter pilots?

J.

[nigelh]

I used to wear one doing ag work but not for passenger work !! Wearing a helmet may make you feel safer but a) is that a good thing ? and b) If the pax then wear them that can create a danger ,as they will not be able to hear you give instructions ( if they are not connected or batt off say in a fire etc )
Lastly dont have too much faith in them ...the wearing of one actually caused the death of a friend of mine when the wire went around his neck .

[Freewheel]

Nigelh,

The thing I learned from that one (was that the squirrel next to the loch?) was that you need to go along to your friendly avionics engineer (if such a thing exists...) and get him to make up a length of cord about 3" long with a fresh set of plugs at each end. This creates a weak link that will detach regardless of the direction it is pulled.

Very handy for vacating an airframe in a hurry, but do make sure you've got enough length or a coil cable so you can lean out the door, very annoying to have to plug it back in with a load on the line.....


Knievel,

While it's true that you can get a failure of any kind, at any time, most passenger ops are conducted outside DennisK's "extra caution area", giving the opportunity to make us of our superior aviating skills to avoid needing what automotive engineers call "passive safety devices". This doesn't mean it can't go wrong, incredibly quickly, but the opportunity is there.

The operations that have sparked my research are those where there is limited opportunity to practice superior aviating skills and where, if any of us manage to find some, they would most likely serve to reduce, rather than avoid, the use of the "passive" equipment.

[mickjoebill]

The Massa accident is drawing attention to his head gear including the use of the HANS.

Anyone have details of the types of head or neck injuries in heli accidents?


Perhaps some form of HANS device would reduce neck injuries in heli accidents? We go to the trouble of donning a helmet but there is considerable risk of neck damage or a basal skull fracture in an accident.

The heli-HANS would need to allow more rotational movement of the head than the HANS designed for racing divers who have the benefit of rear view mirrors:)

The HANS simply rests over the shoulders and the helmet has two tethers attached to it thus limiting the degree of forward movement of the head in relation to the neck.

As far as I know, part of the design problem is that the hans can't be attached to the seat so it must be wedged between driver and his seat back to be effective. Given that pilots are not strapped into seats as rigidly as racing car drivers are, a new design is needed to prevent the hans from moving off the pilots shoulders..


Apparently a common aspect of Basal fracture is that it severs arteries and one bleeds to death in less than a minute.



Mickjoebill

[farsouth]

Are you planning on wearing one in your car as well????

[What Limits]

I was at a lecture by a racing Doctor who treated Zanardi after his accident. He also worked on the development of HANS. I understand that HANS is a device which limits forward rotation of the head due to the seating position of the driver i.e almost supine (lying down). I don't think it would be very effective in a helicopter accident which would be characterised by excessive vertical deceleration.
In the case of excessive horizontal deceleration, you end up with a face full of cyclic or instrument console.
Rather than HANS, how about a full face helmet?

[SilsoeSid]

mickjoebill,

The HANS system only came into play when the car hit the barrier.

The system will do nothing about a dirty great spring hitting you in the head, thats where the helmet does its work.

In our business Pilot Joe 'A to B' will not wear a helmet, flying suit or indeed much if any protective clothing because of the image it portrays.

Either;
a. Customers don't want to be flown around by a pseudo Maverick wannabe out of Top Gun, with badged flying suit and black visored helmet.
Pax wish to have the short sleeved white shirt and tie with gold bars and headset look, complete with polyester trousers.
or
b. Walking from/to the aircraft at the flying school, race course, hotel or golfing venue, he/she might feel a little overdressed for the surroundings.

Of course we all know it makes sense to have a Nomex flying suit, helmet and gloves, but circumstances make us decide what to wear.

Why is it that when you go go-karting for example, they make you wear helmets and overalls, but it doesn't happen at flying schools!


Comparing Massas incident and the HANS to anything flying, is a bit of a red herring IMHO. To relate it to a flying incident, a bird (or spring from another aircraft) would come through the windscreen, hit us on the head rendering us unconscious and consequently not in control of the aircraft.

Now this is where I don't get where you think the HANS would be any use to us....:confused:

[mickjoebill]

The HANS system only came into play when the car hit the barrier.


If you look closely at the pictures you can see that the tyre wall has a smear of yellow paint from Massas helmet.

The system will do nothing about a dirty great spring hitting you in the head, thats where the helmet does its work.

Yes of course a helmet is a good idea.
a. Customers don't want to be flown around by a pseudo Maverick wannabe out of Top Gun, with badged flying suit and black visored helmet.
Pax wish to have the short sleeved white shirt and tie with gold bars and headset look, complete with polyester trousers.

This old chestnut keeps getting trotted out, but where is the evidence?
Show me a survey. There is a chance that passengers would prefer to have a pilot in a helmet!
Walking from/to the aircraft at the flying school, race course, hotel or golfing venue, he/she might feel a little overdressed for the surroundings.
Not a problem to take off a helmet! A one piece flight suit is a different discussion (solved by wearing a two piece outfit!)

Either;
Why is it that when you go go-karting for example, they make you wear helmets and overalls, but it doesn't happen at flying schools!

And it is up to individuals in the industry to make the change. I'll bet that as many customers would be attracted to a flight school that demands its students wears helmets than customers who are turned off. Now you'll say that the cost of the helmet is high. Im sure that the manufacturers can come up with a set of helmets designed specifically for flight schools that can fit most head sizes. Immersion suite manufacturers have done this. In fact part of the market for such helmets could be the offshore industry.


[QUOTE]Comparing Massas incident and the HANS to anything flying, is a bit of a red herring IMHO. To relate it to a flying incident, a bird (or spring from another aircraft) would come through the windscreen, hit us on the head rendering us unconscious and consequently not in control of the aircraft.


Im not comparing it at all, it merely raises the issue of head protection in flying vehicles.:ok:


Now this is where I don't get where you think the HANS would be any use to us....

I am suggesting that a HANS like device could be beneficial, you'll note that I was asking for more references to medical opinion.

I don't believe it is far fetched idea because as has been pointed out a collar for motorbike users has been developed.

What is disheartening is that a view such as yours is not unusual, you are someone who understands the benefits of helmets but are unable to change your daily working practice and perhaps because of this, are generally negative about positive steps to improve crash survivability.



Mickjoebill

[mickjoebill]

Are you planning on wearing one in your car as well????

6 airbags and crumple zone mitigates the risk far more than wearing a helmet!


Mickjoebill

[SilsoeSid]

What is disheartening is that a view such as yours is not unusual, you are someone who understands the benefits of helmets but are unable to change your daily working practice and perhaps because of this, are generally negative about positive steps to improve crash survivability.

As someone who wears a helmet with visor down, a nomex flying suit with natural fibre clothing underneath, a roll necked long sleeved nomex shirt and leather flying gloves everytime I go flying, I find your last remark a bit surprising.

As a 'qualified' Flight Safety Officer, I encourage everyone I fly with to wear the same and all visitors that fly with us have to wear a similar level of protection, including helmet and flying suit.


The problem you have mickjoebill, is that you do not realise there are some of us who take Flight Safety and H&S in the aviation environment a bit more seriously than you do. Because some of us do so, we see the faults where they exist in other areas of our industry.

[SilsoeSid]

Right, now the serious bit has been done;

If you look closely at the pictures you can see that the tyre wall has a smear of yellow paint from Massas helmet.

http://www.abc.net.au/reslib/200907/r406080_1913786.jpg

So what are you trying to say?
a. The HANS was of no relevance as the car punched its way into the barrier too far.
b. The HANS allowed the head to go too far forward.

In fact, the only reason that the 'yellow' is there, would be because the rubber skirting around the tyres came down into the cockpit briefly, as can be seen in the video at about 50 seconds.

As for the rest of your comments...:ugh:

<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/LAbQLkgbFeA&hl=en&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/LAbQLkgbFeA&hl=en&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>

If you look at the colour of the helmet,

http://www.f1fanstore.com/product/HFM2009#

The yellow on the tyre wall matting, if it was indeed from the helmet, would have come from the top. So if you are going to discount the matting bending over, the only other way the yellow of the helmet would get there would have been for the HANS to have failed allowing the top of the head to move from the vertical to horizontal.(which in the vid, it doesn't)
So that paint is irrelevant in your argument.

As for the rest of your comments :ugh:

[ChopperFAN]

Hey guys,

I do alot of motorcross riding... The types ive seen for racing allow the head to move so far forward and back, but it prevents spinal compression as they pack up tight under the helmet

They are a little restrictive for tilting side to side movement because in motorcross and car racing your usually looking mostly forward but im sure a helicopter type could be designed which would allow you to turn your heads and still have compression preventing qualities

If you came down with almost zero airspeed it would prevent your head from compressing down to your body, ive seen many guys trying flips and jumping land right on their head and walk away from it

Without these many would have ended up para and quadraplegic

We use a chest protection too which I could see in helicopters, it protects your chest and back from being punctured in a crash and in helicopters im sure it would help prevent internal injuries from an impact

I think helmets are a must, any accident in any vehicle could be your last. As a pilot your not saying your unsafe to fly with but i think it shows that your professional and safety is important to you

If the option was there when ive been a passenger to use one , I would always take a helmet

Maybe designers should look at race car roll cage design and crumple zone areas and incorperate crash cells into future helicopter designs

We should use helmets in standard cars, they really arnt so safe either, and not all of us can afford anything with airbags... my 72 datsun 1600 has none, and any crash I have, I know it will be my last

Just my 2c of cause, hope I havnt strayed to far

Simon

[mickjoebill]

So what are you trying to say?
a. The HANS was of no relevance as the car punched its way into the barrier too far.
b. The HANS allowed the head to go too far forward.

I wasn't clear, I was drawing attention to the strong evidence that the helmet made contact with the matting and so could have contributed to his Basal head injury, in other words it may not have been that HANS failed to do its job by preventing the head going forward. The assumption is that a violent rearward blow can cause a Basal fracture.


Slisoslid, my apologies if I misread your personal involvement in flight safety, as I read your original comments collectively to be anti helmets and suits.

Perhaps you will reflect on your comment that I don't take flight safety seriously, since I have fueled the question of adopting a Hans like device for helicopters and incidentally couldn't be more proactive and outspoken in respect to education of the media business in respect to flight safety whilst filming.




Mickjoebill

[kristymark]

On the same topic of head / neck injuries - When briefing your passengers for a crash brace position what is better for the head / neck;

1 - back and head against the seat and arms straight holding the seat beside your legs or,
2 - back against the seat and head supported by one arm grasping the oposite shoulder

We brief option 2 as we believe there would be much better protection of the head / neck in an impact!