2007 GoatScrew

1 May, 2007

Our efforts together and the Congressional hearing in which I testified in June 2006 stimulated the military branches to recognize the problem with their helmets and at least start the process to provide blast-protecting helmet upgrades to troops in harm’s way.

All four services are now almost complete in their coverage of troops both in and deploying to Iraq, with just a few more kinks to iron out in the distribution of the upgrades.

Unfortunately, the military (Marines and Army) changed their procurement and the troops wind up with a cheaper pad system that is hard (troops call them ‘bricks’) and will not conform to the skull and is uncomfortable to wear. While it provides blast/impact protection, the new government-issue (‘GI’) pads are so uncomfortable troops have trouble concentrating on the dangerous tasks at hand and take them off for headache relief, even on patrol. That results in an ideal opportunity for snipers or the always-unexpected IED blast. See excerpts from the article below for more info.

We’re trying our best to persuade the government to go back to using the best and most effective/comfortable helmet upgrades available instead of trying to save a few dollars at the expense of the lives and futures of our troops. Helmets are only effective when worn, and if a trooper removes it to relieve a headache caused by poor design the intended protection is lost. To quote the USAARL official test results and recommendations:

P 43: 44;

The comfort of the helmet fitting system is critical for proper and continuous wear of the protective equipment… If it is uncomfortable or pressure points develop after time, it is possible that the wearer will make modifications to the fitting system (e.g., removing pads, cutting pads, substituting with readily available materials, etc.) in pursuit of a comfortable fit, sacrificing protective capability. or the wearer may choose to wear the headgear loosely in order to shift the helmet position to alleviate pressure points. This could alter the coverage area of the ballistic shell.

The Marines have decreed that only the GI pad sets are authorized if available, so we’re not advising families or troopers to invest in the first-class ones we provide without checking with their commanding officer first to see if it will be allowed. There is a provision in the MarAdmin that allows commanders to permit troops’ using their ‘donated’ pads, changing them out for the ‘GI  sets ‘as the operational situation permits‘. This give commanders latitude in deciding when or IF to make such a local ruling.

We feel it appropriate to now declare ‘Mission Accomplished’ as far as stimulating the military to take over our job and provide at least the basic  blast/impact protecting helmet upgrades they should have been doing all along. Therefore, we are no longer actively soliciting donations aside from already-scheduled fund-raising events, memorials and donors who so choose after the end of April.

We continue to send the protective inserts to requesting individuals and units already in Iraq until such time as the government-issued upgrades are available to all hands. That number is falling rapidly as the military supply system ‘stands up’ and we ‘stand down’. Marine Fleet Anti-Terrorism Support Teams (FAST) in the African Horn are still asking for the upgrades, as they seem to have been left out of the planning for now. I have personally been stationed in Ethiopia. The hospital I was in provided emergency care as well as MEDCAPS (Medical Civic Actions Programs) in Ethiopia, Eritrea, Somalia and Djibouti. Believe me, they NEED them.

MILITARY MEDICINE, 172, 6:586, 2007
How Satisfied Are Soldiers with Their Ballistic Helmets?

A Comparison of Soldiers’ Opinions about the Advanced Combat Helmet and the Personal Armor System for Ground Troops Helmet Guarantor: Brian J. Ivins, MPS Contributors: Brian J. Ivins, MPS*; Karen A. Schwab, PhD*; John S. Crowley, MD MPH†; B. Joseph McEntire, MS†; Christopher C. Trumble, BS‡; COL Fred H. Brown, Jr., MS USA§; Deborah L. Warden, MD*
Many factors are considered during ballistic helmet design,including comfort, weight, fit, and maintainability. These factors affect soldiers’ decisions about helmet use; therefore, rigorous research about soldiers’ real-life experiences with helmets is critical to assessing a helmet’s overall protective efficacy. This study compared soldiers’ satisfaction and problem experience with the advanced combat helmet (ACH) and the personal armor system for ground troops (PASGT) helmet. Data were obtained from surveys of soldiers at Fort Bragg, North Carolina. Ninety percent of ACH users were satisfied overall with their helmet, but only 9.5% of PASGT users were satisfied (p 0.001). The most frequently reported problems for the ACH involved malfunctioning helmet parts. The most frequently reported problems for the PASGT involved discomfort. This analysis indicated that there was a strong soldier preference for the ACH over the PASGT, which could enhance its already superior protective qualities. It also demonstrated the usefulness of soldiers’ assessments of protective equipment.

Introduction:    Many factors are considered during ballistic helmet design.1 One major factor is the ability to defeat missiles. Other important factors, known as human use factors, are related to the ways in which a  helmet affects the wearer and influence the probability that a helmet will be worn.2 These factors include comfort, fit, weight, and maintainability. When developing a helmet, designers must make tradeoffs between these factors. For example, one important tradeoff that designers must always make is between the amount of ballistic protection and weight. Increasing the amount of ballistic protection a helmet provides also increases its weight. As its weight increases, a helmet becomes more uncomfortable and burdensome to the wearer, which results in the helmet not being worn as often as it should be. When problematic human use factors reduce helmet use, military personnel increase their risk of sustaining brain injuries, because a helmet cannot protect against injury when it is not used.

According to Carey,1 U.S. Army neurosurgeons who served in Vietnam were concerned about soldiers sustaining unnecessary brain injuries from small fragments because they were not wearing their ballistic helmets. Lack of comfort and heat retention were cited as the reasons why soldiers were not wearing their helmets. Other research by Carey et al.3 on a series of 20 fatal and 8 nonfatal, combat-related, head wound cases from Vietnam found that all of the fatal head wounds resulted from fragments striking unprotected areas of the head and not the helmets. Those authors also identified four cases in which helmets prevented brain injuries when fragments struck the victims’ heads. Because of this link between helmet use and brain injury risk, it is important to identify any human use characteristics that could possibly reduce helmet use by soldiers. The methods used to evaluate helmets play an important role in the quality and usefulness of the information that is produced. Helmets used by the U.S. Army undergo rigorous testing in laboratories during initial development and even after they have been fielded. However, in evaluations of human use characteristics, it is important to supplement laboratory findings with rigorous survey methods designed to obtain information directly from large numbers of soldiers who used their helmets in an operational setting, such as during an actual deployment or a combat training exercise. This ensures that the soldiers’ assessments are based on realistic experiences. It is also important to use a carefully designed survey instrument that combines both open- and closed-ended questions. Open-ended questions allow soldiers to comment about their helmets in detail, whereas closed-ended questions provide standardized data that are conducive to quantitative analysis.


This article presents the results from a study designed to elicit soldier feedback about their helmets by using the survey methods described above. It compares soldiers’ opinions about the two main types of ballistic helmets currently in use by the U.S. Army, namely, the advanced combat helmet (ACH) (Fig. 1) and the personal armor system for ground troops (PASGT) helmet (Fig. 2). The PASGT has been widely used by the U.S. Army since the early 1980s and is still in widespread use. In 2003, however, the Army began replacing it with the ACH. The ACH is based on the Special Operations Forces’ highly successful modular integrated communication helmet. The ACH, compared with the PASGT, features increased blunt-impact and ballistic protection, improved field of view, better three-dimensional sound localization, better compatibility with mission equipment, and a more comfortable fit and is 0.5 pounds lighter.4 These improvements should translate into improved soldier performance, reduced combat injuries, and a strong user preference for the ACH. *Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC 20307. †U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362.
‡Air Task Force, U.S. Army Combat Read iness Center, Fort Rucker, AL 36362. §Psychological Operations Directorate, U.S. Army Special Operations Command, Fort Bragg, NC 28310.

Four of the six most frequently identified problem categories for the PASGT involved discomfort. Twenty-one percent of the soldiers who reported problems with the PASGT (6% of all PASGT users) stated that it caused headaches, especially after being worn for extended periods of time. Nineteen percent of the soldiers with PASGT problems indicated that the helmet was too heavy. Eleven percent of the soldiers reported that the helmet caused skin irritation or cuts on their heads, including scratches, indentations in the skin, bald spots, hot spots, and reduced circulation. Sixteen percent of the soldiers simply stated that the PASGT was uncomfortable, without indicating any specific type of discomfort.
Another type of problem that was frequently reported for the PASGT involved fit (Table III). Many of the soldiers reported that the PASGT fit them poorly. Examples of poor fit were that the helmet was unstable, it was issued without being properly fitted, and it was loose-fitting. Strap problems were also among the more frequently reported problems. Many soldiers who reported problems with straps indicated that the chinstraps were uncomfortable.

Conclusions: bThis analysis has shown that soldiers are more satisfied with the ACH than with the PASGT. The high level of satisfaction with the ACH might motivate soldiers to wear it more often than the PASGT, thereby reducing the risk of sustaining a brain injury. The analysis has also demonstrated the usefulness of systematically surveying large numbers of soldiers to acquire information about helmets. It is important for the Army to continue assessing soldiers’ levels of satisfaction with their ballistic helmets, especially when existing helmets are modified or new helmets are being considered. This can provide additional data that can augment the laboratory studies that are routinely used to evaluate helmets.


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