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Brian W. Benson, MSc; Nicholas G. H. Mohtadi, MD, MSc; M. Sarah Rose, PhD; Willem H. Meeuwisse, MD, PhD

JAMA. 1999;282:2328-2332.

Context  Speculation exists that use of a full face shield by ice hockey players may increase their risk of concussions and neck injuries, offsetting the benefits of protection from dental, facial, and ocular injuries, but, to our knowledge, no data exist regarding this possibility.

Objective  To determine the risk of sustaining a head or neck injury among intercollegiate ice hockey players wearing full face shields compared with those wearing half shields.

Design, Setting, and Participants  Prospective cohort study conducted during the 1997-1998 Canadian Inter-University Athletics Union hockey season of 642 male hockey players (mean age, 22 years) from 22 teams. Athletes from 11 teams wore full face shields and athletes from 11 teams wore half face shields during play.

Main Outcome Measure  Reportable injury, defined as any event requiring assessment or treatment by a team therapist or physician or any mild traumatic brain injury or brachial plexus stretch, categorized by time lost from subsequent participation and compared by type of face shield.

Results  Of 319 athletes who wore full face shields, 195 (61.6%) had at least 1 injury during the study season, whereas of 323 who wore half face shields, 204 (63.2%) were injured. The risk of sustaining a facial laceration and dental injury was 2.31 (95% confidence interval [CI], 1.53-3.48; P<.001) and 9.90 (95% CI, 1.88-52.1; P = .007) times greater, respectively, for players wearing half vs full face shields. No statistically significant risk differences were found for neck injuries, concussion, or other injuries, although time lost from participation because of concussion was significantly greater in the half shield group (P<.001), than in the group wearing full shields.

Conclusions  These data provide evidence that the use of full face shields is associated with significantly reduced risk of sustaining facial and dental injuries without an increase in the risk of neck injuries, concussions, or other injuries.

Author Affiliations: Faculties of Medicine (Mr Benson and Dr Rose) and Kinesiology, Sport Medicine Centre (Drs Mohtadi and Meeuwisse), University of Calgary, Calgary, Alberta.

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