Ben Roethlisberger's crash has revved a national debate over whether people who ride motorcycles should be required to wear helmets.
Doctors who treat motorcyclists after crashes, and experts from the National Highway Traffic Safety Administration, say helmets reduce the likelihood of injury and death, and ask that motorcyclists realize the value of this "dose of common sense."
But some motorcyclists contend the choice to wear or not to wear the protective bubble should be left to them.
Pennsylvania Department of Transportation statistics do not settle the debate.
Although numbers do not reflect what percentage of state motorcyclists wear helmets, the statistics show that more helmet wearers than nonwearers have died since 2003, when the state relaxed its requirement that motorcycle riders wear helmets.
In 2004 and 2005, 180 people wearing helmets died in crashes, while 157 who were not wearing helmets died.
Meanwhile, motorcycle registrations have grown by a whopping 34 percent from 2001 through 2005, when 313,180 motorcycles were registered. The number of motorcycle driving licenses also has been on a steady increase, from 743,183 in 2001 to 772,201 last year.
But the National Highway Traffic Safety Administration said statistics are clear nationwide. With more states repealing helmet laws, the number of deaths and serious injuries is on the rise.
Nationwide, the fatality rate -- the number of deaths per 100,000 registered vehicles -- climbed from 55 in 1997 to 69 in 2003, the last year for which statistics are available.
In 1997, there were 21 deaths for every 100 million miles traveled on motorcycles. That rate climbed to about 39 deaths for every 100 million miles traveled in 2003.
"A helmet is not an absolute guarantee you'll survive a crash," said NHTSA spokesman Rae Tyson. "But helmets are tremendously effective in reducing the likelihood of getting seriously injured or killed."
The NHTSA offered other statistics:
Motorcyclists are 32 times more likely to die in a crash than someone riding in an automobile.
Head injury is a leading cause of death in motorcycle crashes, but helmets reduce the likelihood of a crash fatality by 37 percent.
Helmets are 67 percent effective in preventing brain injuries, while motorcyclists without helmets were three times more likely to suffer brain injuries than those with helmets.
From 1984 through 2003, NHTSA estimates that helmets saved the lives of almost 15,000 motorcyclists.
Nationwide, 20 states and the District of Columbia still have laws requiring motorcyclists to wear helmets. In most states that repealed helmet laws, the number of operators wearing helmets drops to about 50 percent.
Mr. Tyson said Florida experienced a significant increase in fatalities after it repealed its helmet law in 2000. It also experienced a significant increase in medical costs associated with motorcycle injuries.
"The same will be true in Pennsylvania," he said, noting that the raw statistics to date don't yet reflect the national trend.
Currently, riders in Pennsylvania can choose not to wear helmets if they are 21 or older, have two years of riding experience or have completed a state-approved motorcycle safety training course, said Charles Umbenhauer, a lobbyist for ABATE of Pennsylvania, which advocated for the change.
He said the group simply felt those people should be able to decide for themselves whether they wanted to wear the safety equipment.
Mr. Umbenhauser said ABATE did not plan to change its stance in light of Mr. Roethlisberger's accident.
"We're very sorry to hear that happened," he said. But he called it "an isolated accident that occurred to a high-profile individual."
While fatalities and nonfatal injuries have increased, "that didn't come as a surprise to us," Mr. Umbenhauser said, noting that motorcycle registrations in the state have increased. He also said many people from New Jersey, New York and Maryland -- states that have more restrictive helmet laws -- are coming into Pennsylvania to ride.
A number of facial injuries might be avoided if the motorcyclist is wearing a helmet with a face mask, said Dr. Douglas McGee, a Philadelphia physician and immediate past president of the state chapter of the American College of Emergency Physicians, which opposed the change in the helmet law.
"While more motorcycles may be on the highway, clearly more people are dying now than when we had the law in place," he said.
Dr. McGee noted that state officials are examining the effects of the change. Mr. Umbenhauser said a report will be released soon.
"I think Pennsylvania will find its experience is no different from those of other states that have repealed their laws," Dr. McGee said. "Motorcycle fatality rates have gone up in all those states."
By contrast, states that have implemented all-rider helmet laws have seen their motorcycle fatality rates decline, said Dr. Hank Weiss, director of the University of Pittsburgh's Center for Injury Research and Control.
The message, said Dr. Jack Wilberger, chairman of neurosurgery at Allegheny General Hospital, is that motorcyclists should wear helmets.
"High-profile people like [Mr. Roethlisberger] set an example for a lot of people," Dr. Wilberger said. "Hopefully he'll reconsider his stance, and I'm sure his bosses will help him to reconsider his position."