Helmets and head-worn equipment are used for protection during work and sports activities. However, the weight of the equipment and its design increase the mechanical load on the cervical spine and its neck muscles. Flight missions at high Gz-forces, while large head movents are being performed, or the use of night vision goggles (NVG), while the head is kept in a sustained neck flexion angle, both during precision demanding work, represents two different conditions, where different cervical spine pathologies due to excessive neck load can be expected. Beside assessment of load magnitude also load duration has to be taken into account in risk calculations of the exposure. It is concluded that when assessing limits for excessive cervical spine load more emphasis must be put on elucidating the interaction of environmentally, externally induced land, and individual, pilot-related factors.