CLEVELAND. Ohio — Today's football helmets provide no more protection from many on-field collisions, including some that could cause a concussion, than their leather predecessors did decades ago.

That's the finding of Cleveland Clinic researchers who tested 11 modern helmets and two "leatherheads" from early last century. The results were published online today in the Journal of Neurosurgery.

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In September, as part of a separate Clinic-lead study, nurses drew blood from Baldwin-Wallace football players following a game against Heidelberg to test for elevated protein levels that would suggest head injury. The goal of the study is to determine when an athlete who sustains a blow to the head should get medical treatment.

Football is the leading cause of concussions in the United States and 53 percent of those that occur during high school are never reported, according to the Journal of Neurosurgery report.

And yet helmet safety design standards are based on preventing catastrophic injury such as skull fracture, not concussions, said lead researcher Adam Bartsch, director of the Cleveland Clinic's Spine Research Lab located at Lutheran Hospital.

Researchers are not calling for a return to leather helmets, but they do believe more research is in order to make today's helmets more protective in all manner of contact.

The study tested hits in what Bartsch called the near-concussive range, that may or may not result in a concussion. But that's not to say the hits aren't doing damage.

Bartsch cited former Pittsburgh Steeler lineman Mike Webster who developed a debilitating brain disorder called chronic traumatic encaphalopathy despite never having experienced a known concussion during his playing days.

The blows can add up, Bartsch said, especially for those who start playing football at a young age and continue on to adulthood. "You want to reduce every one of those impacts as much as physically possible," he said.

The researchers tested 11 hard plastic helmets that would be used in the National Football League, college and in high school. Brands included Riddell, Schutt, Adams and Xenith.

The two leather helmets date back to between 1920 to 1940 and were collectibles owned by one of the researchers, Bartsch said. They are all leather and are a quarter- to a half-inch thick.

The helmets sustained blows from five different angles, and in most cases the leather helmets performed as well or slightly better than the hard plastic helmets, Bartsch said.

Hank Zaborniak, assistant commissioner for football with the Ohio High School Athletic Association, said the Clinic's research doesn't surprise him. If a helmet could be developed to prevent more concussions, that would be a good thing, he said, but cost would be a factor, "whether anybody wants to admit it or not."

Zaborniak said he thinks helmet manufacturers will design a better product, if they aren't doing so already, because it makes good business sense. "If you have a better product than I do, you're going to sell more than I do," he said.

Representatives of Riddell Sports and Xenith did not immediately respond to a request for comment. A spokesman for Schutt Sports, which acquired Adams USA's football helmet and faceguard business, earlier this year, declined to comment.

Bartsch said the inspiration for the study came from two sources. One was a commonly heard claim that newer helmets are better than older helmets but with no objective evidence to back up the claim.

He also cited an Insurance Institute for Highway Safety crash test that had a 1959 Chevrolet Bel Air plow into a 2009 Malibu to test advances in automobile safety. The modern car's occupants fared much better.

Bartsch said one of the follow-up studies that needs to be done involves coming up with the optimal helmet design for children who play football.

"Is a hard shell a good design?" he said, or "Should the padding on the inside be super-stiff or super soft?"

The current safety standard for a football helmets was developed in 1973, Bartsch said, but beyond preventing catastrophic damage, the only other parameter helmet makers use "is how cool the helmet looks."