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Have you ever ridden a cruiser with straight-through pipes? Perhaps we've got different definitions of overwhelming (mind you, I've never ridden with an open-face), but I've been on the back of one a couple times, and DAMN! Load up the engine and it was very uncomfortable - I could never do it on a daily basis, and I've got no doubt the bloke that rides it is doing himself some damage, though he's already got industrial deafness. The problem's not limited to cruisers either, I've known a few guys/girls who've bought a bike with IXIL/Screamin' Demon/etc cans, and had to swap them out because they found them a PITA to ride.
Like I said, I can't claim a lot of experience on them, but between an open pipe and wind-noise, you're not going to hear anything besides a police/ambo/fire siren. Though that's something I'm surprised no-one's mentioned, and is actually a pretty good point... I can hear sirens through earplugs, but not through isolating IEMs when music's playing at anything above a low volume. Typically I don't have the music past "background noise" anyway, I try to keep 360-degree awareness, and check every intersection before pulling out (put that down to riding - no-one sees you, and half that do don't care), but ability to detect emergency vehicles is certainly a factor to consider when you're trying to work out whether a given 'phone/wearing-habit is safe or not.