If they were not safe, major corporations would not sell them due to the potential liability.
A friend of mine added one to his bike. Before he added one, I loaned him an adjustable stem so that he could try different reach and height with the adjustable. I suggested that with the adjustable he could figure out what kind of angle he might want on a stem but he bought a new extender instead of a stem.
Four years ago I bought a new road bike. It only had 25mm of spacers between the headset and stem, steerer tube was cut for that length. To get my geometry to match my other bikes, I needed a 25 degree stem, it took some trigonometry to figure that out. But, I could not find one with that angle and ended up buying a 35 degree stem, I think the one I got is 90mm.
I also put a 35mm stem on my Nomad several years ago, I cut that steerer shorter to make packing it in my S&S case easier.
First photo is four years old immediately after I changed the stem. I have 15mm of spacers above the stem, 10mm below.
Second photo is last year after I added the accessory T bar for a handlebar bag. The T bar consumes all 25mm of space that the spacers previously used.
I mention this much detail because if a 35 degree stem would get you the height that you desire, I would go that way before getting an extender. I think it looks much better.
You mention it is for a Nomad, thus I assume that the steerer tube is not carbon, I think that an extender on a carbon tube is a no-no.