History

• Section 256, "Prevention, Mitigation, and Treatment of Blast Injuries," of Public Law 109-163, National Defense Authorization Act (NDAA) for Fiscal Year 2006, directed the Office of the Secretary of Defense to designate an Executive Agent (EA) to coordinate Department of Defense (DoD) medical research efforts and programs relating to the prevention, mitigation, treatment of blast injuries.
• In response to the Congressional direction, DoD Directive (DoDD) 6025.21E, Medical Research for Prevention, Mitigation, and Treatment of Blast Injuries, formally established the DoD Blast Injury Research Program. The Secretary of the Army as designated as the EA and assigned program oversight to the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)).

• Secretary of the Army delegated Executive Agent (EA) authority to the Assistant Secretary of the Army for Acquisition, Logistics, and Technology (ASA(ALT)).
• ASA(ALT) delegated EA authority and assigned program responsibility to the Commander, United States Army Medical Command (USAMEDCOM).
• Commander, USAMEDCOM, established the Blast Injury Research Program Coordinating Office (PCO) as a permanent office at the US Army Medical Research and Materiel Command (USAMRMC) to support the EA.

• The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published the Fiscal Year 2007 Annual Report to Congress: Efforts and Programs of the Department of Defense (DoD) Relating to the Prevention, Mitigation, and Treatment of Blast Injuries that identifies blast injury knowledge gaps and capability needs, describes collaborative research efforts, and documents progress to incorporate blast injury effects data into "end user" programs.
• Shaping Research Programs. Co-developed the investment strategy for the Fiscal Year 2007 Congressional appropriation of $300 million to accelerate research on prevention, detection, diagnosis, and treatment of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) resulting from military operations.

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published the Fiscal Year 2008 Annual Report to Congress: Efforts and Programs of the Department of Defense Relating to the Prevention, Mitigation, and Treatment of Blast Injuries that identifies blast injury knowledge gaps and capability needs, describes collaborative research efforts, and documents progress to incorporate blast injury effects data into "end user" programs.
• Promoting Information Sharing and Partnerships. Hosted a delegation from the Singapore Defense Medical and Environmental Research Institute to share critical research information and identify opportunities for the United States and Singapore to collaborate on blast-induced brain injury computational modeling projects.
• Shaping Research Programs. Identified and reported to the Task Force on Assessment of Medical Research and Development Investments, Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics (USD(AT&L)), fiscal year (FY) 2010 to 2015 unfunded requirements for high-priority blast injury research totaling $1.7 billion.

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Facilitating Collaboration. Convened biomedical researchers, physicians, and computational modelers from the Naval Surface Warfare Center (NSWC) Indian Head, University of Maryland, and the Energetics Technology Center to discuss the successes, shortcomings, and opportunities for collaboration in traumatic brain injury (TBI) research efforts. Helmet mounted sensor systems were a key focus of this discussion.
• Identifying Blast Injury Knowledge Gaps. Organized and hosted the International State-of-the-Science (SoS) Meeting, "Non-Impact, Blast-Induced Mild Traumatic Brain Injury," to critically examine research focused on the relationship between blast exposure and non-impact blast-induced mild traumatic brain injury (mTBI) and review proposed injury mechanisms. Read more…
• Shaping Research Programs. Identified opportunities for the Navy Live Fire Test and Evaluation Program (LFT&E) to leverage existing blast injury research tools within the United States Army Medical Research and Materiel Command (USAMRMC) to eliminate the need for new, potentially duplicative, research programs.

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published the Fiscal Year (FY) 2009 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY09 by the Blast Injury Research Program to advance the state of the science and solve difficult blast injury problems. Read more…
• Identifying Blast Injury Knowledge Gaps. Organized and hosted the International State-of-the-Science (SoS) Meeting, "Blast Injury Dosimetry," to explore ways to objectively record and document blast-related exposures and to correlate these exposures with acute injuries or chronic health effects. Read more…
• Shaping Research Programs. Coordinated and conducted five working group meetings for the Department of Defense (DoD) Brain Injury Computational Modeling Expert Panel, which advises the DoD on the development and use of computational modeling to understand the mechanisms of non-impact, blast-induced mild traumatic brain injury (mTBI) and to guide the development of effective protection systems. Read more…

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Facilitating Collaboration. Established a Memorandum of Understanding (MOU) between the United States Army Medical Research and Materiel Command (USAMRMC) and the Office of Naval Research (ONR) to transition injury and performance prediction models developed by USMRMC to ONR for validation and future Navy applications.
• Identifying Blast Injury Knowledge Gaps. Collaborated with the Department of Defense (DoD) Hearing Center of Excellence (HCE) and the Department of Veterans Affairs (VA), to organize and host the International State-of-the-Science (SoS) Meeting, "Blast-Related Tinnitus," to assess current knowledge regarding the cause, diagnosis, and treatment of tinnitus and to identify research gaps for further investigation. Read more…
• Promoting Information Sharing and Partnership. Co-chaired the North Atlantic Treaty Organization (NATO) Human Factors and Medicine (HFM)-207 Symposium: A Survey of Blast Injury across the Full Landscape of Military Science, which served as an initial assessment of the state of the science for blast injury. The symposium resulted in a Technical Activity Proposal to establish a group focused on a toxicological approach to blast injury. This became the NATO HFM-234 Research Task Group (RTG). Read more…
• Promoting Information Sharing and Partnership. Coordinated with the USAMRMC Military Operational Medicine Research Program (MOMRP) to release MOMRP's blast lung injury prediction software application known as "INJURY" to the Technical Team for NATO HFM-198, "Injury Assessment Methods for Vehicle Active and Passive Protection Systems."

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published the Fiscal Year (FY) 2010 to 2011 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY10 and FY11 by the Blast Injury Research Program to advance the state of the science and solve difficult blast injury problems. Read more…
• Promoting Information Sharing and Partnership. Nominated to chair the North Atlantic Treaty Organization (NATO) Human Factors and Medicine (HFM)-234 Research Task Group (RTG), "Environmental Toxicology of Blast Exposures: Injury Metrics, Modeling, Methods and Standards," to develop standardized tools and guidelines for conducting focused, multidisciplinary research that will lead to an understanding of the mechanisms of blast injuries. Read more…

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published "Mathematical Models of Blast-Induced Traumatic Brain Injury (TBI): Current Status, Challenges and Prospects" in the journal, Frontiers in Neurology, which describes how mathematical modeling advances understanding of brain injury mechanisms and supports neuro-diagnostics, treatment, and protection. Read more…
• Disseminating Blast Injury Research Information. Published the Fiscal Year (FY) 2012 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY12 by the Blast Injury Research Program to advance the state of the science and solve difficult blast injury problems. Read more…
• Facilitating Collaboration. Co-chaired, with the Defense Threat Reduction Agency (DTRA), a meeting of the Medical and Chemical, Biological, Radiological and Nuclear Defense Working Group of the United States (US)-India Joint Technology Group, the senior bilateral forum between the US Department of Defense (DoD) and Indian Ministry of Defence. Representatives from the two countries discussed cooperation in research and development, production, procurement, and logistics. Read more…
• Promoting Information Sharing and Partnership. Continued to chair the North Atlantic Treaty Organization (NATO) Human Factors in Medicine (HFM)-234 Research Task Group (RTG), "Environmental Toxicology of Blast Exposures: Injury Metrics, Modeling, Methods, and Standards." Read more…
• Shaping Research Programs. Participated in the Allied NeuroSensory Warrior Related Research (ANSW2R) effort initiated by the Department of Defense (DoD) Hearing Center of Excellence (HCE) to combine data on injury patterns and treatments of neurosensory injuries across specialties and Services, which supports improvements in the continuum of care and translation of bench-to-bed rehabilitation and reintegration for wounded Service Members.

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Provided the coordinated Department of Defense (DoD) response to the Institute of Medicine (IOM) report, "Gulf War and Health, Volume 9: Long-Term Effects of Blast Exposures," which addressed the level of scientific evidence cited for several health outcome conclusions based upon information from ongoing and/or completed DoD research efforts.
• Disseminating Blast Injury Research Information. Published the Fiscal Year (FY) 2013 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY13 by the Blast Injury Research Program to advance the state of the science and solve difficult blast injury problems. Read more…
• Identifying Blast Injury Knowledge Gaps. Organized and hosted the International State-of-the-Science (SoS) Meeting, "Biomedical Basis for Mild Traumatic Brain Injury (mTBI) Environmental Sensor Threshold Values," to identify challenges associated with correlating environmental sensor threshold values to injury outcomes. Read more…
• Promoting Information Sharing and Partnership. Continued to chair the North Atlantic Treaty Organization (NATO) Human Factors in Medicine (HFM)-234 Research Task Group (RTG), "Environmental Toxicology of Blast Exposures: Injury Metrics, Modeling, Methods, and Standards." Read more…
• Shaping Research Programs. Initiated two Small Business Innovation Research (SBIR) projects. The Phase I project, "Human Body Model for Computational Assessment of Blast Injury and Protection," will design a modeling framework that integrates anatomical data, geometric modeling tools for human body articulation, blast scene generation, and material property data needed for biodynamic and biomechanical simulations. The Phase II project, "Antimicrobial Textiles," will identify lightweight, durable, antimicrobial textile finishes that will prevent and/or control infections in military medical shelters and field hospitals.

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Blast Injury Research Information. Published the Fiscal Year (FY) 2014 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY14 by the Blast Injury Research Program, with two special chapters devoted to the Department of Defense (DoD) Hearing Center of Excellence (HCE) and the critical research area of hemorrhage control. Read more…
• Identifying Blast Injury Knowledge Gaps. Organized and hosted the International State-of-the-Science (SoS) Meeting, "Does Repeated Blast-Related Trauma Contribute to the Development of Chronic Traumatic Encephalopathy (CTE)?" This meeting brought together subject matter experts to discuss evidence linking repeated blast exposure to neurodegeneration and potential prevention, assessment, and treatment strategies. Read more…
• Promoting Information Sharing and Partnership. Participated and presented two briefings on key blast injury research topics at the 2015 Shoresh Conference on Military Medicine in March, the primary venue for the exchange of information on military medicine between the United States and Israel. Read more…
• Promoting Information Sharing and Partnership. Continued to chair the North Atlantic Treaty Organization (NATO) Human Factors in Medicine (HFM)-234 Research Task Group (RTG), "Environmental Toxicology of Blast Exposures: Injury Metrics, Modeling, Methods, and Standards." Read more…

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Information. Published the Fiscal Year (FY) 2015 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY15 by the Blast Injury Research Program, with two special chapters devoted to the Department of Defense (DoD) Extremity Trauma and Amputation Center of Excellence (EACE) and Vision Center of Excellence (VCE).
• Facilitating Collaboration. Initiated a collaborative project between the United States Army Medical Research and Materiel Command (USAMRMC) and the Defence Research and Development Organization (DRDO) Institute of Nuclear Medicine & Allied Sciences (INMAS) to support the rapid design, prototyping, and testing of novel protective and therapeutic concepts that will lead to faster introduction of enhanced protective and treatment strategies. Read more…
• Promoting Information Sharing and Partnership. Completed work on the North Atlantic Treaty Organization (NATO) Human Factors and Medicine (HFM)-234 Research Task Group (RTG), "Environmental Toxicology of Blast Exposures: Injury Metrics, Modeling, Methods, and Standards." NATO will publish the final report and four key products:
  
  
  • - A comprehensive dictionary of blast injury research terms
  • - Guidelines for conducting epidemiological studies of blast injury
  • - Guidelines for reproducing blast exposures in the laboratory
  • - Guidelines for using animal models in blast injury research
  Read more…
• Identifying Blast Injury Knowledge Gaps. Organized and hosted the International State-of-the-Science (SoS) Meeting, "Minimizing the Impact of Wound Infections Following Blast-Related Injuries." This meeting brought together subject matter experts to share their expertise on wound infection, identify critical knowledge gaps, and make recommendations for developing more effective wound infection prevention, mitigation, and treatment strategies. Read more…

• Secretary of the Army delegated Executive Agent (EA) authority to the Surgeon General, who further delegated program responsibility to the Commander, US Army Medical Research and Materiel Command (USAMRMC).

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Disseminating Information. Published the Fiscal Year (FY) 2016 Report to the Executive Agent: Science and Technology Efforts and Programs Relating to the Prevention, Mitigation, and Treatment of Blast Injuries, as a resource for the blast injury research community. This report highlights the activities undertaken in FY16 by the Blast Injury Research Program, with two stakeholder chapters devoted to the Defense and Veterans Brain Injury Center (DVBIC) and the Warrior Injury Assessment Manikin (WIAMan) Project.
  
  Published a supplement entitled "Blast-related Trauma and Chronic Traumatic Encephalopathy," in the Journal of Neurotrauma, which captured the proceedings, findings, and recommendations from the 2015 International State-of-the-Science meeting, "Does Repeated Blast-Related Trauma Contribute to the Development of Chronic Traumatic Encephalopathy (CTE)?" The supplement also contains additional original research articles.
• Promoting Partnership. Continued to chair the North Atlantic Treaty Organization (NATO) Human Factors and Medicine (HFM)-270 Research Task Group (RTG), "Framework for Modeling and Simulation of Human Lethality, Injury, and Impairment from Blast-Related Threats." As a first step in developing a computational modeling framework, HFM-270 (RTG) initiated an assessment of previous, ongoing, and planned biomedical research and computational modeling efforts among participating nations. Read more…
  
  Co-organized a joint session with the USAMRMC Combat Casualty Research Program at the 2017 Shoresh conference that focused on blast injury prevention. The conference is the primary venue for the exchange of information on military medicine between the US and Israel. Read more…
  
• Shaping Research. Managed three phase I Small Business Innovation Research (SBIR) projects in response to the PCO-authored FY16 topic "Warrior Health Avatar." These projects aim to develop a simulation framework and physiology based modeling tools of a warfighter body to enable definitive assessment of health status, physical and physiological performance, and injury trajectory by both the user and medical personnel using mobile computing platforms. Read more…
• Facilitating Collaboration. Organized the 2nd Japan-US Technical Information Exchange Forum on Blast Injury (JUFBI-2017) in coordination with the National Defense Medical College of the Japan Self-Defense Forces (JSDF), and US Army Research, Development and Engineering Command (RDECOM) International Technology Center-Pacific (ITC-PAC). The forum was an opportunity to exchange ideas and find a mutual understanding of Japan/US efforts in blast injury research. Read more…

The Blast Injury Research Program Coordinating Office (PCO) supported Executive Agent (EA) responsibilities by:

• Identifying Knowledge Gaps. Hosted the International State-of-the-Science Meeting on the Neurological Effects of Repeated Exposure to Military Occupational Blast. In this meeting, subject matter experts from the DOD, other federal agencies, academia, industry and the international community gathered to describe blast exposures that are repeatedly incurred during military service, describe potential neurological consequences, examine prevention strategies, identify indicators for early detection of health consequences, and prioritize key research and policy gaps related to repeated military occupational blast exposure. Findings and from this meeting were used to inform planning for the DOD's response to the request from Congress for a Longitudinal Medical Study on Blast Pressure Exposure of Members of the Armed Forces (FY18 NDAA, Section 734). Meeting proceedings are available for download.
• Shaping Research. Concluded the nine-nation NATO HFM-234 Research Task Group which published much needed guidelines for conducting blast injury research that will enable high quality research and advance our understanding of blast injuries. The guidelines were published in a series of four publications in the Journal of the Royal Army Medical Corps and in a Final Technical Report:
  
  
  • Environmental toxicology of blast exposures: injury metrics, modelling, methods and standards
  • Guidelines for conducting epidemiological studies of blast injury
  • Guidelines for reproducing blast exposures in the laboratory
  • Guidelines for using animal models in blast injury research
  • Final Technical Report, including a comprehensive dictionary of blast injury research terms
• Disseminating Information. Recovered, digitized, and made available online 50 years of research data on the biological effects of blast from DOD research conducted at Kirtland Air Force Base, New Mexico. This Historical Blast Bio-effects Research Data archive allows program managers, researchers, and decision makers to use existing knowledge to address current and future blast injury research challenges.

In 2019, the PCO changed its name to the Blast Injury Research Coordinating Office (BIRCO) and supported Executive Agent (EA) responsibilities by:

• Identifying Knowledge Gaps. Hosted the International State-of-the-Science Meeting on Limb Salvage and Recovery after Blast-Related Injury. The meeting included presentations and discussion on the scope of the problem, factors that influence treatment decisions, innovations in treatment and rehabilitation, and priority research and policy gaps. An expert panel identified the need to define the complex issue of limb salvage as an essential step for developing policies and designing research studies. The panel also identified the critical need to maintain knowledge and expertise at military treatment facilities, particularly as experienced practitioners retire from military service. Meeting proceedings are available for download.
• Shaping Research. Led a line of inquiry on weapon systems and led development of an interim report to Congress for the Blast Overpressure Studies (BOS) Working Group. The BOS Working Group is an OASD(HA)-led effort to address a congressional mandate for a Longitudinal Medical Study on Blast Pressure Exposure of Members of the Armed Forces (FY18 NDAA Section 734, FY19 NDAA Section 253, FY20 NDAA Sections 717 and 742). The goals of the BOS Working Group are to improve DOD's understanding of the impact of blast pressure exposure from weapon systems to the Service member's brain and auditory health and to better inform policy for risk mitigation, unit readiness, and health care decisions. BIRCO is the office of primary responsibility for one of the five lines of inquiry, LOI 2: Weapon Systems, which aims to assess and review the safety precautions surrounding heavy weapons in training to account for emerging research on blast exposure, and the effects of such exposure on cognitive performance of Service members.
• Promoting Partnership. BIRCO organized the first International Forum on Blast Injury Countermeasures (IFBIC) after BIRCO and the National Defense Medical College of the Japan Self-Defense Forces agreed to open their ongoing information exchange forum to other nations. IFBIC started as the Japan-U.S. Technical Information Exchange Forum on Blast Injury, through which BIRCO has been collaborating with the National Defense Medical College of the Japan Self-Defense Forces since 2016. This first IFBIC meeting was the fourth meeting of the Japan-U.S. Technical Information Exchange Forum on Blast Injury.
• Disseminating Information. Drafted a report to Congress required by Public Law 115-232, Section 226 on the U.S. Army's activities during FY19 to develop and assess the effectiveness of personal protective equipment that provides enhanced protection against blast injuries. The report included input from numerous U.S. Army organizations, highlighting the broad scope of activity to better protect Service members from blast injuries.

In 2020, the Blast Injury Research Coordinating Office (BIRCO) supported Executive Agent (EA) responsibilities by:

• Identifying Knowledge Gaps. Hosted the International State-of-the-Science Meeting on the Mitigating The Impact of Blast-related Burn Injuries: From Prolonged Field Care to Rehabilitation and Resilience. Based on the presentations and working group discussion during the meeting, an expert panel made four recommendations for blast-related burn injury research that covered injury classification and data collection methods, training for prolonged field care of burn injuries, strengthening of rehabilitation practices, and theater-based research on burn management. These recommendations and more information from the meeting, including summaries of a literature review and working group discussions, are available in the proceedings report.
  
  Directed the Military Health System (MHS) Blast Injury Prevention Standards Recommendation (BIPSR) Process and facilitated a thorough evaluation of 14 candidate auditory injury prevention standards by a panel of subject matter experts. The next steps are to review the results of these evaluations, develop a draft recommendation, and hold a consensus-building meeting with stakeholders from DOD, academia, and industry.
• Shaping Research. Led a line of inquiry on weapon systems for the Blast Overpressure Studies (BOS) Working Group addressing the requirements of FY18 NDAA Section 734. BIRCO led a team that initiated the Blast Overpressure Injury Threshold Review to summarize existing and currently used low-level blast overpressure exposure injury thresholds for preventing brain and auditory injury. The BIRCO-led team also established the groundwork to integrate a Blast Overpressure Tool into the Range Manager ToolKit–an existing suite of virtual tools that assist Unit Commanders and range safety officials in promoting safety during weapons training.
• Promoting Partnership. Guided the DOD Working Group on Computational Modeling of Human Lethality, Injury, and Impairment from Blast-Related Threats in drafting a strategic plan that provides actionable, impactful guidance and recommendations for developing a DOD Computational Human Body Modeling Framework. This Framework will support model selection for scenario development, scenario execution, guidelines and best practices for inter-model communication, guidelines and best practices for inputs and outputs, and analyses of results.
• Facilitate Collaboration. Led the U.S.-India Collaboration on Blast and Blunt TBI to a successful conclusion. This was the final year for the U.S.-India project agreement, Experimental and Computational Studies of Blast and Blunt Traumatic Brain Injury. BIRCO chaired the U.S. component of this group, part of a senior bilateral forum between the U.S. and the Indian Ministry of Defence. Notable accomplishments include establishing blast and blunt injury dose-response curves in animal models, developing a validated blast rodent model, and new discoveries on the brain's responses to blast exposure. Studies such as these build toward a better understanding of the mechanisms of injury in TBI, which is critical to accelerating the development and transition of blast injury prevention and treatment strategies.