US Department of Defense
Advancing Blast Injury Research to Protect and Heal Those Who Serve

International State-of-the-Science Meeting On The Neurological Effects of Repeated Exposure to Military Occupational Blast: Implications for Prevention and Health

In March 2018, the Seventh Annual International State-of-the Science (SoS) Meeting continued the legacy of this unique meeting series leveraging the expertise of outstanding scientists, engineers, and clinicians to identify knowledge gaps and inform future research needed to close the gaps in the prevention, mitigation, and treatment of blast injury.

There has been growing concern about the risk of subconcussive neurological injuries that service members face after repeated, low-level blasts during training and in combat. To examine this risk, the current evidence base, and potentially promising methods and tools for prevention and detection, the Department of Defense held its Seventh State-of-the-Science Meeting in March 2018. The meeting featured findings from a scientific literature review, panel discussions, presentations by researchers in the field, a poster session, and working groups chaired by expert panelists that assessed the state of the science and put forward recommendations regarding policy and strategy guidance and future research directions. Experts in the field concluded that a much stronger evidence base is needed to identify the frequency of exposure, occupation-specific risk factors, appropriate exposure thresholds, potential neurological consequences, and approaches to prevent and detect injuries in service members after repeated exposure to low-level blasts. Read more

Key Findings

There has been very little research on the frequency and effects of low-level occupational blast exposure in military populations

  • While there is little doubt that repeated military occupational blast exposure occurs, there is strikingly little empirical knowledge of its frequency and the military contexts and occupational specialties at greatest risk.
  • The literature review found no published information on military service–specific frequencies of exposure to low-level occupational blasts, and experimental animal studies may not adequately translate to real-life experiences in military contexts.
  • More information is also needed on the use of various munition systems in military training and in deployed environments. There has been no systematic effort to document blast loads associated with various munition types and military training experiences.

There is a need for more research into promising tools for preventing and detecting neurological damage from low-level blast exposure

  • Current Department of Defense and military service policies, directives, instructions, standards, and safety guidelines include weapon-specific, health-based standards that mandate the use of hearing-protection devices, limit the number of rounds fired per day, or place restrictions on firing from certain positions. Ensuring awareness of and compliance with these standards is an essential initial step toward preventing injury.
  • Numerous potentially applicable indicators of injury from low-level blast exposure are either available or in development. However, not all are applicable to military contexts. Multidiscipline collaboration and embedding researchers within units would improve efforts to identify appropriate indicators.

Meeting Recommendations can be found on the RAND Corporation website.

Event Photos

Last modified: 11-Mar-2020