A far-reaching study by Navy researchers has found that exposure to munitions blast waves from combat and training may be causing brain injuries the aggregation of which is resulting serious and often deadly ailments such as depression, PTSD and suicide.
Years of prior research with animals has already documented an association between exposure to pressure waves from munitions blasts, known as overpressure, and behaviors mimicking depression. But the new findings are particularly important because they validate that the same phenomenon is occurring in U.S. military members, echoing what some advocates for veterans have been saying all along as suicide rates have dramatically climbed.
“The current research suggests a similar pattern in humans, which may also inform our understanding of the possible associations between overpressure and suicide that has been posited elsewhere,” researchers from the Naval Health Research Center found.
In another key finding, the Navy research “is the first to document an association between overpressure exposure and self-reported diagnoses of chronic fatigue syndrome specifically, though again the mechanism for this effect is still unclear.”
The researchers theorize that undiagnosed symptoms arising from overpressure exposure may impair the ability to get high-quality sleep, a factor in suicidal ideation. “Alternatively, it is possible that the shockwaves associated with overpressure may damage certain regions of the brain like the thalamus, which has been implicated in sleep-wake cycles. Given the importance of both suicide and sleep in military populations, understanding these associations more fully represents exciting avenues for future research,” they concluded.
Medical records from thousands of service members analyzed
The researchers analyzed survey data collected between 2011 and 2013 from 138,949 service members and focused much of their analysis on incoming blasts from enemy munitions, such as improvised explosive devices, and outgoing blasts occurring when service members fire their own weapons in training or combat.
Service members exposed to repeated incoming enemy blast waves had higher risks for PTSD and depression than those exposed to only one incoming blast or no blast. Repeated exposure to both enemy blast waves and blasts during training or combat also increased the risks of migraines and PTSD.
The study was published in March in the journal “Frontier on Neurology.”
“These findings provide further evidence of the potential adverse consequences associated with overpressure exposure and underscore the necessity of public health surveillance initiatives for blast exposure and/or safety recommendations for training and operational environments,” researchers concluded.
A failure to diagnose and treat brain injuries
The findings come in the wake of a critical report from the Department of Defense’s oversight chief that acknowledged the armed forces are woefully ineffective at screening service members for traumatic brain injuries and for following up with those that suffer from them.
Taken together, the two reports are a window into the suicide tragedy befalling veterans and servicemembers.
They indicate that many servicemembers may be suffering from brain injuries – which range from mild to severe and are similarly dangerous – while at the same time the military is bad at diagnosing them. The lack of effective screening and follow-up, combined with the prevalence of brain injuries, often described by military officials as the signature injury of the Afghanistan and Iraq conflicts, could at least partially explain the crisis of suicides plaguing veterans and current service members.
As the Department of Veterans Affairs noted in its 2020 annual report on suicide among veterans, “Veterans Health Administration patients who died by suicide are more likely to have sleep disorders, traumatic brain injury or a pain diagnosis than other VHA patients.” Similarly, a study in the journal Psychological Services found that post-9-11 veterans with a history of traumatic brain injuries were at much greater risk for considering suicide.
After 20-plus years, Department of Defense looks at blast waves factor
The Department of Defense is beginning to take more seriously the issue of blast waves from firing weapons in combat and training, this after 20-plus years in the global war on terror and as suicide rates among vets and service members have soared.
Last August, the Pentagon published a plan for its Department of Defense Warfighter Brain Health Initiative. It seeks to develop policies that prevent, identify and treat brain damage caused by combat or by repeated shakes and blasts during training. Also promising is that the military says it will develop standards for acceptable levels of exposure and exposure frequency guidelines for commonly used weapons and munitions.
But it will require a cultural shift to get the armed forces to achieve these goals – and then stick to them.
This is where Congress is essential. Lawmakers must ensure sufficient funds are set aside to develop screening tools for the range of brain injuries sustained during training and deployment, that the Pentagon develops as soon as possible effective protocols and guidelines for blast exposure and that the military finally takes aim at this pervasive problem that is contributing to surging suicides.
Dr. Jennifer Belding, lead author on the Naval Health Research Center study, opined that by recognizing the impact of blast waves on service member health, “we are better able to identify groups that may have higher risk for adverse health outcomes, even after they leave military service.”
That will only happen if Congress holds the Pentagon to account.