May 17, 2019

Senators Warren and Ernst Introduce Bipartisan Bill to Improve Study of Blast Exposure Injuries in Servicemembers

The Legislation Builds on a Warren Amendment That Established a Defense Department Study on the Effects of Blast Pressure Exposure

Washington, DC – United States Senator Elizabeth Warren (D-Mass.) and Senator Joni Ernst (R-Iowa) yesterday introduced their bill, the Blast Pressure Exposure Study Improvement Act, to improve research on traumatic brain injury (TBI) among servicemembers and strengthen capacity to track and prevent blast pressure exposure.  The legislation builds on an amendment Senator Warren introduced in the Fiscal Year 2018 National Defense Authorization Act (NDAA) that required the Department of Defense (DoD) to establish a longitudinal medical study examining the effects of blast pressure exposure. It also follows previous bipartisan legislation that Senators Warren and Ernst introduced in 2018 that included provisions requiring DoD to review and update its guidance on blast exposure during training.
The Blast Pressure Exposure Study Improvement Act builds on these efforts by requiring more frequent progress reports from DoD regarding the ongoing longitudinal study, and by adding two feasibility assessments to the study underway:
  1. Determine if the Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH) would be an appropriate system for the study data to reside, and
  2. Determine if both DoD and Department of Veterans Affairs (VA) personnel could have access to this data.
The DOEHRS-IH system is DoD’s principal tool for tracking similar longitudinal data for servicemembers who are repeatedly exposed to environmental hazards. If both DoD and VA personnel were able to access longitudinal blast exposure data, this information could be seamlessly added to a servicemember’s health records and personnel files.
Since 2000, more than 380,000 servicemembers have received a first-time diagnosis of traumatic brain injury, in many cases due to the use of improvised explosive devices (IEDs) in the wars in Iraq and Afghanistan.  While TBI is often associated with blunt physical injuries to the head, recent research has shown that the blast wave produced by even minor explosions can result in TBI - even if the individual does not exhibit outward physical signs of a head injury. Blast overpressure -- the pressure caused from a severe shock wave -- causes harm to the brain not just by moving the brain around inside the skull, but also by acutely damaging individual brain cells.
Exposure to blast pressure may result not only from battlefield IEDs, but also from smaller concussive events such as firing artillery and other heavy-caliber weapons, which military personnel may do multiple times a day, over multiple days at a time, while training to use these weapons.  Although research has demonstrated that exposure to blast pressure can damage the brain, scientists' ability to longitudinally track these effects and understand variation in health outcomes is constrained by the limited data collected on servicemembers' exposure to blast pressure events during their military service.
"We know that many servicemembers exposed to blasts during combat and training later experience long-term brain injury,” said Senator Warren. “Our servicemembers and veterans are owed the very best care available, which is why we need to keep studying how to prevent and treat injuries from blast exposure.”