Assistant Professor Department of Neurology, USU Uniformed Services University Bethesda, Maryland
Abstract Text:
Background: Increased knowledge and communication about the potential relation between blast overpressure exposure and brain health impairment resulted in increased interest in Service member use of heavy weapon systems in training and combat both at the Congressional and research level. Yet, the epidemiology of blast overpressure exposure among service members across the military is not well known. DoD/DARPA-sponsored evaluation of blast exposures in deployed settings during Operation Enduring Freedom demonstrated that 2/3 of all recorded blast exposure among service members occurred during training. With an initial focus on the training environment, the CONQUER operational monitoring program is designed to capture, quantify, and record blast overpressure events experienced by service members. Data are analyzed to support the preparation and dissemination of reports to command leadership at multiple levels.
Methods: To quantify blast overpressure exposure, CONQUER employs the BlackBox Biometrics (B3) blast gauge system of three overpressure sensors with one sensor worn on the helmet, one on the chest, and one on the shoulder. In addition to providing person-specific overpressure exposure data, the B3 blast gauge system can be mounted in static positions to enable mapping and computer-based modeling of blast overpressure propagation across a variety of sites and situations, including training ranges and structures, vehicles (e.g., motor vehicles, aircraft, watercraft, etc.) and, when requested, in specific combat situations. Both personnel and static blast event data collected by CONQUER field operations personnel are securely transmitted to the CONQUER central data repository for storage, aggregation and creation of reports for Units, Commands and Senior Leadership. The CONQUER operational monitoring program is designed and structured for expansion to include all military personnel for whom repetitive blast exposure may occur in training and/or in theatre, through three primary service lines: Training Commands/Schoolhouses, Operational Unit Level Training, and a rapid deployment capability to respond to operational situations and provide data and reports from unique field-based situations.
Results: Initiated in 2018, CONQUER has deployed more than 7,600 blast gauge systems and has collected and centralized data on approximately 200,000 blast gauge measured exposures from units associated with the Navy, Marine Corps, Army and Air Force with more than 300 reports provided to command leadership ranging from single training events to comprehensive exposure reporting across multiple months of a multi-activity unit level training cycle. Reports have enabled commanders to develop evidence-based strategies for optimizing training while limiting blast overpressure exposure. By providing both between and within unit comparisons of overpressure exposure across time, leadership is able to assess the effects of strategy implementation or other changes in training.
Discussion: CONQUER provides the DoD with a fully functional centralized program for the collection, storage, aggregation and reporting of environmental blast exposure data collected directly from military service members during the performance of their duties that supports command decision-making.
Keywords: blast exposure, hazard, monitoring, military training
