New Military Blast Exposure Policies Direct Cognitive Testing, Keeping Instructors Farther from Fired Weapons

New military recruits will get baseline cognitive testing and training instructors will have to stand farther away when some weapons are being fired under new Pentagon policies aimed at reducing troops' risk of brain injuries from blast exposure.

The policies were laid out in a memo from Deputy Defense Secretary Kathleen Hicks released Friday afternoon that comes after increasing pressure from lawmakers to do more to prevent brain injuries. The updates also come after reporting from Military.com and other news outlets on the risks of brain injuries among service members and the Pentagon's slow response to the issue.

"The health and well-being of our service members and civilian personnel are crucial to maintaining the U.S. military's status as the most capable and ready fighting force in the world," Hicks said in a statement about the memo. "To maintain that advantage, I have directed the development of a comprehensive policy to manage risks associated with blast overpressure, integrating various department and military service initiatives and directives into a unified Warfighter Brain Health (WBH) Initiative."

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Blast overpressure is any pressure caused by a shockwave that is over the normal pressure in the atmosphere. A growing body of evidence indicates that troops are at risk of brain injury-causing blast overpressure not just from enemy attacks but also from routine military activities such as repeatedly firing artillery. Further, those brain injuries are causing devastating symptoms for service members and veterans, such as increased risk of suicide, as Military.com previously reported.

To address those issues, Hicks' memo lays out a series of new steps to monitor service members' brain health and reduce their exposure to blasts.

Perhaps most significantly, the department will track all service members' cognitive health from the beginning of their careers -- a step lawmakers have been calling for but that Pentagon officials have previously been reluctant to embrace. The memo directs the Pentagon to ensure that all new active-duty and reserve recruits undergo cognitive assessments as part of the entry process by the end of 2024.

Each service will also have to identify and track all personnel who are potentially exposed to blast overpressure in a Defense Department database, with special priority placed on troops who have a specialty or rating that, "by nature of operational activities, regularly places them at increased risk of [blast] exposures," the memo says.

A table included in the memo lists nearly 100 jobs in the Army, Navy, Marine Corps and Air Force at increased risk of blast overpressure, showing many of the specialties are combat arms, special operations, or weapons technicians and operators.

Noting that cognitive impairment has been seen from blasts with as low as 4 pounds per square inch of pressure, another table attached to the memo lists weapons in the military's inventory that meet that threshold. The weapons include .50 caliber guns and rifles, mortars and howitzers, as well as a few shoulder-mounted anti-tank weapons and breaching explosives.

As such, the memo directs that certain personnel involved in training, such as instructors and range safety officers, should stand farther away when those weapons are being fired. For example, the minimum standoff distance for an M3 anti-armor and anti-personnel weapon system is 16 feet, while the minimum for an M107 Sniper Rifle is 7 feet. Still, the memo says that personnel can stand closer if standing farther away "inadvertently introduces a safety risk."

While the new policies address some of lawmakers' concerns, they do not go as far as lawmakers have been calling for. For example, a wide-ranging bipartisan bill introduced earlier this year would require modifying some weapons systems to reduce the blast exposure to the person firing the weapon.

Elements of that legislation were included in both the House and Senate version of this year's annual defense policy bill that Congress is expected to pass into law before the end of the year.

A spokesperson for Sen. Elizabeth Warren, D-Mass., one of the lead sponsors of the blast exposure bill, did not respond to a request for comment Monday on the Pentagon's new policy. But she and other lawmakers have previously pushed the department to take more aggressive action.

"The department needs to take more urgent action to mitigate blast overpressure and support service members," Warren; Sen. Joni Ernst, R-Iowa; Rep. Ro Khanna, D-Calif.; and other lawmakers wrote in a letter to a government watchdog last month. "Otherwise, troops will continue to struggle to get the care they need and deserve."

Although evidence was growing as early as the late 2000s that blast overpressure was responsible for head injuries unique to military service members, the Defense Department dragged its heels to address the problem.

In 2008, the Army's Program Executive Office Soldier fielded a sensor with the 101st Airborne Division to measure pressure waves from blasts, while at the same time, the Defense Advanced Research Projects Agency sought wearable technology to measure the level of blast experienced by service members.

The systems had drawbacks. The Army's gauges measured what happened to a soldier's helmet -- including any movements, bumps or strikes -- and used an algorithm to estimate the concussive impact and extent of injury, without actually measuring what was happening inside the wearer's head. DARPA's project, which got underway in 2010 and measured overpressure from three different sensors on a service member's body armor, detected the most exposure in troops whose jobs were to fire heavy weapons.

The data seemed to indicate that repeated exposure to blasts that were much more common than roadside bomb attacks could add up and cause brain injuries, and that weapons such as recoilless rifles, shoulder-fired rockets, artillery and mortars were likely harming troops' brains.

At the time, the findings were not what a Defense Department at war wanted to hear.

"It completely changes the landscape when you say most of these exposures are happening in training and are preventable," David Borkholder, a professor at Rochester Institute of Technology who founded BlackBox Biometrics Inc., maker of the Blast Gauge System, told Military.com in 2022.

In 2018, a Center for a New American Security report found that extensive use of shoulder-fired weapons such as the Carl Gustaf recoilless rifle, the M72 Light Anti-Armor Weapon and AT4 Rocket Launcher exposed users to blast overpressure, potentially causing brain damage.

Other studies continued to show that moderate to severe blast exposure caused damage to blood vessels, nerve damage and brain inflammation.

A series of articles in The New York Times last year renewed interest in the topic, with the publication detailing symptoms among artillery troops such as hallucinations, seizures and suicidal thoughts, and among Navy SEALs who died by suicide and whose post-mortem examination showed damage patterns consistent with blast exposure from training.

Related: They Said the Rise in Military Suicide Is a Mystery. Traumatic Brain Injury May Be an Answer.