WASHINGTON — The blast shook the ground and the red flash of fire covered the doorway as U.S. special operations forces blew open a door during a recent training exercise.
Moments later, on their next attempt, the boom was noticeably quelled and the fire slightly smaller, a testament to just one of the new technologies the U.S. Special Operations Command is using to limit brain injuries, which have become a growing problem for the military.
From new required tests and blast monitors to reforming an explosive charge that reduces recoil on troops, the command is developing new ways to better protect warfighters from such overpressure and evaluate their health risks, especially during training.
“There are guys lining up to volunteer for these studies,” says the retired sergeant. Major F. Bowling, a former special operations medic who now works as a contractor for the command. “This is extremely important for the community. They are very concerned about it.”
The Department of Defense does not have good data on the number of troops with hypertensive problems, which are much harder to detect than traumatic brain injuries.
Traumatic brain injury is better known and is an ongoing problem among armed forces personnel, including those exposed to nearby rocket attacks and explosions.
According to the department Center of Excellence for Traumatic Brain InjuryLast year, more than 20,000 soldiers were diagnosed with a traumatic brain injury. More than 500,000 have been diagnosed since 2000.
Josh Wick, a Pentagon spokesman, said new information from evaluations of both acute blasts and repeated exposures at low levels shows links to adverse effects such as inability to sleep, reduced cognitive performance, headaches and dizziness.
“Our top priority remains the cognitive well-being and long-term operational effectiveness of our armed forces as warfighters,” said Gen. Bryan Fenton, chief of U.S. Special Operations Command. “We aim to understand and identify the impact of overpressure on the brain health of our workforce.”
Fenton said research with academics and medical and industry experts is helping find ways to soothe and treat overpressure. He said advanced technologies are critical to reducing the effects of repeated exposures like those faced by many of his troops.
At a remote training area for Army special forces at Fort Liberty in North Carolina, commandos used what they call a Muchete breach blast, specifically shaped into a shape that focuses the blasts more precisely and limits the damaging waves that come from an explosion. A small number of journalists were allowed to watch the training.
“The reduction in excess pressure returned to the operator averages between 40 and 60%,” says Chris Wilson, who leads the team overseeing clinical research and other performance-related initiatives. “It really depends on where someone stands. But it’s certainly a pretty dramatic reduction in exposure. So I think this is a victory.”
Wilson said development and testing of the refined payload is ongoing, but units are now using it in training until final approval is received and it can be more widely distributed.
Because of the extensive training for special operations troops – both to hone their skills and to prepare for specific operations – troops may practice breaching a door dozens or hundreds of times. As a result, they are most likely to receive such repeated exposures during training. The command wants to get a better picture of the consequences for each person.
During the demonstration, a number of Army Special Forces soldiers wore small monitors or sensors to help leaders better understand the level of blast pressure the troops are absorbing. The sensors allow officials to compare measurements based on where troops stood and how close they were to the blast.
The command is currently evaluating a number of blast sensors available on the market, and some higher-risk forces are already using them. Testing and other research will continue with the aim of spreading it throughout the force in the coming years.
According to Wilson and Col. Amanda Robbins, the command’s psychologist, there are clear differences between acute traumatic brain injuries and what is called prolonged exposure to explosions or overpressure.
Traumatic brain injury, they said, is an acute injury that is relatively well documented and diagnosed. They said repeated exposure to explosions needs more attention as there are many questions about the impact on the human brain. The damage is much more complex to diagnose and requires more research to establish links between the repeated blasts and any damage or symptoms.
To support the research, Special Operations Command is considering conducting more routine testing throughout service members’ careers. One test is a neurocognitive assessment that is administered every three years. Officials also want warfighters to be assessed if they have suffered a concussion or a similar event.
The Defense Department will more broadly require cognitive assessments for all new recruits as part of an effort to protect troops from brain injuries resulting from blast exposure. New guidelines released in August require greater use of protective equipment, minimum “stand-off distances” during certain types of training and a reduction in the number of people near blasts.
The other test administered by Special Operations Command is a more subjective comprehensive assessment that identifies each person’s history of injuries or falls, even as a child. It’s done early to get a baseline.
Robbins said they have seen new, younger operators and those with 20 or more years of experience be more willing to perform the tests.
“The challenge will be with mid-career operators, who may be more concerned that self-reporting may have a perceived negative impact,” she said.
She added that the review is a way to take into account incidents that may not be in their medical records, so that problems can be identified early and people can get treatment.