Skip to content

Ernst Works to Improve Mitigation and Treatment of Blast Exposure Injuries in Servicemembers

The Iowa Senator introduced bipartisan legislation asking DoD to provide timely updates on research of TBI

WASHINGTON—Building off of her efforts from last Congress to support servicemembers impacted by traumatic brain injury (TBI), U.S. Senator Joni Ernst (R-IA), the first female combat veteran elected to the Senate, has put forward a bipartisan bill with Senator Elizabeth Warren (D-MA) that would improve research on TBI among servicemembers and strengthen capacity to track and mitigate blast pressure exposure.

The Blast Pressure Exposure Study Improvement Act builds on previous bipartisan legislation that the two senators introduced in 2018 that required the Department of Defense (DoD) to review and update its guidance on blast exposure during training, much of which was included in the FY19 National Defense Authorization Act (NDAA).

"During combat and in training, many of our men and women in uniform are exposed to blasts which can lead to conditions like Traumatic Brain Injury (TBI). Last year, Senator Warren and I asked DoD to take a hard look at the effects of blast pressure exposure; and today, we're building on our effort to ensure we have the necessary information to better care for our servicemembers and help mitigate these types of injuries," said Senator Joni Ernst, chairman of the Senate Armed Services Subcommittee on Emerging Threats and Capabilities.

"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."


The Blast Pressure Exposure Study Improvement Act requires more frequent progress reports from DoD regarding an ongoing longitudinal study, and by adding two feasibility assessments to the study underway:

  • 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,
  • 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 TBI, 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.