Long-Term Health Risks Linked to High-Level Blasts
Veterans with a history of high-level blast exposure face an increased likelihood of being diagnosed with a range of neurological, respiratory, cardiovascular, and metabolic conditions years after their service ends. According to study author Sarah L. Martindale, PhD, of the Salisbury VA Health Care System in North Carolina, blast exposure functions as a whole-body problem rather than just an acute brain injury. Researchers tracked 36,641 veterans who received care at the Veterans Health Administration for at least two years after leaving the military, following them for up to 10 years after they completed a survey on blast exposure.
Data from the study show that 11% of participants reported exposure to at least one high-level blast, while 17% worked in occupations carrying a high risk of low-level blasts from outgoing munitions such as heavy artillery or shoulder-fired weapons. Approximately 5% of the participants experienced both types of exposure. When researchers looked at specific diagnoses, differences emerged between exposed and unexposed groups. For instance, 3.92% of veterans reporting high-level blast exposure developed seizures, compared to 1.88% of those with no blast exposure. Neuropathy affected 11.41% of the exposed group versus 7.75% of the unexposed group, while stroke was diagnosed in 2.03% of exposed veterans compared to 1.62% of those without exposure.
Did you know? Approximately 5% of the study participants reported experiencing both high-level blasts from incoming devices and low-level blasts from outgoing heavy artillery during their military service.
Adjusted Risk Ratios for Seizures, Neuropathy, and Stroke
To ensure accuracy, researchers adjusted for confounding variables such as age, sex, and total number of days deployed. Based on the results detailed in Neurology, veterans who had high-level blast exposure were 35% more likely to be diagnosed with a stroke, 38% more likely to be diagnosed with neuropathy, and 79% more likely to receive a diagnosis of seizures.
In addition to neurological issues, high-level blast exposure showed associations with hepatitis B and C, diabetes, high cholesterol, and chronic lung diseases like chronic bronchitis and emphysema. Conversely, the study found that service members with low-level blast exposure were less likely to be diagnosed with conditions such as diabetes, high cholesterol, and Crohn’s disease. However, Martindale cautioned that these low-level exposure findings could be influenced by the relatively young age of participants at the start of the study and a follow-up period that may have been too short for certain conditions to manifest. She emphasized that the absence of elevated risk from low-level exposure in this specific cohort should not be interpreted as definitive evidence that low-level blasts lack long-term physical health consequences.
Pro Tip: Healthcare providers can utilize a comprehensive history of a veteran’s blast exposure to better anticipate and monitor long-term cardiovascular, metabolic, and neurological risks over time, according to recommendations supported by the study findings.
Study Limitations and Future Medical Monitoring
While the research offers valuable insight into post-military health, authors noted several limitations. High-level blast exposures were self-reported by participants, and the study lacked precise data regarding blast intensity, injury severity, or specific medical treatments received immediately following the events. Furthermore, tracking of conditions relied strictly on diagnoses documented within the VA health care system after the survey was completed, meaning conditions diagnosed prior to the study or outside the VA network were not captured.
The Naval Health Research Center, VA Puget Sound Health Care System, Salisbury VA Health Care System, and the Henry M. Jackson Foundation for the Advancement of Military Medicine provided support and funding for this research. Understanding a veteran’s complete blast exposure profile provides a piece of the puzzle for designing targeted long-term monitoring protocols.
Frequently Asked Questions
Does the study prove that blast exposure causes stroke and seizures?
No. The study establishes an association between high-level blast exposure and an increased risk of conditions like stroke and seizures, but it does not prove direct causation.
What percentage of participants reported high-level blast exposure?
A total of 11% of the 36,641 participating veterans reported exposure to at least one high-level blast.
Which organizations supported the research?
Support for the study was provided by the Naval Health Research Center, the Salisbury VA Health Care System, the VA Puget Sound Health Care System, and the Henry M. Jackson Foundation for the Advancement of Military Medicine.
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