Redefining “Blast” in TBI Discourse

Current TBI screening tools only prompt Servicemembers to recall and report their acute blast exposures (e.g. incidents, accidents, injuries, etc.). Since repetitive blast exposures from firing weapons do not fit this criteria, these potentially harmful exposures are not reported during screening — leaving thousands of Servicemembers and veterans without proper medical attention.

veterans affairs

You should be screened for TBI if you experienced any of the following during your military service:

  • Close proximity to a blast or explosion
  • Fragment wound or bullet wound above the shoulders
  • Blow to the head
  • Vehicle accident or crash
  • Fall

Source: U.S. Dept. of Veterans Affairs website; Recommendation for Military Exposure Screening

Defense and Veterans Brain Injury Center

Did you have any injury(ies) during your deployment from any of the following?

  • Fragment
  • Bullet
  • Vehicular (any type of vehicle, including airplane)
  • Fall
  • Blast (IED, RPG, landmine, grenade, etc.)
  • Other

Source: Defense and Veterans Brain Injury Center: 3 Question DVBIC Screening Tool

Patrick M Shanahan on blast exposureTBI has been shown to result from concussive impact and exposure to blast waves. Blast exposure derives from both the effects of enemy action in combat and from training on our own weapons and tactics.”

Patrick M. Shanahan, Acting U.S. Secretary of Defense

recoilless rifle

Crew-Served Weapons

Shoulder-Fired Weapons



Main Guns

Breaching Explosives

Although TBI screening tools include exposure to a blast or explosion, the definition of blast must be expanded from a singular, accident or enemy-triggered incident (e.g. IED, grenade, incoming RPG). In order to identify and properly screen all blast-exposed personnel, somebody must account for the true at-risk population that includes non-deployed Servicemembers.

On behalf of the Department of Defense, I assure you that we are dedicated to understanding and mitigating the effects of blast overpressure.”

James N. Mattis, Former U.S. Secretary of Defense