Leidos, Inc., San Diego, CA 92106, USA.
Naval Health Research Center, San Diego, CA 92106, USA.
Int J Environ Res Public Health. 2021 Dec 8;18(24):12925. doi: 10.3390/ijerph182412925.
Because traumatic brain injury (TBI)-most often caused by exposure to high-level blast (HLB)-is a leading cause of medical evacuations of deployed U.S. service members in recent conflicts, researchers seek to identify risk factors for TBI. Previous research using self-reported data has identified low-level blast (LLB) as one such risk factor and suggests an association with susceptibility to and symptoms associated with TBI. This article presents a population-based study of all branches of military service that examines the association between occupational risk for LLB and both clinically diagnosed TBIs-from concussions to severe and penetrating TBIs-and conditions commonly comorbid with concussion. Using archival medical and career records from >2 million service members between 2005-2015, this work demonstrates that occupational risk of LLB is associated with any TBI, mild TBI, moderate TBI, cognitive problems, communication problems, hearing problems, headaches, any behavioral health condition, anxiety, drug abuse/dependence, alcohol abuse/dependence, delirium/dementia, posttraumatic stress disorder, post-concussive syndrome, tinnitus, fatigue, and migraines. Understanding the full scope of the effects of LLB on service members will help ensure the health and readiness of service members and may influence both military policy and clinical practice guidelines for blast-induced injuries.
由于创伤性脑损伤（TBI）——通常是由接触高水平爆炸（HLB）引起的——是最近冲突中部署的美国军人医疗后送的主要原因，研究人员正在寻求确定 TBI 的风险因素。先前使用自我报告数据的研究已经确定低水平爆炸（LLB）是此类风险因素之一，并表明与 TBI 的易感性和相关症状有关。本文对所有军事部门进行了一项基于人群的研究，调查了职业性 LLB 风险与临床诊断的 TBI（从脑震荡到严重和穿透性 TBI）之间的关联，以及与脑震荡常见的共病情况。本研究使用了 2005-2015 年超过 200 万名军人的档案医疗和职业记录，证明职业性 LLB 风险与任何 TBI、轻度 TBI、中度 TBI、认知问题、沟通问题、听力问题、头痛、任何行为健康状况、焦虑、药物滥用/依赖、酒精滥用/依赖、谵妄/痴呆、创伤后应激障碍、脑震荡后综合征、耳鸣、疲劳和偏头痛有关。了解 LLB 对军人的全面影响将有助于确保军人的健康和战备状态，并可能影响军事政策和爆炸伤临床实践指南。
