Traumatic Brain Injury Bill Calls for Sweeping Changes in Military Health Care, Training, Safety to Protect Troops

Service members would get regular brain function tests and some weapons could be modified to reduce blast exposure risks under a wide-ranging bill being introduced in Congress aimed at reducing traumatic brain injuries.

The bill, spearheaded by Sens. Elizabeth Warren, D-Mass., and Joni Ernst, R-Iowa, and Rep. Ro Khanna, D-Calif., would also require the Pentagon to consider ways to reduce explosive pressure when it buys new weapons and publish safety information for weapons already in use; mandate that service members' blast exposures be systematically logged; create a new brain health program for the special operations community; and order a watchdog investigation of the DoD's efforts to address blast exposure.

The 46-page bill comes amid growing evidence that troops are at risk of exposure to potentially dangerous blasts not just from enemy attacks but also from routine military activities such as repeatedly firing artillery, and that brain injuries from those exposures are causing devastating symptoms for service members and veterans.

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“Too many of our service members are suffering the health consequences of blast overpressure, so we need real change to our approaches to prevent these injuries and protect our service members in training and combat,” Warren said in a statement Thursday. “My bipartisan bill will tackle these pressing challenges from every direction – creating better transparency and brain health tracking, expanding efforts to mitigate exposure and provide treatment, and ensuring accountability that our military is supporting impacted service members.”

Blast overpressure is any pressure caused by a shockwave that is over the normal pressure in the atmosphere.

The New York Times, which first reported on the bill, last year detailed symptoms including hallucinations, seizures and suicide risks among troops who fired artillery during the war against the Islamic State terror group.

Military.com has also reported on evidence that traumatic brain injury, or TBI, is linked to an increased risk of suicide among veterans.

In response to lawmaker concerns that the Pentagon has not been doing enough to protect service members from unneeded blast exposure in environments such as training, department officials earlier this year vowed to collect more data on troops' exposure.

But they also said more research would be needed before taking some of the steps that lawmakers were advocating for, such as more frequent cognitive testing and defining safety limits for using certain weapons.

"There's more data and more science that we need to look into," Lester Martínez-López, assistant secretary of defense for health affairs, said at a February hearing in the Senate when asked whether service members should be given annual cognitive tests to track the effects of blast exposure.

Lawmakers, though, have been pressing for immediate action.

"We need to do better for our troops, and we need to do it right now," Warren said at the February hearing.

The bill introduced Thursday, dubbed the Blast Overpressure Safety Act, would require service members be given a baseline neurocognitive test before basic training starts. Troops would also be tested at least once every three years after that, as well as in post-deployment health assessments and health exams prior to separating from the military.

The bill would also refine the Warfighter Brain Health Initiative so that it is responsible for, among other things, modifying "high-risk training and operational activities" to lower the risk of blast exposure and adjusting existing weapons systems to "reduce blast exposure of the individual using the weapon and those within the minimum safe distance," according to the bill text.

It would also create blast overpressure exposure and TBI logs for all service members and require the Pentagon to collect more data on concussive and subconcussive injuries, including documenting discharges related to those injuries.

It also seeks to improve health care for service members with brain injuries by creating a Special Operations Comprehensive Brain Health and Trauma program; bolstering the existing National Intrepid Center of Excellence by making it an official "program of record" and requiring the Pentagon to provide child care to troops being treated there; and mandating instruction for medical and training personnel on blast overpressure, exposure and TBI.

The bill would also require the Government Accountability Office to review Defense Department efforts, address blast exposure, protect service members who seek care from retaliation, and identify the most at-risk military occupational specialties.

Warren chairs the Senate Armed Services Committee's personnel subcommittee, and Ernst is also a senior member of the committee who's the top Republican on the emerging threats subcommittee, giving the bill influential backers who could advance it through the annual defense policy bill process.

In addition to Warren and Ernst, the bill has nine co-sponsors in the Senate, including seven other members of the Senate Armed Services Committee.

Related: They Said the Rise in Military Suicide Is a Mystery. Traumatic Brain Injury May Be an Answer.