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Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff

Currently, there is strong interest within the military to better understand the effects of long-term occupational exposure to repeated low-level blast on health and performance. To gain traction on the chronic sequelae of blast, we focused on breaching—a tactical technique for gaining entry into cl...

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Autores principales: Vartanian, Oshin, Tenn, Catherine, Rhind, Shawn G., Nakashima, Ann, Di Battista, Alex P., Sergio, Lauren E., Gorbet, Diana J., Fraser, Douglas D., Colantonio, Angela, King, Kristen, Lam, Quan, Saunders, Doug, Jetly, Rakesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744759/
https://www.ncbi.nlm.nih.gov/pubmed/33343492
http://dx.doi.org/10.3389/fneur.2020.588531
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author Vartanian, Oshin
Tenn, Catherine
Rhind, Shawn G.
Nakashima, Ann
Di Battista, Alex P.
Sergio, Lauren E.
Gorbet, Diana J.
Fraser, Douglas D.
Colantonio, Angela
King, Kristen
Lam, Quan
Saunders, Doug
Jetly, Rakesh
author_facet Vartanian, Oshin
Tenn, Catherine
Rhind, Shawn G.
Nakashima, Ann
Di Battista, Alex P.
Sergio, Lauren E.
Gorbet, Diana J.
Fraser, Douglas D.
Colantonio, Angela
King, Kristen
Lam, Quan
Saunders, Doug
Jetly, Rakesh
author_sort Vartanian, Oshin
collection PubMed
description Currently, there is strong interest within the military to better understand the effects of long-term occupational exposure to repeated low-level blast on health and performance. To gain traction on the chronic sequelae of blast, we focused on breaching—a tactical technique for gaining entry into closed/blocked spaces by placing explosives and maintaining a calculated safe distance from the detonation. Using a cross-sectional design, we compared the neuropsychological and neurocognitive profiles of breaching instructors and range staff to sex- and age-matched Canadian Armed Forces (CAF) controls. Univariate tests demonstrated that breaching was associated with greater post-concussive symptoms (Rivermead Post Concussion Symptoms Questionnaire) and lower levels of energy (RAND SF-36). In addition, breaching instructors and range staff were slower on a test that requires moving and thinking simultaneously (i.e., cognitive-motor integration). Next, using a multivariate approach, we explored the impact of other possible sources of injury, including concussion and prior war-zone deployment on the same outcomes. Concussion history was associated with higher post-concussive scores and musculoskeletal problems, whereas deployment was associated with higher post-concussive scores, but lower energy and greater PTSD symptomatology (using PCL-5). Our results indicate that although breaching, concussion, and deployment were similarly correlated with greater post-concussive symptoms, concussion history appears to be uniquely associated with altered musculoskeletal function, whereas deployment history appears to be uniquely associated with lower energy and risk of PTSD. We argue that the broader injury context must, therefore, be considered when studying the impact of repetitive low-level explosives on health and performance in military members.
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spelling pubmed-77447592020-12-18 Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff Vartanian, Oshin Tenn, Catherine Rhind, Shawn G. Nakashima, Ann Di Battista, Alex P. Sergio, Lauren E. Gorbet, Diana J. Fraser, Douglas D. Colantonio, Angela King, Kristen Lam, Quan Saunders, Doug Jetly, Rakesh Front Neurol Neurology Currently, there is strong interest within the military to better understand the effects of long-term occupational exposure to repeated low-level blast on health and performance. To gain traction on the chronic sequelae of blast, we focused on breaching—a tactical technique for gaining entry into closed/blocked spaces by placing explosives and maintaining a calculated safe distance from the detonation. Using a cross-sectional design, we compared the neuropsychological and neurocognitive profiles of breaching instructors and range staff to sex- and age-matched Canadian Armed Forces (CAF) controls. Univariate tests demonstrated that breaching was associated with greater post-concussive symptoms (Rivermead Post Concussion Symptoms Questionnaire) and lower levels of energy (RAND SF-36). In addition, breaching instructors and range staff were slower on a test that requires moving and thinking simultaneously (i.e., cognitive-motor integration). Next, using a multivariate approach, we explored the impact of other possible sources of injury, including concussion and prior war-zone deployment on the same outcomes. Concussion history was associated with higher post-concussive scores and musculoskeletal problems, whereas deployment was associated with higher post-concussive scores, but lower energy and greater PTSD symptomatology (using PCL-5). Our results indicate that although breaching, concussion, and deployment were similarly correlated with greater post-concussive symptoms, concussion history appears to be uniquely associated with altered musculoskeletal function, whereas deployment history appears to be uniquely associated with lower energy and risk of PTSD. We argue that the broader injury context must, therefore, be considered when studying the impact of repetitive low-level explosives on health and performance in military members. Frontiers Media S.A. 2020-12-03 /pmc/articles/PMC7744759/ /pubmed/33343492 http://dx.doi.org/10.3389/fneur.2020.588531 Text en Copyright © 2020 Her Majesty the Queen in Right of Canada. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Vartanian, Oshin
Tenn, Catherine
Rhind, Shawn G.
Nakashima, Ann
Di Battista, Alex P.
Sergio, Lauren E.
Gorbet, Diana J.
Fraser, Douglas D.
Colantonio, Angela
King, Kristen
Lam, Quan
Saunders, Doug
Jetly, Rakesh
Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title_full Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title_fullStr Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title_full_unstemmed Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title_short Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Armed Forces' Breaching Instructors and Range Staff
title_sort blast in context: the neuropsychological and neurocognitive effects of long-term occupational exposure to repeated low-level explosives on canadian armed forces' breaching instructors and range staff
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744759/
https://www.ncbi.nlm.nih.gov/pubmed/33343492
http://dx.doi.org/10.3389/fneur.2020.588531
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