Post by Dave Homewood on Nov 5, 2024 17:48:01 GMT 12
New Zealand Defence Force’s new brain injury warning to troops over weapons and explosives
By David Fisher
Senior writer·NZ Herald·
2 Nov, 2024 05:05 AM
New Zealand Defence Force (NZDF) medical experts have told military personnel some of its explosives and weapons could cause them brain damage – but its own veteran support agency has not yet accepted the injury as a direct pathway for compensation claims.
The formal NZDF “defence health directive” – released in September 2023 – highlights the risk of “firing high-calibre weapons and training with repeated low-level blasts such as that used in explosive methods of entry”.
In contrast, Veterans’ Affairs – an agency inside the NZDF – says it doesn’t have a recognised pathway for claims relating to damage caused by repeated low-level blasts.
Instead, veterans like Gregg “Pup” Johnson, who served with the NZSAS in Afghanistan, need to build a case supporting their claim – even though traumatic brain injury is often called the “signature injury” of the so-called “War on Terror”.
Former NZSAS Corporal Gregg Johnson at home in Abel Tasman and (inset) in Afghanistan. Main photo / Tim Cuff
The defence health directive was issued by the NZDF’s chief medical officer, Colonel Dr Charmaine Tate, and brought in new safety standards for those carrying out particular types of training, such as firing heavy calibre weapons or using explosives to gain entry to buildings.
It was issued around the time the NZDF was exploring firing limits for those using its most powerful rifle, the long-range M107A1 anti-materiel rifle, because of the potential for the blast wave to cause brain damage.
It warned: “There are a number of military weapons system hazards that have been shown to potentially have a deleterious cognitive health effect on some people if exposure is not mitigated.”
An information sheet with the directive said common symptoms associated with brain injury included problems with memory, balance, concentration, headaches, hearing problems, sensitivity to light, fatigue and irritability.
In Tate’s directive, she listed blast overpressure – the concussive wave of force from an explosion – among the outcomes from heavy weapons or explosives that “can present symptoms similar to direct force concussion in some operators, particularly after repeated exposures to activities”.
“Frequent (cumulative) exposure to hazards can be expected to increase the risk of cognitive health effects.”
s3.documentcloud.org/documents/25260390/oia-2024-5116_enclosure-1.pdf
Tate said new safety guidelines and training rules were “designed to minimise an individual’s exposure to hazards in order to mitigate this risk”.
That meant those carrying out heavy weapon or explosive training should avoid contact sport, alcohol and activities that can bring on fatigue for 24 hours beforehand and 48 hours afterwards, she said.
Blast wave damage stacks and increases risk
Regular-calibre weapons and explosives such as demolitions, claymores and grenades “do not trigger the same mechanism” and “are not known to contribute to health hazards of this nature” when used in standard training situations.
Tate said those with concussion or head injuries from other activities, such as sport, should not take part in potentially damaging weapons training without medical clearance.
Tate said the NZDF’s health division might not know which personnel had been exposed to risk and relied on issues being raised with its medical specialists by commanders, safety advisers and those who experienced symptoms.
Weapons such as the anti-vehicle Barrett M107A1 now come with a warning over potential brain damage to the operator. Photo / NZDF
She said those working with high-calibre weapons or involved in explosive breaching needed to declare that they did so to NZDF health personnel during regular medicals so they could be monitored. Medical staff then would carry out “cognitive monitoring” of those who declared they were at risk, she said.
Tate said the NZDF’s approach to “weapons training-related brain injury” would align with current sports concussion guidelines but warned the symptoms “are often more subtle” and often did not reach the standard threshold for “injury”.
“Evidence shows that symptoms resolve after a period of rest and a break from ongoing exposure to the weapons system.”
She said there was also “no single diagnostic test to prove that a cognitive injury has occurred” and “research is ongoing to find accurate, objective measures of adverse clinical effects”. Diagnosis and assessment would be via questionnaires and clinical assessment, in line with concussion management.
But Tate warned that those who lost consciousness, suffered severe headaches or who were disoriented or confused needed to be removed from weapons training for medical assessment. Those who showed cognitive symptoms would not return to training until they had no symptoms and were cleared by a doctor.
The warning from the NZDF’s chief medical officer is so serious that it spells out that those who experienced symptoms for four weeks or longer could see their career paths altered to keep them out of the danger zone.
Ex-NZSAS soldier and his ‘brain fog’ symptoms
Johnson said the NZDF’s advice that there was a risk ran contrary to Veterans’ Affairs’ apparent lack of access to military medical knowledge to identify the cause of his symptoms, many of which match those in the directive.
He said the new safety rules aligned with activities he believed may have contributed to his symptoms, which included using explosives to access buildings and compounds in Afghanistan and in training.
Johnson told the NZDF in 2021 he had concerns about “brain fog” and an “inability to focus” after years of using explosives to enter buildings. He left the military shortly afterwards and almost three years later is still waiting for Veterans’ Affairs to rule on his claim that the symptoms were the result of an injury that occurred during his military service.
Veterans in New Zealand are covered by Veterans’ Affairs for injuries tied to specific, approved operational deployments under the “Statement of Principles” (SOP) system. The system allows a clear path for claims where a veteran can match an SOP with a particular injury and the circumstances in which it was acquired.
Former NZSAS Corporal Gregg Johnson getting an MRI scan at the Matai Medical Research Institute for possible traumatic brain injury. Photo / Rebecca Grunwell
Those whose injuries fall outside that specific pathway need to make a case to Veterans’ Affairs, for which it will provide access to medical specialists for assessment.
Veterans’ Affairs, in a letter to Johnson two months later, said: “There isn’t currently a [Statement of Principles] specifically related to the neurocognitive effects of multiple sub-concussive blast exposures, but there may well be in the future as clinical knowledge evolves.”
Veterans’ Affairs head Bernadine Mackenzie said her agency was an “operational element” of NZDF Defence Health and she would not comment on the “knowledge base” it held.
“Veterans’ Affairs has been aware of the risks of adverse health outcome associated with repeated exposure to blast overpressure or other sub concussive trauma for several years,” Mackenzie said.
“Veterans’ Affairs inclusive approach to claims where there is evidence of both exposure to the trauma and subsequent objective cognitive decline has evolved independently of the NZDF health position.”
Mackenzie said the lack of a direct pathway “will not preclude” access to support “given current knowledge of the possible relationship between repeated blast exposure” and injury.
She said the NZDF’s plan to record exposures would make claims and decisions “easier for Veterans’ Affairs to manage in the future”.
David Fisher is based in Northland and has worked as a journalist for more than 30 years, winning multiple journalism awards, including being twice named Reporter of the Year and being selected as one of a small number of Wolfson Press Fellows to Wolfson College, Cambridge. He first joined the Herald in 2004.
www.nzherald.co.nz/nz/new-zealand-defence-forces-new-brain-injury-warning-to-troops-over-weapons-and-explosives/4TVF2MOHHRD7DCHZOOEHKXRSDI/
By David Fisher
Senior writer·NZ Herald·
2 Nov, 2024 05:05 AM
- The Defence Force is warning some weapons and explosives can damage operators’ brains.
- New Zealand soldiers have been told even low-level blasts can accumulate damage over years.
- Veterans’ Affairs doesn’t have a recognised pathway to compensation claims for this type of brain damage.
New Zealand Defence Force (NZDF) medical experts have told military personnel some of its explosives and weapons could cause them brain damage – but its own veteran support agency has not yet accepted the injury as a direct pathway for compensation claims.
The formal NZDF “defence health directive” – released in September 2023 – highlights the risk of “firing high-calibre weapons and training with repeated low-level blasts such as that used in explosive methods of entry”.
In contrast, Veterans’ Affairs – an agency inside the NZDF – says it doesn’t have a recognised pathway for claims relating to damage caused by repeated low-level blasts.
Instead, veterans like Gregg “Pup” Johnson, who served with the NZSAS in Afghanistan, need to build a case supporting their claim – even though traumatic brain injury is often called the “signature injury” of the so-called “War on Terror”.
Former NZSAS Corporal Gregg Johnson at home in Abel Tasman and (inset) in Afghanistan. Main photo / Tim Cuff
The defence health directive was issued by the NZDF’s chief medical officer, Colonel Dr Charmaine Tate, and brought in new safety standards for those carrying out particular types of training, such as firing heavy calibre weapons or using explosives to gain entry to buildings.
It was issued around the time the NZDF was exploring firing limits for those using its most powerful rifle, the long-range M107A1 anti-materiel rifle, because of the potential for the blast wave to cause brain damage.
It warned: “There are a number of military weapons system hazards that have been shown to potentially have a deleterious cognitive health effect on some people if exposure is not mitigated.”
An information sheet with the directive said common symptoms associated with brain injury included problems with memory, balance, concentration, headaches, hearing problems, sensitivity to light, fatigue and irritability.
In Tate’s directive, she listed blast overpressure – the concussive wave of force from an explosion – among the outcomes from heavy weapons or explosives that “can present symptoms similar to direct force concussion in some operators, particularly after repeated exposures to activities”.
“Frequent (cumulative) exposure to hazards can be expected to increase the risk of cognitive health effects.”
s3.documentcloud.org/documents/25260390/oia-2024-5116_enclosure-1.pdf
Tate said new safety guidelines and training rules were “designed to minimise an individual’s exposure to hazards in order to mitigate this risk”.
That meant those carrying out heavy weapon or explosive training should avoid contact sport, alcohol and activities that can bring on fatigue for 24 hours beforehand and 48 hours afterwards, she said.
Blast wave damage stacks and increases risk
Regular-calibre weapons and explosives such as demolitions, claymores and grenades “do not trigger the same mechanism” and “are not known to contribute to health hazards of this nature” when used in standard training situations.
Tate said those with concussion or head injuries from other activities, such as sport, should not take part in potentially damaging weapons training without medical clearance.
Tate said the NZDF’s health division might not know which personnel had been exposed to risk and relied on issues being raised with its medical specialists by commanders, safety advisers and those who experienced symptoms.
Weapons such as the anti-vehicle Barrett M107A1 now come with a warning over potential brain damage to the operator. Photo / NZDF
She said those working with high-calibre weapons or involved in explosive breaching needed to declare that they did so to NZDF health personnel during regular medicals so they could be monitored. Medical staff then would carry out “cognitive monitoring” of those who declared they were at risk, she said.
Tate said the NZDF’s approach to “weapons training-related brain injury” would align with current sports concussion guidelines but warned the symptoms “are often more subtle” and often did not reach the standard threshold for “injury”.
“Evidence shows that symptoms resolve after a period of rest and a break from ongoing exposure to the weapons system.”
She said there was also “no single diagnostic test to prove that a cognitive injury has occurred” and “research is ongoing to find accurate, objective measures of adverse clinical effects”. Diagnosis and assessment would be via questionnaires and clinical assessment, in line with concussion management.
But Tate warned that those who lost consciousness, suffered severe headaches or who were disoriented or confused needed to be removed from weapons training for medical assessment. Those who showed cognitive symptoms would not return to training until they had no symptoms and were cleared by a doctor.
The warning from the NZDF’s chief medical officer is so serious that it spells out that those who experienced symptoms for four weeks or longer could see their career paths altered to keep them out of the danger zone.
Ex-NZSAS soldier and his ‘brain fog’ symptoms
Johnson said the NZDF’s advice that there was a risk ran contrary to Veterans’ Affairs’ apparent lack of access to military medical knowledge to identify the cause of his symptoms, many of which match those in the directive.
He said the new safety rules aligned with activities he believed may have contributed to his symptoms, which included using explosives to access buildings and compounds in Afghanistan and in training.
Johnson told the NZDF in 2021 he had concerns about “brain fog” and an “inability to focus” after years of using explosives to enter buildings. He left the military shortly afterwards and almost three years later is still waiting for Veterans’ Affairs to rule on his claim that the symptoms were the result of an injury that occurred during his military service.
Veterans in New Zealand are covered by Veterans’ Affairs for injuries tied to specific, approved operational deployments under the “Statement of Principles” (SOP) system. The system allows a clear path for claims where a veteran can match an SOP with a particular injury and the circumstances in which it was acquired.
Former NZSAS Corporal Gregg Johnson getting an MRI scan at the Matai Medical Research Institute for possible traumatic brain injury. Photo / Rebecca Grunwell
Those whose injuries fall outside that specific pathway need to make a case to Veterans’ Affairs, for which it will provide access to medical specialists for assessment.
Veterans’ Affairs, in a letter to Johnson two months later, said: “There isn’t currently a [Statement of Principles] specifically related to the neurocognitive effects of multiple sub-concussive blast exposures, but there may well be in the future as clinical knowledge evolves.”
Veterans’ Affairs head Bernadine Mackenzie said her agency was an “operational element” of NZDF Defence Health and she would not comment on the “knowledge base” it held.
“Veterans’ Affairs has been aware of the risks of adverse health outcome associated with repeated exposure to blast overpressure or other sub concussive trauma for several years,” Mackenzie said.
“Veterans’ Affairs inclusive approach to claims where there is evidence of both exposure to the trauma and subsequent objective cognitive decline has evolved independently of the NZDF health position.”
Mackenzie said the lack of a direct pathway “will not preclude” access to support “given current knowledge of the possible relationship between repeated blast exposure” and injury.
She said the NZDF’s plan to record exposures would make claims and decisions “easier for Veterans’ Affairs to manage in the future”.
David Fisher is based in Northland and has worked as a journalist for more than 30 years, winning multiple journalism awards, including being twice named Reporter of the Year and being selected as one of a small number of Wolfson Press Fellows to Wolfson College, Cambridge. He first joined the Herald in 2004.
www.nzherald.co.nz/nz/new-zealand-defence-forces-new-brain-injury-warning-to-troops-over-weapons-and-explosives/4TVF2MOHHRD7DCHZOOEHKXRSDI/
