In the Military

Limited understanding

The medical profession's understaning of mild TBI is very limited and needs significant further research.

Different contexts

In the military, the contexts in which TBI is experienced, diagnosied and treated are very different from one country to another.

These is need for significant further research.

Australia

In Australia:

  • 28.3% of ADF personnel have experienced at least one mTBI in their lifetime.
  • 12.6% of the ADF reported being exposed to a blast or explosion IED, and 14.0%reported being exposed to an RPG.
  • Motor vehicle accidents were the most prevalent cause of mTBI.
  • Motor vehicle accidents and falls carry a greater risk of mTBI than blast exposure.

US

According to the US Defense Medical Surveillance System and the Theater Medical Data Store, about 58% of all traumatic brain injuries occur in US Army personnel, while the remainder is evenly spread among the Navy, Marines, and Air Force (69).

An overall high prevalence of persistent PCS has been identified in US Armed Forces returning from the Iraq and Afghanistan wars. Although the exact percentage of those affected by mTBI post-deployment remains unclear, research has suggested that this is between 15% (61) and 22% (70). Furthermore, a substantially higher percentage of those sustaining an mTBI are combat personnel (71), as might be expected as combat roles increase the risk of exposure to blast and therefore an increased risk of sustaining mTBI (72).

UK and Canada

Much lower prevalence rates of mTBI have been reported among UK service personnel as compared to those in the US. For example, according to Rona et al. (73) the overall prevalence for those returning from Afghanistan and Iraq is 4.4%, rising to 9.5% for combat personnel. Furthermore, more recently Jones et al. (14) reported an even lower yearly rate of 3.2% with no significant difference between combat and other military personnel. Finally, a similarly low prevalence rate of mTBI has been identified in a recent study based on the responses of 16,193 Canadian military who were sent to Afghanistan between 2009 and 2012 (5.2%, (10,74)16.