Prevalence and Epidemiology of Combat Blast Injuries from the Military Cohort 2001-2014 [Internet].

Combat blast injuries are typically categorized by the mechanism of injury. Primary blast injuries result from the over-pressurization wave and typically affect gas-filled body structures (eg, lungs, gastrointestinal tract, middle ear) resulting in injuries such as blast lung, tympanic membrane rupture, abdominal hemorrhage, and concussion. Secondary blast injuries result from flying debris propelled by the blast wind and may affect any body part. Blunt force or penetrating injuries are possible. Tertiary blast injuries occur when the body is accelerated by the blast wind or pressure gradients. Any body part may be affected and typical injuries include fracture and traumatic amputation, closed and open brain injuries, and crush injuries. Quaternary blast injuries are due to other products of the explosion (eg, heat, light) and exposure to toxins and gases. Any body part may be affected and injuries include burns, blindness, and respiratory problems from inhaled toxic gases. Quinary blast injuries include illnesses, injuries, and diseases resulting from post-explosion environmental contaminants (eg, bacteria, radiation). Factors such as type of explosive, distance from the explosion, and body orientation relative to the explosion influence the impact of the explosion on the body.

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