Researchers at KI have been involved in a NATO working group that has drawn up guidelines designed to reduce the risk of soldiers' brains being affected by shock waves from explosions, primarily during training. The Unit for Experimental Traumatology has been conducting defence medicine research for nearly 20 years and has worked closely with the Swedish Armed Forces. The NATO assignment forms part of the group's long-term work to advance knowledge in the field of Swedish defence medicine.
"It's gratifying to see that the report is being put to prompt practical use," says Mattias Sköld , researcher at KI's Department of Neuroscience and chair of the NATO committee that has been investigating the health dangers of shockwaves and how to mitigate their effects on the human brain. "The aim of getting to grips with the impacts of this type of exposure is to ensure military personnel get the highest possible standards of risk-mitigation, care and protection."
It is a well known fact that powerful explosions can cause brain damage; however, in recent years there has been increasing interest in what happens on lower exposure to shockwaves from explosions, especially repeatedly. The question is particularly important for the military, not least during training.
"It's probably during training and drills that soldiers are exposed to the most explosions during their career, so we need to understand how these effects can accumulate over time," says Dr Sköld.
Broad-based collaboration in the security alliance
The committee comprised 27 experts from a dozen NATO member states in such fields as medicine, physics and military activities, and included a number of researchers from KI.
"We need to understand which brain areas and cells are affected and why the brain suffers from repeated exposure to shockwaves," says Mattias Günther , anaesthesiologist and leader of the experimental traumatology research group at KI's Department of Neuroscience. "In the long run, what we learn will help to inform clearer threshold values for exposure and safety procedures."
The NATO group has drawn up guidance for how national armed forces are to approach the issue of shockwave exposure.
Gradual application of the guidelines
The resulting report, which was published in the summer, states, amongst other data, levels of pressure and the total energy that should be heeded on exposure.
Since the NATO member states have made varying progress in this area, the guidelines have been written to be put into successive military application. For one country, the first step might be to start recording exposure levels during drills, while another country that has made more progress can work with more specific metrics and medical follow-ups. The report also identifies the kind of research that should be given priority by the member states in order to advance the field.
Specific issues for the military
Defence-related medicine is a growing field at Karolinska Institutet. Dr Günther's research group is on several scientific NATO committees and is in a long-standing collaborative partnership with the Swedish armed forces on medical issues specific to the military in times of both peace and war.
Another example is the use of tourniquets for stopping severe bleeding. Here, the question is how long they can be applied before they cause unnecessary injury or a need for amputation.
"Questions like this can't always be answered by civilian medical research," says Dr Günther. "Sweden also needs its own knowledge to be able to take autonomous decisions in the military-medical field. Our group plays an important part in this respect, as we can combine medical research with a military understanding."
The new guidance on shockwave exposure is already in international use. The UK and Australian armed forces, for example, now apply it in their work on safety procedures.
Text: Johanna Aggestam
Translation: Neil Betteridge
Experts from NATO member states
The committee falls under NATO's Science and Technology Organization (STO) Human Factors and Medicine Panel, in which experts from the member states work together on issues of a scientific and technical nature.
Experts can table proposals on fields that need investigating or researching. Once they have been reviewed by the STO, these proposals can lead to the formation of an international committee. Such a committee normally sits over a three-year period after which it submits its findings for review and publication.
