Search Results (300)

Jet fuels are a complex mixture of hydrocarbons and performance additives, including some compounds with established human toxicity. They represent a significant occupational hazard for military personnel; however, little is known about possible long-term health effects, particularly following cessation of exposure. In response to United States (US) Veterans’ concerns, the US Department of Veterans Affairs (VA) and the Department of Defense (DoD) launched a large retrospective cohort study to assess the impact of military occupational jet fuel exposure on Veterans’ health. The Long-Term Impact of Fuel Exposure (LIFE) cohort consists of over 1.3 million Veterans who entered service on or after 1 January 1995, including both individuals with jet fuel-exposed occupations in their service history and a random sample of unexposed Veterans. Data from multiple VA and DoD administrative datasets were linked to evaluate morbidity, disability, and mortality endpoints. Analyses are underway to assess associations between jet fuel exposure and adverse health outcomes in multiple body systems. This study represents the largest effort to date to investigate these effects, with the intention of informing policies affecting Veterans for years to come. Full article

Background: Training planning in military environments is complex due to diverse operational demands and constant exposure to stressors. When combined with high training volumes and insufficient recovery, this can result in physical and mental overload. Regular assessments are crucial to monitor the condition of personnel and adjust training accordingly, though more research is needed to effectively track performance in real operational settings. Objectives: This study aims to monitor neuromuscular and psychological performance in relation to training load in a military school, addressing the research gap in tracking performance in operational settings. Methods: Overall, 27 marines (age: 27.9 ± 4.8 years; height: 178.1 ± 6.3 cm; weight: 79.1 ± 7.8 kg) were monitored over a 13-week academic-military training period to assess neuromuscular performance and psychological fatigue. Results: Laboratory tests included the countermovement jump (p = 0.002), isometric mid-thigh pull (p = 0.001), and handgrip strength for both dominant (p = 0.947) and non-dominant hands (p = 0.665). Field tests involved maximum pull-ups (p = 0.015), push-ups (p = 0.001), and the medicine ball throw (p = 0.334). Psychological evaluation via the POMS questionnaire showed the highest negative mood scores in Tension–Anxiety, Depression–Melancholia, and Fatigue–Inertia, while Vigor–Activity was the highest positive state. RESTQ-Sport results indicated total recovery was 68.9% greater than total stress. Conclusions: Despite improvements in some field tests, no significant neuromuscular gains were observed, likely due to excessive training loads, limited recovery, and sustained stress. Full article

Background: Cardiovascular diseases (CVD) remain the leading cause of death in both Poland and worldwide. Despite a decline in CVD-related mortality observed in Poland since 1991, national rates still exceed the European Union average. Methods: The aim of this study was to assess the prevalence of cardiovascular risk factors and the level of health awareness among Polish Armed Forces personnel, including both soldiers and civilian employees. A total of 308 participants (82.00% soldiers) underwent anthropometric measurements, lipid profile testing, and completed a structured questionnaire. Results: The results indicate a high prevalence of modifiable risk factors, such as overweight (30.30%), low physical activity (21.20%), and tobacco use (21.20%). Additionally, 54.00% of respondents reported experiencing stress, and 17.00% had elevated cholesterol levels. Statistically significant associations were found between selected parameters and gender, age, service corps, and occupational status. Despite a moderate level of knowledge regarding CVD, the majority of participants expressed a willingness to expand their understanding. Conclusions: The findings highlight the importance of early prevention and health education on cardiovascular diseases, especially in military environments where stress and lifestyle factors may contribute to increased risk. Full article

Moral injury is a discrete form of harm affecting individuals as a potentially avoidable consequence of exposure to a morally injurious event. That injury (independent of psychological injury or illness) has been identified as a cause of physical symptoms, suicide and suicidality. Originally identified within military and veteran cohorts, it is observable in emergency responders, healthcare providers, human rights advocates and others. Its aetiology suggests that other groups where the potential for tensions between personal morals, professional ethics and occupational activities arises (such as whistleblowers, law enforcement personnel and lawyers) may be at risk. Despite increasingly diverse evidence identifying moral injury as a substantive harm with significant consequences, the legal options for redress are unclear. This article explores whether requirements for establishing a duty of care as a precursor to a negligence claim are likely to pose an insurmountable obstacle for plaintiffs, including in the context of employer–employee duty relationships. It concludes that despite popular perceptions that negligence law is unlikely to be able to accommodate moral injury claims, a closer reading of key judgments indicates that there are opportunities for it to potentially be recognised as a harm on a principled basis—consistent with existing jurisprudence and legislation—for the purposes of establishing a duty of care. In the event that normative claims for its recognition are resisted, the justification for that resistance must be found outside historical development of legal principles from case law. Full article

Traumatic brain injury (TBI) remains a significant public health concern, particularly among military personnel and contact sport athletes who are frequently exposed to repeated blast overpressure waves and mild concussive impacts, respectively. While moderate and severe TBIs have been extensively studied, the long-term neuroendocrine consequences of mild, repetitive brain trauma are poorly understood. In this study, we investigated the temporal dynamics of hypothalamic–pituitary–adrenal (HPA) axis dysregulation following repeated mild concussive head impacts and blast exposures using two clinically relevant rodent models. Male Sprague-Dawley rats were subjected to repeated mild concussive impacts using a modified weight drop model or repeated blast exposures using an advanced blast simulator. Plasma levels of adrenocorticotropic hormone (ACTH) and corticosterone were measured on days 1 and 30 post-injuries. Our findings revealed that repeated blast exposures induced elevation of plasma ACTH and corticosterone on days 1 and 30 post-blasts. After the repeated mild concussive impacts, increased plasma levels of corticosterone were observed on days 1 and 30, but ACTH levels were increased only on day 30. This study is among the first to directly compare neuroendocrine outcomes of repeated mild concussive impacts and blast exposures within a unified experimental framework. Our findings demonstrate distinct temporal trajectories of HPA axis dysregulation depending on injury type and highlight plasma levels of ACTH and corticosterone as potential biomarkers of subclinical brain trauma. These insights may inform early diagnostic approaches and therapeutic strategies aimed at mitigating long-term stress-related complications following mild traumatic brain injuries. Full article

Wound care in military and combat environments poses distinct challenges that set it apart from conventional medical practice in civilian settings. The nature of injuries sustained on the battlefield—often complex, contaminated, and involving extensive tissue damage—combined with limited access to immediate medical intervention, significantly increases the risk of infection, delayed healing, and adverse outcomes. Traditional wound dressings frequently prove inadequate under such extreme conditions, as they have not been designed to address the specific physiological and logistical constraints present during armed conflicts. This review provides a comprehensive overview of recent progress in the development of advanced wound dressings tailored for use in military scenarios. Special attention has been given to multifunctional dressings that go beyond basic wound coverage by incorporating biologically active macromolecules such as collagen, chitosan, thrombin, alginate, therapeutic peptides, and growth factors. These compounds contribute to properties including moisture balance control, exudate absorption, microbial entrapment, and protection against secondary infection. This review highlights the critical role of advanced wound dressings in improving medical outcomes for injured military personnel. The potential of these technologies to reduce complications, enhance healing rates, and ultimately save lives underscores their growing importance in modern battlefield medicine. Full article

Background/Objectives: Traumatic brain injury is one of the leading causes of death and disability. When traumatic brain injury is repeated over time, it can lead to the development of Chronic Traumatic Encephalopathy, a chronic neurodegenerative disease commonly observed in individuals who engage in contact sports or military personnel involved in activities with a high risk of repeated head trauma. At autopsy, the examination of the brain reveals regional atrophy, corresponding to high concentrations of glutamate receptors. Microscopically, the primary findings are the deposition of neurofibrillary tangles and neuropil threads. The aim of this study is to highlight the clinical and histopathological characteristics of Chronic Traumatic Encephalopathy, providing diagnostic support to forensic pathologists. Additionally, it seeks to aid in the differential diagnosis of similar conditions. Methods: A review of literature was conducted following the PRISMA criteria. Of 274 articles, 7 were selected. Results: According to these papers, most patients were male and exhibited neurological symptoms and neuropsychiatric impairments, and a proportion of them committed suicide or had aggressive behavior. Conclusions: Chronic Traumatic Encephalopathy remains largely underdiagnosed during life. The definitive diagnosis of Chronic Traumatic Encephalopathy is established post-mortem through the identification of pathognomonic tauopathy lesions. Early and accurate antemortem recognition, particularly in at-risk individuals, is highly valuable for its differentiation from other neurodegenerative conditions, thereby enabling appropriate clinical management and potential interventions. Full article

Background/Objectives: This scoping review critically evaluated existing literature and summarized the impact of occupational, physiological, and psychological stressors on adrenal and neuroendocrine responses, body composition, and physical performance amongst women in tactical occupations. Methods: Boolean searches identified potentially qualifying reports involving: (1) adult women (≥19 y) currently employed or completing their training for a tactical profession; (2) ≥1 marker of “stress”; and (3) ≥1 adrenal, neuroendocrine, body composition, or fitness/performance outcome. Quantitative data (e.g., sample characteristics, outcomes of interest) were extracted and summarized. The completeness of reporting for each study was documented using existing checklists and quantified as: low (<50%), moderate (50–79%), or high (≥80%). Results: 40 studies (k) of moderate reporting quality (~64%) were included in the final sample (3693 women); 11 studies (28%) focused on women exclusively, and 16 studies identified sex differences in ≥1 outcome. Most studies involved military trainee populations (80%, k = 32). Occupation-related stress tended to negatively impact adrenal, neuroendocrine, body composition, and performance outcomes. Conclusions: This review highlights progress in assessing occupational performance in female tactical personnel exposed to diverse stressors; however, our understanding remains incomplete due to methodological and conceptual limitations in the literature. Holistic research strategies are needed to capture the complexity of performance readiness in women, integrating how stress affects key tactical performance aspects such as muscle physiology, reproductive health, and energy and nutrient balance in realistic operational contexts. Integrating such data is vital for informing policy, improving readiness, and enhancing the health and career longevity of female tactical personnel. Full article

Military personnel deployed to Iraq and Afghanistan were exposed to emissions from open-air burn pits, where plastics, metals, and medical waste were incinerated. These exposures have been linked to deployment-related respiratory diseases (DRRD) and may also impact neurological health via the lung–brain axis. To investigate molecular mechanisms, adult male rats were exposed to filtered air, naphthalene (a representative volatile organic compound), or a combination of naphthalene and carbon black (surrogate for particulate matter; CBN) via whole-body inhalation (six hours/day, three consecutive days). Lung, brain, and plasma samples were collected 24 h after the final exposure. Pro-inflammatory biomarkers were assessed using multiplex electrochemiluminescence and western blot. Differentially expressed genes (DEGs) were identified by RNA sequencing, and elastic net modeling was used to define exposure-predictive gene signatures. CBN exposure altered inflammatory biomarkers across tissues, with activation of nuclear factor kappa B (NF-κB) signaling. In the lung, gene set enrichment revealed activated pathways related to proliferation and inflammation, while epithelial–mesenchymal transition (EMT) and oxidative phosphorylation were suppressed. In the brain, EMT, inflammation, and senescence pathways were activated, while ribosomal function and oxidative metabolism were downregulated. Elastic net modeling identified a lung gene signature predictive of CBN exposure, including Kcnq3, Tgfbr1, and Tm4sf19. These findings demonstrate that inhalation of a surrogate burn pit mixture induces inflammatory and metabolic gene expression changes in both lung and brain tissues, supporting the utility of this animal model for understanding systemic effects of airborne military toxicants and for identifying potential biomarkers relevant to DRRD and Veteran health. Full article

Background/Objectives: Oral health has specific importance and consequences from a military and Navy standpoint. The aim of this study was to determine and compare caries prevalence and dental care in Spanish Navy personnel. Methods: A retrospective observational study was carried out with a sample size of 1318 individuals (34.65 ± 8.82 years old) stationed at the Rota naval base in Spain, whose dental charts were examined. Caries prevalence was assessed using the Decayed, Missing, Filled Teeth (DMFT) index; dental care was evaluated using the care index (CI); and demographic and occupational factors were recorded. Results: The population of this study had a mean DMFT index of 5.99 ± 4.71 and a CI of 79%. Through the results of the DMFT index and CI, the statistical significance of the age and rank variables (p < 0.01) was confirmed, with personnel >45 years old and non-commissioned officers (NCOs) having the highest mean DMFT values and the youngest and officer groups having the greatest CI variable. Comparing the DMFT index across genders and ages and between age and rank also revealed significant differences. Conclusions: This study’s findings show a low prevalence of cavitated caries (14.5%), with intermediate DMFT values and higher CIs compared to those in previous published data. Full article

Background/Objectives: This study examines the academic discourse surrounding Critical Incident Stress Debriefing (CISD) and Critical Incident Stress Management (CISM) for first responders using Latent Dirichlet Allocation (LDA) topic modeling. It aims to uncover latent topical structures in the literature and critically evaluate assumptions to identify gaps and limitations. Methods: A corpus of 214 research article abstracts related to CISD/M was gathered from the Web of Science Core Collection. After preprocessing, we used Orange Data Mining software’s LDA tool to analyze the corpus. We tested models ranging from 2 to 10 topics. To guide interpretation and labeling, we evaluated them using log perplexity, topic coherence, and LDAvis visualizations. A four-topic model offered the best balance of detail and interpretability. Results: Four topics emerged: (1) Critical Incident Stress Management in medical and emergency settings, (2) psychological and group-based interventions for PTSD and trauma, (3) peer support and experiences of emergency and military personnel, and (4) mental health interventions for first responders. Key gaps included limited focus on cumulative trauma, insufficient longitudinal research, and variability in procedural adherence affecting outcomes. Conclusions: The findings highlight the need for CISD/M protocols to move beyond event-specific interventions and address cumulative stressors. Recommendations include incorporating holistic, proactive mental health strategies and conducting longitudinal studies to evaluate long-term effectiveness. These insights can help refine CISD/M approaches and enhance their impact on first responders working in high-stress environments. Full article

Blast-induced polytrauma (BIPT) is a common injury among military personnel exposed to explosive blasts. It is increasingly recognized as a complex, multisystem disorder that extends beyond neurological damage to include systemic metabolic and inflammatory dysfunction. Adipokines, particularly leptin and adiponectin, are hormones secreted by adipose tissue and are emerging as key mediators in the pathophysiology of traumatic brain injuries. Yet, their long-term dynamics following blast exposure remain unclear. This study investigated the temporal profiles of plasma leptin and adiponectin in a longitudinal rat model of BIPT. Adult male Sprague Dawley rats were subjected to either a single (B) or repeated (BB) blast exposure (20 psi) or served as sham controls. Plasma samples were collected at 24 h, 1 month, 6 months, and 12 months post-exposure, and adipokine levels were measured using Enzyme-linked Immunosorbent Assay. Adiponectin levels exhibited a biphasic response: both B and BB groups showed significant early decrease at 24 h and 1 month compared to sham animals, followed by robust elevation at 6 and 12 months, particularly in the repeated blast group. In contrast, leptin levels remained unchanged acutely but rose significantly at 6 and 12 months post-blast, with the BB group again showing the highest levels. These patterns indicate sustained, exposure-dependent dysregulation of adipokine signaling after blast trauma. The study provides the first longitudinal profile of systemic adipokine responses to BIPT, revealing their potential as accessible biomarkers and therapeutic targets. These findings support a model of chronic metabolic and inflammatory imbalance in BIPT and warrant further investigation in human cohorts and mechanistic studies. Full article

Individuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (PE) among those with and without hazardous drinking and whether treatment outcomes varied across these groups as a function of PE format. Data used were from a randomized controlled trial that examined two daily, compressed formats of PE treatment for PTSD (massed and intensive outpatient program) in military personnel and veterans (N = 234). Individuals without hazardous drinking had greater PTSD symptom reductions compared to those with hazardous drinking (d = 0.42, p = 0.001). However, the hazardous drinking group also demonstrated significant reductions in PTSD (d = 1.46, p < 0.001) following treatment, as well as in the number of drinks per week (d = 0.63, p = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE. Full article

Infectious disease outbreaks amplify the influence of stressors on psychological conditions. The purpose of this study was to analyze the disturbing influence of COVID-19 outbreak-related information and the influence of trust on the Serbian healthcare system and COVID-19 preventive measures on anxiety and depression. An anonymous online questionnaire assessing the demographic information, disturbance level and causes, and levels of anxiety and depression has been distributed to the participants, divided into student and non-student groups. The non-student group was further divided into healthcare, military, and education workers. Anxiety and depression levels, as well as the level of decreased trust in COVID-19-related preventive measures, were higher among students compared to non-students (p = 0.011). Higher anxiety and depression levels, and higher influence of the COVID-19 outbreak on those levels, were observed in education and healthcare workers, compared to military personnel. Medical doctors reported a higher level of trust in the healthcare system compared to nurses (p = 0.023). Trust in the healthcare system increased more frequently compared to the pre-vaccination period among medical doctors, compared to nurses (p = 0.040). Higher anxiety and depression and lower public trust levels in students and workers in education and the healthcare sector indicate a need to focus on these important society members during public health emergencies. Full article

Advancements in biosensing technologies have introduced opportunities for non-invasive, real-time monitoring of salivary biomarkers, enabling progress in fields ranging from personalized medicine to public health. Identifying and prioritizing the most critical analytes to measure in saliva is essential for estimating physiological status and forecasting performance in applied contexts. This study examined the value of 12 salivary analytes, including hormones, metabolites, and enzymes, for predicting cognitive and physical performance outcomes in military personnel (N = 115) engaged in stressful laboratory and field tasks. We calculated a series of features to quantify time-series analyte data and applied multiple regression techniques, including Elastic Net, Partial Least Squares, and Random Forest regression, to evaluate their predictive utility for five outcomes of interest: the ability to move, shoot, communicate, navigate, and sustain performance under stress. Predictive performance was poor across all models, with R-squared values near zero and limited evidence that salivary analytes provided stable or meaningful performance predictions. While certain features (e.g., post-peak slopes and variance metrics) appeared more frequently than others, no individual analyte emerged as a reliable predictor. These results suggest that salivary biomarkers alone are unlikely to provide robust insights into cognitive and physical performance outcomes. Future research may benefit from combining salivary and other biosensor data with contextual variables to improve predictive accuracy in real-world settings. Full article