Military blast exposure associated with long-term health conditions

Exposure to high-level blasts from incoming explosive devices or land mines among military veterans is associated with an increased risk of several conditions such as seizures, neuropathy and stroke years later, according to a study published September 16, 2026, in Neurology^®, the medical journal of the American Academy of Neurology. The study does not prove that exposure to blasts causes these conditions; it only shows an association.

"Blast exposure is often viewed through the lens of acute injury and brain health, but our findings reinforce that blast exposure is a whole-body problem with health implications that extend well beyond the time of exposure," said study author Sarah L. Martindale, PhD, of the Salisbury VA Health Care System in North Carolina. "In this study, veterans with a history of high-level blast exposure were more likely to be diagnosed with a range of neurological, respiratory, cardiovascular, and metabolic conditions years later."

The study involved 36,641 veterans who received care at the Veterans Health Administration for at least two years during the study after leaving military service. The participants completed a survey on exposure to blasts and then were followed for up to 10 years. The researchers also looked at participants' occupations to determine exposure to low-level blasts from outgoing munitions such as heavy artillery or shoulder-fired weapons.

A total of 11% of participants reported exposure to at least one high-level blast and 17% were in an occupation with a high risk of low-level blasts. About 5% had both exposures.

Researchers found that exposure to high-level blasts was associated with increased likelihood of many conditions, including hepatitis B and C, seizures, diabetes, stroke, neuropathy, high cholesterol and the lung diseases chronic bronchitis and emphysema.

For seizures, 3.92% of veterans reported exposure to high-level blasts compared to 1.88% of those with no blast exposure. For neuropathy, prevalence was 11.41% of those with exposure compared to 7.75% of those who did not report blast exposure. For stroke, 2.03% of veterans exposed to high-level blasts compared to 1.62% of those with no exposure.

Once researchers adjusted for other factors that could affect the prevalence of these conditions, such as age, sex and total number of days deployed, they found that veterans with high-level blast exposure were 79% more likely to have a seizure diagnosis, 38% more likely to be diagnosed with neuropathy and 35% more likely to have a stroke diagnosis..

For low-level blast exposure, researchers found that service members were less likely to be diagnosed with conditions such as diabetes, high cholesterol and Crohn's disease. However, Martindale noted that several factors could have affected these findings, including that many of the participants were relatively young at the start of the study and the follow-up period may not have been long enough for conditions to develop. She said the absence of elevated risk from low-level exposure in this study should not be interpreted as evidence that low-level exposure to blasts has no long-term physical health consequences.

"Understanding a veteran's history of blast exposure may give us another piece of the puzzle when considering their long-term health risks and how those risks should be monitored over time," Martindale said.

A limitation of the study was that exposure to high-level blasts was reported by participants and no information was available about the intensity of the blast, type and severity of injuries or treatment. Also, information on diagnosis of conditions was limited to cases documented through the VA health care system after the survey. Diagnoses occurring before the start of the study or outside the VA system were not captured.

The study was supported by the Salisbury VA Health Care System, Naval Health Research Center, VA Puget Sound Health Care System and the Henry M. Jackson Foundation for the Advancement of Military Medicine.