Repetitive Low-level Blast Exposure and Neurocognitive Effects in Army Ranger Mortarmen.

Mortarmen experienced high cumulative blast exposure coinciding with altered neurocognition that is suggestive of blast-related subconcussive injury. These neurocognitive effects occurred even in mortarmen with average BOP below the 4 psi safety threshold. While this study was limited by a small sample size, its results demonstrate a concerning health risk for mortarmen that requires additional study and immediate action. Behavioral changes like ducking and standing farther from the mortar when firing can generally help reduce mortarmen BOP exposure, but we recommend the establishment of daily cumulative safety thresholds and daily firing limits in training to reduce cumulative blast exposure, and ultimately, improve mortarmen's quality of life and longevity in service.