Why It Matters
Service members face a hidden occupational hazard during training and combat: blast overpressure exposure from firing certain weapons. The exposure can cause headaches, memory loss, and traumatic brain injury. The Department of Defense (DOD) launched a monitoring program in 2024, but a Government Accountability Office (GAO) report released August 18, 2026, titled "Defense Health Care: DOD Should Assess Its Needs for Managing Potential Brain Health Effects from Weapons Blast Exposures" found that the effort is already hitting a wall. Insufficient staff and technology are hampering the military's ability to track and assess brain health damage across the force.
Nearly 200,000 recruits were screened for cognitive damage in fiscal year 2025, yet the Pentagon lacks the resources to expand testing to all active and reserve service members as planned, or to repeat assessments every five years as intended. These military health system resource challenges reflect broader constraints facing DOD. Without adequate staffing and systems, the military risks missing service members who need treatment and failing to maintain records of their exposures.
The Big Picture
In August 2024, DOD issued a memo establishing blast overpressure requirements for all military components, including mandated stand-off distances when firing weapons, periodic cognitive assessments, and tracking of service members' exposures. All high-risk active duty service members were required to complete a baseline cognitive assessment in fiscal year 2025, and all new service members must complete one during initial military training.
Implementation has been uneven across the services. By fiscal year 2025, 86 percent of personnel in occupations at increased risk received cognitive assessments overall. The Army screened 87 percent of its personnel, the Air Force screened 81 percent, and the Navy screened 59 percent of sailors. By March 2026, the overall completion rate had climbed to 96 percent. As of fiscal year 2025, DOD components began updating centralized data systems to track exposures.
However, DOD officials acknowledged they "did not have an opportunity to fully evaluate and ensure they allocated the resources necessary, as required by DOD policy and guidance." The rush to launch the program meant skipping the normal planning process. Component officials identified persistent obstacles: insufficient staff, insufficient technology, and a lack of industrial hygiene personnel to complete exposure tracking requirements.
To address staffing bottlenecks, DOD is piloting a new web-based cognitive assessment tool launching in summer 2026. The tool could allow service members to complete testing more independently, potentially reducing staffing requirements. DOD is also distributing informational materials to service members on blast exposure, instructing leaders to schedule training breaks as a prevention measure, and working to improve access to specialty care for blast exposure effects.
The Bottom Line
The GAO recommended that DOD conduct comprehensive assessments of the resources needed to implement both cognitive assessment and exposure tracking requirements. The first recommendation includes evaluating the new cognitive assessment tool pilot to determine whether it addresses staffing shortages. The second recommendation calls for a comprehensive resource assessment to support industrial hygiene staff needs across DOD components.
DOD agreed with both GAO recommendations and estimates it will complete actions to address them by December 2026. As service members continue to train and deploy, the department faces a critical window to demonstrate that it can scale its monitoring and protection efforts across the entire active and reserve force without compromising quality or timeliness.
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