Article Text

Guidelines for conducting epidemiological studies of blast injury
  1. Dan Bieler1,
  2. I Cernak2,
  3. L Martineau3,
  4. S Bjarnason4,
  5. A Franke1,
  6. E Kirkman5,
  7. M J Leggieri Jr6,
  8. H Orru7,
  9. S Ouellet3,
  10. M Philippens8,
  11. M G Risling9,
  12. J-C Sarron10,
  13. S Skriudalen11,
  14. J A Teland11,
  15. S Watts5 and
  16. R Gupta6
  1. 1Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery and Burn Medicine, German Armed Forces Central Hospital Koblenz, Koblenz, Germany
  2. 2STARR-C, LLC (Stress, Trauma and Resilience Research Consulting), Ottawa, Ontario, Canada
  3. 3Defence Research and Development Canada, Valcartier Research Centre, Ottawa, Ontario, Canada
  4. 4Defence Research and Development Canada, Suffield Research Centre, Ottawa, Ontario, Canada
  5. 5CBR Division, Salisbury, UK
  6. 6DoD Blast Injury Research Program Executive Agency, US Army Medical Research and Materiel Command, Fort Detrick, Maryland, USA
  7. 7Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  8. 8TNO Rijswijk, Rijswijk, The Netherlands
  9. 9Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
  10. 10Sous-direction ‘ Plans-Capacités’, Direction centrale du service de santé des armées DCSSA, Paris, France
  11. 11Protection Division, Norwegian Defence Research Establishment (FFI), Kjeller, Norway
  1. Correspondence to Dr Dan Bieler, Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery and Burn Medicine, German Armed Forces Central Hospital of Koblenz 56072, Koblenz, Germany; dr.dan.bieler{at}


Blast injuries are often caused by more than one mechanism, do not occur in isolation, and typically elicit a secondary multi-system response. Research efforts often do not separate blast injuries caused by blast waves from those caused by blunt force trauma and other mechanisms. 15 experts from nine different NATO nations developed in the HFM Research Task Group (RTG; HFM-234 (RTG)) ‘Environmental Toxicology of Blast Exposures: Injury Metrics, Modelling, Methods and Standards’ Guidelines for Conducting Epidemiological Studies of Blast Injury. This paper describes these guidelines, which are intended to provide blast injury researchers and clinicians with a basic set of recommendations for blast injury epidemiological study design and data collection that need to be considered and described when conducting prospective longitudinal studies of blast injury.

  • epidemiology
  • general medicine (see internal medicine)

Statistics from


  • Funding H Orru work was supported by the Estonian Ministry of Defence under the project "Assessment and management of health risks among military personnel" and by the Estonian Ministry of Education and Research grant IUT34-17.

  • Competing interests The authors know of no known conflict of interest in the production and dissemination of this manuscript.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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