BLAST OVERPRESSURE AND COGNITIVE MONITORING PROGRAM

[Tony]

CLASSIFICATION: UNCLASSIFIED/
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MSGID/GENADMIN/SECNAV WASHINGTON DC/-/JUL//
SUBJ/BLAST OVERPRESSURE AND COGNITIVE MONITORING PROGRAM//
REF/A/DOC/DEPSECDEF MEMO/08JUN2022//
REF/B/DOC/DEPSECDEF MEMO/08AUG2024//
REF/C/DOC/DOD BOP REFERENCE AND INFORMATION GUIDE/OCT 2024//
REF/D/DOC/DODINST 6490.13/28MAY2024//
REF/E/DOC/DODINST 6490.03/19JUL2019//
REF/F/DOC/USD(P&R) MEMO/12DEC2024//
NARR/REF A IS THE DOD BLAST OVERPRESSURE POLICY
REF B IS A DEPSECDECF MEMO REGARDING COMPREHENSIVE STRATEGY AND ACTION PLAN
FOR WARFIGHTER BRAIN HEALTH
REF C IS THE DOD BLAST OVERPRESSURE REFERENCE INFORMATION GUIDE (D BOP RIG)
REF D IS THE DOD COMPREHENSIVE POLICY ON TRAUMATIC BRAIN INJURY-RELATED
NEUROCOGNITIVE ASSESSMENTS BY THE MILITARY
REF E IS THE DOD POLICY ON DEPLOYMENT HEALTH
REF F IS THE DOD IMPLEMENTATION GUIDANCE FOR MANAGING BRAIN HEALTH RISKS FOR
BLAST OVERPRESSURE//
RMKS/1. The Department of the Navy (DON) remains committed to the health and
safety of our Sailors and Marines. Decades of combat operations have taught
us that some injuries particularly to the brain may not be immediately
apparent and repeated exposure to certain conditions can have cumulative
effects. The science surrounding these exposures continues to evolve, and we
recognize a strong relationship between Blast Overpressure (BOP) and the
Warfighter Brain Health (WBH).
2. As discussed in reference (a), the WBH Initiative addresses concussions
and other forms of Traumatic Brain Injury (TBI). Brain injuries may result
from direct impacts, exposure to blasts or low-level blasts or operation of
certain weapons systems. BOP encompasses exposure to events that release
energy through multiple pathways (impulse noise, pressure waves, body
acceleration, and vibration), potentially causing injury. These exposures
may occur in combat, operational evolutions and training environments.
3. Managing risks related to BOP and WBH spans across operations, training,
safety, medical and information communities. Reference (b) establishes four
pounds per square inch (psi) as the action threshold for BOP exposure.
Per reference (c), the four psi action threshold is consistently reached or
exceeded by operators of shoulder- fired weapons. Other activities, such as
training involving detonations, have the potential to exceed four psi and may
amplify or prolong exposures of any level. Therefore, DON categorizes such
personnel as high risk based on the definition below, and these personnel
must complete a Cognitive Monitoring Program (CMP) baseline assessment by
September 30, 2025 as required by reference (b). The Department of Defense
(DoD) tool to complete a CMP baseline is the Automated Neuropsychological
Assessment Metrics.
 a. High-risk is defined as all Active Component personnel assigned to
units where they will or are likely to engage in training or operational
activities that place them in the proximity of weapons systems recognized or
suspected to produce hazardous BOP exposures often within a 12-month period.
The term "often" means a more frequent or regular exposure, such as daily or
multiple times per week, with little variability. The term "high-risk" would
traditionally include those assigned to "warfighter" and training units.
4. All other DON active-duty military members must be baselined by September
30, 2027. These efforts are directly tied to overall force readiness.
5. CMP baseline assessments have been a longstanding pre- deployment
requirement per references (d) and (e), though previously, shipboard
personnel were exempt. Reference (b) rescinds that exemption. Currently,
baseline assessment capabilities exist at several locations, including Camp
Lejeune, Camp Pendleton and Marine Corps Air Ground Combat Center Twentynine
Palms. A complete list of all CMP testing sites can be found at:
https://esportal.med.navy.mil/bumed/rh/m3/M33/Pages/TBI.aspx.
As there are many additional sites being created across the DoD, this list
will be updated regularly.
6. Chief of Naval Operations and Commandant of the Marine Corps will:
 a. Designate a Navy and a Marine Corps BOP Management Action Lead at the
O-7 level or above to be responsible and accountable for implementing BOP and
WBH requirements including those listed in the references. Notify Assistant
Secretary of the Navy for Energy, Installations, and Environment (ASN (EI&E))
via Memorandum of the BOP Management Action Lead designations no later than
July 24, 2025. ASN
(EI&E) will coordinate with the BOP Management Action Leads to ensure
implementation of all requirements.
7. The Management Action Leads for the Navy and the Marine Corps will ensure
that Commanders and Commanding Officers:
 a. Leverage existing capabilities at installations conducting live-fire
activities to facilitate baseline cognitive assessments for personnel who are
deemed high-risk based on the guidance above.
 b. Utilize remaining capabilities to assess personnel who are deemed
increased-risk based on the guidance above, followed by all remaining
personnel if resources are available.
 c. Support the establishment of additional testing locations, including
but not limited to, providing physical space for testing sites (when
necessary) and identifying personnel who can serve as proctors for testing.
 d. Direct exposed personnel to existing training sites as capacity
becomes available.
8. All DON personnel will:
 a. Be vigilant for symptoms which may be attributable to exposure to BOP
in oneself and others. An excellent resource created by the Defense Health
Agency Traumatic Brain Injury Center of Excellence is the following:
https://health.mil/Reference-Center/Fact-Sheets/2024/10/16/Low-Level-BlastService-Members-Fact-Sheet
 b. Promptly report suspected brain injuries to the cognizant medical
department and chain of command.
9. Every member of the DON is responsible for minimizing the risk of brain
injury. Through vigilance and proactive behavior, we strengthen our
collective ability to protect our mission and our people.
10. Our success depends on the commitment of every Sailor, Marine, civilian,
and contractor. Together, we will maintain a secure environment that
protects both mission accomplishment and the safety of our force.
11. Released by the Honorable John C. Phelan, Secretary of the Navy.//
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CLASSIFICATION: UNCLASSIFIED/