PT - JOURNAL ARTICLE AU - Garrett W Wood AU - Matthew B Panzer AU - Jay K Shridharani AU - Kyle A Matthews AU - Bruce P Capehart AU - Barry S Myers AU - Cameron R Bass TI - Attenuation of blast pressure behind ballistic protective vests AID - 10.1136/injuryprev-2011-040277 DP - 2013 Feb 01 TA - Injury Prevention PG - 19--25 VI - 19 IP - 1 4099 - http://injuryprevention.bmj.com/content/19/1/19.short 4100 - http://injuryprevention.bmj.com/content/19/1/19.full SO - Inj Prev2013 Feb 01; 19 AB - Background Clinical studies increasingly report brain injury and not pulmonary injury following blast exposures, despite the increased frequency of exposure to explosive devices. The goal of this study was to determine the effect of personal body armour use on the potential for primary blast injury and to determine the risk of brain and pulmonary injury following a blast and its impact on the clinical care of patients with a history of blast exposure. Methods A shock tube was used to generate blast overpressures on soft ballistic protective vests (NIJ Level-2) and hard protective vests (NIJ Level-4) while overpressure was recorded behind the vest. Results Both types of vest were found to significantly decrease pulmonary injury risk following a blast for a wide range of conditions. At the highest tested blast overpressure, the soft vest decreased the behind armour overpressure by a factor of 14.2, and the hard vest decreased behind armour overpressure by a factor of 56.8. Addition of body armour increased the 50th percentile pulmonary death tolerance of both vests to higher levels than the 50th percentile for brain injury. Conclusions These results suggest that ballistic protective body armour vests, especially hard body armour plates, provide substantial chest protection in primary blasts and explain the increased frequency of head injuries, without the presence of pulmonary injuries, in protected subjects reporting a history of blast exposure. These results suggest increased clinical suspicion for mild to severe brain injury is warranted in persons wearing body armour exposed to a blast with or without pulmonary injury.