While Blast Over Pressure (BOP) was first recognized as a serious health issue after World War I, mainly as a psychological issue, overtime BOP became recognized as a physical health issue with potential short- and long-term effects.

Because of this, years of research and studies have been conducted to better understand the physiological impacts of blast exposure on the brain. Additionally, the military began implementing protective measures and monitoring efforts, to minimize the effects of exposure following the conflicts in Iraq and Afghanistan.

However, despite scientific research, something that was missing was a systematic, service-wide approach to exposure monitoring, and long-term tracking of individual exposures, especially in real-time operational and training environments. In military speak, it wasn’t integrated into everyday force health protection.

According to Jena Brunson, an Industrial Hygienist (IH) with the Acquisition and Technical Support (ATS) Division of the Navy and Marine Corps Force Health Protection Command (NMCFHPC), one of the first questions that needed to be answered was how to regularly monitor BOP to understand exposure profiles.

“To me, it made sense that this would fall under the IH roles and responsibilities. We’re already out there regularly with the operational community monitoring and assessing other hazards, and if blast is something that needs to be monitored and there's the ability to do it, it should be our IH’s,” said Brunson.

In the spirit of Navy Medicine’s Get Real, Get Better initiative, the ATS Division soon transformed this complex challenge into an operationally relevant solution—well before formal policy required it.

Ultimately the ATS Division developed and implemented the Navy’s first BOP exposure assessment strategy. Their approach not only aligns with emerging Department of Defense (DOD) policy but also demonstrates how Navy Medicine drives readiness through foresight, innovation, and collaboration.

Their proactive strategy leverages existing industrial hygiene expertise, scalable processes, and centralized support. According to Brunson, field IHs collect monitoring data during operational training and real-world scenarios. That data is processed and analyzed centrally by the ATS Division, ensuring consistency, accuracy, and scientific rigor.

“Other than buying the equipment, everything has been built by us in-house. No contracts, no outsourcing,” said Brunson.

To date, nearly 4,400 samples have been collected across approximately 30 Navy and Marine Corps units, including shipboard and shore-based weapons training environments. According to Brunson the strategy has already enabled operational units to take informed steps—adjusting personnel positioning, minimizing unnecessary exposure, and enhancing training safety without compromising lethality. It also encourages innovation like a hybrid approach to training which includes a combination of simulation and live-round training.

“Our role is to give commanders high-quality data so they can make smart decisions,” Brunson said. “It’s not about limiting capability—it’s about protecting it.”

The program has drawn interest from across the joint force. Naval Special Warfare has recently engaged with NMCFHPC to assess unique exposure scenarios and praised the Navy’s centralized, science-based approach. Feedback from these operational partners has affirmed the program’s value and encouraged broader integration.

One of the products the ATS Division provides commands is an exposure report. “These reports give decision-makers a clear picture of the operation,” said Brunson. “From the type of weapons used and the exposure profile for personnel. Not just the operator, but everyone around them: instructors, range safety officers, support staff. Previously, the focus was always just the operator and the weapon.”

As part of the Navy’s broader BOP response, NMCFHPC’s efforts are tied to ongoing development of medical surveillance programs and emerging tools to better understand long-term health risks. Exposure data is being structured for future inclusion into what is known as Defense Occupational and Environmental Health Readiness System (DOEHRS), the official DOD repository for all exposure monitoring data. This information is meant to flow into the Individual Longitudinal Exposure Record (ILER), which tracks a person’s exposures throughout their career, ensuring long-term documentation and medical visibility.

“We didn’t wait for a mandate,” said Brunson. “We saw a risk to our warfighters and leaned forward to protect them—because that’s what public health and readiness demand. We saw the gap, built the solution with the tools and people we had, and we’re improving the process every day based on feedback from the fleet.”

Ultimately, by embedding public health experts alongside operational forces, Navy Medicine is once again proving that readiness isn’t just about equipment or tactics—it’s about the health and protection of the warfighter.

Navy and Marine Corps Force Health Protection Command plays a critical role in protecting the health and readiness of deployed forces. Through expeditionary units such as the Forward Deployable Preventive Medicine Unit (FDPMU), and with support from Navy Environmental and Preventive Medicine Units (NEPMUs), these public health or force health protection teams provide rapid, flexible, and scalable health protection capabilities. From identifying environmental and occupational health hazards to advising commanders on risk mitigation, their mission is to ensure operational forces remain medically ready and mission capable—anytime, anywhere.