The ABC has interviewed more than two dozen ADF veterans with symptoms of mTBI, which they believe is linked to years spent firing heavy weapons and using explosives.
All worked in positions involving high levels of exposure to blasts during training, many at the special forces training facility at Holsworthy Barracks in New South Wales.
Peter Cafe spent years training troops to breach doors and entry ways, using explosive force. (Supplied: Gwen Cherne)
They described symptoms like debilitating headaches, memory loss, tinnitus and personality changes, including uncharacteristic impulsivity and rage.
One former special forces soldier said towards the end of his career he felt a “sting” through his body after a charge went off nearby, followed by extreme fatigue.
“I don’t want to sound like a pussy but these things are stinging my body and head,” he recalled telling colleagues during routine training firing a rocket launcher.
He now has short-term memory loss and chronic headaches.
Do you know more about this story? You can securely contact eliseworthington@protonmail.com.
He said after leaving defence, his cognitive testing results showed such a severe deficit that his neuropsychologist asked if he’d ever been smashed “with a baseball bat to the front of [his] forehead or in a car crash”.
He then saw a neurologist who concluded that with no physical trauma to explain the cognitive decline, his traumatic brain injury was likely due to repeated blast exposure.
“We all talk about it amongst ourselves and we all know it’s from explosives, but it’s not recognised anywhere,” he said.
A serving ADF member, not authorised to speak publicly, said some soldiers seemed to be more affected than others, but the impacts of blast exposure were obvious.
“People are taking the piss who think shooting a rocket off your shoulder isn’t going to produce some kind of brain injury,” he said.
Many veterans who spoke to the ABC admitted to uncharacteristic and sometimes violent fits of rage. Some said they’d started drinking heavily.
They all knew colleagues who had taken their own lives. Several said they had also considered or attempted suicide themselves.
Most had also been diagnosed with PTSD, a diagnosis some felt wasn’t right, because they hadn’t seen active combat or couldn’t pinpoint a traumatic event that could have caused it.
This month the US deputy defence secretary issued a memo acknowledging personnel were experiencing “possible adverse effects on brain health and cognitive performance” from exposure to blast overpressure (BOP).
The memo described BOP as “the sudden onset of a pressure wave … caused by the energy released during explosions and weapons firing”.
It said the reported symptoms included “headache, decreased reaction time, attention difficulty, memory loss”.
While US Defense acknowledged that the condition was not yet fully understood, it ordered officials to take immediate action to better protect soldiers.
An ADF member holds a Carl Gustav rifle during exercise Chong Ju in 2019. (Getty Images: Scott Barbour)
Another veteran told the ABC they thought mTBI was being routinely misdiagnosed as PTSD here in Australia because the symptoms can be similar.
“The fact we are treating PTSD but not blast-related traumatic brain injury is a problem because the way you treat both is very different,” they said.
“When people aren’t seeing results, it can increase the risk of suicide.”
Despite the US Pentagon figures, which show suicide rates of soldiers in roles with high degrees of blast exposure are almost double that of their counterparts, comparative data is not available in Australia.
The ABC asked the ADF if it or any of its partner agencies were working “to obtain similar data by occupation and exposure”, but the ADF did not address the question.
Memory loss, irritability, impulsivity and anger
The potential health implications of blast exposure go far beyond special forces soldiers.
ADF personnel including infantry, artillery armour, engineers and naval gunners, as well as those within state and federal police tactical units, are most at risk because they regularly work with explosives and heavy weapons.
After World War I, “shell shock” was deemed an inability to deal with the stress and difficulties of war, but Professor Anne McKee, considered a world-leading expert in neurodegenerative disease, said modern science paints the picture in much greater detail.
“Now we know there are actual injuries to the brain,” said Professor McKee, who is the chief of neuropathology at Boston VA Healthcare System.
Leading neuropathologist Professor Ann McKee directs multiple brain banks in Boston, including one for Veterans Affairs. (Supplied: VA Boston Healthcare System)
Professor McKee has studied the brains of hundreds of veterans, and says the impacts of blasts vary and can include brain inflammation, changes to white matter, and a new kind of damage called Interface Astroglial Scarring.
Under the microscope, this looks like tiny star-shaped scars that appear after damage to the surface of the brain between the white and grey matter.
“There’s something about the blast wave injury that causes these two parts of the brain to slide against each other and cause scarring,” she said.
Professor McKee said the science behind brain injury from repeated low-level blasts was still evolving but it had likely been under-diagnosed for years.
“There’s an awareness that something’s not right. There’s an awareness that their brain isn’t in their control. There’s something going wrong,” she said.
She says the most common symptoms include memory loss, irritability, impulsivity and anger.
“In some cases, they can feel that their sleep is disturbed, that they are more aggressive, more prone to violence, like a small infraction makes them have sort of an exaggerated response,” Dr McKee said.
“They can be quite depressed and feel hopeless and suicidal.”
In the absence of Peter Cafe’s brain tissue, it’s impossible to know whether blast exposure contributed to his death.
But Gwen Cherne believes it was a factor.
“I believe there is no way that you can do the jobs he did, military and overseas, have the expertise that he had, be exposed to it so often and not have any impact on your brain,” she said.
From happy-go-lucky to short-tempered and angry
Not long after attending Peter Cafe’s memorial in 2017, friend and special forces soldier Paul Dunbavin’s memory started failing too.
Peter Cafe had trained him in explosives years earlier, before Paul also became a demolition instructor, running hundreds of training exercises for young troops.
Paul Dunbavin wants to have his brain injury recognised so he can move forward. (ABC News: Brendan Esposito)
“I’ve been exposed to blasts from my whole military career, but special forces exposes you due to the nature of the training — they’ve got to train at the operational edge and that requires pushing the boundaries,” he said.
Paul was in the prime of his career, having been appointed to the senior role of command sergeant major of Australia’s Special Operations Command.
It was around then that his wife, Nicolle Hann-Dunbavin, first noticed personality changes in her husband.
“He’s gone from happy-go-lucky and very relaxed to quite a serious person, and quite short-tempered with the kids in particular,” she said.
He described uncharacteristic bursts of anger “which would go from, like zero to 1,000 degrees”, especially with his teenage boys.
Nicolle said it had been hard to explain to their children why their father had changed.
Nicolle says she worried about Paul when he was on deployment, but thought when he retired they’d lead a relaxed life. (ABC News: Brendan Esposito)
“Yeah, it’s been pretty tough and just getting the kids to understand what’s going on, because sometimes he does react in a way that he normally wouldn’t,” she said.
Retired from full-time service and struggling with memory loss, he now sees neurologist Dr Rowena Mobbs.
She believes it’s likely he had the same type of mTBI seen in professional athletes subjected to multiple concussions — known as chronic traumatic encephalopathy (CTE).
Inside a brain with suspected CTE
The effect of head knocks over Gordi Kirkbank-Ellis’s decades-long sporting career isn’t immediately obvious. That is, until you see what’s happening to his brain.
“I think there are many servicemen and women who are experiencing these types of symptoms [and decline] with abnormal testing and results,” she said.
Differentiating direct head injury from damage caused by repeated low-level blast exposure is more difficult.
“We don’t have that technology yet on our brain imaging to understand that microscopic damage and to see it, so these tests such as MRI and PET scan really are a broad brush at this stage,”
“Blast damage — we cannot know for sure unless we looked under the microscope pathologically after death.” Dr Mobbs said.
In April, Paul Dunbavin submitted a claim for mild traumatic brain injury to the Department of Veteran Affairs (DVA) to acknowledge his brain injury and cover medical expenses.
“I’m not asking for anything. I just want them to recognise the condition is due to service,” he said.
He’s yet to receive a response, but in a statement, the DVA said current and former members “are encouraged to claim for these conditions”.
He has pledged his brain to be studied after his death to help other veterans.
Paul Dunbavin had a decorated military career, finishing his career as a command sergeant major of Australia’s Special Operations Command. (Supplied: Paul Dunbavin (ADF))
Australia’s only Veterans Brain Bank has been operating for a year but has only had one brain donated so far.
Its director, Professor Michael Buckland, says efforts have been hampered by a lack of awareness of the impacts of blast damage, as well as a lack of funding.
“We need to be able to retrieve brains from across the country in a timely way to make sure that they are most valuable for research,” he said.
“And then we need as many people, as many veterans as possible, to sign up, to understand the full spectrum of exposure in the veterans’ community.”
ADF taking ‘precautionary approach’ to research
In the US there’s considerable investment in research into ways to protect troops from exposure to blasts from their own weapons.
Tiny blast gauges, attached to soldiers’ helmets and armour, are being widely used to track how much blast over pressure soldiers are being exposed to in training.
“Then you can actually start regulating and saying, OK, this person, you’ve had too much for this week. You need to step back and have a rest and come back next week,” Dr Buckland explains.
It is something the ADF has been considering for more than a decade but is yet to fully implement.
As far back as 2012, an ADF trial of thousands of soldiers fitted with blast gauges found “personnel are exposed to potentially harmful blasts effects” in both combat and training.
The trial was run by Diggerworks, an ADF department that looks at technological innovations.
The published study recommended more mTBI research and that the gauges continue to be used.
The ADF decided against a wide-scale roll-out of the gauges, and in a statement, told the ABC “the technology was not fully matured and that without additional research it would be premature to introduce into service”.
The ABC can reveal a second trial was conducted in 2016, during an annual live fire training exercise called Chong Ju.
It found a notable and dangerous risk from blast overpressure, and again recommended the continued use of gauges.
Despite the recommendations, blast gauges weren’t introduced. The ADF said the 2016 trial “contributed to the understanding of [blast overpressure] impacts’, but it would be years before they conducted another.
“It wasn’t until I read that report that I truly understood the dangers of blast overpressure,” said former commando Paul Scanlan.
“I realised we were hurting our soldiers,” he said.
Paul Scanlan became the acting Director of Diggerworks in 2019 — the same year blast gauges were trialled a third time.
“By 2019, Diggerworks had gathered sufficient blast data to identify that there was a problem,” he said.
Mr Scanlan said he referred that data to Defence in 2020. The ADF confirmed to the ABC its fourth blast gauge trial commenced in June 2024.
In contrast, federal police and some state forces have been far swifter to introduce blast gauges.
Victoria Police said in a statement that select Special Operations Group members had been wearing blast gauges to monitor training exposure since as far back as 2021.
The ABC understands police task forces in New South Wales and South Australia are also using blast gauges, as well as the Australian Federal Police.
Blast gauges are worn on the back of a soldier’s helmet to measure the level of overpressure on the brain.
In its statement, the ADF said it had been involved in research and trials relating to blast exposure for more than a decade and was taking a “precautionary approach”.
It said internal guidance was updated last year to include measures to minimise exposure to repeated low-level blast overpressure where possible.
“The guidelines make clear that where ADF members are exposed to blast overpressure, individuals will be assessed and monitored, in accordance with Defence procedures and relevant data relating to the exposure is recorded,” the statement said.
“Existing work, health and safety systems are employed to manage and minimise exposure to repeated low-level blast exposure.”
Call for more brain injury research and awareness
Paul Scanlan has now set up Vigil Australia, a social enterprise dedicated to raising awareness of blast exposure and its links to mTBI within the ADF, veteran, and police communities.
“The sad truth is that Australia is far behind … with little research or action being taken on this critical issue,” he said.
In the US there’s bipartisan support for the Blast Overpressure Safety Act introduced to Congress earlier this year, which will give oversight and force action to protect troops from blasts.
It’s the kind of action Paul Scanlan says is urgently needed here.
“I’ve attended far too many funerals of commandos who took their own lives, likely due to undiagnosed mTBI,” he said.
The Royal Commission into Defence and Veterans Suicide (DVSRC) is currently looking into systemic issues and risk factors relevant to suicide.
An interim report released in 2022 made no reference to the potential risks of blast overpressure exposure and its links to mTBI or suicide.
The commission’s findings are due to be delivered next month.
Nicolle and Paul are doing their best to manage his condition in his retirement. (ABC News: Brendan Esposito)
If this story has caused issues for you, please call:
- Lifeline 13 11 14 or Beyond Blue on 1300 22 46 36
- Veterans & Families Counselling Open Arms on 1800 011 046
- ADF Mental Health All-hours Support Line on 1800 628 036
- National Sexual Assault, Domestic and Family Violence Counselling Service on 1800RESPECT / 1800 737 732
- Australian Veterans Brain Bank on (02) 9351 0943
Content retrieved from: https://www.abc.net.au/news/2024-08-20/elite-adf-soldiers-concern-blasts-from-own-weapons-brain-injury/104154038?utm_source=abc_news_app&utm_medium=content_shared&utm_campaign=abc_news_app&utm_content=other.
