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Finding –* – + –Sx, +Vi + + +# +B, –Sx + – -S, +Sx – –Sx, +V +H, –V +C,M@ +B, +C, ?Sx – ?H, +I

Outcomes Assessed C, N, Sx, V B I Sx, Vi Sx B C, I, Sx B, Sx B, Sx B, C, I, Sx S, Sx H, I, Sx Sx, V H, V C, M B, C, Sx C, Sx H, I

Exposure (psi) max psi 3 max 183 dB max 184 dB max 182 dB 1.40 psi ? ? ? 40 blasts >5 psi >5 psi <4psi ? ? ? ? 4.8-8.5 psi ? ? 1.99 psi

Days Exposed 10 1 1 2 years <5 to 30+ years 10 6 max psi 13 6 10 ? years 12 17 months 17 months 14 21 5 years 1

TBI Hx? Y ? ? ? Y Y ? ? ? Y Y Y Y ? ? Y ? ? Note. Settings: LAW, light anti-tank weapon; RPG, rocket propelled grenade; TBI Hx, included those with positive history for TBI (and did not control for). Outcomes Assessed: B, blood serum or CSF biomarker(s); C, cognitive performance; H, hearing; I, neuroimaging; M, motor; S, sleep (objective); Sx, symptoms; N, neurological exam (cranial nerves, ataxia); V, vestibular/p

#Blast Gauges 0 0 3 0 0 2 4 2 2 0 0 0 0 4 5 0 0 3

TABLE 2 Characteristics and Findings of the 18 Studies Included in the Review

n Controls 0 19 11 exposed but treated 4 0 0 0 32 exposed 79 0 0 4 4 ? 0 0 28 10 exposed but treated visual. Findings: –, no adverse effect of low-level blast exposure on any domains assessed; RCI, reliable change index.

n Exposed 14 21 32 7 11 9 184 105 30 (5 instructors, 25 students) 30 29 22 18 (4 instructors, 14 students) 11 11 ? 59 19 10 8 or worse with exposure; @, changes were apparent in those with reliable cognitive decline.

Setting(s) Breachers Police Howitzer, Bazooka Carl-Gustaf Explosives Breacher Police Breachers Military Breachers Police, Military Breachers Military Breachers Military Breachers Military Breachers Military Breachers Military Breachers Military Breachers Military Breachers Military Breachers Military Carl Gustav; LAW; RPG Breachers Military Breachers Military Breachers Police

First Author (year) Baker (2011) Blennow (2011) Bonnette (2018) Capo-Aponte (2015) Carr (2015a) Carr (2015b) Carr (2016) Gill (2017) Gill (2017) Kamimori (2018) Kelley (2010) Kubli (2017) Littlefield (2016) St. Onge (2011) Rhea 2017 Tate (2013) Thiel (2015) Yuan (2019)

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