Belding, Jennifer N, Kolaja, Claire A, Rull, Rudolph P et al. · Frontiers in neurology · 2023 · DOI
This study followed a large group of U.S. military personnel and veterans to investigate whether exposure to blast pressure—both from single or repeated high-level blasts and occupational low-level blast exposure—was associated with new health diagnoses. Researchers found that blast exposure was linked to several conditions including chronic fatigue syndrome, PTSD, hearing loss, depression, and nerve damage. The study suggests that repeated blast exposure may carry greater health risks than single exposure, and that combinations of different blast exposures may increase risks further.
This large prospective study provides evidence that blast exposure is associated with new-onset chronic fatigue syndrome and related conditions (peripheral neuropathy, depression, hearing loss), which are clinically relevant to understanding potential causative factors and comorbidity patterns in patients with blast exposure history. For ME/CFS researchers, the documented association between overpressure exposure and chronic fatigue syndrome suggests a potential environmental or physiological mechanism worth investigating further.
This study demonstrates associations between blast exposure and new diagnoses but does not establish causation—other factors associated with military service could explain the observed relationships. The use of self-reported diagnoses rather than confirmed medical records or objective diagnostic testing means conditions were not verified by clinical assessment. Occupational classification as a proxy for LLB exposure is imprecise and does not measure individual-level blast exposure.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Belding, Jennifer N, Kolaja, Claire A, Rull, Rudolph P, & Trone, Daniel W (2023). Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation.. Frontiers in neurology. https://doi.org/10.3389/fneur.2023.1110717
BibTeX
@article{mecfsatlas-belding-2023-single-repeated,
author = {Belding, Jennifer N and Kolaja, Claire A and Rull, Rudolph P and Trone, Daniel W},
title = {Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation.},
journal = {Frontiers in neurology},
year = {2023},
doi = {10.3389/fneur.2023.1110717},
note = {PubMed: 37025202},
url = {https://www.mecfsatlas.com/evidence/belding-2023-single-repeated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/belding-2023-single-repeated
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