Abstract

Neck injuries from explosively propelled fragments are present in 11% of injured U.K. soldiers and result in significant mortality and long-term morbidity. U.S. forces in contrast sustain only neck wounds in 3 to 4% of those injured, which is believed to be because of their greater acceptance in the wearing of issued neck protection. A three-piece neck collar, two-piece neck collar, a nape pad, a ballistic scarf, and an enhanced protection under body armor shirt (EP-UBACS) reinforced at the collar were objectively compared during a treadmill test using physiological measurements. Designs were subjectively compared regarding their effect on soldier performance using representative military tasks. Both neck collars and the EP-UBACS prototype demonstrated 90% acceptability in terms of military task performance. No statistical difference in tympanic temperature and heart rate was found between prototypes. The statistically significant higher skin temperatures found for prototypes lying close to the skin (EP-UBACS and ballistic scarf) were unrelated to perceived comfort. Neck collars remain the most successful design in terms of military performance, comfort, and potential levels of ballistic protection. However the EP-UBACS concept should also be developed further, with future iterations potentially removing the zip and increasing skin standoff.

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