Bundeswehr Institute of Preventive Medicine

Division A, Health and Fitness Promotion, is the departmental research element of the Bundeswehr Institute of Preventive Medicine (BwIPM). In close interdisciplinary cooperation, its branches examine significant questions of preventive medicine for the Bundeswehr.

With more than 40 million health records of former servicemen and women, Division B, Health Information, administers an extensive repository of knowledge. This knowledge is made available for medical information and scientific issues.

Research results are taken into account in decisions

The institute covers a broad range of both functional and methodological responsibilities and has domain knowledge. Research and services of the institute range from simple information on the development of practical tests to detailed scientific studies. This broad spectrum of services offered can make available important decision-making bases for the Bundeswehr and the scientific public.

BwIPM hosts symposiums with international lecturers regularly. The "Heat Symposium" (Health and Performance during Heat Stress) held in spring 2018, for instance, gave important impulses regarding protection against heat illnesses. On this basis, the Institute developed specific and feasible recommendations that were implemented in the units in training and missions in the summer 2018 already.

The Headquarters Section is the central support element for all personnel, materiel, organisational, and structural matters. It assists and advises the Director of the institute and provides services for all members of the institute.

The Institute Staff divides into the primary staff functions responsible for personnel, military security, organisation and training, materiel, and ITInformationstechnik.

Beside these core tasks that are typical for military agencies, the Institute Staff provides services for the departmental research area and support for instance to science and quality management.

Handling data and knowledge is one of our core competencies. A professional science and quality management supports the collection, management, and analysis of data in the ten branches.

Science management is to support research planning and the research process, as well as to promote scientific networking inside and outside the Bundeswehr. It supports the Academic Advisory Council of the institute. An important focus is on the transfer of knowledge and on the closing the chain of effects from research through to practical application.

The Academic Advisory Council advises the Institute and the superior agencies with the aim to promote the scientific work of the Institute and ensure the quality of research and teaching. Furthermore, the Academic Advisory Council supports contacts and cooperation with other research institutes in Germany and abroad. The expertise of the voluntary members of the Academic Advisory Council covers the different fields of research of the Bundeswehr Institute of Preventive Medicine.

The Chairman of the Academic Advisory Council of the institute is the sports physician Professor Dr Rüdiger Reer (University of Hamburg). His deputy is the organisational psychologist Professor Dr Jörg Felfe (Bundeswehr University Hamburg). The broad range of research done by the BwIPM is reflected by the five-member council, which also includes private lecturer Dr Thomas Ellrott (University of Goettingen), specialist in nutritional medicine and nutrition psychology; Prof. Dr Rolf Ellegast, physician and ergonomist (Institute for Occupational Safety of the German Social Accident Insurance (DGUV), St. Augustin); and Brigadier, Medical Corps, (ret.) Prof. Dr Dr Erhard Grundwald, an experienced physician and historian.

The Academic Advisory Council has the following tasks:

• Advice in the development of medium- and long-term research objectives
• Advice in projects to be introduced during the annual research conferences of the Bundeswehr Medical Service
• Advice in sudden research requirements/projects
• Expert advice in the run-up to individual projects as required
• Promotion of the academic connection of the Institute with civilian research and scientific societies in Germany and abroad
• Support in the promotion of scientists and scientific assistants of the Institute

Digitisation and technization at work and during leisure time, as well as daily routines with negative health effects also in the armed forces have resulted in a reduction in resilience and fitness, as well as in the spread of chronical diseases.

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Task of Branch A1 is the development of addressee-appropriate health promotion measures for all Bundeswehr personnel, research on attractors, impediments and incentives for health-promoting behaviour, and the scientific support and further development of measures within the scope of Corporate Health Management (BGMBetriebliches Gesundheitsmanagement).

Deployment activities, as for instance movement in the terrain, rescue of wounded, or urban operations place high demands on fitness, resilience, and sustainability of the service men and women. This is in particular true in view of the difficult military conditions like for instance carrying heavy loads, fatigue, duration of deployment and many more.

Branch A2 conducts field and laboratory tests in this context to collect and analyse individual stress and strains of typical military activities. Portable systems to measure circulatory, respiratory and metabolic parameters and specially developed procedures to measure physical strengths and body dimensions were used for the examinations.

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Research ranges from data collection to recommendations regarding selection of personnel, to training, through to the development of performance tests. The data collected are used for instance to develop a fitness registry. The Basic Fitness Test and the Basic Military Fitness Tool, both developed by BwIPM, analyse the physical fitness of military personnel.

Performance begins in the head. Mental fitness plays a central role regarding both demanding mental tasks and physical strain. Motivation, endurance, and attentiveness are but some of the factors that influence our job performance.

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Branch A3 among other things researches on predictors, the early identification of drops in performance, and the training of cognitive skills. For this purpose, psychological and psycho-physiological data, as for instance eye movements, reaction times, fatigue, working memory, under physical and mental stress are collected and analysed.

In their operational scenarios around the world, service men and women encounter climatic and geographic stressors they are not used to, like for instance heat, cold, altitude, and air humidity. At the same time, military threats require them to wear heavy and isolating protective gear as for instance ballistic body protection or CBRNchemical, biological, radiological, nuclear protective clothing.

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For this purpose, Branch A4 conducts field tests and realistic studies in the environmental simulation chamber for climate and altitude testing. Among others, human heat and fluid balance are determined, here, and circulatory and metabolic parameters, as well as changes in performance are ascertained.

Research ranges from practice-oriented recommendations for training and deployment to the new development of technologies for cooling the body.

The traditional field of research of medical ergonomics includes studies on health- and performance-relevant effects military-technical stressors have on military personnel. For example ensuring fresh air supply and air-conditioning of armoured vehicles.

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The enormous technological progress results in operational forces being increasingly equipped with complex systems. This brings new research tasks in Branch A5 to the fore, as for instance monitoring of physiological body functions, wearable computing, extended and virtual realities.

Scientific systems informatics develops practical hard and software systems for common use in the research activities of the entire institute. This includes test methods and survey tools, as well as proprietary data base management of empirically obtained primary data and aggregated parameters.

Task of Branch B1 is to archive health documents in the Bundeswehr as required by law.

With more than 40 million health records - in the original or on microfilm - it has become one of the largest health archives in Germany. Among other things, it comprises the complete health records of all former service members of the Bundeswehr, from its establishment to date.

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With targeted concepts of archiving and specially developed records management systems, all health records are made rapidly available and usable for patient information, health reporting, and scientific research.

For: "Good archiving means not having to seek."

The future viability of the Bundeswehr Medical Service is closely related to the digitisation of health care. Branch B2 – together with ITInformationstechnik working groups of responsible FMoD agencies – is working on viable concepts and processes for the digital archiving and using of health data and documents.

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Beside the goal to make quickly available high-quality data for individual medical information, the aim is to develop electronic registries, for instance for epidemiological analyses for training and deployment as sound decision-making aids and advisory services.

The electronic collection and analysis of deployment-related diseases and injuries in a registry, for instance, could open new options for the evidence-based further development of field medicine and landmark joint ventures with NATO partners.

Branch B3 is the centre of health information of the Bundeswehr on archived personal health documents.

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In strict compliance with the provisions of the data protection law, we accomplish our statutory mission of providing information to authorised persons, usually former service members or institutions. We answer more than 30,000 requests each year.

Furthermore, we assist in the processing of damage to property of the Bundeswehr, as for instance in case of third-party liability in the event of service members involved in accidents.

Furthermore, we perform medical assessments and document cases of death of active service members.

Branch B4 informs the Federal Ministry of Defence, major commands, and health care facilities of the Bundeswehr Medical Service, but also for instance the Defence Committee, and the Parliamentary Commissioner for the Armed Forces on health disorders occurring and the services provided by the Bundeswehr Medical Service.

In this context, more than 400 "tailor-made" health reports are prepared. In addition, anthropometric data, incidences / prevalences of diseases as well as injuries and deaths can be epidemiologically analysed.

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In the course of the digitisation of health care, the development and the analysis of health registries, the Branch will assume an important function for the evidence-based further development of the Bundeswehr Medical Service.

In Germany, each employee exposed to certain, potentially hazardous substances, dusts, and radiation in his/her work is entitled to lifelong follow-up preventive medical care.

As Service for the Organisation of Postexposure Medical Examinations of the Bundeswehr, Branch B5 fulfils this legal obligation for the Bundeswehr and, thus, supports the Bundeswehr's obligation as an employer to provide care and welfare services to its military personnel beyond the end of service.

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Asbestos exposure, which often causes chronic pulmonary diseases or tumours not until after decades, is an example for the necessity of lifelong preventive medical care.