Making a home in space.
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Cosmic Radiation↗
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Evaluation of shoulder integrity in space: first report of musculoskeletal US on the International Space Station.
Investigative procedures were approved by Henry Ford Human Investigation Committee and NASA Johnson Space Center Committee for Protection of Human Subjects. Informed consent was obtained. Authors evaluated ability of nonphysician crewmember to obtain diagnostic-quality musculoskeletal ultrasonographic (US) data of the shoulder by following a just-in-time training algorithm and using real-time remote guidance aboard the International Space Station (ISS). ISS Expedition-9 crewmembers attended a 2.5-hour didactic and hands-on US training session 4 months before launch. Aboard the ISS, they completed a 1-hour computer-based Onboard Proficiency Enhancement program 7 days before examination. Crewmembers did not receive specific training in shoulder anatomy or shoulder US techniques. Evaluation of astronaut shoulder integrity was done by using a Human Research Facility US system. Crew used special positioning techniques for subject and operator to facilitate US in microgravity environment. Common anatomic reference points aided initial probe placement. Real-time US video of shoulder was transmitted to remote experienced sonologists in Telescience Center at Johnson Space Center. Probe manipulation and equipment adjustments were guided with verbal commands from remote sonologists to astronaut operators to complete rotator cuff evaluation. Comprehensive US of crewmember's shoulder included transverse and longitudinal images of biceps and supraspinatus tendons and articular cartilage surface. Total examination time required to guide astronaut operator to acquire necessary images was approximately 15 minutes. Multiple arm and probe positions were used to acquire dynamic video images that were of excellent quality to allow evaluation of shoulder integrity. Postsession download and analysis of high-fidelity US images collected onboard demonstrated additional anatomic detail that could be used to exclude subtle injury. Musculoskeletal US can be performed in space by minimally trained operators by using remote guidance. This technique can be used to evaluate shoulder integrity in symptomatic crewmembers after strenuous extravehicular activities or to monitor microgravity-associated changes in musculoskeletal anatomy. Just-in-time training, combined with remote experienced physician guidance, may provide a useful approach to complex medical tasks performed by nonexperienced personnel in a variety of remote settings, including current and future space programs.
Humans↗
Preparing for Mars: the physiologic and medical challenges.
As the twentieth century closes, retrospectives cite the Apollo moon missions as one of the important events of the past 100 years. A trip to Mars, however, would be even more challenging and significant. A round-trip Mars journey would require nearly three years away from Earth, a significant leap in complexity compared to the two week long Moon trips or the record-breaking fourteen-month flight on Mir. What would be the physiologic and medical challenges of a Mars flight? Two key areas of physiology present the greatest potential problems--calcium metabolism and radiation exposure. Data from Mir missions show that bone loss continues in space despite an aggressive countermeasure program. Average losses were 0.35% per month, but some load bearing areas lost >1% per month. A 1% loss rate, if it continued unabated for 30 months, could produce osteoporosis. Smaller losses could still increase fracture risk. Some bone loss can be well tolerated, particularly if the bone can be regained after the mission. But the effectiveness of post-flight rehabilitation to restore the density and quality of bone after spaceflight is not well known. Bone loss estimates are based on continuous weightlessness exposure, but this is not a requirement for a Mars trip. Most of the time on a Mars trip will be spent in the 1/3 Earth's gravity environment on Mars, and either intermittent or continuous artificial gravity can be provided for the transit between planets (although at an engineering cost). The dosing of the gravity exposure (e.g. the level and duration), however, has not been established. Radiation protection also requires a balance between engineering cost and human health. Excessive shielding could add billions of dollars to the cost of a mission. Trips in interplanetary space, however, expose the crew to heavy high-energy particles from cosmic rays (HZE particles), which have a high linear energy transfer. This high energy leads to significant biological damage (e.g. chromosomal aberrations, cancer induction). A recent report from the Committee on Space Biology and Medicine notes that only one systematic study of cancer induction from high-energy particles has been conducted (using the mouse Harderian gland). Predictions of cancer risk and acceptable radiation exposure in space are extrapolated from minimal data. Other areas of physiology also present problems, such as muscle loss, cardiovascular deconditioning, and vestibular adaptation. Despite all the issues, however, a focussed, aggressive research program that uses the resources of the International Space Station should pave the way for mankind's greatest adventure--a trip to Mars.
Humans↗
Medical management of U.S. astronauts.
The medical management of U.S. astronauts involves a comprehensive health care program and a variety of NASA and support organizations. The scope of this program includes aspects of medical monitoring and certification, health maintenance and counter-measures programs, medical intervention, psychosocial support, and environmental health monitoring. Each of these areas have activities in all mission phases preflight, inflight, and postflight. The wide range of potential health hazards from space flight mandates an aggressive health care program to maintain crew health and performance, and to prevent unwanted mission and long-term health consequences.
Aerospace Medicine↗
The NASA Sounding Rocket Program and space sciences.
High altitude suborbital rockets (sounding rockets) have been extensively used for space science research in the post-World War II period; the NASA Sounding Rocket Program has been on-going since the inception of the Agency and supports all space science disciplines. In recent years, sounding rockets have been utilized to provide a low gravity environment for materials processing research, particularly in the commercial sector. Sounding rockets offer unique features as a low gravity flight platform. Quick response and low cost combine to provide more frequent spaceflight opportunities. Suborbital spacecraft design practice has achieved a high level of sophistication which optimizes the limited available flight times. High data-rate telemetry, real-time ground up-link command and down-link video data are routinely used in sounding rocket payloads. Standard, off-the-shelf, active control systems are available which limit payload body rates such that the gravitational environment remains less than 10(-4) g during the control period. Operational launch vehicles are available which can provide up to 7 minutes of experiment time for experiment weights up to 270 kg. Standard payload recovery systems allow soft impact retrieval of payloads. When launched from White Sands Missile Range, New Mexico, payloads can be retrieved and returned to the launch site within hours.
Research↗
Risk of cancer mortality among the Longitudinal Study of Astronaut Health (LSAH) participants.
BACKGROUND: The potential for occupational radiation exposures in the U.S. Space Program makes cancer risk a major health concern. METHODS: The NASA Medical Operations Branch and KRUG Life Sciences Epidemiology Section at the Johnson Space Center (JSC) investigated the rate of cancer mortality among the astronauts and the comparison participants of the Longitudinal Study of Astronaut Health (LSAH). Medical records are maintained by the JSC Flight Medicine Clinic, JSC Occupational Medicine Clinic, and LSAH. Cause of death data from death certificates were reviewed for cancer mortality. These data were compared with cancer mortality data for the general population residing in the Texas Gulf Coast area. RESULTS: The astronauts had a higher age-specific risk of cancer mortality than the comparison group (SMR = 345; 95% CI = 69.5-756.2), but the difference did not reach statistical significance. Both the astronauts and the comparison group had lower age-specific rates than the general population (SMR = 47, 95% CI = 9.6-105.1; SMR = 17, 95% CI = 3.5-37.9, respectively).
Adult↗
Asthenia--does it exist in space?
OBJECTIVE: First popularized as neurasthenia in the late 1800s by American George Beard, asthenia has been viewed by Russian psychologists and flight surgeons as a major problem that affects cosmonauts participating in long-duration space missions. However, there is some controversy about whether this syndrome exists in space; this controversy is attributable in part to the fact that it is not recognized in the current American psychiatric diagnostic system. METHODS: To address this issue empirically, we retrospectively examined the data from our 4 1/2-year, NASA-funded study of crew member and mission control interactions during the Shuttle/Mir space program. Three of the authors identified eight items of stage 1 asthenia from one of our measures, the Profile of Mood States (POMS). Scores on these items from 13 Russian and American crew members were compared with scores derived from the opinions of six Russian space experts. RESULTS: Crew members' scores in space were significantly lower than the experts' scores on seven of the eight items, and they generally were in the "not at all" to "a little" range of the item scales. There were no differences in mean scores before and after launch or across the four quarters of the missions. There were no differences in response between Russian and American crew members. CONCLUSIONS: We could not demonstrate the presence of asthenia in space as operationally defined using the POMS. However, the POMS addresses only emotional and not physiological aspects of the syndrome, and the subject responses in our study generally were skewed toward the positive end of the scales. Further research on this syndrome needs to be done and should include physiological measures and measures that are specific to asthenia.
Adult↗
Effects of spaceflight, simulated spaceflight and countermeasures on single muscle fiber physiology.
Since the first human flew in space in 1961, there has been extensive scientific interest in the responses of the human body and how it adapts to this unique environment. From the available data, it appears that all major systems in the human body undergo an adaptive change while in a microgravity environment. In particular the human muscle system appears to undergo loss of muscle mass and strength which greatly influences the maximal work capacity of the muscle. Recently, our research group has been involved in a series of whole muscle and cellular studies during periods of short duration space flight, bed rest, and unilateral lower limb suspension (ULLS) in an attempt to elucidate the changes that are occurring in the whole muscle and single muscle fiber contractile properties with unloading. In addition, various countermeasure activities for skeletal muscle have been part of the space flights and ground-based studies. The intention of this paper will be to briefly review our findings in whole muscle, cellular, and countermeasure effectiveness with human muscle.
NASA Discipline Musculoskeletal↗
Reproduction in the space environment: Part II. Concerns for human reproduction.
Long-duration space flight and eventual colonization of our solar system will require successful control of reproductive function and a thorough understanding of factors unique to space flight and their impact on gynecologic and obstetric parameters. Part II of this paper examines the specific environmental factors associated with space flight and the implications for human reproduction. Space environmental hazards discussed include radiation, alteration in atmospheric pressure and breathing gas partial pressures, prolonged toxicological exposure, and microgravity. The effects of countermeasures necessary to reduce cardiovascular deconditioning, calcium loss, muscle wasting, and neurovestibular problems are also considered. In addition, the impact of microgravity on male fertility and gamete quality is explored. Due to current constraints, human pregnancy is now contraindicated for space flight. However, a program to explore effective countermeasures to current constraints and develop the required health care delivery capability for extended-duration space flight is suggested. A program of Earth- and space-based research to provide further answers to reproductive questions is suggested.
Extraterrestrial Environment↗
Cardiac health for astronauts: current selection standards and their limitations.
INTRODUCTION: The screening tests for coronary artery disease (CAD) for applicants and the active astronaut corps are similar to those performed in the 1960s. Due to the limited treatment and return capabilities of most space vehicles, an in-flight cardiac event would result in mission failure. Improved CAD screening of astronauts is, therefore, paramount to long-duration mission success. METHODS: Literature review was performed to compare active and retired astronaut populations to other asymptomatic low-risk cohorts. All populations were examined to determine the incidence and prevalence of CAD. Framingham risk scores were calculated in NASA's active and retired astronaut corps and compared with age- and gender-matched controls. RESULTS: The current standards used for astronaut selection have been successful in creating a cohort that has less risk than their age- and gender-matched counterparts from the general population. However, the existing astronaut cardiovascular screening and selection tests do not adequately rule out CAD for long-duration missions, and, therefore, a "significant" risk of cardiac event remains, especially as we look toward Exploration Class missions. CONCLUSIONS: The current astronaut selection and retention standards may not adequately prevent cardiac events from occurring with the longer duration flights. Future research should be directed toward increasing the primary and secondary prevention of CAD in the astronaut cohort. In the meantime, the space program should evaluate the use of more aggressive terrestrial screening tools. It is important not to remove all older, experienced pilots from spaceflight crews unless overt or predictable pathology has been clearly identified.
Acute Disease↗
Training of aerospace medicine physicians.
In the U. S. there are 23 recognized medical specialty boards. One of these is preventive medicine. Within preventive medicine there are three areas: Aerospace Medicine, Occupational Medicine, and Public Health/General Preventive Medicine. The preventive medicine specialties have a common core of required training including biostatistics, epidemiology, health services administration and environmental health. These, plus associated topics are covered during year one of training. Year two of training involves clinical rotations specifically tailored to the eye, ear, heart, lungs and brain, plus flight training to the private pilot level, and a Masters Degree research project for the required thesis. During year three the physicians in aerospace medicine practice full-time aerospace medicine in a NASA or other government laboratory or a private facility. To date, more than 40 physicians have received aerospace medicine training through the Wright State University School of Medicine program. Among these are physicians from Japan, Australia, Taiwan, Canada and Mexico. In addition to the civilian program at Wright State University, there are programs conducted by the U. S. Air Force and Navy. The Wright State program has been privileged to have officers from the U. S. Army, Navy and Air Force. A substantial supporter of the Wright State program is the National Aeronautics and Space Administration and a strong space component is contained in the program.
Aerospace Medicine↗
Space shuttle operations at the NASA Kennedy Space Center: the role of emergency medicine.
The Division of Emergency Medicine at the University of Florida coordinates a unique program with the NASA John F. Kennedy Space Center (KSC) to provide emergency medical support (EMS) for the United States Space Transportation System. This report outlines the organization of the KSC EMS system, training received by physicians providing medical support, logistic and operational aspects of the mission, and experiences of team members. The participation of emergency physicians in support of manned space flight represents another way that emergency physicians provide leadership in prehospital care and disaster management.
Aerospace Medicine↗
Ergonomics technology.
Many aspects of NASA's research programs and projects focus on the working environment of man. Ergonomics research has a broader application of technological spinoffs. This paper describes these research efforts and may have implications for environmental control in industry.
Atmosphere↗
Sensorimotor adaptations to microgravity in humans.
Motor function is altered by microgravity, but little detail is available as to what these changes are and how changes in the individual components of the sensorimotor system affect the control of movement. Further, there is little information on whether the changes in motor performance reflect immediate or chronic adaptations to changing gravitational environments. To determine the effects of microgravity on the neural control properties of selected motor pools, four male astronauts from the NASA STS-78 mission performed motor tasks requiring the maintenance of either ankle dorsiflexor or plantarflexor torque. Torques of 10 or 50% of a maximal voluntary contraction (MVC) were requested of the subjects during 10 degrees peak-to-peak sinusoidal movements at 0.5 Hz. When 10% MVC of the plantarflexors was requested, the actual torques generated in-flight were similar to pre-flight values. Post-flight torques were higher than pre- and in-flight torques. The actual torques when 50% MVC was requested were higher in- and post-flight than pre-flight. Soleus (Sol) electromyographic (EMG) amplitudes during plantarflexion were higher in-flight than pre- or post-flight for both the 10 and 50% MVC tasks. No differences in medial gastrocnemius (MG) EMG amplitudes were observed for either the 10 or 50% MVC tasks. The EMG amplitudes of the tibialis anterior (TA), an antagonist to plantarflexion, were higher in- and post-flight than pre-flight for the 50% MVC task. During the dorsiflexion tasks, the torques generated in both the 10 and 50% MVC tasks did not differ pre-, in- and post-flight. TA EMG amplitudes were significantly higher in- than pre-flight for both the 10 or 50% MVC tasks, and remained elevated post-flight for the 50% MVC test. Both the Sol and MG EMG amplitudes were significantly higher in-flight than either pre- or post-flight for both the 10 and 50% MVC tests. These data suggest that the most consistent response to space flight was an elevation in the level of contractions of agonists and antagonists when attempting to maintain constant torques at a given level of MVC. Also, the chronic levels of EMG activity in selected ankle flexor and extensor muscles during space flight and during routine activities on Earth were recorded. Compared with pre- and post-flight values, there was a marked increase in the total EMG activity of the TA and the Sol and no change in the MG EMG activity in-flight. These data indicate that space flight, as occurs on shuttle missions, is a model of elevated activation of both flexor and extensor muscles, probably reflecting the effects of programmed work schedules in flight rather than a direct effect of microgravity.
Adaptation, Physiological↗
Advanced Crew Escape Suit.
Design of the S1032 Launch Entry Suit (LES) began following the Challenger loss and NASA's decision to incorporate a Shuttle crew escape system. The LES (see Figure 1) has successfully supported Shuttle missions since NASA's Return to Flight with STS-26 in September 1988. In 1990, engineers began developing the S1035 Advanced Crew Escape Suit (ACES) to serve as a replacement for the LES. The ACES was designed to be a simplified, lightweight, low-bulk pressure suit which aided self donning/doffing, provided improved comfort, and enhanced overall performance to reduce crew member stress and fatigue. Favorable crew member evaluations of a prototype led to full-scale development and qualification of the S1035 ACES between 1990 and 1992. Production of the S1035 ACES began in February 1993, with the first unit delivered to NASA in May 1994. The S1035 ACES first flew aboard STS-68 in August 1994 and will become the primary crew escape suit when the S1032 LES ends its service life in late 1995. The primary goal of the S1035 development program was to provide improved performance over that of the S1032 to minimize the stress and fatigue typically experienced by crew members. To achieve this, five fundamental design objectives were established, resulting in various material/configuration changes.
Astronauts↗
NASA's Exobiology Program.
The goal of NASA's Exobiology Program is to understand the origin, evolution, and distribution of life, and life-related molecules, on Earth and throughout the universe. Emphasis is focused on determining how the rate and direction of these processes were affected by the chemical and physical environment of the evolving planet, as well as by planetary, solar, and astrophysical phenomena. This is accomplished by a multi-disciplinary program of research conducted by over 60 principal investigators in both NASA and university laboratories. Major program thrusts are in the following research areas: biogenic elements; chemical evolution; origin of life; organic geochemistry; evolution of higher life forms; solar system exploration; and the search for extraterrestrial intelligence (SETI).
Biological Evolution↗
NASA' s life sciences and space radiation biology.
Plans for the various missions in which men and women are expected to participate during the next 10 years are outlined. Such missions include flights of up to three months duration in low earth orbit as well as possible short excursions to geosynchronous orbit. Research activities are described which cover the full spectrum of physiological and psychological responses to space flight. These activities are shown to contribute to the ongoing Shuttle program and the future Space Station. The paper includes a summary of the major technical thrusts needed to support extended habitation in space.
Adaptation, Physiological↗
NASA strategic planning for 2000 and beyond.
This short paper outlines the United States National Aeronautics and Space Administration's development of its 2000 Strategic Plan.
Biological Science Disciplines↗