Engineering topics

Conkin, Johnny

Publications and source records attributed to Conkin, Johnny.

At least 37 records · Page 2

NASA NTRS2007

Risk Assessment of Physiological Effects of Atmospheric Composition and Pressure in Constellation Vehicles

To limit the risk of fire and reduce denitrogenation time to prevent decompression sickness to support frequent extravehicular activities on the Moon, a hypobaric (PB = 414 mmHg) and mildly hypoxic (ppO2 = 132 mmHg, 32% O2 - 68% N2) living environment is considered for the Crew Exploration Vehicle (CEV) and Lunar Surface Access Module (LSAM). With acute change in ppO2 from 145-178 mmHg at standard vehicular operating pressure to less than 125 mmHg at desired lunar surface vehicular operating pressures, there is the possibility that some crewmembers may develop symptoms of Acute Mountain Sickness (AMS). The signs and symptoms of AMS (headache plus nausea, dizziness, fatigue, or sleeplessness), could impact crew health and performance on lunar surface missions. An exhaustive literature review on the topic of the physiological effects of reduced ppO2 and absolute pressure as may contribute to the development of altitude symptoms or AMS was performed. The results of the nine most rigorous studies were collated, analyzed and contents on AMS and hypoxia symptoms summarized. There is evidence for an absolute pressure effect per se on AMS, so the higher the altitude for a given hypoxic alveolar O2 partial pressure (PAO2), the greater the AMS response. About 25% of adults are likely to experience mild AMS near 2,000 m altitude following a rapid ascent from sea level while breathing air (6,500 feet, acute PAO2 = 75 mmHg). The operational experience with the Shuttle staged denitrogenation protocol at 528 mmHg (3,048 m) while breathing 26.5% O2 (acute PAO2 = 85 mmHg) in astronauts adapting to microgravity suggests a similar likely experience in the proposed CEV environment. We believe the risk of mild AMS is greater given a PAO2 of 77 mmHg at 4,876 m altitude while breathing 32% O2 than at 1,828 m altitude while breathing 21% O2. Only susceptible astronauts would develop mild and transient AMS with prolonged exposure to 414 mmHg (4,876 m) while breathing 32% O2 (acute PAO2 = 77 mmHg). So the following may be employed for operational risk reduction: 1) develop procedures to increase PB as needed in the CEV, and use a gradual or staged reduction in cabin pressure during lunar outbound; 2) train crews for symptoms of hypoxia, to allow early recognition and consider pre-adaptation of crews to a hypoxic environment prior to launch, 3) consider prophylactic acetazolamide for acute pressure changes and be prepared to treat any AMS associated symptoms early with both carbonic anhydrase inhibitors and supplemental oxygen.

Scheuring, Richard A.↗

NASA NTRS2007

Exploiting Aerobic Fitness To Reduce Risk Of Hypobaric Decompression Sickness

Decompression sickness (DCS) is multivariable. But we hypothesize an aerobically fit person is less likely to experience hypobaric DCS than an unfit person given that fitness is exploited as part of the denitrogenation (prebreathe, PB) process prior to an altitude exposure. Aerobic fitness is peak oxygen uptake (VO2pk, ml/kg/min). METHODS: Treadmill or cycle protocols were used over 15 years to determine VO2pks. We evaluated dichotomous DCS outcome and venous gas emboli (VGE) outcome detected in the pulmonary artery with Doppler ultrasound associated with VO2pk for two classes of experiments: 1) those with no PB or PB under resting conditions prior to ascent in an altitude chamber, and 2) PB that included exercise for some part of the PB. There were 165 exposures (mean VO2pk 40.5 +/- 7.6 SD) with 25 cases of DCS in the first protocol class and 172 exposures (mean VO2pk 41.4 +/- 7.2 SD) with 25 cases of DCS in the second. Similar incidence of the DCS (15.2% vs. 14.5%) and VGE (45.5% vs. 44.8%) between the two classes indicates that decompression stress was similar. The strength of association between outcome and VO2pk was evaluated using univariate logistic regression. RESULTS: An inverse relationship between the DCS outcome and VO2pk was evident, but the relationship was strongest when exercise was done as part of the PB (exercise PB, coef. = -0.058, p = 0.07; rest or no PB, coef. = -0.005, p = 0.86). There was no relationship between VGE outcome and VO2pk (exercise PB, coef. = -0.003, p = 0.89; rest or no PB, coef. = 0.014, p = 0.50). CONCLUSIONS: A significant change in probability of DCS was associated with fitness only when exercise was included in the denitrogenation process. We believe a fit person that exercises during PB efficiently eliminates dissolved nitrogen from tissues.

Conkin, Johnny↗

NASA NTRS2007

Gender Consideration in Experiment Design for Airbrake in Prebreathe

If gender is a confounder of the decompression sickness (DCS) or venous gas emboli (VGE) outcomes of a proposed air break in oxygen prebreathe (PB) project, then decisions about the final experiment design must be made. We evaluated if the incidence of DCS and VGE from tests in altitude chambers over 20 years were different between men and women after resting and exercise prebreathe protocols. Nitrogen washout during PB is our primary risk mitigation strategy to prevent subsequent DCS and VGE in subjects. Bubbles in the pulmonary artery (venous blood) were detected from the precordial position using Doppler ultrasound bubble detectors. The subjects were monitored for VGE for four min at about 15 min intervals for the duration of the altitude exposure, with maximum bubble grade assigned a Spencer Grade of IV. There was no difference in DCS incidence between men and women in either PB protocol. The incidence of VGE and Grade IV VGE is statistically lower in women compared to men after resting PB. Even when 10 tests were compared with Mantel-Haenszel 2 where both men (n = 168) and women (n = 92) appeared, the p-value for VGE incidence was still significant at 0.03. The incidence of VGE and Grade IV VGE is not statistically lower in women compared to men after exercise PB. Even when six tests were compared with Mantel-Haenszel x2 where both men (n = 165) and women (n = 49) appeared, the p-value for VGE incidence was still not significant at 0.90. Our goal is to understand the risk of brief air breaks during PB without other confounding variables invalidating our conclusions. The cost to additionally account for the confounding role of gender on VGE outcome after resting PB is judged excessive. Our decision is to only evaluate air breaks in the exercise PB protocol. So there is no restriction to recruiting women as test subjects.

Conkin, Johnny↗

NASA NTRS2007

Gender Consideration in Experiment Design for Air Break in Prebreathe

Conkin, Johnny↗

NASA NTRS2007

A Start Toward Micronucleus-Based Decompression Models; Altitude Decompression

Do gaseous micronuclei trigger the formation of bubbles in decompression sickness (DCS)? Most previous instructions for DCS prevention have been oriented toward supersaturated gas in tissue. We are developing a mathematical model that is oriented toward the expected behavior of micronuclei. The issue is simplified in altitude decompressions because the aviator or astronaut is exposed only to decompression, whereas in diving there is a compression before the decompression. The model deals with four variables: duration of breathing of 100% oxygen before going to altitude (O2 prebreathing), altitude of the exposure, exposure duration, and rate of ascent. Assumptions: a) there is a population of micronuclei of various sizes having a range of characteristics, b) micronuclei are stable until they grow to a certain critical nucleation radius, c) it takes time for gas to diffuse in or out of micronuclei, and d) all other variables being equal, growth of micronuclei upon decompression is more rapid at high altitude because of the rarified gas in the micronuclei. To estimate parameters, we use a dataset of 4,756 men in altitude chambers exposed to various combinations of the model s variables. The model predicts occurrence of DCS symptoms quite well. It is notable that both the altitude chamber data and the model show little effect of O2 prebreathing until it lasts more than 60 minutes; this is in contrast to a conventional idea that the benefit of prebreathing is directly due to exponential washout of tissue nitrogen. The delay in response to O2 prebreathing can be interpreted as time required for outward diffusion of nitrogen; when the micronuclei become small enough, they are disabled, either by crushing or because they cannot expand to a critical nucleation size when the subject ascends to altitude.

Van Liew, H. D.↗

NASA NTRS2007

Comparison of V-4 and V-5 Exercise/Oxygen Prebreathe Protocols to Support Extravehicular Activity in Microgravity

The Prebreathe Reduction Program (PRP) used exercise during oxygen prebreathe to reduce necessary prebreathe time prior to depressurizing to work in a 4.3 psi suit during extravehicular activity (EVA). Initial testing produced a two-hour protocol incorporating ergometry exercise and a 30 min cycle of depress/repress to 10.2 psi where subjects breathed 26.5% oxygen/balance nitrogen (Phase II - 10 min at 75% peak oxygen consumption [VO2 peak] followed by 40 min intermittent light exercise [ILE] [approx. 5.8 mL-per kilogram- per minute], then 50 min of rest). The Phase II protocol (0/45 DCS) was approved for operations and has been used on 40 EVAs, providing significant time savings compared to the standard 4 h resting oxygen prebreathe. The Phase V effort focused on performing all light in-suit exercise. Two oxygen prebreathe protocols were tested sequentially: V-4) 160 min prebreathe with 150 min of continuous ILE. The entire protocol was completed at 14.7 psi. All exercise involved upper body effort. Exercise continued until decompression. V-5) 160 min prebreathe with 140 min of ILE - first 40 min at 14.7 psi, then 30 min at 10.2 psi (breathing 26.5% oxygen) after a 20 min depress, simulating a suit donning period. Subjects were then repressed to 14.7 psi and performed another 50 min of lower body ILE, followed by 50 min rest before decompression. The V-4 protocol was rejected with 3 DCS/6 person-exposures. Initial V-5 testing has produced 0 DCS/11 person-exposures (ongoing trials). The difference in DCS rate was significant (Fisher Exact p=0.029). The observations of DCS were significantly lower in early V-5 trials than in V-4 trials. Additional studies are required to evaluate the relative contribution of the variables in exercise distribution, the 10.2 psi depress/repress component, pre-decompression rest, or possible variation in total oxygen consumption.

Pollock, N. W.↗

NASA NTRS2007

Risk Assessment of Physiological Effects of Atmospheric Composition and Pressure in Constellation Vehicles

To reduce denitrogenation time to prevent decompression sickness to support frequent extravehicular activities on the Moon, and to limit the risk of fire, a hypobaric (P(sub B) = 414 mmHg) and mildly hypoxic (ppO2 = 132 mmHg, 32% O2 - 68% N2) living environment is being considered during lunar missions for the Crew Exploration Vehicle (CEV) and Lunar Surface Access Module (LSAM). If the vehicular ppO2 is acutely changed from 145-178 mmHg at standard vehicular operating pressure to less than 125 mmHg at desired lunar surface outpost operating pressures, there is the possibility that some crewmembers may develop symptoms of Acute Mountain Sickness (AMS). The signs and symptoms of AMS (headache plus nausea, dizziness, fatigue, or sleeplessness), could impact crew health and performance on lunar surface missions. Methods: An exhaustive literature review on the topic of the physiological effects of reduced ppO2 and absolute pressure as may contribute to the development of hypoxia and altitude symptoms or AMS. The results of the nine most rigorous studies were collated, analyzed and contents on the physiological concerns associated with hypobaric operations, AMS and hypoxia symptoms summarized. Results: Although space vehicles have operated in hypobaric conditions previously, they have not operated in a mildly hypoxic ppO2. There is evidence for an absolute pressure effect per se on AMS, such that the higher the altitude for a given hypoxic alveolar O2 partial pressure (P(sub A)O2), the greater the likelihood of an AMS response. About 25% of adults are likely to experience mild AMS near 2,000 m (xxx mmHg) altitude following a rapid ascent from sea level while breathing air (6,500 feet, acute (P(sub A)O2) = 75 mmHg). The operational experience with the Shuttle staged denitrogenation protocol at 528 mmHg (3,048 m) while breathing 26.5% O2 (acute (P(sub A)O2) = 85 mmHg) in astronauts adapting to microgravity suggests a similar likely experience in the proposed CEV environment. Conclusions: We feel that the slightly elevated risk of AMS with the recommended exploration atmospheric parameters is offset by the DCS risk reduction and improved operational efficiency offered by the hypobaric lunar surface vehicular pressure. We believe the risk of mild AMS is greater given a (P(sub A)O2) of 77 mmHg at 4,876 m altitude while breathing 32% O2 than at 1,828 m altitude while breathing 21% O2. Only susceptible astronauts would develop mild and transient AMS with prolonged exposure to 414 mmHg (4,876 m) while breathing 32% O2 (acute (P(sub A)O2) = 77 mmHg). So the following may be employed for operational risk reduction: 1) develop procedures to increase P(sub B) as needed in the CEV, and use a gradual or staged reduction in cabin pressure during lunar outbound; 2) train crews for symptoms of hypoxia, to allow early recognition and consider pre-adaptation of crews to a hypoxic environment prior to launch, 3) consider prophylactic acetazolamide for acute pressure changes and be prepared to treat any AMS associated symptoms early with both carbonic anhydrase inhibitors and supplemental oxygen.

Scheuring, Richard A.↗

NASA NTRS2005

The Decompression Sickness and Venous Gas Emboli Consequences of Air Breaks During 100% Oxygen Prebreathe

Not enough is known about the increased risk of hypobaric decompression sickness (DCS) and production of venous (VGE) and arterial (AGE) gas emboli following an air break in an otherwise normal 100% resting oxygen (O2) prebreathe (PB), and certainly a break in PB when exercise is used to accelerate nitrogen (N2) elimination from the tissues. Current Aeromedical Flight Rules at the Johnson Space Center about additional PB payback times are untested, possibly too conservative, and therefore not optimized for operational use.

Conkin, Johnny↗

NASA NTRS2004

A Probability Model of Decompression Sickness at 4.3 Psia after Exercise Prebreathe

Exercise PB can reduce the risk of decompression sickness on ascent to 4.3 psia when performed at the proper intensity and duration. Data are from seven tests. PB times ranged from 90 to 150 min. High intensity, short duration dual-cycle ergometry was done during the PB. This was done alone, or combined with intermittent low intensity exercise or periods of rest for the remaining PB. Nonambulating men and women performed light exercise from a semi-recumbent position at 4.3 psia for four hrs. The Research Model with age tested the probability that DCS increases with advancing age. The NASA Model with gender hypothesized that the probability of DCS increases if gender is female. Accounting for exercise and rest during PB with a variable half-time compartment for computed tissue N2 pressure advances our probability modeling of hypobaric DCS. Both models show that a small increase in exercise intensity during PB reduces the risk of DCS, and a larger increase in exercise intensity dramatically reduces risk. These models support the hypothesis that aerobic fitness is an important consideration for the risk of hypobaric DCS when exercise is performed during the PB.

Conkin, Johnny↗

NASA NTRS2003

Age affects severity of venous gas emboli on decompression from 14.7 to 4.3 psia

INTRODUCTION: Variables that define who we are, such as age, weight and fitness level influence the risk of decompression sickness (DCS) and venous gas emboli (VGE) from diving and aviation decompressions. We focus on age since astronauts that perform space walks are approximately 10 yr older than our test subjects. Our null hypothesis is that age is not statistically associated with the VGE outcomes from decompression to 4.3 psia. METHODS: Our data are from 7 different NASA tests where 188 men and 50 women performed light exercise at 4.3 psia for planned exposures no less than 4 h. Prebreathe (PB) time on 100% oxygen ranged from 150-270 min, including ascent time, with exercise of different intensity and length being performed during the PB in four of the seven tests with 150 min of PB. Subjects were monitored for VGE in the pulmonary artery using a Doppler ultrasound bubble detector for a 4-min period every 12 min. There were six design variables; the presence or absence of lower body adynamia and five PB variables; plus five concomitant variables on physical characteristics: age, weight height, body mass index, and gender that were available for logistic regression (LR). We used LR models for the probability of DCS and VGE, and multinomial logit (ML) models for the probability of Spencer VGE Grades 0-IV at exposure times of 61, 95, 131, 183 min, and for the entire exposure. RESULTS: Age was significantly associated with VGE in both the LR and ML models, so we reject the null hypothesis. Lower body adynamia was significant for all responses. CONCLUSIONS: Our selection of tests produced a wide range of the explanatory variables, but only age, lower body adynamia, height, and total PB time was helpful in various combinations to model the probability of DCS and VGE.

Clinical Trial↗

NASA NTRS2003

Description of 103 Cases of Hypobaric Sickness from NASA-sponsored Research

One hundred and three cases of hypobaric decompression sickness (DCS) are documented, with 6 classified as Type II DCS. The presence and grade of venous gas emboli (VGE) are part of the case descriptions. Cases were diagnosed from 731 exposures in 5 different altitude chambers from 4 different laboratories between the years 1982 and 1999. Research was funded by NASA to develop operational prebreathe (PB) procedures that would permit safe extravehicular activity from the Space Shuttle and International Space Station using an extravehicular mobility unit (spacesuit) operated at 4.3 psia. Both vehicles operate at 14.7 psia with an "air" atmosphere, so a PB procedure is required to reduce nitrogen partial pressure in the tissues to an acceptable level prior to depressurization to 4.3 psia. Thirty-two additional descriptions of symptoms that were not diagnosed as DCS together with VGE information are also included. The information for each case resides in logbooks from 32 different tests. Additional information is stored in the NASA Decompression Sickness Database and the Prebreathe Reduction Protocol Database, both maintained by the Environmental Physiology Laboratory at the Johnson Space Center. Both sources were reviewed to provide the narratives that follow.

Conkin, Johnny↗

NASA NTRS2003

Improved pulmonary function in working divers breathing nitrox at shallow depths

INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p < 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Non-programmatic↗

NASA NTRS2003

Cox Proportional Hazards Models for Modeling the Time to Onset of Decompression Sickness in Hypobaric Environments

In this paper we fit Cox proportional hazards models to a subset of data from the Hypobaric Decompression Sickness Databank. The data bank contains records on the time to decompression sickness (DCS) and venous gas emboli (VGE) for over 130,000 person-exposures to high altitude in chamber tests. The subset we use contains 1,321 records, with 87% censoring, and has the most recent experimental tests on DCS made available from Johnson Space Center. We build on previous analyses of this data set by considering more expanded models and more detailed model assessments specific to the Cox model. Our model - which is stratified on the quartiles of the final ambient pressure at altitude - includes the final ambient pressure at altitude as a nonlinear continuous predictor, the computed tissue partial pressure of nitrogen at altitude, and whether exercise was done at altitude. We conduct various assessments of our model, many of which are recently developed in the statistical literature, and conclude where the model needs improvement. We consider the addition of frailties to the stratified Cox model, but found that no significant gain was attained above a model that does not include frailties. Finally, we validate some of the models that we fit.

Thompson, Laura A.↗

NASA NTRS2002

Modeling Grade IV Gas Emboli using a Limited Failure Population Model with Random Effects

Venous gas emboli (VGE) (gas bubbles in venous blood) are associated with an increased risk of decompression sickness (DCS) in hypobaric environments. A high grade of VGE can be a precursor to serious DCS. In this paper, we model time to Grade IV VGE considering a subset of individuals assumed to be immune from experiencing VGE. Our data contain monitoring test results from subjects undergoing up to 13 denitrogenation test procedures prior to exposure to a hypobaric environment. The onset time of Grade IV VGE is recorded as contained within certain time intervals. We fit a parametric (lognormal) mixture survival model to the interval-and right-censored data to account for the possibility of a subset of "cured" individuals who are immune to the event. Our model contains random subject effects to account for correlations between repeated measurements on a single individual. Model assessments and cross-validation indicate that this limited failure population mixture model is an improvement over a model that does not account for the potential of a fraction of cured individuals. We also evaluated some alternative mixture models. Predictions from the best fitted mixture model indicate that the actual process is reasonably approximated by a limited failure population model.

Thompson, Laura A.↗

NASA NTRS2002

Case Descriptions and Observations About Cutis Marmorata From Hypobaric Decompressions

There is disagreement about the pathophysiology, classification, and treatment of cutis marmorata (CM), so there is disagreement about the disposition and medical status of a person that had CM. CM is rare, associated with stressful decompressions, and may be associated with serious signs and symptoms of decompression sickness (DCS). CM presents as purple or bluish-red skin mottling, often in the pectoral region, shoulders, chest, or upper abdomen. It is unethical to induce CM in humans so all information comes from retrospective analysis of case reports, or from animal models. A literature search, seven recent case reports from the Johnson Space Center and Brooks Air Force Base Hypobaric DCS Databases, interviews with DCS treatment experts, and responses to surveys provided the factual information used to arrive at our conclusions and recommendations. The "weight of evidence" indicates that CM is a local, not centrally mediated or systemic response to bubbles. It is unclear whether obstruction of arterial or venous blood flow is the primary insult since the lesion is reported under either condition. Any neurological or cardiovascular involvements are coincidental, developing along the same time course. The skin could be the source of the bubbles due to its mass, the associated layer of fat, and the variable nature of skin blood flow. CM should not be categorized as Type II DCS, should be included with other skin manifestations in a category called cutaneous DCS, and hyperbaric treatment is only needed if ground level oxygen is ineffective in the case of altitude-induced CM.

Conkin, Johnny↗

NASA NTRS2001

A Log Logistic Survival Model Applied to Hypobaric Decompression Sickness

Decompression sickness (DCS) is a complex, multivariable problem. A mathematical description or model of the likelihood of DCS requires a large amount of quality research data, ideas on how to define a decompression dose using physical and physiological variables, and an appropriate analytical approach. It also requires a high-performance computer with specialized software. I have used published DCS data to develop my decompression doses, which are variants of equilibrium expressions for evolved gas plus other explanatory variables. My analytical approach is survival analysis, where the time of DCS occurrence is modeled. My conclusions can be applied to simple hypobaric decompressions - ascents lasting from 5 to 30 minutes - and, after minutes to hours, to denitrogenation (prebreathing). They are also applicable to long or short exposures, and can be used whether the sufferer of DCS is at rest or exercising at altitude. Ultimately I would like my models to be applied to astronauts to reduce the risk of DCS during spacewalks, as well as to future spaceflight crews on the Moon and Mars.

Conkin, Johnny↗

NASA NTRS2001

Evidence-Based Approach to the Analysis of Serious Decompression Sickness with Application to EVA Astronauts

It is important to understand the risk of serious hypobaric decompression sickness (DCS) in order to develop procedures and treatment responses to mitigate the risk. Since it is not ethical to conduct prospective tests about serious DCS with humans, the necessary information was gathered from 73 published reports. We hypothesize that a 4-hr 100% oxygen (O2) prebreathe results in a very low risk of serious DCS, and test this through analysis. We evaluated 258 tests containing information from 79,366 exposures in attitude chambers. Serious DCS was documented in 918 men during the tests. Serious DCS are signs and symptoms broadly classified as Type II DCS. A risk function analysis with maximum likelihood optimization was performed to identify significant explanatory variables, and to create a predictive model for the probability of serious DCS [P(serious DCS)]. Useful variables were Tissue Ratio, the planned time spent at altitude (T(sub alt)), and whether or not repetitive exercise was performed at altitude. Tissue Ratio is P1N2/P2, where P1N2 is calculated nitrogen (N2) pressure in a compartment with a 180-min half-time for N2 pressure just before ascent, and P2 is ambient pressure after ascent. A prebreathe and decompression profile Shuttle astronauts use for extravehicular activity (EVA) includes a 4-hr prebreathe with 100% O2, an ascent to P2 = 4.3 lb per sq. in. absolute, and a T(sub alt) = 6 hr. The P(serious DCS) is: 0.0014 (0.00096 - 0.00196, 95% confidence interval) with exercise and 0.00025 (0.00016 - 0.00035) without exercise. Given 100 Shuttle EVAs to date and no report of serious DCS, the true risk is less than 0.03 with 95% confidence (Binomial Theorem). It is problematic to estimate the risk of serious DCS since it appears infrequently, even if the estimate is based on thousands of altitude chamber exposures. The true risk to astronauts may lie between the extremes of the confidence intervals (0.00016 - 0.00196) since the contribution of other factors, particularly exercise, to the risk of serious DCS during EVA is unknown. A simple model that only accounts for four important variables in retrospective data is still helpful to increase our understanding about the risk of serious DCS.

Conkin, Johnny↗

NASA NTRS2000

The Mars Project: Avoiding Decompression Sickness on a Distant Planet

A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

Conkin, Johnny↗