Engineering topics
Publications and source records attributed to Van Baalen, Mary.
We propose using meta-analytic methods to combine summary measures across space agencies: (1) Non-attributable data (2) Avoids problems with sharing health related data (3) Unpublished data
The NASA Johnson Space Center s (NASA JSC) Committee for the Protection of Human Subjects (CPHS) recently approved the formation of two human data repositories: the Lifetime Surveillance of Astronaut Health Repository (LSAH-R) for clinical data and the Life Sciences Data Archive Repository (LSDA-R) for research data. The establishment of these repositories forms the foundation for the release of data and information beyond the scope for which the data was originally collected. The release of clinical and research data and information is primarily managed by two NASA groups: the Evidence Base Working Group (EBWG), consisting of members of both repositories, and the LSAH Policy Board. The goal of unifying these repositories and their processes is to provide a mutually supportive approach to handling medical and research data, to enhance the use of medical and research data to reduce risk, and to promote the understanding of space physiology, countermeasures and other mitigation strategies. Over the past year, both repositories have received over 100 data and information requests from a wide variety of requesters. The disposition of these requests has highlighted the challenges faced when attempting to make data collected on a unique set of subjects available beyond the original intent for which the data were collected. As the EBWG works through each request, many considerations must be factored into account when deciding what data can be shared and how - from the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA), to NASA s Health Information Management System (10HIMS) and Human Experimental and Research Data Records (10HERD) access requirements. Additional considerations include the presence of the data in the repositories and vetting requesters for legitimacy of their use of the data. Additionally, fair access must be ensured for intramural, as well as extramural investigators. All of this must be considered in the formulation of the charters, policies and workflows for the human data repositories at NASA.
Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain anthropometric body types should conduct NBL EVA training in the pivoted HUT.
Space flight is a very unique occupational exposure with potential hazards that are not fully understood. A limited number of individuals have experienced the exposures incurred during space flight, and epidemiologic research would benefit from shared information across space agencies. However, data sharing can be problematic due to agency protection policies for personally identifiable information as well as medical records. Compliance with these protocols in the astronaut population is particularly difficult given the small, high-profile population under study. Creativity in combining data is necessary in order to overcome these difficulties and improve statistical power in research. This study presents methods in meta-analysis that may be used to combine non-attributable data across space agencies so that meaningful conclusions may be drawn about study interests. Methods for combining epidemiologic data across space agencies are presented, and the processes are demonstrated using life-time mortality data in U.S. astronauts and Russian cosmonauts. This proof of concept was found to be an acceptable way of sharing data across agencies, and will be used in the future as more relevant research interests are identified.