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NASA NTRS2010

Human Factors in Space Exploration

The exploration of space is one of the most fascinating domains to study from a human factors perspective. Like other complex work domains such as aviation (Pritchett and Kim, 2008), air traffic management (Durso and Manning, 2008), health care (Morrow, North, and Wickens, 2006), homeland security (Cooke and Winner, 2008), and vehicle control (Lee, 2006), space exploration is a large-scale sociotechnical work domain characterized by complexity, dynamism, uncertainty, and risk in real-time operational contexts (Perrow, 1999; Woods et ai, 1994). Nearly the entire gamut of human factors issues - for example, human-automation interaction (Sheridan and Parasuraman, 2006), telerobotics, display and control design (Smith, Bennett, and Stone, 2006), usability, anthropometry (Chaffin, 2008), biomechanics (Marras and Radwin, 2006), safety engineering, emergency operations, maintenance human factors, situation awareness (Tenney and Pew, 2006), crew resource management (Salas et aI., 2006), methods for cognitive work analysis (Bisantz and Roth, 2008) and the like -- are applicable to astronauts, mission control, operational medicine, Space Shuttle manufacturing and assembly operations, and space suit designers as they are in other work domains (e.g., Bloomberg, 2003; Bos et al, 2006; Brooks and Ince, 1992; Casler and Cook, 1999; Jones, 1994; McCurdy et ai, 2006; Neerincx et aI., 2006; Olofinboba and Dorneich, 2005; Patterson, Watts-Perotti and Woods, 1999; Patterson and Woods, 2001; Seagull et ai, 2007; Sierhuis, Clancey and Sims, 2002). The human exploration of space also has unique challenges of particular interest to human factors research and practice. This chapter provides an overview of those issues and reports on sorne of the latest research results as well as the latest challenges still facing the field.

FROM↗
NASA NTRS2012

Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

Chough, Natacha G.↗
NASA NTRS2000

A strategic vision for telemedicine and medical informatics in space flight

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

Aerospace Medicine/organization & administration↗
NASA NTRS2013

Computational Modeling of Cephalad Fluid Shift for Application to Microgravity-Induced Visual Impairment

An improved understanding of spaceflight-induced ocular pathology, including the loss of visual acuity, globe flattening, optic disk edema and distension of the optic nerve and optic nerve sheath, is of keen interest to space medicine. Cephalad fluid shift causes a profoundly altered distribution of fluid within the compartments of the head and body, and may indirectly generate phenomena that are biomechanically relevant to visual function, such as choroidal engorgement, compromised drainage of blood and cerebrospinal fluid (CSF), and altered translaminar pressure gradient posterior to the eye. The experimental body of evidence with respect to the consequences of fluid shift has not yet been able to provide a definitive picture of the sequence of events. On earth, elevated intracranial pressure (ICP) is associated with idiopathic intracranial hypertension (IIH), which can produce ocular pathologies that look similar to those seen in some astronauts returning from long-duration flight. However, the clinically observable features of the Visual Impairment and Intracranial Pressure (VIIP) syndrome in space and IIH on earth are not entirely consistent. Moreover, there are at present no experimental measurements of ICP in microgravity. By its very nature, physiological measurements in spaceflight are sparse, and the space environment does not lend itself to well-controlled experiments. In the absence of such data, numerical modeling can play a role in the investigation of biomechanical causal pathways that are suspected of involvement in VIIP. In this work, we describe the conceptual framework for modeling the altered compartmental fluid distribution that represents an equilibrium fluid distribution resulting from the loss of hydrostatic pressure gradient.

Nelson, Emily S.↗
NASA NTRS2004

Training Space Surgeons for Missions to the Moon and Mars

Over a period of 4 years, several working groups reviewed the provisions for medical care in low earth orbit and for future flights such as to the Moon and Mars. More than 60 medical experts representing a wide variety of clinical backgrounds participated in the working groups. They concluded that NASA medical training for long-duration missions, while critical to success, is currently aimed at short-term skill retention. They noted that several studies have shown that skills and knowledge deteriorate rapidly in the absence of adequate sustainment training. American Heart Association studies have shown that typically less than twenty-five percent of learned skills remain after 6 to 8 months. In addition to identifying the current training deficiencies, the working groups identified additional skill and knowledge sets required for missions to the Moon and Mars and curricula were developed to address inadequacies. Space medicine care providers may be categorized into 4 types based on health care responsibilities and level of education required. The first 2 types are currently recognized positions within the flight crew: crew medical officers and astronaut-physician. The crew medical officer (CMO), a non-medically trained astronaut crewmember, is given limited emergency medical technician-like training to provide medical care on orbit. Many of hidher duties are carried out under the direction of a ground-based flight surgeon in mission control. Second is the astronaut- physician whose primary focus is on mission specialist duties and training, and who has very limited ability to maintain medical proficiency. Two new categories are recommended to complete the 4 types of care providers primarily to address the needs of those who will travel to the Moon and Mars. Physician astronaut - a physician, who in addition to being a mission specialist, will be required to maintain and enhance hidher medical proficiency while serving as an astronaut. Space surgeon - a physician astronaut given special training to address the unique health care requirements envisioned for expeditions such as those to Mars.

Pool, S. L.↗
NASA NTRS2013

Intravenous Fluid Generation System

The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in the water before entering the salt bag and mixing with the salt to create a normal saline solution.

McQuillen, John↗
NASA NTRS2007

The Lunar Environment: Determining the Health Effects of Exposure to Moon Dusts

The Earth s moon presents a hostile environment in which to live and work. There is no atmosphere to protect its surface from the ravages of solar wind and micrometeorite impacts. As a result, the moon s surface is covered with a thin layer of fine, charged, reactive dust capable of entering habitats and vehicle compartments, where it can result in crewmember health problems. During the Apollo missions, lunar dusts were introduced into the crew vehicle, resulting in direct exposure and occasional reports of respiratory, dermal and ocular irritation. In order to study the toxicological effects of lunar dust, NASA formed the Lunar Airborne Dust Toxicity Advisory Group (LADTAG). This interdisciplinary group is comprised of leading experts in space toxicology, lunar geology, space medicine and biomedical research. LADTAG has demonstrated that lunar soil contains several types of reactive dusts, including an extremely fine respirable component. These dusts have highly reactive surfaces in the lunar environment; the grains contain surface coatings which are generated by vapor phases formed by hypervelocity impact of micrometeorites. This unique class of dusts has surface properties that are unlike any Earth based analog. These distinctive properties are why lunar dusts are of great toxicological interest. Understanding how these reactive components behave "biochemically" in a moisture-rich pulmonary environment will aid in determining how toxic these particles are to humans. The data obtained from toxicological examination of lunar dusts will determine the human risk criteria for lunar dust exposure and produce a lunar health standard. LADTAG s analysis of lunar dusts and lunar dust simulants will include detailed lunar particle characterizations, determining the properties of particle activation, reactivation of lunar dust, the process of dust passivation and discerning the pathology of lunar dust exposure via inhalation, intratracheal instillation, cell culture exposure, dermal exposure and ocular exposure. The resulting health standard will be time-based and will vary by the duration and type of exposure. It may also be necessary to set multiple standards for different types of lunar dust, as well as for dust in its activated form vs. aged & passivated dust. This standard, set to protect the health of our robust astronaut crews, will not only impact NASA medical operations, but engineering designs as well. The data from our multidisciplinary research are vital in developing remediation devices and environmental monitors. Ultimately, the engineering and safety groups will design and develop countermeasures for space vehicles, suits, rovers and habitats that will be sustained within the limits of the health standard.

Khan-Mayberry, Noreen↗
NASA NTRS2008

The Integrated Medical Model: Statistical Forecasting of Risks to Crew Health and Mission Success

The Integrated Medical Model (IMM) helps capture and use organizational knowledge across the space medicine, training, operations, engineering, and research domains. The IMM uses this domain knowledge in the context of a mission and crew profile to forecast crew health and mission success risks. The IMM is most helpful in comparing the risk of two or more mission profiles, not as a tool for predicting absolute risk. The process of building the IMM adheres to Probability Risk Assessment (PRA) techniques described in NASA Procedural Requirement (NPR) 8705.5, and uses current evidence-based information to establish a defensible position for making decisions that help ensure crew health and mission success. The IMM quantitatively describes the following input parameters: 1) medical conditions and likelihood, 2) mission duration, 3) vehicle environment, 4) crew attributes (e.g. age, sex), 5) crew activities (e.g. EVA's, Lunar excursions), 6) diagnosis and treatment protocols (e.g. medical equipment, consumables pharmaceuticals), and 7) Crew Medical Officer (CMO) training effectiveness. It is worth reiterating that the IMM uses the data sets above as inputs. Many other risk management efforts stop at determining only likelihood. The IMM is unique in that it models not only likelihood, but risk mitigations, as well as subsequent clinical outcomes based on those mitigations. Once the mathematical relationships among the above parameters are established, the IMM uses a Monte Carlo simulation technique (a random sampling of the inputs as described by their statistical distribution) to determine the probable outcomes. Because the IMM is a stochastic model (i.e. the input parameters are represented by various statistical distributions depending on the data type), when the mission is simulated 10-50,000 times with a given set of medical capabilities (risk mitigations), a prediction of the most probable outcomes can be generated. For each mission, the IMM tracks which conditions occurred and decrements the pharmaceuticals and supplies required to diagnose and treat these medical conditions. If supplies are depleted, then the medical condition goes untreated, and crew and mission risk increase. The IMM currently models approximately 30 medical conditions. By the end of FY2008, the IMM will be modeling over 100 medical conditions, approximately 60 of which have been recorded to have occurred during short and long space missions.

Fitts, M. A.↗
NASA NTRS1989

USSR Space Life Sciences Digest. Index to issues 15-20

This bibliography provides an index to issues 15 through 20 of the USSR Space Life Sciences Digest. There are two sections. The first section lists bibliographic citations of abstracts in these issues, grouped by topic area categories. The second section provides a key word index for the same abstracts. The topic categories include exobiology, space medicine and psychology, human performance and man-machine systems, various life/body systems, human behavior and adaptation, biospherics, and others.

Hooke, Lydia Razran↗
NASA NTRS1988

Terrestrial implications of mathematical modeling developed for space biomedical research

This paper summarizes several related research projects supported by NASA which seek to apply computer models to space medicine and physiology. These efforts span a wide range of activities, including mathematical models used for computer simulations of physiological control systems; power spectral analysis of physiological signals; pattern recognition models for detection of disease processes; and computer-aided diagnosis programs.

Lujan, Barbara F.↗
NASA NTRS1990

USSR Space Life Sciences Digest. Index to issues 21-25

This bibliography provides an index to issues 21 through 25 of the USSR Space Life Sciences Digest. There are two sections. The first section lists bibliographic citations of abstracts in these issues, grouped by topic area categories. The second section provides a key word index for the same abstracts. The topic categories include exobiology, space medicine and psychology, human performance and man-machine systems, various life/body systems, human behavior and adaptation, biospherics, and others.

Hooke, Lydia Razran↗
NASA NTRS1989

Perception-action relationships reconsidered in light of spatial display instruments

Spatial display instruments convey information about both the identity and the location of objects in order to assist surgeons, astronauts, pilots, blind individuals, and others in identification, remote manipulations, navigation, and obstacle avoidance. Scientists believe that these instruments have not reached their full potential and that progress toward new applications, including the possibility of restoring sight to the blind, will be accelerated by advancing the understanding of perceptual processes. This stimulating challenge to basic researchers was advanced by Paul Bach-Y-Rita (1972) and by the National Academy of Science (1986) report on Electronic Aids for the Blind. Although progress has been made, new applications of spatial display instruments in medicine, space, aviation, and rehabilitation await improved theoretical and empirical foundations.

Shebilske, Wayne L.↗
NASA NTRS1989

Workshop on Exercise Prescription for Long-Duration Space Flight

The National Aeronautics and Space Administration has a dedicated history of ensuring human safety and productivity in flight. Working and living in space long term represents the challenge of the future. Our concern is in determining the effects on the human body of living in space. Space flight provides a powerful stimulus for adaptation, such as cardiovascular and musculoskeletal deconditioning. Extended-duration space flight will influence a great many systems in the human body. We must understand the process by which this adaptation occurs. The NASA is agressively involved in developing programs which will act as a foundation for this new field of space medicine. The hallmark of these programs deals with prevention of deconditioning, currently referred to as countermeasures to zero g. Exercise appears to be most effective in preventing the cardiovascular and musculoskeletal degradation of microgravity.

Harris, Bernard A., Jr.↗
NASA NTRS1991

USSR Space Life Sciences Digest. Index to issues 26-29

This bibliography provides an index to issues 26 through 29 of the USSR Space Life Sciences Digest. There are two sections. The first section lists bibliographic citations of abstracts in these issues, grouped by topic area categories. The second section provides a key word index for the same abstracts. The topic categories include exobiology, space medicine and psychology, human performance and man-machine systems, various life/body systems, human behavior and adaptation, biospherics, and others.

Stone, Lydia Razran↗
NASA NTRS1991

Biomedical applications of NASA technology

Through the active transfer of technology, NASA Technology Utilization (TU) Program assists private companies, associations, and government agencies to make effective use of NASA's technological resources to improve U.S. economic competitiveness and to provide societal benefit. Aerospace technology from such areas as digital image processing, space medicine and biology, microelectronics, optics, and electro-optics, and ultrasonic imaging have found many secondary applications in medicine. Examples of technology spinoffs are briefly discussed to illustrate the benefits realized through adaptation of aerospace technology to solve health care problems. Successful implementation of new technologies increasingly requires the collaboration of industry, universities, and government and the TU Program serves as the liaison to establish such collaborations with NASA. NASA technology is an important resource to support the development of new medical products and techniques that will further advance the quality of health care available in the U.S. and worldwide.

Friedman, Donald S.↗
NASA NTRS1991

Use of telescience for biomedical research during space flight

When the U.S. first embarked on a manned space flight program, NASA's use of medical telescience was focused on crew health monitoring. In recent years, medical telescience use has been expanded to include support of basic research in space medicine. It enables ground support personnel to assist on-board crews in the performance of experiments and improves the quality and quantity of data return. NASA is continuing to develop its telescience capabilities. Future plans include telemedicine that will enable physicians on Earth to support crewmembers during flight and telescience that will enable investigators at their home institutions to support and conduct in-flight medical research. NASA's use of telescience for crew safety and biomedical research from Project Mercury to the present is described and NASA's plans for the future are presented.

Huntoon, Carolyn L.↗
NASA NTRS1994

Influence of gravity on the circadian timing system

The circadian timing system (CTS) is responsible for daily temporal coordination of physiological and behavioral functions both internally and with the external environment. Experiments in altered gravitational environments have revealed changes in circadian rhythms of species ranging from fungi to primates. The altered gravitational environments examined included both the microgravity environment of spaceflight and hyperdynamic environments produced by centrifugation. Acute exposure to altered gravitational environments changed homeostatic parameters such as body temperature. These changes were time of day dependent. Exposure to gravitational alterations of relatively short duration produced changes in both the homeostatic level and the amplitude of circadian rhythms. Chronic exposure to a non-earth level of gravity resulted in changes in the period of the expressed rhythms as well as in the phase relationships between the rhythms and between the rhythms and the external environment. In addition, alterations in gravity appeared to act as a time cue for the CTS. Altered gravity also affected the sensitivity of the pacemaker to other aspects of the environment (i.e., light) and to shifts of time cues. Taken together, these studies lead to the conclusion that the CTS is indeed sensitive to gravity and its alterations. This finding has implications for both basic biology and space medicine.

Fuller, C. A.↗