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An Integrated Extravehicular Activity Research Plan

Multiple organizations within NASA and outside of NASA fund and participate in research related to extravehicular activity (EVA). In October 2015, representatives of the EVA Office, the Crew and Thermal Systems Division (CTSD), and the Human Research Program (HRP) at NASA Johnson Space Center agreed on a formal framework to improve multi-year coordination and collaboration in EVA research. At the core of the framework is an Integrated EVA Research Plan and a process by which it will be annually reviewed and updated. The over-arching objective of the collaborative framework is to conduct multi-disciplinary cost-effective research that will enable humans to perform EVAs safely, effectively, comfortably, and efficiently, as needed to enable and enhance human space exploration missions. Research activities must be defined, prioritized, planned and executed to comprehensively address the right questions, avoid duplication, leverage other complementary activities where possible, and ultimately provide actionable evidence-based results in time to inform subsequent tests, developments and/or research activities. Representation of all appropriate stakeholders in the definition, prioritization, planning and execution of research activities is essential to accomplishing the over-arching objective. A formal review of the Integrated EVA Research Plan will be conducted annually. External peer review of all HRP EVA research activities including compilation and review of published literature in the EVA Evidence Book is already performed annually. Coordination with stakeholders outside of the EVA Office, CTSD, and HRP is already in effect on a study-by-study basis; closer coordination on multi-year planning with other EVA stakeholders including academia is being actively pursued. Details of the current Integrated EVA Research Plan are presented including description of ongoing and planned research activities in the areas of: Benchmarking; Anthropometry and Suit Fit; Sensors; Human-Suit Modeling; Suit Trauma Monitoring and Countermeasures; EVA Workload and Duration Effects; Decompression Sickness Risk Mitigation; Deconditioned EVA Performance; and Exploration EVA Concept of Operations.

Abercromby, Andrew F. J.↗

Compiling a Comprehensive EVA Training Dataset for NASA Astronauts

Training for a spacewalk or extravehicular activity (EVA) is considered hazardous duty for NASA astronauts. This activity places astronauts at risk for decompression sickness as well as various musculoskeletal disorders from working in the spacesuit. As a result, the operational and research communities over the years have requested access to EVA training data to supplement their studies.

Laughlin, M. S.↗

Modeling Oxygen Prebreathe Protocols for Exploration Extravehicular Activities Using Variable Pressure Suits

Exploration missions are expected to use variable pressure extravehicular activity (EVA) spacesuits as well as a spacecraft "exploration atmosphere" of 56.5 kPa (8.2 psia), 34% O2, both of which provide the possibility of reducing the oxygen prebreathe times necessary to reduce decompression sickness (DCS) risk. Previous modeling work predicted 8.4% DCS risk for an EVA beginning at the exploration atmosphere, followed by 15 minutes of in-suit O2 prebreathe, and 6 hours of EVA at 29.6 kPa (4.3 psia). In this study we model notional prebreathe protocols for a variable pressure suit where the exploration atmosphere is unavailable.

Abercromby, Andrew F. J.↗

Tracking Historical NASA EVA Training: Lifetime Surveillance of Astronaut Health (LSAH) Development of the EVA Suit Exposure Tracker (EVA SET)

During a spacewalk, designated as extravehicular activity (EVA), an astronaut ventures from the protective environment of the spacecraft into the vacuum of space. EVAs are among the most challenging tasks during a mission, as they are complex and place the astronaut in a highly stressful environment dependent on the spacesuit for survival. Due to the complexity of EVA, NASA has conducted various training programs on Earth to mimic the environment of space and to practice maneuvers in a more controlled and forgiving environment. However, rewards offset the risks of EVA, as some of the greatest accomplishments in the space program were accomplished during EVA, such as the Apollo moonwalks and the Hubble Space Telescope repair missions. Water has become the environment of choice for EVA training on Earth, using neutral buoyancy as a substitute for microgravity. During EVA training, an astronaut wears a modified version of the spacesuit adapted for working in water. This high fidelity suit allows the astronaut to move in the water while performing tasks on full-sized mockups of space vehicles, telescopes, and satellites. During the early Gemini missions, several EVA objectives were much more difficult than planned and required additional time. Later missions demonstrated that "complex (EVA) tasks were feasible when restraints maintained body position and underwater simulation training ensured a high success probability".1,2 EVA training has evolved from controlling body positioning to perform basic tasks to complex maintenance of the Hubble Space Telescope and construction of the International Space Station (ISS). Today, preparation is centered at special facilities built specifically for EVA training, such as the Neutral Buoyancy Laboratory (NBL) at NASA's Johnson Space Center ([JSC], Houston) and the Hydrolab at the Gagarin Cosmonaut Training Centre ([GCTC], Star City, outside Moscow). Underwater training for an EVA is also considered hazardous duty for NASA astronauts. This activity places astronauts at risk for decompression sickness and barotrauma as well as various musculoskeletal disorders from working in the spacesuit. The medical, operational and research communities over the years have requested access to EVA training data to better understand the risks. As a result of these requests, epidemiologists within the Lifetime Surveillance of Astronaut Health (LSAH) team have compiled records from numerous EVA training venues to quantify the exposure to EVA training. The EVA Suit Exposure Tracker (EVA SET) dataset is a compilation of ground-based training activities using the extravehicular mobility unit (EMU) in neutrally buoyant pools to enhance EVA performance on orbit. These data can be used by the current ISS program and future exploration missions by informing physicians, researchers, and operational personnel on the risks of EVA training in order that future suit and mission designs incorporate greater safety. The purpose of this technical report is to document briefly the various facilities where NASA astronauts have performed EVA training while describing in detail the EVA training records used to generate the EVA SET dataset.

Laughlin, Mitzi S.↗

Space Suit Portable Life Support System Oxygen Regulator History, Development, & Testing Results

An oxygen regulator has been in development for the space suit Exploration Extravehicular Mobility Unit (xEMU) Portable Life Support System (PLSS). The regulator provides the necessary oxygen pressure for the crew member during pre-breathe, extra-vehicular activity (EVA), post EVA airlock operations, and decompression sickness treatment. The last time a spacesuit oxygen regulator was designed was for the Space Shuttle Program EMU. The regulator & EMU were then used on the International Space Station (ISS) with no significant changes to the regulator throughout its life. This xEMU PLSS spacesuit oxygen regulator implements many elements of the previous EMU Secondary Oxygen Pack (SOP) design while integrating numerous new improvements and changes. There are changes both to the high-level regulator architecture approach in the suit itself, in addition to modernizations with electrical motor control & sensing. For architecture, there are two oxygen regulators for each space suit, a primary and secondary that are nearly identical to each other and have the same maximum design pressure of 3750 Pounds per Square Inch Absolute (PSIA). The primary regulator provides nominal pressure during EVA, while the secondary provides a backup pressure only in case of primary regulator failure or if an emergency purge of the suit oxygen is required. The design was based originally off of the secondary oxygen regulator on the EMU which utilizes a two-stage regulator to improve safety and controllability. The xEMU PLSS Oxygen Regulator development started with a modification to add a linear actuator to the design to control the downstream pressure electronically instead of a manual control with a wire linkage system used with the EMU. The design was iterated to include a Monel body for oxygen fire safety, and sensors for pressure verification at each stage. Then the regulator design was packaged to fit into the xEMU PLSS envelope. Development included extensive testing which brought to light some issues with the design which were addressed at each stage of development. This paper will review the design history, development, testing results, and lessons learned designing the xEMU PLSS Oxygen Regulator.

Ryan Ogilvie↗

Medical Lessons Learned from the Exploration Atmospheres Study

Background: The National Aeronautics and Space Administration’s (NASA) Exploration Atmospheres study (EA) was done to evaluate alternative cabin atmospheres for future spacecraft designs and planetary surface exploration of the Moon, Mars and beyond. Deep space exploration involves creating habitats and environments safe for human occupancy and means to explore the outside environment (extravehicular activities, EVA). In order to validate alternative atmospheres and pre-spacewalk procedures, the EA study was conducted to evaluate factors such as hypoxia risks, denitrogenation protocols, food limitations, medications, and the impact of other factors on human performance. Overview: Space travel is constrained by mass, volume, power and the cost of vehicle development, which creates tradeoffs in various capabilities, including breathing gasses. Higher atmospheric pressure in a vehicle means more gas, and a stronger containment vessel/habitat; while lower pressure requires higher oxygen partial pressure, which may increase fire risk. NASA’s EA study evaluated a proposed alternative cabin environment (8.2 psia, 34% Oxygen), for future spacecraft habitat, and planetary EVAs. EA included both a 3-day and a 11-day trial. These trials included a depressurization and saturation to 8.2psi at 34% O2 with additional depresses to 4.3 psia at 85% O2 for simulated EVAs, (1 EVA during the 3-day and 5 during the 11-day trials). Discussion: Planning for and executing the medical monitoring and response plan for a trial of this scope was a huge undertaking with no prior practice to fall back on. Food obstacles, sleeping issues, medications, joint injury, equipment limitations, medical privacy, multiple cases of decompression sickness, and even a COVID outbreak among the support team proved challenging. Conclusion: Testing of this nature is an essential part NASA’s preparation for the upcoming Lunar Artemis missions. As spaceflight transitions beyond low earth orbit, to planetary, even more trials of this nature will be required to learn what are the optimal atmospheric and associated operational constraints to maintain the optimal health of the crew and achieve mission objectives.

R Sanders↗

Habitability Assessments And Lessons-learned From 3-day And 11-day Enriched Oxygen Hypobaric Chamber Tests At NASA Johnson Space Center

INTRODUCTION: Decompression sickness (DCS) is a risk to the health and performance of astronauts and high-altitude aircrew. Tolerance to flammability, hypoxia, prebreathe duration, and DCS risk varies across different organizations, vehicles, suits, and destinations, necessitating a variety of DCS risk mitigation approaches. Existing models of altitude DCS risk are often insufficient to enable accurate risk-informed decisions during hardware development, mission planning, and flight operations. METHODS: NASA completed outfitting of a dedicated facility at Johnson Space Center to support testing of up to eight human subjects for multiple days in hypobaric and enriched oxygen atmospheres. The primary purpose of the testing capability is validation of DCS risk mitigation protocols for Artemis missions to the Moon; however, it will also support development and validation of a generalizable altitude DCS risk estimation tool. A 3-day and an 11-day prebreathe validation test were completed in 2022, each with 8 human subjects living at 56.5 kPa (8.2 psia), 34% O2, 66% N2, with 5 simulated EVAs performed on masks at 29.6 kPa (4.3 psi), 85% O2, 15% N2. Facility and organizational lessons-learned and process improvements were recorded during and following the tests, and subjective habitability ratings were recorded daily during the 11-day test. Hypoxia and DCS-related physiological and cognitive outcome measures were recorded during both tests and are reported in companion presentations. RESULTS & DISCUSSION: All subjects completed each of the tests. Primary habitability issues related to mask discomfort during simulated EVAs and poor sleep quality due to thin mattresses. Polybenzimidazole (PBI) clothing was worn by all subjects due to the increased fire risk and may be required for Artemis missions; clothing was found to be acceptable overall with the worst ratings being due to poor fit and inelasticity. Chamber O2 and CO2 sensor inconsistency was observed that did not result in test termination but required post-test follow-up. Forward plans include additional hypobaric testing and integration of existing and future physiological outcome data into an open-source Aerospace Estimation Tool for Hypobaric Exposure Risk (AETHER). NASA is also working to make the testing capability available to commercial companies.

Andrew F J Abercromby↗

Habitability Assessments And Lessons-learned From 3-day And 11-day Enriched Oxygen Hypobaric Chamber Tests At NASA Johnson Space Center

INTRODUCTION: Decompression sickness (DCS) is a risk to the health and performance of astronauts and high-altitude aircrew. Tolerance to flammability, hypoxia, prebreathe duration, and DCS risk varies across different organizations, vehicles, suits, and destinations, necessitating a variety of DCS risk mitigation approaches. Existing models of altitude DCS risk are often insufficient to enable accurate risk-informed decisions during hardware development, mission planning, and flight operations. METHODS: NASA completed outfitting of a dedicated facility at Johnson Space Center to support testing of up to eight human subjects for multiple days in hypobaric and enriched oxygen atmospheres. The primary purpose of the testing capability is validation of DCS risk mitigation protocols for Artemis missions to the Moon; however, it will also support development and validation of a generalizable altitude DCS risk estimation tool. A 3-day and an 11-day prebreathe validation test were completed in 2022, each with 8 human subjects living at 56.5 kPa (8.2 psia), 34% O2, 66% N2, with 5 simulated EVAs performed on masks at 29.6 kPa (4.3 psi), 85% O2, 15% N2. Facility and organizational lessons-learned and process improvements were recorded during and following the tests, and subjective habitability ratings were recorded daily during the 11-day test. Hypoxia and DCS-related physiological and cognitive outcome measures were recorded during both tests and are reported in companion presentations. RESULTS & DISCUSSION: All subjects completed each of the tests. Primary habitability issues related to mask discomfort during simulated EVAs and poor sleep quality due to thin mattresses. Polybenzimidazole (PBI) clothing was worn by all subjects due to the increased fire risk and may be required for Artemis missions; clothing was found to be acceptable overall with the worst ratings being due to poor fit and inelasticity. Chamber O2 and CO2 sensor inconsistency was observed that did not result in test termination but required post-test follow-up. Forward plans include additional hypobaric testing and integration of existing and future physiological outcome data into an open-source Aerospace Estimation Tool for Hypobaric Exposure Risk (AETHER). NASA is also working to make the testing capability available to commercial companies.

Andrew Abercromby↗

Space Suit Portable Life Support System Oxygen Regulator History, Development, & Testing Results

An oxygen regulator has been in development for the Exploration Extravehicular Mobility Unit (xEMU) Portable Life Support System (PLSS). The regulator provides the necessary oxygen pressure control for the crew member during prebreathe, Extra-Vehicular Activity (EVA), post EVA airlock operations, and Decompression Sickness (DCS) treatment. It has been over four decades since a new spacesuit oxygen regulator has been designed. The regulator and EMU that is presently used on the International Space Station (ISS) was developed for the space shuttle program without any significant changes made throughout its service life. The xEMU spacesuit oxygen regulator is based on the previous EMU Secondary Oxygen Pack (SOP). The new design integrates numerous improvements and changes including an innovative approach to regulator architecture, a more robust first stage pressure sensing mechanism, digital actuation control, and electronic pressure sensing. These upgrades replace manual control linkages, physical gauges, and enable infinitely variable pressure set points. The new setpoints can decrease prebreathe time and make in suit DCS treatment possible. Throughout its four iterations design concerns have been addressed, safety features have been added, and the envelope of the regulator designed to fit inside the xEMU PLSS package. This paper will review the history, design, testing, and lessons learned during the development of the xEMU PLSS Oxygen Regulator.

Ryan Eric Ogilvie↗

Space Suit Portable Life Support System (PLSS) Oxygen Regulator History, Development, & Testing Results

An oxygen regulator has been in development for the Exploration Extravehicular Mobility Unit (xEMU) Portable Life Support System (PLSS). The regulator provides the necessary oxygen pressure control for the crew member during prebreathe, Extra-Vehicular Activity (EVA), post EVA airlock operations, and Decompression Sickness (DCS) treatment. It has been over four decades since a new spacesuit oxygen regulator has been designed. The regulator and EMU that is presently used on the International Space Station (ISS) was developed for the space shuttle program without any significant changes made throughout its service life. The xEMU spacesuit oxygen regulator is based on the previous EMU Secondary Oxygen Pack (SOP). The new design integrates numerous improvements and changes including an innovative approach to regulator architecture, a more robust first stage pressure sensing mechanism, digital actuation control, and electronic pressure sensing. These upgrades replace manual control linkages, physical gauges, and enable infinitely variable pressure set points. The new setpoints can decrease prebreathe time and make in suit DCS treatment possible. Throughout its four iterations design concerns have been addressed, safety features have been added, and the envelope of the regulator designed to fit inside the xEMU PLSS package. This paper will review the history, design, testing, and lessons learned during the development of the xEMU PLSS Oxygen Regulator.

Ryan Ogilvie↗

Effects of Mild Hypobaric Hypoxia on Visual Field Impairment

INTRODUCTION: The primary objective of the Exploration Atmosphere (EA) study is to validate a new prebreathe protocol necessary before exposure to a suited hypobaric environment during extravehicular activity (EVA) from a habitat ‘exploration atmosphere’ of 56.5kPa (8.2 psia), 34% O2, 66% N2. Prebreathe protocols must be time and resource efficient while also controlling Decompression Sickness (DCS) risk to within acceptable limits. The habitat hypobaric exploration atmosphere also results in a mildly hypoxic environment (piO2 = 128mmHg). As a secondary objective of the EA study, we characterized the effects of 11-day exposure to a mild hypobaric hypoxic environment on visual performance. METHODS: Two, 11-day hypobaric chamber tests were performed (EA-1and EA-2, n=8 each) in NASA’s 20-foot chamber at Johnson Space Center where subjects lived in the exploration atmosphere. Subjects also underwent simulated 6-hour EVAs at 85% O2 and 29.6 kPa during EVA on days 3, 5, 7, 9, and 11. Visual acuity (VA), a measure of spatial resolution, and contrast sensitivity (CS), a measure of ability to distinguish ever finer increments of brightness, were assessed on non-EVA days by using gapped Landolt C testing. The luminance was controlled by using a booth, a light monitor, and a lighting rheostat. EA-1 data had revealed problems in lighting control impacting consistency of the data. Procedures were subsequently updated for the EA-2 test. RESULTS: EA-1 data revealed large variance and data recording errors and was removed from the analysis. One participant left the study at Test Day 3 during EA-2. EA-2 ANOVA results showed CS (mean change=0.010 logCSWeber) and VA (mean change, -0.016 logMAR) between pre-test and 11-day test phases; however, neither VA nor CS changes were statistically significant. There were non-statistically significant declines in VA across test phases. DISCUSSION: Overall, visual field performance did not exhibit clinically significant changes (3 lines or greater change in LogMar chart) during exposure to the mild hypoxic exploration atmosphere environment compared to pre-test baseline. The consistency and stability of VA data during EA-2 suggests that the mild hypobaric hypoxic environment did not cause clinically significant negative impacts to participants’ visual field performance.

Visual Acuity↗

Effects of Mild Hypobaric Hypoxia on Response From Mild Exercise in NASA Exploration Atmosphere Tests

INTRODUCTION: The NASA Exploration Atmosphere study aims to validate a new prebreathe protocol incorporating an alternate habitat atmosphere of 56.5 kPa (8.2psia), 34% O 2 , and 66% N 2 to control and mitigate decompression sickness risk associated with spaceflight extravehicular activities. This alternate atmosphere results in a mild hypoxic environment (PIO 2 of 128 mmHg) that may influence inhabitant physiological responses to exercise. Therefore, the responses to light exercise in relation to the mild hypobaric hypoxic environment were investigated. METHODS: Eight participants (4M/4F; age=38.3±9.0 yr; weight=76.0±13.1 kg; peak aerobic capacity [VO 2 pk]= 3.1±0.7 L/min) were exposed to a mild hypobaric hypoxic environment for 11 days in NASA’s 20-foot hypobaric chamber at Johnson Space Center. Participants alternated test days between a habitat atmosphere of 56.5 kPA/34% O 2 and simulated 6-hour EVA environment, 29.6 kPa/85% O 2 . Participants completed pre-mission graded VO 2 pk tests on a LODE cycle ergometer with ParvoMedics metabolic analyzer. Submaximal aerobic tests were performed pre and during the mission (10-minutes of exercise at a workload of 40% VO 2 pk).Pre-mission, performed submaximal exercise exposed to a breathing air mixture of, 18% O 2 and balance N 2 , to simulate the mildly hypoxic environment within the 20-foot chamber. Linear mixed models (fixed effect: test day; random effects: subject, age) were performed to determine whether physiological responses (oxygen uptake [VO 2 ], carbon dioxide production [VCO 2 ], ventilation [VE], oxygen saturation [SPO 2 ], heart rate [HR], respiratory exchange ratio [RER]) to submaximal exercise performed within the 20-foot hypobaric chamber every 2 days differed from the pre-mission (18% O 2 ) testing. Results are presented as estimated marginal means with lower and upper confidence limits, with significance set to 0.05. RESULTS AND DISCUSSION: Seven of eight participants completed the chamber study. Mixed models for VO 2 , VCO 2 , SpO 2 , HR, and RER indicated negligible impact of the mild hypoxic chamber environment compared to pre-mission testing (all p>0.05).Results for VE indicated a minor impact of chamber environment compared to pre-mission testing (37.0 L/min [30.8, 43.2]), with increased VE at test day 10 (40.4 L/min [34.2, 46.6]; p= 0.029).The aerobic performance data collected suggests limited physiologic responses to mild exercise when performed at normobaric hypoxia and hypobaric hypoxia.

B Siders↗

Quantifying Risk to Improve Medical System Design for Long Duration Artemis Missions: A Demonstration of NASA's IMPACT Tradespace Analysis Tool

BACKGROUND NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. A greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the evacuation of ill or injured crew. Mass, volume, and power will be limited while higher demands will be placed on the crews to manage medical events. NASA’s Moon to Mars exploration strategy outlines increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human system risk attributable to medical conditions and use these estimates to advance medical system design. METHODS IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and tradespace analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; a large increase in the number of medical resources and the flexibility of their use; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to mimic a foundational exploration Artemis mission. The DRM profile includes outbound transit on Orion, Gateway space station rendezvous in lunar orbit, 6 months on the Lunar surface with extravehicular activity (EVA), return rendezvous with Gateway, and transit back to Earth. RESULTS/DISCUSSION: Overall, IMPACT successfully quantified medical risk and derived an optimal medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to medical risk were decompression sickness, trauma, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions and performed as expected. This demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Arian Anderson↗

Effects of Mild Hypobaric Hypoxia on Visual Field Impairment

INTRODUCTION: The primary objective of the Exploration Atmosphere (EA) study is to validate a new prebreathe protocol necessary before exposure to a suited hypobaric environment during extravehicular activity (EVA) from a habitat ‘exploration atmosphere’ of 56.5kPa (8.2 psia), 34% O2, 66% N2. Prebreathe protocols must be time and resource efficient while also controlling Decompression Sickness (DCS) risk to within acceptable limits. The habitat hypobaric exploration atmosphere also results in a mildly hypoxic environment (piO2 = 128mmHg). As a secondary objective of the EA study, we characterized the effects of 11-day exposure to a mild hypobaric hypoxic environment on visual performance. METHODS: Two, 11-day hypobaric chamber tests were performed (EA-1and EA-2, n=8 each) in NASA’s 20-foot chamber at Johnson Space Center where subjects lived in the exploration atmosphere. Subjects also underwent simulated 6-hour EVAs at 85% O2 and 29.6 kPa during EVA on days 3, 5, 7, 9, and 11. Visual acuity (VA), a measure of spatial resolution, and contrast sensitivity (CS), a measure of ability to distinguish ever finer increments of brightness, were assessed on non-EVA days by using gapped Landolt C testing. The luminance was controlled by using a booth, a light monitor, and a lighting rheostat. EA-1 data had revealed problems in lighting control impacting consistency of the data. Procedures were subsequently updated for the EA-2 test. RESULTS: EA-1 data revealed large variance and data recording errors and was removed from the analysis. One participant left the study at Test Day 3 during EA-2. EA-2 ANOVA results showed CS (mean change=0.010 logCSWeber) and VA (mean change, -0.016 logMAR) between pre-test and 11-day test phases; however, neither VA nor CS changes were statistically significant. There were non-statistically significant declines in VA across test phases. DISCUSSION: Overall, visual field performance did not exhibit clinically significant changes (3 lines or greater change in LogMar chart) during exposure to the mild hypoxic exploration atmosphere environment compared to pre-test baseline. The consistency and stability of VA data during EA-2 suggests that the mild hypobaric hypoxic environment did not cause clinically significant negative impacts to participants’ visual field performance.

Visual Acuity↗

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗

Investigating Risks Due to Artemis EVA Tempo Via Probabilistic Risk Assessment

Spaceflight operations pose unique challenges to crew health, safety, and resource management. As space agencies and private companies continue to push the boundaries of human exploration, it is essential to understand the risks associated with Extravehicular Activities (EVAs) and develop strategies to mitigate them. The tempo at which EVAs are conducted – the total number and frequency of these activities – can have a profound impact on medical risks, resource consumption, and overall mission success. Probabilistic risk assessment (PRA) provides a powerful framework for evaluating complex systems and identifying potential hazards. Our work employs the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) [1] to simulate mission events, occurrence and treatment of medical conditions, and track the utilization of resources. Coupled with the Evidence Library [2], a medical evidence base for exploration-class missions developed by the Exploration Medical Capability within NASA’s Human Research Program, we can estimate these risks with increased fidelity and optimize medical kit contents to meet specific mission requirements. This presentation provides a detailed examination of how EVA tempo influences medical risk estimates for a lunar surface design reference mission. A comprehensive analysis is conducted to assess the additional mass and volume burden imposed on medical kits required to maintain adequate levels of risk mitigation. Furthermore, we estimate the distribution of the number of successful EVAs completed based on the level of task impairment imposed by medical events and flight rules related to specific medical events, such as decompression sickness.

Modeling↗