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Behavioral Health and Performance (BHP) is an operational group under medical sciences at NASA/Johnson Space Center. Astronaut applicant screening and assessment is one function of this group, along with psychological training, inflight behavioral support and family services. Direct BHP assessment spans 6-7 months of a 17-month overall selection process.
This final report will summarize research that relates to human behavioral health and performance of astronauts and flight controllers. Literature reviews, data archival analyses, and ground-based analog studies that center around the risk of human space flight are being used to help mitigate human behavior and performance risks from long duration space flights. A qualitative analysis of an astronaut autobiography was completed. An analysis was also conducted on exercise countermeasure publications to show the positive affects of exercise on the risks targeted in this study. The three main risks targeted in this study are risks of behavioral and psychiatric disorders, risks of performance errors due to poor team performance, cohesion, and composition, and risks of performance errors due to sleep deprivation, circadian rhythm. These three risks focus on psychological and physiological aspects of astronauts who venture out into space on long duration space missions. The purpose of this research is to target these risks in order to help quantify, identify, and mature countermeasures and technologies required in preventing or mitigating adverse outcomes from exposure to the spaceflight environment
The visual impairment and intracranial pressure syndrome (VIIP) is a newly described space flight-associated medical condition made up of a constellation of symptoms affecting at least 34% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures, and is thought to be related to elevated intracranial pressure secondary to space flightinduced cephalad fluid shifts. Loss of visual acuity could be a significant threat to crew health and performance and may be suggestive of other adaptations with implications for years post-flight. Our primary objective is to determine whether vascular compliance is altered by space flight and whether such adaptations are related to the incidence of VIIP. In particular, we will measure ocular parameters and vascular compliance in vessels of the head and neck in astronauts who have no space flight experience, in astronauts before, during, and after space flight, and in bed rest subjects with conditions similar to space flight. Additionally, we will analyze astronaut data from the Lifetime Surveillance of Astronaut Health (LSAH) archive to determine which factors might be predictive of the development of VIIP. The project will be conducted in four separate but related parts. To understand the baseline condition of astronauts without any prior space flight experience, we will study 10 astronauts who have never flown in space by performing a comprehensive evaluation of the vasculature of the head, neck and eyes. Hemodynamic data (stroke volume and blood pressure), ocular (tonometry and ocular ultrasound), venous and arterial parameters will be acquired across a range of tilt angles (20, 10, 0, -10, -20 degrees). Vessels to be studied include the temporal, jugular, and vertebral veins and the cerebral, carotid and vertebral arteries. Ophthalmic data from the annual physical will be obtained through data sharing. To examine the relation between vascular compliance in the head and neck and the development of VIIP after a long duration space flight, we will study 10 astronauts before, during, and after long-duration ISS missions. Pre- and post-flight testing will be identical to that described above. During flight, images of the same vessels of interest will be obtained for later analysis. Ophthalmic data including VIIP scores will be obtained through data sharing from medically-required tests. To investigate the effects of age and elevated sodium intake, two potential contributors to VIIP, we will study 24 men (in two age groups: 25-35 and 45-55) during a 14 day 6deg head-down bed rest, a well-accepted analog of space flight. Standard NASA bed rest conditions will be maintained except for dietary sodium. Sodium intake will be similar to that of ISS astronauts, which is higher than consumed in previous bed rest studies. Pre- and post-bed rest testing procedures will be identical to the testing protocol described above for astronauts. Ophthalmic testing (optical coherence tomography, fundoscopy, and tonometry) will be conducted on the same day that vascular compliance measures are obtained. To identify parameters that may relate to an increase in an astronaut's susceptibility to developing VIIP, we will use data mining techniques to evaluate astronaut data obtained from the LSAH. Medical history, family history, space flight history and its related exposures, and history of high performance jet aircraft exposure will be examined for their potential relationship to ocular data. We hypothesize that the cephalad fluid shift induced by space flight will result in structural and functional adaptations in head and neck vessels leading to decreased vascular compliance and related to the development of VIIP symptoms. Further, although VIIP has not been observed in previous bed rest studies, we hypothesize that an elevated sodium intake will increase the incidence of VIIP symptoms in this space flight analog. Finally, we hypothesize that data mining analyses will reveal relationships between health history, previous exposures (including space flight and high performance aircraft), and the development of VIIP in the astronaut population.
Astronauts perform exercise throughout their missions to counter the health declines that occur as a result of long-term exposure to weightlessness. Although all astronauts perform exercise during their missions, the specific prescriptions, and thus the mechanical loading, differs among individuals. For example, inflight ground reaction force data indicate that subject-specific differences exist in foot forces created when exercising on the second-generation treadmill (T2) [1]. The current exercise devices allow astronauts to complete prescriptions at higher intensities, resulting in greater benefits with increased efficiency. Although physiological outcomes have improved, the specific factors related to the increased benefits are unknown. In-flight exercise hardware collect data that allows for exploratory analyses to determine if specific performance factors relate to physiological outcomes. These analyses are vital for understanding which components of exercise are most critical for optimal human health and performance. The relationship between exercise performance variables and physiological changes during flight has yet to be fully investigated. Identifying the critical performance variables that relate to improved physiological outcomes is vital for creating current and future exercise prescriptions to optimize astronaut health. The specific aims of this project are: 1) To quantify the exercise-related mechanical loading experienced by crewmembers on T2 and ARED during their mission on ISS; 2) To explore relationships between exercise loading variables, bone, and muscle health changes during the mission; 3) To determine if specific mechanical loading variables are more critical than others in protecting physiology; 4) To develop methodology for operational use in monitoring accumulated training loads during crew exercise programs. This retrospective analysis, which is currently in progress, is being conducted using data from astronauts that have flown long-duration missions onboard the ISS and have had access to exercise on the T2 and the Advanced Resistive Exercise Device (ARED). The specific exercise prescriptions vary for each astronaut. General exercise summary metrics will be developed to quantify exercise intensities, volumes, and durations for each subject. Where available, ground reaction force data will be used to quantify mechanical loading experienced by each astronaut. These inflight exercise metrics will be investigated relative to changes in pre- to post-flight bone and muscle health to identify which specific variables are related with improved or degraded physiological outcomes. The information generated from this analysis will fill gaps related to typical bone loading characterization, exercise performance capability, exercise volume and efficiency, and importance of exercise hardware. In addition, methods for quantification of exercise loading for use in monitoring the exercise programs during future space missions will be explored with the intent to inform exercise scientists and trainers as to the critical aspects of inflight exercise prescriptions.
History has often proven the criticality for adequate nutrition to ensure expedition success. Space exploration will be no different, with the exception of the certainty that food will not be found along the journey. Ensuring the health and safety of astronauts is critical and nutrition will serve several functions to that end. Nutritional assessment of International Space Station (ISS) crewmembers not only serves to evaluate the nutritional health of individuals, but also allows a better understanding of how space flight affects nutritional requirements, and how nutrition can serve in mitigating the negative effects of weightlessness on the human. Available data suggest that the nutritional status of astronauts is compromised during and after flight. Inadequate dietary intake and subsequent weight loss are often considered hallmarks of space flight, although exceptions to this do exist, and provide hope. However, beyond energy intake, specific nutrient issues also exist. Several vitamins, including D and folate, are affected in space travelers. Hematological and antioxidant defense systems are impacted, with increased iron storage, and increased markers of oxidative damage. Bone loss during space flight remains a critical challenge. Ground-based studies have proven that nutrition is a potent modulator of the bone response to simulated weightlessness. Protein and sodium are two nutrients which tend to exacerbate bone resorption and loss, likely mediated through acid base balance. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health. Both flight and ground-based research provide a unique situation, one where healthy individuals are put in a unique and challenging environment. A full understanding of the role of nutrition during space flight will not only enhance crew health and safety during flight, but will also expand our understanding of the role of nutrition in health of those remaining on Earth.
Radiation encountered on an extended duration space mission (estimates of 3 Sieverts for a mission to Mars) poses a threat not only to human health, but also to the quality, nutritional value, and palatability of the food system. Free radicals generated by radiation interaction with foods may initiate many unwanted reactions including: 1) autoxidation in lipids that alters flavor, odor, and concentrations of essential fatty acids, and 2) depletion of antioxidants food products and dietary supplements. Studies have shown that antioxidants may provide long term health protection from oxidative stress caused by radiation exposure; therefore, consumption of antioxidants will be important. Stability of essential fatty acids is also important for astronauts long-term health status. The objectives of this study were to characterize the effects of low dose gamma-radiation on lipids and antioxidants by monitoring oxidation and reducing power, respectively, in model systems. Select oils and antioxidants were exposed to levels of gamma-radiation ranging from 0 to 1000 Gy (1 Gy = 1 Sv) using a Gammacell 220 and stored at ambient or elevated temperatures (65 C) for up to 3 months prior to analysis. A Fricke dosimeter was used to verify differences between the radiation doses administered. Primary and secondary products of lipid oxidation in soybean and peanut oils were monitored using conjugated diene and 2-thiobarbituric acid (TBARs) assays. Changes in fatty acid composition and formation and vitamin E levels were also measured. The reducing power of antioxidant compounds, including vitamins C and E and beta-carotene, was determined using the ferric reducing antioxidant power (FRAP) assay. Significant differences (alpha =0.05) were present between all radiation doses tested using the Fricke dosimeter. Increasing radiation doses above 3 Sv resulted in significantly (alpha =0.05) elevated levels of oxidation and free fatty acids in soybean and peanut oils. Decreases in concentrations of essential fatty acids upon increasing radiation doses were also observed. Increasing radiation doses caused significant (alpha =0.05) decreases in reducing power and hence the effectiveness of vitamins C and E as well as beta-carotene. This work establishes a need for quantifying the effects of space relevant radiation doses in the development of a food system for an extended duration mission and for identifying threshold radiation levels that will impact the useful shelf-life of the variety of foods that will be sent. Eventual rancidity of lipids and the loss of antioxidant bioprotective effects are major concerns for the acceptability and nutritional profile of a food system.
Space Toxicology is a specialized discipline for spaceflight, space habitation and occupation of celestial bodies including planets, moons and asteroids [1]. Astronaut explorers face unique challenges to their health while working and living with limited resources for rescue and medical care during space operation. At its core the practice of space toxicology to identify, assess and predict potential chemical contaminants and limit the astronaut s exposure to these environmental factors in order to protect crew health. Space toxicologists are also charged with setting safe exposure limits that will protect the astronaut against a multitude of chemical exposures, in a physiologically altered state. In order to maintain sustained occupation in space, toxicological risks are gauged and managed within the context of isolation, continual exposures, reuse of air and water, limited rescue options, and the necessary use of highly toxic compounds required for propulsion. As the space program move towards human presence and exploration other celestial bodies in situ toxicological risks, such as inhalation of unusual and/or reactive mineral dusts must also be analyzed and controlled. Placing humans for long-term presence in space creates several problems and challenges to the long-term health of the crew, such as bone-loss and immunological challenges and has spurred research into acute, chronic and episodic exposure of the pulmonary system to mineral dusts [2]. NASA has demonstrated that lunar soil contains several types of reactive dusts, including an extremely fine respirable component. In order to protect astronaut health, NASA is now investigating the toxicity of this unique class of dusts. 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.
Maintaining optimal alertness and neurobehavioral functioning during space operations is critical to enable the National Aeronautics and Space Administration's (NASA's) vision "to extend humanity's reach to the Moon, Mars and beyond" to become a reality. Field data have demonstrated that sleep times and performance of crewmembers can be compromised by extended duty days, irregular work schedules, high workload, and varying environmental factors. This paper documents evidence of significant sleep loss and disruption of circadian rhythms in astronauts and associated performance decrements during several space missions, which demonstrates the need to develop effective countermeasures. Both sleep and circadian disruptions have been identified in the Behavioral Health and Performance (BH&P) area and the Advanced Human Support Technology (AHST) area of NASA's Bioastronautics Critical Path Roadmap. Such disruptions could have serious consequences on the effectiveness, health, and safety of astronaut crews, thus reducing the safety margin and increasing the chances of an accident or incident. These decrements oftentimes can be difficult to detect and counter effectively in restrictive operational environments. NASA is focusing research on the development of optimal sleep/wake schedules and countermeasure timing and application to help mitigate the cumulative effects of sleep and circadian disruption and enhance operational performance. Investing research in humans is one of NASA's building blocks that will allow for both short- and long-duration space missions and help NASA in developing approaches to manage and overcome the human limitations of space travel. In addition to reviewing the current state of knowledge concerning sleep and circadian disruptions during space operations, this paper provides an overview of NASA's broad research goals. Also, NASA-funded research, designed to evaluate the relationships between sleep quality, circadian rhythm stability, and performance proficiency in both ground-based simulations and space mission studies, as described in the 2003 NASA Task Book, will be reviewed.
Since its formation in 2007, the NASA Human Research Program’s (HRP) mission has been to protect the health and performance of astronauts as they explore beyond low Earth orbit. The HRP helps enable exploration spaceflight through a focused program of research that leads to the development and delivery of solutions to protect human health and performance during and after these missions. This research is conducted primarily in ground analogs of the spaceflight environment and on the International Space Station (ISS). Over the last 3 years, NASA has undergone transformative changes with the flight of Artemis I, the formation of the Commercial Low Earth Orbit Destinations Program, commercial flights to the ISS, and collaboration with new international partners participating in human spaceflight. The HRP has embraced these new opportunities and is collaborating on all these fronts to collect biomedical research data. Artemis I marked the arrival of NASA’s new human spaceflight exploration missions. NASA established the Moon to Mars Program Office to design a roadmap for the exploration of the lunar surface and the journey beyond to Mars. The HRP has a critical role in conducting research and delivering technologies that will lead to solutions that protect human health and performance, and is working closely with the Moon to Mars Office to ensure these deliverables are ready in time to support their strategy. The HRP is also developing the partnership strategies required to support these deliverables. Commercial space flights, both free flyer and suborbital missions and private astronaut missions to the ISS, are providing broader opportunities and more subjects to characterize spaceflight-induced changes to the human system and to test countermeasures. To better use these opportunities to achieve its mission, the HRP has been working to understand the commercial spaceflight companies’ needs and then partnering with them on aspects of mutual interest. In addition, the HRP continues to engage in long-standing relationships with its international partners through the International Space Life Sciences Working Group and other joint international groups. The HRP is interested in sharing its knowledge and collaborating on projects of mutual interest with new countries that are developing capabilities for human spaceflight. The next 10 years will shape how humanity partners on exploration missions to Mars, and the HRP is committed to enabling and developing collaborative strategies with commercial and international partners to keep humans safe and productive as they explore longer and further into space.
In order to measure astronauts' metabolic rates in space, Glenn Research Center partnered with Case Western University and the Cleveland Clinic to develop the Portable Unit for Metabolic Analysis (PUMA). Cleveland-based Orbital Research licensed and then modified PUMA to help the US Navy assess pilot oxygen problems and is now designing a device that can be used in hospitals.
Astronauts have begun to spend increasingly longer periods in space, putting themselves in foreign environments in order to explore the unknown. Space radiation is one of the largest health risks faced by astronauts on their missions. The space radiation environment has the ability to cause high levels of irreversible damage. Multiple sources of charged particle radiation exist in the space environment that may increase risk of carcinogenesis, degeneration of bodily tissue (e.g. gastrointestinal, cardiovascular, or pulmonary), acute radiation syndromes, and acute and late central nervous system (CNS) disorders. In order to help inform an understanding of the risk of degenerative CNS disease due to radiation exposure, an initial step is presented here to develop an adverse outcome pathway from radiation exposure focused on Alzheimer’s disease.
Protecting astronauts' spine, hip, and lower body musculoskeletal strength will be critical to safely and efficiently perform physically demanding vehicle egress, exploration, and habitat building activities necessary to expand human presence in the solar system. Functionally limiting decrements in musculoskeletal health are likely during Mars proving-ground and Earth-independent missions given extended transit times and the vehicle limitations for exercise devices (low-mass, small volume). Most small exercise device concepts are designed with single-cable loading, which inhibits the ability to perform full body exercises requiring two-point loading at the shoulders. Shoulder loading is critical to protect spine, hip, and lower body musculoskeletal strength. We propose a novel low-mass, low-maintenance, and rapid deploy pulley-based system that can attach to a single-cable small exercise device to enable two-point loading at the shoulders. This attachment could protect astronauts' health and save cost, space, and energy during all phases of the Journey to Mars.
The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti‐lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post‐flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio‐ each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured
The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.
This presentation is an overview of the function of the work of the Space Medicine & Health Care Systems Office. The objective of the medical operations is to ensure the health, safety and well being of the astronaut corps and ground support team during all phases of space flight. There are many issues that impact the health of the astronauts. Some of them are physiological, and others relate to behavior, psychological issues and issues of the environment of space itself. Reviews of the medical events that have affected both Russian, and Americans while in space are included. Some views of shuttle liftoff, and ascent, the medical training aboard NASA's KC-135 and training in weightlessness, the Shuttle Orbiter Medical system (SOMS), and some of the medical equipment are included. Also included are a graphs showing Fluid loading countermeasures, and vertical pursuit tracking with head and eye. The final views are representations of the future crew exploration vehicle (CEV) approaching the International Space Station, and the moon, and a series of perspective representations of the earth in comparison to the other planets and the Sun, the Sun in relation to other stars, and a view of where in the galaxy the Sun is.
The human skeletal muscular and cardiovascular systems are adapted to the upright posture of Earth’s gravitational environment. Astronauts experience an altered gravity environment in spaceflight that leads to a number of physiological changes and decrements to these systems that can decrease overall crew performance. Countermeasures, including prescribed exercise during spaceflight, is vital for astronauts to maintain optimal health and performance. The degree of physiological deconditioning is dependent on a multitude of factors such as sex, age, mission duration, fitness level, and gravity environments experienced. Deconditioning begins immediately upon entering an altered gravity environment and physiological decrements of the skeletal muscular and cardiovascular systems are measurable among astronauts within a few days. Thus, to maintain their physical fitness, ability to perform mission duties, and be able to egress vehicles when needed, it is imperative that astronauts participate in exercise during all phases of flight. This is especially important for long duration flights where deconditioning effects can be more deleterious. The NASA Office of the Chief Health and Medical Officer 3001 Standards Team develops requirements utilized by commercial and international partners to better understand spaceflight-induced physiological changes and countermeasures and expected outcomes with or without exercise.
For missions beyond low Earth orbit to the Moon or Mars, astronauts will encounter a complex space radiation field composed of various ion species with a broad range of energies. Such missions pose significant radiation protection challenges that need to be managed to minimize astronaut exposures and associated health risks. An innovative galactic cosmic ray simulator (GCRsim) was recently developed for the NASA Space Radiation Laboratory at Brookhaven National Laboratory. The GCRsim technology is intended to recapitulate major components of the space radiation environment in a ground-analog laboratory setting. It is used for experimental studies to improve the understanding of biological risks and act as a test bed for counter measure development and validation. Currently, the GCRsim consists of 33 energetic ion beams that collectively simulate the primary and secondary GCR field encountered by astronauts over the broad range of particle types, energies, and linear energy transfer (LET) of interest to human health effects. A virtual workshop was held in December 2020 to assess the status of NASA's GCRsim and attendees examined various aspects of simulator design, with an emphasis on beam selection strategies. Modeling approaches, experimental constraints, areas of consensus, and questions of concern were also discussed in detail. An overview of the workshop considerations and discussion for research strategies that are important for future advancements and applications in space radio biology are presented.
The impact of spaceflight on immune function is undoubtedly a critical focus in the area of space biology and human health research. Heat shock proteins (Hsp) are an evolutionarily conserved family of proteins that are expressed in response to cellular and physiological stressors, experienced during radiation exposure, confinement, circadian rhythm disruption, and altered gravity (hypergravity experienced at launch/landing and microgravity experienced in-flight). In particular, Hsp70 aids in the folding of proteins, facilitates the movement of proteins across the membranes during signal transductions and can stimulate innate immunity. Since Hsp70 is induced during cellular stress, and can act as a stimulator for innate immunity, we sought to address how a loss of Hsp70 affects immunity, under the stress-inducing model of acute and chronic hypergravity. Moreover, the effects of gravity as a continuum on the induction of Hsps and key immune genes were also assessed to determine if increased cellular stress, via increased gravity (g)-force, contributes to immune dysfunctions. For this, wildtype (W1118) and Hsp70 deficient (Hsp70null) Drosophila melanogaster were subjected to simulated hypergravity at increasing levels of g-force (1.2g, 3g, and 5g) for acute (1hr) and chronic (7-day) timepoints and were compared to 0g 'non-hypergravity' controls. Following simulation, whole bodies were sex-segregated, RNA was isolated and quantitative (q)PCR was performed to determine differential immune gene expression profiles. Further, functional output of hemocytes were assessed by a phagocytosis assay. Collectively, these studies evaluated the effects of Hsp70 in the context of immunity during acute and chronic hypergravity. Indeed, relevance for this work can directly translate to acute effects of launch/landing gravitational forces upon liftoff (~1.7g) and entry (~3.4g) that astronauts experience. In addition, the effects of chronic cellular stress is directly relevant to the immune health of astronauts on long duration missions, as well. Thus, as we approach the goal of returning to the Moon and landing the first humans on Mars, an evaluation of gravity as a continuum and the stress-inducing effects of altered gravity experienced during spaceflight on astronaut immunity and health are necessary.