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Proposed Schematics and Modeling Results for a Lunar Portable Life Support System

The Constellation Space Suit Element (CSSE) is an integrated assembly made up of primarily a Pressure Garment System (PGS) and a Portable Life Support System (PLSS). The PLSS is further composed of an oxygen (O2) subsystem, a ventilation subsystem, and a thermal subsystem. This paper baselines a detailed schematic of the CSSE PLSS to provide a basis for current and future CSSE PLSS development efforts. Both context diagrams and detailed schematics describe the hardware components and overall functions for all three of the PLSS subsystems. Additionally, PLSS functions are presented for multiple operational scenarios as follows: 1) Nominal Extravehicular Activity (EVA) Mode; 2) Umbilical Modes; a) No Recharge, b) With Recharge; 3) Decompression Sickness (DCS) Treatment Mode; 4) Buddy Mode; 5) Secondary O2 Modes; a) Helmet Purge; b) Suit Purge; c) Operational; and 5) PLSS Removed Umbilical Mode. A performance modeling effort is being performed to provide a preliminary confirmation of this layout and the current state of the thermal hydraulic modeling efforts being conducted for the PLSS is presented. The goal of these efforts is to provide realistic simulations of the PLSS under various modes of operation. Modeling approaches and assumptions are discussed as well as component model descriptions. Results from the models are included that show PLSS operations at steady-state and transient conditions. Finally, conclusions and recommendations are offered that summarize results, identify PLSS design weaknesses uncovered during review of the analysis results, and propose areas for improvement to increase model fidelity and accuracy.

Conger, Bruce↗

A mechanism for the reduction in risk of decompression sickness in microgravity environment

There is an apparent reduction in the incidence of decompression sickness reported by astronauts (from both the USA and the USSR) during extravehicular activity (EVA). The expected incidence, based on studies conducted under unit gravity conditions in Earth-based laboratories, is greater than that encountered during EVA. A biophysical explanation has been proposed for this difference based upon the mechanism of stress-assisted nucleation. Since the partial pressure ratio at which this gas phase forms is considerably smaller in living systems that in quiescent in vitro models, it was proposed that mechanical forces are involved. In that the lower extremities of astronautics are not gravitationally loaded in microgravity, it is possible that tissue gas micronuclei are but minimally regenerated. Most likely, gas micronuclei formed on Earth (by ambulation under 1 g conditions) would be eventually depleted. In a crossover study, 20 individuals were decompressed--from 1 ATA to 0.43 ATA for 3 hours--following either being fully ambulatory at unit gravity or following being hypokinetic and adynamic (simulated microgravity of 3-day bed rest). The subjects were monitored for gas phase formation by means of precordial Doppler monitoring. The results indicate a reduction in whole body gas phase formation in individuals who were bed rested as compared with themselves when fully ambulatory (p = 0.02). In hypokinetic individuals, the protection conferred was equivalent to an extra 175 minutes of oxygen prebreathe. These results are compatible with a hypothesis relating stress-assisted nucleation to the continual formation of tissue gas micronuclei and their gradual depletion with hypokinesia.

Powell, Michael R.↗

Nasa Exploration Atmosphere Tests 3 & 4: Development and Validation of Planetary Extravehicular Activity Prebreathe Protocols for Alternate Atmospheres and Suit Pressures

INTRODUCTION: Space suits operate at low pressures to optimize astronauts’ performance. The drop in pressure from the habitat environment to the suit carries a risk of decompression sickness (DCS), which is mitigated by a 95% O2 prebreathe protocol. Prebreathe protocols for the lunar surface have a significantly higher risk compared to International Space Station microgravity Extravehicular Activities (EVA). In previous studies, we validated a prebreathe protocol from a 56.5 kPa 34% O2 cabin to a 29.6 kPa EVA pressure; however, the enriched oxygen cabin environment poses a flammability risk that requires significant changes to material design and selections. Here, we report outcomes for prebreathe protocols from a sub-30% O2 cabin and associated changes necessary to control DCS risk critical to upcoming lunar missions. METHODS: Fourteen volunteers completed 11-day hypobaric chamber studies with an “alternate exploration atmosphere” of 66.2kPa, 28.5% O2. Subjects acclimated for 48 hrs and then participated in five 6-hour simulated EVAs at 29.6 or 35.6kPa, 95% O2. Prior to EVA, subjects underwent a 20, 90, or 150-minute prebreathe. The EVA simulation was designed to be representative of future planetary EVAs, proportionate to the subject’s VO2max. Decompression stress was monitored by real-time doppler and echocardiograph alternating every 15 min, as well as clinical monitoring for DCS signs/symptoms. Venous gas emboli (VGE) and DCS outcomes were verified against NASA-STD-3001 acceptance criteria. RESULTS AND DISCUSSION: Venous gas emboli (VGE) were identified during all EVAs. A neurological DCS case was identified in the 90-min/29.6kPa prebreathe, terminating further testing of this protocol. No DCS cases were identified in the 150 min/29.6kPa protocol. The 20 min/36.5kPa protocol was rejected due to a Type II DCS case. All DCS symptoms resolved with treatment, with no sequelae post initial treatment of DCS. These various test points highlighted to the significant benefit of elevated suit pressure to shorten prebreathe protocols, but also the difficulty in assessing and managing DCS during sustained EVA operations in remote planetary surfaces.

decompression sickness↗

Compatible atmospheres for a space suit, Space Station, and Shuttle based on physiological principles

Fundamental physiological principles have been invoked to design compatible environments for a space suit, Space Station and the spacecraft used to transport the astronauts from earth. These principles include the long-term memory of tissues for a bubble-provoking decompression, the intermittent nature of blood flow in the tight connective tissue(s) responsible for the bends whose incidence in aviators has been shown to be related to bubble volume by the Weibull distribution. In the overall design an astronaut breathing a mixture of 30 percent O2 in N2 for 4-5 h in a spacecraft at 11.9 psia can transfer to a Space Station filled with the same mix at 8.7 psia and, after a further 4-5 h, go EVA at any time without any oxygen prebreathing at any stage. The probable incidence of decompression sickness has been estimated as less than 0.5 percent using the present suit operating at 4.3 psia but the risk could be reduced to zero if the suit pressure were increased to 6.5 psia.

Hills, B. A.↗

Design and Testing of a 2-Hour Oxygen Prebreathe Protocol for Space Walks from the International Space Station

To develop and test a 2-hour prebreathe protocol for performing extravehicular activities (EVAs) from the International Space Station (ISS). Combinations of adynamia (non-walking), prebreathe exercise, and space suit donning options (10.2 vs. 14.7 psi) were evaluated, against timeline and consumable contraints to develop an operational 2- hour prebreathe protocol. Prospective accept/reject criteria were defined for decompression sickness (DCS) and venous gas emboli (VGE) from analysis of historical DCS data, combined with risk management of DCS under ISS mission circumstances. Maximum operational DCS levels were defined based on protecting for EVA capability with two crew-members at 95% confidence, throughout ISS lifetime (within the constraints of NASA DCS disposition policy JPG 1800.3). The accept/reject limits were adjusted for greater safety based on analysis of related medical factors. Monte-Carlo simulation was performed to design a closed sequential, multi-center human trial. Protocols were tested with 4 different prebreathe exercises (Phases I-IV), prior to exposure to 4.3 psi for 4 hrs. Subject selection, Doppler monitoring for VGE, test termination criteria, and DCS definitions were standardized. Phase I: upper and lower body exercises using dual-cycle ergometry (75% VO2 max for 10 min). Phase II: ergometry plus 24 min of light exercise (simulating space-suit preparations). Phase III: same 24 min of light exercise but no ergometry, and Phase IV: 56 min of light exercise without ergometry. A prebreathe procedure was accepted if, at 95% confidence, the incidence of DCS was less than 15% (with no Type II DCS), and Grade IV VGE was less than 20%.

Gernhardt, Michael L.↗

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 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↗

The relationship of intravascular bubbles to bends at altitude

In response to recent findings attesting to a correlation between intravehicular bubbling and decompression sickness at intermediate altitudes, an attempt was made to define a minimum pressure for a pressure suit which would obviate the need for prebreathing 100 percent oxygen prior to extravehicular activity (EVA). Fifty-seven male subjects were exposed to altitudes ranging from 16,000 to 30,000 ft in two separate protocols. The first was designed to determine a pressure at which no bends occurred if a crewmember were decompressed from a sea level space station pressure just prior to EVA without prebreathing 100 percent oxygen. The other study was designed to define an altitude and exercise regimen at which bends-susceptible and bends-resistant crewmembers could be separated. It is shown that the close association which exists between severe bubbling and bends at a pressure altitude of 4.3 psia (30,000 ft) decreases as pressure is increased and essentially disappears at pressures less than or equal to 7.8 psia (16,000 ft).

Krutz, R. W.↗

Spaceflight Decompression Sickness Contingency Plan

A viewgraph presentation on the Decompression Sickness (DCS) Contingency Plan for manned spaceflight is shown. The topics include: 1) Approach; 2) DCS Contingency Plan Overview; 3) Extravehicular Activity (EVA) Cuff Classifications; 4) On-orbit Treatment Philosophy; 5) Long Form Malfunction Procedure (MAL); 6) Medical Checklist; 7) Flight Rules; 8) Crew Training; 9) Flight Surgeon / Biomedical Engineer (BME) Training; and 10) DCS Emergency Landing Site.

Dervay, Joseph P.↗

Study of Hind Limb Tissue Gas Phase Formation in Response to Suspended Adynamia and Hypokinesia

The purpose of this study was to investigate the hypothesis that reduced joint/muscle activity (hypo kinesia) as well as reduced or null loading of limbs (adynamia) in gravity would result in reduced decompression-induced gas phase and symptoms of decompression sickness (DCS). Finding a correlation between the two phenomena would correspond to the proposed reduction in tissue gas phase formation in astronauts undergoing decompression during extravehicular activity (EVA) in microgravity. The observation may further explain the reported low incidence of DCS in space.

Butler, Bruce D.↗

Benefits of a Single-Person Spacecraft for Weightless Operations

Historically, less than 20 percent of crew time related to extravehicular activity (EVA) is spent on productive external work.1 A single-person spacecraft with 90 percent efficiency provides productive new capabilities for maintaining the International Space Station (ISS), exploring asteroids, and servicing telescopes or satellites. With suits, going outside to inspect, service or repair a spacecraft is time-consuming, requiring pre-breathe time, donning a fitted space suit, and pumping down an airlock. For ISS, this is between 12.5 and 16 hours for each EVA, not including translation and work-site set up. The work is physically demanding requiring a day of rest between EVAs and often results in suit-induced trauma with frequent injury to astronauts fingers2. For maximum mobility, suits use a low pressure, pure oxygen atmosphere. This represents a fire hazard and requires pre-breathing to reduce the risk of decompression sickness (bends). With virtually no gravity, humans exploring asteroids cannot use legs for walking. The Manned Maneuvering Unit offers a propulsive alternative however it is no longer in NASA s flight inventory. FlexCraft is a single person spacecraft operating at the same cabin atmosphere as its host so there is no risk of the bends and no pre-breathing. This allows rapid, any-time access to space for repeated short or long EVAs by different astronauts. Integrated propulsion eliminates hand-over-hand translation or having another crew member operate the robotic arm. The one-size-fits-all FlexCraft interior eliminates the suit part inventory and crew time required to fit all astronauts. With a shirtsleeve cockpit, conventional displays and controls are used and because the work is not strenuous no rest days are required. Furthermore, there is no need for hand tools because manipulators are equipped with force multiplying end-effectors that can deliver the precise torque for the job.

Griffin, Brand N.↗

Design of a 2-Hour Prebreathe Protocol for Space Walks (EVAs) from the International Space Station (ISS)

The majority of extravehicular activities (EVAs) performed from the shuttle use a 10.2 psi staged decompression. The International Space Station (ISS) will operate at 14.7 psi, requiring crews to "campout" in the airlock at 10.2 psi. The constraints associated with campout (crew isolation, oxygen usage, and waste management), provided the rationale to develop a 2-hour prebreathe protocol from 14.7 psi. Previous studies on the affect of microgravity and exercise during prebreathe suggested the feasibility of this approach. Various combinations of adynamia (nonwalking subjects), prebreathe exercise doses, and space suit donning options (10.2 vs. 14.7 psi) were analyzed against timeline and consumable constraints. Prospective decompression sickness (DCS) and venous gas emboli (VGE) accept/reject criteria were defined from statistical analysis of historical DCS data, combined with risk management of DCS under ISS mission circumstances. Maximum operational DCS levels were defined based on protecting for EVA capability with two crew members at 95% confidence, throughout ISS lifetime (within the constraints of NASA DCS disposition policy JPG 1800.3). The accept / reject limits were adjusted for greater safety (including Grade IV VGE criteria) based on analysis of related medical factors. Monte-Carlo simulation was performed to design a closed sequential, multi-center laboratory trial, including the capability of rejecting the primary protocol and testing at least one alternate exercise dose, within the 2-hour prebreathe. The 2-hour protocol incorporates 0, breathing for 5 0 min at 14.7 psi, including 10 min dual cycle ergometry at 75%VO(2max). It requires an additional 30 minO2breathing during depress from 14.7 to 10.2 psi, followed by a 30-60 min suit donning break at 10.2 psi/26.5% O2. It concludes with a 40 min in-suit O2 prebreathe. The protocol would be accepted for operations, if the incidence of DCS was less than 15% and Grade IV VGE less than 20%, both at 95% confidence. The above protocol and accept/reject limits were implemented in a multi-center study.

Gernhardt, M. L.↗

Determining a bends-preventing pressure for a space suit

Research conducted to determine the proper pressure for preventing bends during EVA without preoxygenation is examined. Male and female subjects with different breathing gas mixtures and pressures are studied in order to define the pressure. Visual and auditory Doppler ultrasonic signals are utilized to monitor intravascular gas bubbles. The workload, which simulates EVA, consists of a handturned bicycle ergometer, a torque wrench operation, and a rope pull. The experimental data reveal that the minimum space suit pressure needed to prevent decompression sickness is 9.5 psi.

Krutz, R. W., Jr.↗

Physiological considerations for EVA in the Space Station era

The physiological parameters that will affect EMU design and operational scheduling for the Space Station Program are discussed. The system must be designed to safely and effectively handle the increased frequency of extravehicular activity projected for longer flight periods than in the past. In order to minimize the risk of decompression sickness a proper combination of equilibration time to cabin pressure, suit pressure, and prebreathing denitrogenation, is necessary. Effective thermal exchange is projected to be automatically controlled and to have an 8-hr 1000 BTU/hr capability. Physiological changes due to adaptation to weightlessness must be considered in scheduling for their impact on performance/fatigue and in coping with motion sickness. Radiation protection to the limit of 80 rad/quarter must be achieved by scheduling to avoid periodic proton and solar flare exposure, and by additional EMU shielding. Additional EMU considerations are the control of microorganisms and the higher pressure requirement for emergency O2 purge.

Horrigan, D. J., Jr.↗

Shallow-Water Nitrox Diving, the NASA Experience

NASA s Neutral Buoyancy Laboratory (NBL) contains a 6.2 million gallon, 12-meter deep pool where astronauts prepare for space missions involving space walks (extravehicular activity EVA). Training is conducted in a space suit (extravehicular mobility unit EMU) pressurized to 4.0 - 4.3 PSI for up to 6.5 hours while breathing a 46% NITROX mix. Since the facility opened in 1997, over 30,000 hours of suited training has been completed with no occurrence of decompression sickness (DCS) or oxygen toxicity. This study examines the last 5 years of astronaut suited training runs. All suited runs are computer monitored and data is recorded in the Environmental Control System (ECS) database. Astronaut training runs from 2004 - 2008 were reviewed and specific data including total run time, maximum depth and average depth were analyzed. One hundred twenty seven astronauts and cosmonauts completed 2,231 training runs totaling 12,880 exposure hours. Data was available for 96% of the runs. It was revealed that the suit configuration produces a maximum equivalent air depth of 7 meters, essentially eliminating the risk of DCS. Based on average run depth and time, approximately 17% of the training runs exceeded the NOAA oxygen maximum single exposure limits, with no resulting oxygen toxicity. The NBL suited training protocols are safe and time tested. Consideration should be given to reevaluate the NOAA oxygen exposure limits for PO2 levels at or below 1 ATA.

Fitzpatrick, Daniel T.↗

Operational Implementation of a 2-Hour Prebreathe Protocol for International Space Station

Procedures, equipment, and analytical techniques were developed to implement the ground tested 2-hour protocol in-flight operations. The methods are: 1) The flight protocol incorporates additional safety margin over the ground tested protocol. This includes up to 20 min of additional time on enriched O2 during suit purge and pressure check, increased duration of extravehicular activity (EVA) preparation exercise during O2 prebreathing (up to 90 min vs; the tested 24 min), and reduced rates of depressurization. The ground test observations were combined with model projections of the conservative measures (using statistical models from Duke University and NASA JSQ to bound the risk of Type I and Type II decompression sickness (DCS). 2) An inflight exercise device using the in-flight ergometer and elastic tubes for upper body exercise was developed to replicate the dual cycle exercise in the ground trials. 3) A new in-flight breathing system was developed and man-tested. 4) A process to monitor inflight experience with the protocol, including the use of an in-suit Doppler bubble monitor when available, was developed. The results are: 1) The model projections of the conservative factors of the operational protocol were shown to reduce the risk of DCS to levels consistent with the observations of no DCS to date in the shuttle program. 2) Cross over trials of the dual cycle ergometer used in ground tests and the in-flight exercise system verified that02consumption and the % division of work between upper and lower body was not significantly different at the p= 0.05 level. 3) The in-flight breathing system was demonstrated to support work rates generating 75% O2(max) in 95 percentile subjects. 4) An in-flight monitoring plan with acceptance criteria was put in place for the 2-hour prebreathe protocol. And the conclusions are: The 2-hour protocol has been approved for flight, and all implementation efforts are in place to allow use of the protocol as early as flight ISS 7A, now scheduled in November of 2000.

Waligora, James M.↗

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↗

Personal cooling systems: Possibilities and limitations

Personal thermal control by means of gas- or liquid-conditioned garments was developed during the 1960s and has been applied in a variety of aerospace and industrial settings. Both USAF fighter pilots and astronauts are required to wear heavy protective clothing which insulates them from the environment and thus creates stress through storage of metabolic heat. The problem is particularly severe in astronauts who perform heavy physical work during extra-vehicular activity (EVA); without artificial cooling they could reach incapacitating hyperthermia in a matter of minutes. This paper reviews the factors which influence the design of personal cooling systems. An important early step is determination of acceptable heat stress level, taking into account possible interactions of heat stress with other physiological problems such as motion sickness, diminished plasma volume, decompression sickness and acceleration tolerance. Other factors which require consideration include the work schedule, the area to be covered by the cooling garment, and the practicalities of a fixed or body-mounted heat sink and its power source. Nearly every imaginable heat sink has been proposed or tried over the past 30 years, including direct gas systems, phase-change systems with open or closed loops and thermoelectric heat sinks. The latter are now the system of choice for aircraft.

Nunneley, Sarah A.↗