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Dose limits for astronauts

Radiation exposures to individuals in space can greatly exceed natural radiation exposure on Earth and possibly normal occupational radiation exposures as well. Consequently, procedures limiting exposures would be necessary. Limitations were proposed by the Radiobiological Advisory Panel of the National Academy of Sciences/National Research Council in 1970. This panel recommended short-term limits to avoid deterministic effects and a single career limit (of 4 Sv) based on a doubling of the cancer risk in men aged 35 to 55. Later, when risk estimates for cancer had increased and were recognized to be age and sex dependent, the NCRP, in Report No. 98 in 1989, recommended a range of career limits based on age and sex from 1 to 4 Sv. NCRP is again in the process of revising recommendations for astronaut exposure, partly because risk estimates have increased further and partly to recognize trends in limiting radiation exposure occupationally on the ground. The result of these considerations is likely to be similar short-term limits for deterministic effects but modified career limits.

Review↗

CHP-PRA Proof-of-Concept [Simulation] Sensitivity Assessment

An effort is underway to establish a Crew Health and Performance system (CHP) tradespace tool using a Probabilistic Risk Assessment (PRA) modeling and simulation system. The goal of the CHP-PRA effort is to provide a means of quantifying the integrated influence of CHP functions and capabilities on risk outcome metrics associated with health, performance, and long-term health. These metrics can then be used to establish potential risk-based trades on CHP system designed functionality and capabilities. Previously, our team demonstrated a proof-of-concept PRA approach that estimated the integrated influence of exercise countermeasures on 8 human system risks (Figure 1a) with outcomes associated with health and medical risk metrics. We reported that the change in the integrated relative health risk was small (Figure 1b) and that the small change in overall risk resulted from compounding and competing contribution levels of the individual risks. This interesting observation illustrates the emergent complexity of even straightforward representations of the human health and performance risk space and the ability of PRA models to capture this balance of global risk concerns. A key question that is not addressed in the initial analysis is “even though the global risk is relatively nominal, do any of the local risks become unacceptable?” In essence, we seek to determine what relative change in the human system risks are contributing to the relatively muted sensitivity of the proof-of-concept model combined risk assessments. Evaluations at the component risk level should elucidate if any individual risk reaches a high level that is subsequentially balanced by reductions in other areas. To further understand the relative changes in the component risks in the proof-of-concept model, and to elucidate how future refinements can be targeted, a means of establishing the contributions of the robustness of the proof-of-concept approach will be demonstrated.

astronaut health↗

Spatial and Seasonal Patterns of the Mosquito Community in Central Oklahoma

Mosquitoes (Culicidae) are ubiquitous flying insects that function as vectors for several viruses that cause disease in humans. Mosquito abundance and diversity are influenced by landscape features and environmental factors such as temperature and precipitation and vary across seasons and years. The range and phenology of many mosquito species that vector viruses relevant to human health are changing. We sampled mosquito communities in central Oklahoma for four years at thirteen sites, collecting over 25,000 mosquitoes; among these, we identified 27 different species, including several that transmit human pathogens and were collected in suburban backyards. Community composition differed across the landscape and changed from early season to late season and year to year. This effort to describe mosquito communities in Oklahoma is a first step toward assessing and predicting arbovirus risk, an ongoing and dynamic public health challenge.

David Hoekman↗

Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

Barsten, Kristina↗

Standard measures in Analogs of Spaceflight

Standard measures are defined as research measures (physiological, performance, or otherwise) that quantify the subject’s health and performance before, during, and after a spaceflight or a spaceflight analog mission. The Standard Measures Cross-Cutting Project (SMCCP) collects and analyzes standard measures that support assessment and quantification of health risks and efficacy of countermeasures and technologies required to prevent or mitigate adverse outcomes from exposure to the spaceflight environment. SMCCP uses the following spaceflight analogs: - Human Exploration Research Analog (HERA) in Houston, TX: 4-person isolation/confinement; nominal mission duration of 45 days; run by the Human Research Program (HRP). SMCCP uses weekly questionnaires to gather data on the crewmembers’ emotional and mental state and collects blood samples biweekly to measure crewmembers’ serum cortisol levels at the start, middle, and end of the mission. - Institute for Biomedical Problems (IBMP) Ground-Based Experimental Complex, called NEK, in Moscow, Russia: 6-person isolation/confinement; duration of 8 months; run by IBMP. Standard measures data collected during NEK are the same as for HERA above. - :envihab in Cologne, Germany: 12-person bed rest facility; closed environment; 30 to 60-day campaigns; run by the German Aerospace Center (DLR). For bedrest studies, SMCCP uses the international standard measures as documented in the International Academy of Astronautics publication titled Guidelines for Standardization of Bed Rest Studies in the Spaceflight Context (June 2014). These international standard measures evaluate potential changes in bone, muscle, cardiovascular, and visual systems, as well as changes in psychology and nutrition. The international standard measures complement those collected during studies by individual investigators and allow comparison of responses across different bed rest and countermeasures durations. In this presentation, we will review available SMCCP data collected during the recent isolation studies in HERA (C6) and NEK (SIRIUS-21), and during the SANS (SM1, SM2) bed rest studies in :envihab. These standard measures datasets are made available to concurrent investigators in the given mission or campaign via data sharing agreements and/or data sharing plans and to other investigators that have been granted retrospective access to the data (researchers with IRB approved protocols, risk custodians) to advance understanding of physiological and behavioral risks associated with these spaceflight analogs.

Standard Measures↗

Renal Stone Risk During Space Flight: Assessment and Countermeasure Validation

NASA has focused its future on exploration class missions including the goal of returning to the moon and landing on Mars. With these objectives, humans will experience an extended exposure to the harsh environment of microgravity and the associated negative effects on all the physiological systems of the body. Exposure to microgravity affects human physiology and results in changes to the urinary chemical composition during and after space flight. These changes are associated with an increased risk of renal stone formation. The development of a renal stone would have health consequences for the crewmember and negatively impact the success of the mission. As of January 2007, 15 known symptomatic medical events consistent with urinary calculi have been experienced by 13 U.S. astronauts and Russian cosmonauts. Previous results from both MIR and Shuttle missions have demonstrated an increased risk for renal stone formation. These data have shown decreased urine volume, urinary pH and citrate levels and increased urinary calcium. Citrate, an important urinary inhibitor of calcium-containing renal stones binds with calcium in the urine, thereby reducing the amount of calcium available to form calcium oxalate stones. Urinary citrate also prevents calcium oxalate crystals from aggregating into larger crystals and into renal stones. In addition, citrate makes the urine less acidic which inhibits the development of uric acid stones. Potassium citrate supplementation has been successfully used to treat patients who have formed renal stones. The evaluation of potassium citrate as a countermeasure has been performed during the ISS Expeditions 3-6, 8, 11-13 and is currently in progress during the ISS Expedition 14 mission. Together with the assessment of stone risk and the evaluation of a countermeasure, this investigation provides an educational opportunity to all crewmembers. Individual urinary biochemical profiles are generated and the risk of stone formation is estimated. Increasing fluid intake is recommended to all crewmembers. These results can be used to lower the risk for stone formation through lifestyle, diet changes or therapeutic administration to minimize the risk for stone development. With human presence in microgravity a continuing presence and exploration class missions being planned, maintaining the health and welfare of all crewmembers is critical to the exploration of space.

Whitson, P. A.↗

Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

Cintron, Nitza↗

Assessing the Likelihood of Rare Medical Events in Astronauts

Despite over half a century of manned space flight, the space flight community is only now coming to fully assess the short and long term medical dangers of exposure to reduced gravity environments. Further, as new manned spacecraft are designed and with the advent of commercial flight capabilities to the general public, a full understanding of medical risk becomes even more critical for maintaining and understanding mission safety and crew health. To address these critical issues, the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) has begun to address the medical hazards with a formalized risk management approach by effectively identifying and attempting to mitigate acute and chronic medical risks to manned space flight. This paper describes NASA Glenn Research Center?s (GRC) efforts to develop a systematic methodology to assess the likelihood of in-flight medical conditions. Using a probabilistic approach, medical risks are assessed using well established and accepted biomedical and human performance models in combination with fundamentally observed data that defines the astronauts? physical conditions, environment and activity levels. Two different examples of space flight risk are used to show the versatility of our approach and how it successfully integrates disparate information to provide HRP decision makers with a valuable source of information which is otherwise lacking.

Myers, Jerry G., Jr.↗

Radiation Beamline Testbeds for the Simulation of Planetary and Spacecraft Environments for Human and Robotic Mission Risk Assessment

The Center for Radiation Engineering and Science for Space Exploration (CRESSE) at Prairie View A&M University, Prairie View, Texas, USA, is establishing an integrated, multi-disciplinary research program on the scientific and engineering challenges faced by NASA and the international space community caused by space radiation. CRESSE focuses on space radiation research directly applicable to astronaut health and safety during future long term, deep space missions, including Martian, lunar, and other planetary body missions beyond low earth orbit. The research approach will consist of experimental and theoretical radiation modeling studies utilizing particle accelerator facilities including: 1. NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory; 2. Proton Synchrotron at Loma Linda University Medical Center; and 3. Los Alamos Neutron Science Center (LANSCE) at Los Alamos National Laboratory. Specifically, CRESSE investigators are designing, developing, and building experimental test beds that simulate the lunar and Martian radiation environments for experiments focused on risk assessment for astronauts and instrumentation. The testbeds have been designated the Bioastronautics Experimental Research Testbeds for Environmental Radiation Nostrum Investigations and Education (BERT and ERNIE). The designs of BERT and ERNIE will allow for a high degree of flexibility and adaptability to modify experimental configurations to simulate planetary surface environments, planetary habitats, and spacecraft interiors. In the nominal configuration, BERT and ERIE will consist of a set of experimental zones that will simulate the planetary atmosphere (Solid CO2 in the case of the Martian surface.), the planetary surface, and sub-surface regions. These experimental zones can be used for dosimetry, shielding, biological, and electronic effects radiation studies in support of space exploration missions. BERT and ERNIE are designed to be compatible with the experimental areas associated with the above facilities. CRESSE has broad expertise in space radiation in the areas of space radiation environment modeling, Monte-Carlo radiation transport modeling, space radiation instrumentation and dosimetry, radiation effects on electronics, and multi-functional composite shielding materials. The BERT and ERNIE testbeds will be utilized in individual and collaborative research incorporating this expertise. The research goal is to maximize the technical readiness level (TRL) of radiation instrumentation for human and robotic missions, optimizing the return value of CRESSE for NASA exploration and international co-operative missions. Outcomes and knowledge from research utilizing BERT and ERNIE will be applied to a variety of scientific and engineering disciplines vital for safe and reliable execution of future space exploration missions, which can be negatively impacted by the space radiation environment. The testbeds will be central to a variety of university educational activities and educational goals of NASA. Specifically, BERT and ERNIE will enhance educational opportunities in science, technology, engineering and mathematics (STEM) disciplines for engineering and science students at PVAMU, a historically black college/university. Preliminary data on prototype testbed configurations, including simulated lunar regolith (JSC-1A stimulant based on Apollo 11 samples), regolith/polyethylene composites, and dry ice, will be presented to demonstrate the usefulness of BERT and ERNIE in radiation beam line experiments.

Wilkins, Richard↗

Cincinnati & Covington Urban Development II: Assessing Flooding and Landslide Susceptibility Along the Ohio-Kentucky Border

Landslides and flooding are reoccurring environmental hazards that lead to health risks and economic burdens in the urban areas of Cincinnati, Ohio and Covington, Kentucky. These communities share underlying natural and artificial conditions that make them vulnerable to these hazards, including excessive precipitation, weak lithology, high impervious surface levels, and steep slopes. Despite the human and economic risks associated with these environmental hazards, the areas of highest vulnerability within the region remain unknown. NASA DEVELOP partnered with Groundwork USA and Groundwork Ohio River Valley (ORV) to assess the region’s susceptibility to landslides and flooding. The team utilized NASA Earth observations, including the Landsat 8 Operational Land Imager (OLI), Landsat 8 Thermal Infrared Sensor (TIRS), and Global Precipitation Measurement (GPM) Integrated Multi-satellitE Retrieval for GPM (IMERG), alongside ancillary datasets to map landslide susceptibility and exposure throughout the study area. The team also used ancillary data to map surface runoff and runoff retention using the Natural Capital Project’s Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) Urban Flood Risk Mitigation Model. The resulting landslide susceptibility and exposure maps highlight the neighborhoods around Avondale and Fairmount as areas of particularly high landslide exposure. Meanwhile, the InVEST outputs demonstrate that Downtown Cincinnati and the Queensgate neighborhood retain the least amount of rainfall. This research provides partners with a more complete hazard analysis of the greater Cincinnati area while also producing refined methodologies to enhance future flood and landslide vulnerability mapping throughout Groundwork USA’s nationwide network of communities.

Paxton LaJoie↗

Physiology, medicine, long-duration space flight and the NSBRI

The hazards of long-duration space flight are real and unacceptable. In order for humans to participate effectively in long-duration orbital missions or continue the exploration of space, we must first secure the health of the astronaut and the success of such missions by assessing in detail the biomedical risks of space flight and developing countermeasures to these hazards. Acquiring the understanding necessary for building a sound foundation for countermeasure development requires an integrated approach to research in physiology and medicine and a level of cooperative action uncommon in the biomedical sciences. The research program of the National Space Biomedical Research Institute (NSBRI) was designed to accomplish just such an integrated research goal, ameliorating or eliminating the biomedical risks of long-duration space flight and enabling safe and productive exploration of space. The fruits of these labors are not limited to the space program. We can also use the gained understanding of the effects and mechanisms of the physiological changes engendered in space and the applied preventive and rehabilitative methods developed to combat these changes to the benefit of those on Earth who are facing similar physiological and psychological difficulties. This paper will discuss the innovative approach the NSBRI has taken to integrated research management and will present some of the successes of this approach. c2003 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

NASA Discipline General Space Life Sciences↗

Prioritizing Medical Resources for Exploration Missions

Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In‐flight Medical Capabilities."

Shah, R. V.↗

The intersection of risk assessment and neurobehavioral toxicity

Neurobehavioral toxicology is now established as a core discipline of the environmental health sciences. Despite its recognized scientific prowess, stemming from its deep roots in psychology and neuroscience and its acknowledged successes, it faces additional demands and challenges. The latter, in fact, are a product of its achievements because success at one level leads to new and higher expectations. Now the discipline is counted upon to provide more definitive and extensive risk assessments than in the past. These new demands are the basis for the appraisals presented in the SGOMSEC 11 workshop. They extend beyond what would be offered in a primer of methodology. Instead, these appraisals are framed as issues into which what are usually construed as methodologies have been embedded.

NASA Discipline Environmental Health↗

Visual Impairment/Intracranial Pressure Risk Assessment

Since 2006 there have been 6 reported cases of altered visual acuity and intracranial pressure (ICP) in long duration astronauts. In order to document this risk and develop an integrated approach to its mitigation, the NASA Space Life Sciences Directorate (SLSD) and Human Research Program (HRP) have chosen to use the Human System Risk Board (HSRB) and the risk management analysis tool (RMAT). The HSRB is the venue in which the stakeholders and customers discuss and vet the evidence and the RMAT is the tool that facilitates documentation and comparison of the evidence across mission profiles as well as identification of risk factors, and documentation of mitigation strategies. This process allows for information to be brought forward and dispositioned so that it may be properly incorporated into the RMAT and contribute to the design of the research and mitigation plans. The evidence thus far has resulted in the identification of a visual impairment/intracranial pressure (VIIP) project team, updating of both short and long duration medical requirements designed to assess visual acuity, and a research plan to characterize this issue further. In order to understand this issue more completely, a plan to develop an Accelerated Research Collaboration (ARC) has been approved by the HSRB. The ARC is a novel research model pioneered by the Myelin Repair Foundation. It is a patient centered research model that brings together researchers and clinicians, under the guidance of a scientific advisory panel, to collaborate and produce results much quickly than accomplished through traditional research models. The data and evidence from the updated medical requirements and the VIIP ARC will be reviewed at the HSRB on a regular basis. Each review package presented to the HSRB will include an assessment and recommendation with respect to continuation of research, countermeasure development, occupational surveillance modalities, selection criteria, etc. This process will determine the course of the VIIP project and ultimately how SLSD and HRP mitigate this emerging human health and performance risk.

Fogarty, Jennifer A.↗

Pulmonary Inflammatory Responses To Acute Meteorite Dust Exposures - Implications For Human Space Exploration

The previous manned missions to the Moon represent milestones of human ingenuity, perseverance, and intellectual curiosity. However, one of the major ongoing concerns is the array of hazards associated with lunar surface dust. Not only did the dust cause mechanical and structural integrity issues with the suits, the dust 'storm' generated upon reentrance into the crew cabin caused "lunar hay fever" and "almost blindness" (Figure 1). It was further reported that the allergic response to the dust worsened with each exposure. The lack of gravity exacerbated the exposure, requiring the astronauts to wear their helmet within the module in order to avoid breathing the irritating particles. Due to the prevalence of these high exposures, the Human Research Roadmap developed by NASA identifies the Risk of Adverse Health and Performance Effects of Celestial Dust Exposure as an area of concern. Extended human exploration will further increase the probability of inadvertent and repeated exposures to celestial dusts. Going forward, hazard assessments of celestial dusts will be determined through sample return efforts prior to astronaut deployment. Studies on the lunar highland regolith indicate that the dust is not only respirable but also reactive, and previous studies concluded that it is moderately toxic; generating a greater response than titanium oxide but a lower response than quartz. The presence of reactive oxygen species (ROS) on the surface of the dust has been implicated. However, there is actually little data related to physicochemical characteristics of particulates and pulmonary toxicity, especially as it relates to celestial dust exposure. As a direct response to this deficit, the present study evaluates the role of a particulate's innate geochemical features (e.g., bulk chemistry, internal composition, morphology, size, and reactivity) in generating adverse toxicological responses in vitro and in vivo. This highly interdisciplinary study evaluates the relative toxicity of six meteorite samples representing either basalt or regolith breccia on the surfaces of the Moon, Mars, and Asteroid 4Vesta; three potential candidates for future human exploration or colonization. Terrestrial mid-ocean ridge basalt (MORB) is also used for comparison as a control sample.

Harrington, A. D.↗

The Importance of Primary Martian Surface and Airfall Dust Sample Return for Toxicological Hazard Evaluations for Human Exploration

Manned missions to the Moon highlight a major hazard for future human exploration of the Moon and beyond: surface dust. Not only did the dust cause mechanical and structural integrity issues with the suits, the dust 'storm' generated upon reentrance into the crew cabin caused "lunar hay fever" and "almost blindness" . It was further reported that the allergic response to the dust worsened with each exposure. Due to the prevalence of these high exposures, the Human Research Roadmap developed by NASA identifies the Risk of Adverse Health and Performance Effects of Celestial Dust Exposure as an area of concern. Extended human exploration will further increase the probability of inadvertent and repeated exposures to celestial dusts. Going forward, hazard assessments of celestial dusts will be determined through sample return efforts prior to astronaut deployment.

Harrington, A. D.↗

Evaluation of risk from space radiation with high-energy heavy ion beams

The most challenging radiation in space consists of fully ionized atomic elements with high energy for which only the few lowest energy ions can be stopped in shielding materials. The health risk from exposure to these ions and their secondary radiations generated in shield materials is poorly understood since there are few human data and a systematic study in relevant animal model systems has not been made. The accuracy of risk prediction is described as the major limiting factor in the management of space radiation risk. The expected impact of systematic studies is examined using the limited available biological data and models. Given the limitations of current predictions, models must be developed that are able to incorporate the required fundamental scientific data into accurate risk estimates. The important radiation components that can be provided for laboratory testing are identified. The use of ground-based accelerator beams to simulate space radiation is explained and quantitative scientific constraints on such facilities are derived. Three facilities, one each in the United States, in Germany and in Japan, currently have the partial capability to satisfy these constraints. A facility has been proposed using the Brookhaven National Laboratory Booster Synchrotron in the United States; in conjuction with other on-site accelerators, it will be able to provide the full range of heavy ion beams and energies required.

NASA Discipline Radiation Health↗

Characterization of a novel epigenetic effect of ionizing radiation: the death-inducing effect

The detrimental effects associated with exposure to ionizing radiation have long been thought to result from the direct targeting of the nucleus leading to DNA damage; however, the emergence of concepts such as radiation-induced genomic instability and bystander effects have challenged this dogma. After cellular exposure to ionizing radiation, we have isolated a number of clones of Chinese hamster-human hybrid GM10115 cells that demonstrate genomic instability as measured by chromosomal destabilization. These clones show dynamic and persistent generation of chromosomal rearrangements multiple generations after the original insult. We hypothesize that these unstable clones maintain this delayed instability phenotype by secreting factors into the culture medium. To test this hypothesis we transferred filtered medium from unstable cells to unirradiated GM10115 cells. No GM10115 cells were able to survive this medium. This phenomenon by which GM10115 cells die when cultured in medium from chromosomally unstable GM10115 clones is the death-inducing effect. Medium transfer experiments indicate that a factor or factors is/are secreted by unstable cells within 8 h of growth in fresh medium and result in cell killing within 24 h. These factors are stable at ambient temperature but do not survive heating or freezing, and are biologically active when diluted with fresh medium. We present the initial description and characterization of the death-inducing effect. This novel epigenetic effect of radiation has implications for radiation risk assessment and for health risks associated with radiation exposure.

Non-NASA Center↗