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Medical examinations and treatment of crewmen preflight, during Skylab missions, and postflight periods are outlined. From a clinical point of view, all of the physiological responses noted in the various missions were either self-limiting or represented work-around problems requiring minimal counteraction. As such, these changes do not preclude extending man's duration in zero-gravity for longer periods of time.
Crew health concerns for Space Station Freedom are numerous due to medical hazards from isolation and confinement, internal and external environments, zero gravity effects, occupational exposures, and possible endogenous medical events. The operational crew health program will evolve from existing programs and from life sciences investigations aboard Space Station Freedom to include medical monitoring and certification, medical intervention, health maintenance and countermeasures, psychosocial support, and environmental health monitoring. The knowledge and experience gained regarding crew health issues and needs aboard Space Station Freedom will be used not only to verify requirements and programs for long duration space flight, but also in planning and preparation for Lunar and Mars exploration and colonization.
The flight crew health stabilization program was developed to minimize or eliminate the possibility of adverse alterations in the health of flight crews during immediate preflight, flight, and postflight periods. The elements of the program, which include clinical medicine, immunology, exposure prevention, and epidemiological surveillance, are discussed briefly. No crewmember illness was reported for the missions for which the program was in effect.
The Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) team at NASA Glenn Research Center is planning a customized approach to quantify human spaceflight performance changes with respect to changes to the CHP system functions and capabilities. Using the Directed Acyclic Graphs (DAG) initiated by NASA’s Human Systems Risk Board (HSRB) [1], the team is surveying potential candidate models and novel strategies that generate metrics suitable for supporting decision making related to how the CHP system may influence human system performance risk. One such investigation includes classic Human Reliability Analysis (HRA) models. Traditionally, HRA methods estimate the occurrence of human errors and their impact on the success of an activity when designing and operating a system. While humans perceive, interpret, decide on, and carry out a course of action, the factors affecting performance and error likelihood are commonly referred to as performance shaping factors (PSFs). Originally developed to alleviate safety concerns related to nuclear power plant operations, HRA methods such as THERP [2] and CREAM [3] dismantle an activity into tasks, requiring elemental steps to be executed, and assess their failure due to predefined PSFs. In this study, we compare generic HRA methods and those that incorporate some human spaceflight aspects, such as sleep conditions (SCREAM [4]), with respect to how they may be adopted to capture performance with an intention to mitigate detrimental outcomes elucidated by the HSRB DAGs. We suggest strategies to quantify astronaut performance specific to spaceflight activities and illustrate how such concepts may help in optimizing the CHP system capabilities with respect to Artemis missions.
The challenges involved in vehicle/habitat design and operation for long-duration deep space missions are complex, and the needs of a human crew must be considered in the context of all the system trades required to enable such missions. An exploration Crew Health and Performance (CHP) system complements all the other vehicle/habitat systems to achieve one specific and critical endpoint – ensuring that the astronauts can perform the job that they were sent into space to do. This includes accounting for all aspects of the physiological, psychological, medical, and environmental realities that the human crew must face in deep space. Along with this system complexity comes the additional need for increased autonomy of the crew due to the immense distance from Earth. The design of future systems must respect the real human capabilities and limitations within the context of a mission to the Moon or Mars. The NASA Moon to Mars Objectives document outlines the need for advanced CHP system designs: • Develop systems that monitor and maintain crew health and performance throughout all mission phases, including during communication delays to Earth, and in an environment that does not allow emergency evacuation or terrestrial medical assistance. • Evaluate and validate progressively Earth-independent crew health & performance systems and operations with mission durations representative of Mars-class missions. • Validate readiness of systems and operations to support crew health and performance for the initial human Mars exploration campaign. This presentation will outline the initial work that Exploration Medical Capability is leading on the development of a prototype design for an exploration Crew Health and Performance (CHP) system for future NASA human deep space long-duration missions. This effort will require commitment from all stakeholders to a shared mental model of what a future exploration CHP system should look like, one that will address the needs, goals, and objectives of the Agency and help to ensure mission success in deep space.
The crew health and performance (CHP) system represents the span of technological interventions and tested processes and procedures that in combination address the human risk to space flight. The Human Research Program (HRP) mental model of the CHP system breaks the capabilities needed to meet NASA human flight systems standards into specific categories (i.e., countermeasures, behavioral health, medical intervention). These categories are further broken down into specific sub-groups generally associated with the human system risks that these capabilities seek to mitigate. Like the approach used to develop the Integrated Medical Model (IMM) and the Medical Extensible Dynamic Probabilistic Risk Analysis Tool (MEDPRAT), HRP tasked NASA GRC’s Cross-Cutting Computational Modeling Project with developing a CHP probabilistic risk assessment tool, the CHP-PRA. The CHP-PRA model seeks to quantify and relatively assess the human risk state within the crew health and performance domain, using a combination of knowledge about human system risks and technology and practices likely to be applied during space flight missions. This modeling system will incorporate customer and stakeholder feedback and be flexible enough to address multiple different questions about important low-level mission-specific parameters. This presentation will introduce the initial concept and development timeline for this tool and demonstrate proof-of-concept through an application addressing a specific human risk question posed within the Artemis program.
The Moon to Mars eXploration Systems and Habitation (M2M X-Hab) 2024 Academic Innovation Challenge features a project titled “Intelligent Devices/Equipment/Instruments (IDEI) for Enabling Crew Health and Performance on Mars”. The project calls for the development of prototype IDEIs “that could be used for implementing integrated system health management for Crew Health and Performance (CHP) required for crew living on Mars for extended periods of time”. Thus, the deliverable for the project is not only a prototype exercise device, but also an ontology that provides insight into the best ways to exercise on Mars. To that end, we on the BLiSS team, supported by advisors from industry and academia, set out to ideate an exercise ontology and demonstrate its effectiveness through a functional prototype. To achieve the stakeholders’ requests, the device must operate semi-autonomously, must be an analog for an extant exercise device on Earth, and must provide quantitative information about the exercise and the device’s own state of health. Here, we define “semi-autonomous” as referring to the fact that while the system should be as autonomous as possible, there are some processes that the system cannot fulfill on its own. These include, but are not limited to, user identification, physical exercise reconfiguration, and wearable sensor placement.
This paper will discuss the specific mission architectures associated with the NASA Exploration Vision and review the challenges and drivers associated with developing crew health care and habitability systems to manage human system risks. Crew health care systems must be provided to manage crew health within acceptable limits, as well as respond to medical contingencies that may occur during exploration missions. Habitability systems must enable crew performance for the tasks necessary to support the missions. During the summer of 2005, NASA defined its exploration architecture including blueprints for missions to the moon and to Mars. These mission architectures require research and technology development to focus on the operational risks associated with each mission, as well as the risks to long term astronaut health. This paper will review the highest priority risks associated with the various missions and discuss NASA s strategies and plans for performing the research and technology development necessary to manage the risks to acceptable levels.
At NASA, the Crew Health and Performance (CHP) system represents the span of countermeasures, capabilities, interventions, and tested processes and procedures that in combination work to mitigate the human component of spaceflight mission risk. Across the varying NASA mental models of the CHP system, the different functionalities needed to meet human flight systems standards can be broken down into specific categories (i.e. medical capability, environmental health, behavioral health). These categories can be further broken down into specific subgroups generally associated with the CHP functionalities meant to mitigate or buy down individual human system risks. Taking a similar development approach we seek to leverage dynamic probabilistic risk assessment as a means to quantify and relatively assess the human risk state within the crew health and performance domain. By utilizing existing tools as integrators, we propose a rapid development strategy for incorporating research and operational data that represent the influence of the CHP system functionalities, in order to provide order of magnitudes estimates of the influence on most human system risks outcomes. The model system utilizes a modest cumulative risk approach and that limits the scope to primary paths of influence between the CHP functionalities and human system risks, thus enabling quick prototypes of the integrative effects of CHP functional combinations to solicit valuable feedback from stakeholders and customers on the data, relationship, and structure of the integration.
This document establishes the policy and procedures for the HSP and is authorized through the Director, Johnson Space Center (JSC). This document delineates the medical operations requirements for the HSP. The HSP goals are accomplished through an awareness campaign and procedures such as limiting access to flight crewmembers, medical screening, and controlling flight crewmember activities. NASA's Human Space Flight Program uses strategic risk mitigation to achieve mission success while protecting crew health and safety. Infectious diseases can compromise crew health and mission success, especially in the immediate preflight period. The primary purpose of the Flight Crew Health Stabilization Program (HSP) is to mitigate the risk of occurrence of infectious disease among astronaut flight crews in the immediate preflight period. Infectious diseases are contracted through direct person-to-person contact, and through contact with infectious material in the environment. The HSP establishes several controls to minimize crew exposure to infectious agents. The HSP provides a quarantine environment for the crew that minimizes contact with potentially infectious material. The HSP also limits the number of individuals who come in close contact with the crew. The infection-carrying potential of these primary contacts (PCs) is minimized by educating them in ways to avoid infections and avoiding contact with the crew if they are or may be sick. The transmission of some infectious diseases can be greatly curtailed by vaccinations. PCs are strongly encouraged to maintain updated vaccinations.
To maintain Crew Health and Performance (CHP) during an Artemis mission, the NASA Human Research Program (HRP) and Exploration Medical Capabilities (ExMC) element recognize the challenge that many different vehicles, habitats, and operational groups must come together to develop and implement cross program capabilities. To address this challenge, the ExMC team created the prototype 2023 Artemis CHP System Model to analyze how human system requirements are implemented throughout an Artemis mission and help understand the effects of changing an individual vehicle or habitat requirement on a full mission. Since presenting this work at the 2024 HRP Investigators’ Workshop, ExMC has continued this effort, now called the Artemis III and IV CHP System Model, to better support its operational end users within the NASA Human Health and Performance Directorate (HHPD) workforce. In this presentation, we will recapitulate how visualizing requirements and their relationships using a Model-Based Systems Engineering approach (MBSE) serves to improve understanding of an Artemis mission’s CHP capabilities along with discussion on updates made to the model to increase accessibility for users within HHPD so that it may be used in the development of cross program CHP capabilities at NASA.
While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper
Human spaceflight is a complex endeavor requiring multiple capabilities for transportation, crew health, scientific goals, and safe return to Earth. The difference between spaceflight proven capabilities and those needed for future exploration architectures is defined as a capability gap. Capability gaps are not technology specific. Each capability gap may be closed with a wide array of technologies that have unique benefits and challenges. Determining what a capability’s relevant and distinguishing key performance parameters (KPPs) are for a mission is critical. Mass, power, and volume are always constrained and important, but defining these in a way normalized by performance is very important. KPP definition for reliability, dormancy, and integration needs are hard to define but critical. Outside of technical considerations, the programmatic factors of the estimated time to develop the technology and how the technology validation objectives are matured are strong considerations in which technologies should be pursued and how they should leverage earlier mission elements. The Environmental Control and Life Support (ECLSS) and Crew Health and Performance (CHP) capability areas are decomposed to high level gaps. While KPPs should be technology agnostic, they can be used to both compare technologies and measure progress of technology development over time. KPPs help define when the gap is closed, and the core mission objectives can be accomplished. Proposed technology improvements to enhance a capability should balance improved KPPs and against investments in other capabilities that are not yet closed. A selection of gaps, KPPs, and validation objectives and their formulation, current state, and how they inform capability roadmap planning are discussed.
The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.
While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper
The NASA engineering community utilizes event-driven and fault-tree probabilistic techniques to classify risks in the space environment by taking advantage of the inherent knowledge of complex spaceflight system design and testing to quantify failure risk. In harmonizing the risk of human space flight, answering the question of ‘How do we balance health, performance and resource risks with other engineering risks on long duration space missions?’ remains a deeply challenging and largely qualitative practice. The Human Research Program’s Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) was a significant step forward in efforts to robustly quantify the risk to crew health for exploration missions. However, there remains a significant gap in the ability to comprehensively assess and characterize risk across the disparate functionalities and capabilities which comprise the Crew Health and Performance (CHP) system. The Crew Health and Performance – Probabilistic Risk Assessment (CHP-PRA) project seeks to characterize CHP risks by expanding beyond the foundation established by its PRA predecessors like IMM and MEDPRAT, that simulate medical risk metrics like loss of crew life and evacuations. One of the new risk measures in the CHP-PRA system is embodied in our Performance Risk Model (PRisM). PRisM provides a novel way of assessing crew performance on mission tasks, using a generalized framework which relates back to NASA-STD-3001. This approach allows PRisM to capture and integrate data from a variety of different domains into a single, unified, reproducible representation of astronaut performance. In this presentation, we discuss the motivation for the CHP-PRA work and give a high level overview of the goals of the project, outline the forward work for PRisM, and discuss collaboration opportunities for the community who might explore if their domain knowledge and data could be represented, integrated, and quantified with these tools, whose outcomes are metrics useful for supporting operational mission planning and decision making.
Carbon dioxide (CO2) removal is one of the primary functions of the International Space Station (ISS) atmosphere revitalization systems. Primary CO2 removal is via the ISS s two Carbon Dioxide Removal Assemblies (CDRAs) and the Russian carbon dioxide removal assembly (Vozdukh); both of these systems are regenerable, meaning that their CO2 removal capacity theoretically remains constant as long as the system is operating. Contingency CO2 removal capability is provided by lithium hydroxide (LiOH) canisters, which are consumable, meaning that their CO2 removal capability disappears once the resource is used. With the advent of 6 crew ISS operations, experience showing that CDRA failures are not uncommon, and anecdotal association of crew symptoms with CO2 values just above 4 mmHg, the question arises: How much lower do we keep CO2 levels to minimize the risk to crew health and performance, and what will the operational cost to the CDRAs be to do it? The primary crew health concerns center on the interaction of increased intracranial pressure from fluid shifts and the increased intracranial blood flow induced by CO2. Typical acute symptoms include headache, minor visual disturbances, and subtle behavioral changes. The historical database of CO2 exposures since the beginning of ISS operations has been compared to the incidence of crew symptoms reported in private medical conferences. We have used this database in an attempt to establish an association between the CO2 levels and the risk of crew symptoms. This comparison will answer the question of the level needed to protect the crew from acute effects. As for the second part of the question, operation of the ISS s regenerable CO2 removal capability reduces the limited life of constituent parts. It also consumes limited electrical power and thermal control resources. Operation of consumable CO2 removal capability (LiOH) uses finite consumable materials, which must be replenished in the long term. Therefore, increased CO2 removal means increased resource use, with increased logistical capability to maintain necessary resources on board ISS. We must strike a balance between sufficiently low CO2 levels to maintain crew health and CO2 levels which are operationally feasible for the ISS program
The Environmental Control and Life Support System (ECLSS) – Crew Health and Performance (CHP) Systems Capability Leadership Team (SCLT) is a community of practice (not a funded program) sponsored by Headquarters to develop, retain, and infuse the ECLSS and CHP capabilities necessary to enable the human exploration of the Moon and Mars through the integration and empowerment of experts across NASA, other government agencies, commercial industry, and academia. The goals of the SCLT are as follows: Use the Architecture Definition Document use cases and functions to identify gaps in NASA’s current technological capabilities to meet Agency objectives and develop strategies and roadmaps for closing such gaps Make technical/strategic recommendations on ECLSS and CHP technology development efforts and investments for PPBE, acquisition strategies, and leveraging NASA’s critical capabilities Establish key performance parameters and participate in key program and project reviews Maintain cognizance of relevant ECLSS and CHP national and international technology activities in government, industry, and academia, specifically, emerging innovations and technologies, trends, and opportunities Coordinate with commercial and international partners to identify areas of mutual interest and cooperation Support future mission and system architecture studies for human exploration This document is intended to be a comprehensive overview of the strategic development plans, or Roadmaps, of key technologies and capabilities identified by the SCLT. Each Roadmap is organized by Capability Gap as the gap name and number appears in STARPort, follows a fiscal year timeline, and displays any additional information on milestones, decision points, or important details on the right-hand side of the page. The Roadmaps should be used to facilitate discussion, decision making, and planning for programs and development projects, but are not expected to accurately depict the details and statuses of the projects and tasks appearing within the plans.