Engineering topics
Lee, Lesley R.
Publications and source records attributed to Lee, Lesley R..
Tracking Historical NASA EVA Training: Lifetime Surveillance of Astronaut Health (LSAH) Development of the EVA Suit Exposure Tracker (EVA SET)
During a spacewalk, designated as extravehicular activity (EVA), an astronaut ventures from the protective environment of the spacecraft into the vacuum of space. EVAs are among the most challenging tasks during a mission, as they are complex and place the astronaut in a highly stressful environment dependent on the spacesuit for survival. Due to the complexity of EVA, NASA has conducted various training programs on Earth to mimic the environment of space and to practice maneuvers in a more controlled and forgiving environment. However, rewards offset the risks of EVA, as some of the greatest accomplishments in the space program were accomplished during EVA, such as the Apollo moonwalks and the Hubble Space Telescope repair missions. Water has become the environment of choice for EVA training on Earth, using neutral buoyancy as a substitute for microgravity. During EVA training, an astronaut wears a modified version of the spacesuit adapted for working in water. This high fidelity suit allows the astronaut to move in the water while performing tasks on full-sized mockups of space vehicles, telescopes, and satellites. During the early Gemini missions, several EVA objectives were much more difficult than planned and required additional time. Later missions demonstrated that "complex (EVA) tasks were feasible when restraints maintained body position and underwater simulation training ensured a high success probability".1,2 EVA training has evolved from controlling body positioning to perform basic tasks to complex maintenance of the Hubble Space Telescope and construction of the International Space Station (ISS). Today, preparation is centered at special facilities built specifically for EVA training, such as the Neutral Buoyancy Laboratory (NBL) at NASA's Johnson Space Center ([JSC], Houston) and the Hydrolab at the Gagarin Cosmonaut Training Centre ([GCTC], Star City, outside Moscow). Underwater training for an EVA is also considered hazardous duty for NASA astronauts. This activity places astronauts at risk for decompression sickness and barotrauma as well as various musculoskeletal disorders from working in the spacesuit. The medical, operational and research communities over the years have requested access to EVA training data to better understand the risks. As a result of these requests, epidemiologists within the Lifetime Surveillance of Astronaut Health (LSAH) team have compiled records from numerous EVA training venues to quantify the exposure to EVA training. The EVA Suit Exposure Tracker (EVA SET) dataset is a compilation of ground-based training activities using the extravehicular mobility unit (EMU) in neutrally buoyant pools to enhance EVA performance on orbit. These data can be used by the current ISS program and future exploration missions by informing physicians, researchers, and operational personnel on the risks of EVA training in order that future suit and mission designs incorporate greater safety. The purpose of this technical report is to document briefly the various facilities where NASA astronauts have performed EVA training while describing in detail the EVA training records used to generate the EVA SET dataset.
Evidence Report: Risk of Injury and Compromised Performance due to EVA Operations
Given the high physiological and functional demands of operating in a self-contained EVA or training suit in various gravity fields and system environments, there is a possibility that crew injury can occur and physiological and functional performance may be comprised.
Example of Occupational Surveillance in a Telemedicine Setting: Application of Epidemiologic Methods at NASA Johnson Space Center
In 2010, NASA implemented Lifetime Surveillance of Astronaut Health, a formal occupational surveillance program for the U.S. astronaut corps. Because of the nature of the space environment, space medicine presents unique challenges and opportunities for epidemiologists. One such example is the use of telemedicine while crewmembers are in flight, where the primary source of information about crew health is verbal communication between physicians and their crewmembers. Due to restricted medical capabilities, the available health information is primarily crewmember report of signs and symptoms, rather than diagnoses. As epidemiologists at NASA, Johnson Space Center, we have shifted our paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one in which we also incorporate reported symptomology as potential antecedents of disease. In this presentation we describe how characterization of reported signs and symptoms can be used to establish incidence rates for inflight immunologic events. We describe interdisciplinary data sources of information that are used in combination with medical information to analyze the data. We also delineate criteria for symptom classification inclusion. Finally, we present incidence tables and graphs to illustrate the final outcomes. Using signs and symptoms reported via telemedicine, the epidemiologists provide summary evidence regarding incidence of potential inflight medical conditions. These results inform our NASA physicians and scientists, and support evaluation of the occupational health risks associated with spaceflight.
Surveillance in a Telemedicine Setting: Application of Epidemiologic Methods at NASA Johnson Space Center Adriana
Space medicine presents unique challenges and opportunities for epidemiologists, such as the use of telemedicine during spaceflight. Medical capabilities aboard the International Space Station (ISS) are limited due to severe restrictions on power, volume, and mass. Consequently, inflight health information is based heavily on crewmember (CM) self-report of signs and symptoms, rather than formal diagnoses. While CM's are in flight, the primary source of crew health information is verbal communication between physicians and crewmembers. In 2010 NASA implemented the Lifetime Surveillance of Astronaut Health, an occupational surveillance program for the U.S. Astronaut corps. This has shifted the epidemiological paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one that incorporates symptomatology and may gain a more population-based understanding of early detection of disease process.
Cerebrovascular Accident Incidence in the NASA Astronaut Population
The development of atherosclerosis is strongly associated with an increased risk for cerebrovascular accidents (CVA), including stroke and transient ischemic attacks (TIA). Certain unique occupational exposures that individuals in the NASA astronaut corps face, specifically high-performance aircraft training, SCUBA training, and spaceflight, are hypothesized to cause changes to the cardiovascular system. These changes, which include (but are not limited to) oxidative damage as a result of radiation exposure and circadian rhythm disturbance, increased arterial stiffness, and increased carotid-intima-media thickness (CIMT), may contribute to the development of atherosclerosis and subsequent CVA. The purpose of this study was to review cases of CVA in the NASA astronaut corps and describe the comorbidities and occupational exposures associated with CVA.
Evalution of a DE-Identification Process for Ocular Imaging
Medical privacy of NASA astronauts requires an organized and comprehensive approach when data are being made available outside NASA systems. A combination of factors, including the uniquely small patient population, the extensive medical testing done on these individuals, and the relative cultural popularity of the astronauts puts them at a far greater risk to potential exposure of personal information than the general public. Therefore, care must be taken to ensure that the astronauts' identities are concealed. Magnetic Resonance Imaging (MRI) medical data is a recent source of interest to researchers concerned with the development of Visual Impairment due to Intracranial Pressure (VIIP) in the astronaut population. Each vision MRI scan of an astronaut includes 176 separate sagittal images that are saved as an "image series" for clinical use. In addition to the medical information these image sets provide, they also inherently contain a substantial amount of non-medical personally identifiable information (PII) such as-name, date of birth, and date of exam. We have shown that an image set of this type can be rendered, using free software, to give an accurate representation of the patient's face. This currently restricts NASA from dispensing MRI data to researchers in a deidentified format. Automated software programs, such as the Brain Extraction Tool, are available to researchers who wish to de-identify MRI sagittal brain images by "erasing" identifying characteristics such as the nose and jaw on the image sets. However, this software is not useful to NASA for vision research because it removes the portion of the images around the eye orbits, which is the main area of interest to researchers studying the VIIP syndrome. The Lifetime Surveillance of Astronaut Health program has resolved this issue by developing a protocol to de-identify MRI sagittal brain images using Showcase Premier, a DICOM (Digital Imaging and Communications in Medicine) software package. The software allows manual editing of one image from a patient's image set to be automatically applied to the entire image series. This new approach would allow a new level of access to untapped medical imaging data relating to VIIP that can be utilized by researchers while protecting the privacy of the astronauts. In the next step toward finalizing this technique, NASA clinical radiology consultants will test the images to verify removal of all metadata and PII.
Email-Based Informed Consent: Innovative Method for Reaching Large Numbers of Subjects for Data Mining Research
Since the 2010 NASA authorization to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for data has greatly increased. Correspondingly, both the number and scope of requests have increased, from 142 requests fulfilled in 2011 to 224 in 2014, and with some datasets comprising up to 1 million data points. To meet the demand, the LSAH and LSDA Repositories project was launched, which allows active and retired astronauts to authorize full, partial, or no access to their data for research without individual, study-specific informed consent. A one-on-one personal informed consent briefing is required to fully communicate the implications of the several tiers of consent. Due to the need for personal contact to conduct Repositories consent meetings, the rate of consenting has not kept up with demand for individualized, possibly attributable data. As a result, other methods had to be implemented to allow the release of large datasets, such as release of only de-identified data. However the compilation of large, de-identified data sets places a significant resource burden on LSAH and LSDA and may result in diminished scientific usefulness of the dataset. As a result, LSAH and LSDA worked with the JSC Institutional Review Board Chair, Astronaut Office physicians, and NASA Office of General Counsel personnel to develop a "Remote Consenting" process for retrospective data mining studies. This is particularly useful since the majority of the astronaut cohort is retired from the agency and living outside the Houston area. Originally planned as a method to send informed consent briefing slides and consent forms only by mail, Remote Consenting has evolved into a means to accept crewmember decisions on individual studies via their method of choice: email or paper copy by mail. To date, 100 emails have been sent to request participation in eight HRP-funded studies. The development of the Remote Consent process, the laws allowing transmission of consent via electronic means, total metrics to date, and remaining challenges (e.g., response issues, use of International Partner data, biospecimens/genetic data) for the research use of LSAH/LSDA data will be described.
The Lifetime Surveillance of Astronaut Health (LSAH) Project
From 1989-2010 NASA conducted a research study, the Longitudinal Study of Astronaut Health, to investigate the incidence of acute and chronic morbidity and mortality in astronauts and to determine whether their occupational exposures were associated with increased risk of death or disability. In 2004, the Institute of Medicine recommended that NASA convert the longitudinal study into an occupational health surveillance program and in 2010, NASA initiated the Lifetime Surveillance of Astronaut Health project. The new program collects data on astronaut workplace exposures, especially those occurring in the training and space flight environments, and conducts operational and health care analyses to look for trends in exposure and health outcomes. Astronaut selection and retention medical standards are rigorous, requiring an extensive clinical testing regimen. As a result, this employee population has contributed to a large set of health data available for analyses. Astronauts represent a special population with occupational exposures not typically experienced by other employee populations. Additionally, astronauts are different from the general population in terms of demographic and physiologic characteristics. The challenges and benefits of conducting health surveillance for an employee population with unique occupational exposures will be discussed. Several occupational surveillance projects currently underway to examine associations between astronaut workplace exposures and medical outcomes will be described.
NASA Life Sciences Data Repositories: Update on Data Access and Lessons Learned 2012
No abstract available