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NASA NTRS2018

Assessing the Completeness of Occupational Exposure Data in the Lifetime Surveillance of Astronaut Health

INTRODUCTION: Longitudinal analysis on how spaceflight affects human health requires significant amounts of data. Missing data, especially if missing in a non-random fashion, could be a significant challenge to the success and validity of ongoing occupational surveillance and research. Astronaut occupational health data have been collected since 1959 in various formats and as part of several flight programs. As a result of changing methodologies over this span, epidemiologists in the NASA Lifetime Surveillance of Astronaut Health (LSAH) project regularly compile data sets with important exposure or outcome data missing. METHODS: NASA medical records of astronauts participating in voluntary annual LSAH examinations were reviewed and compiled to develop Individual Exposure Profiles (IEP) for each astronaut. These data were supplemented by an interview. If the interview yielded medically relevant information absent from the medical record, that information was considered an update. The IEPs were analyzed to identify trends regarding the characteristics of astronauts who provided updates and what kinds of information were consistently being updated. RESULTS: To date, 190 astronauts have participated in the IEP project. Medical information was updated for 119 individuals during these interviews. The astronauts' likelihood of updating their record upon interview was not significantly related to their spaceflight experience, era of active spaceflight, or duration of longest spaceflight. The most commonly updated categories of medical information were issues encountered during spaceflights, including CO2 symptoms, vision changes, back pain, headaches, and space motion sickness. DISCUSSION: The most commonly updated categories correspond to areas where LSAH has ongoing analysis efforts and therefore do not appear to have been reported at random. This presentation will address identification of missing astronaut health data and trends, forward work identified by the IEP project and how this information may be used for future LSAH data gap analyses.

Sieker, Jeremy↗
NASA NTRSDate not supplied

Monitoring Biomarkers for Muscular Atrophy using an Electronic Chip for Astronaut Health

Skeletal muscle atrophy is a serious health problem for astronauts in long-duration space flight under microgravity conditions. Preventative measures against muscle atrophy require specific exercise and dietary regimens. Preemptive measurements to improve treatment have the potential to streamline these regimens, decreasing their daily footprint and increasing astronaut quality of life. The objective of our proposed project is to (1) develop a fully integrated disposable microelectrode array chip (with the size of a stamp) that can be interfaced with a handheld electronic system for simultaneous detection of the a panel of biomarkers to monitor the progression of skeletal muscle atrophy due to disuse under microgravity in long-duration spaceflights; and (2) use such quantitative information to guide the combined countermeasures of physical exercise and pharmaceuticals (i.e. specific protease inhibitors) so that the intensity, duration and frequency of exercise can be reduced.

Biosensing↗
NASA NTRS2022

The Lifetime Surveillance of Astronaut Health Newsletter

This volume of the Newsletter discusses the Johnson Space Center Clinic (JSC) restarting in-person Lifetime Surveillance of Astronaut Health (LSAH) Formers Examinations after being on hold due to COVID-19 as well as introducing a forthcoming option for LSAH Virtual Surveillance. JSC welcomes three new members of the JSC Clinic who will be heavily involved in Formers Exams. Finally, from the LSAH team, the newsletter talks about how your health data is utilized through the IMPALA platform for research such as the SANS Maturation Project, and building the LSAH Evidence Base to understand prostate cancer trends in the astronaut corps compared to other comparison cohorts.

Joseph (Tim) LaVan↗
NASA NTRS2017

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.

Laughlin, Mitzi S.↗
NASA NTRSDate not supplied

Analyzing the Impact of Lunar Dust on Astronaut Health – an Update to the Risk Modeling

INTRODUCTION Lunar dust exposure is an unavoidable hazard during lunar surface operations. Given the large number of surface EVAs expected to be performed during Artemis missions, it is critical that the incidence and extent of symptoms resulting from contact with lunar dust be fully understood in order to accurately predict the resources needed to treat Artemis astronauts. The purpose of this study will be to gather the latest data regarding the risk of and severity of symptoms associated with lunar dust exposure and refine the estimates of the impact of lunar dust on astronaut health for PRA models, both those in operational use and those currently being developed. METHODS The latest data on the pathophysiologic effects of lunar dust on humans will be gathered by querying the peer-reviewed literature as well as NASA technical documents. This data will be supplemented with discussions with hardware designers regarding methods used to mitigate exposure to lunar dust during lunar surface operations. Taken together, this data will be used to refine both the estimates for exposure to lunar dust for astronauts inside and outside lunar habitats, as well as provide evidence to guide estimates for the percentage of astronauts who are exposed to lunar dust who will be symptomatic. RESULTS Querying the peer-reviewed literature and NASA technical documents will begin in October of 2024, with the goal of codifying this information by the end of October. In parallel, discussions will begin with hardware engineering teams, also in October. Using the evidence found will help refine the estimate for resources needed to treat astronauts who exhibit symptoms from lunar dust exposure. DISCUSSION Lunar dust exposure is expected to be a major risk for upcoming exploration missions that include a lunar surface interval. Until recently, most of the information to inform the risk associated with lunar dust exposure has come from anecdotal evidence from Apollo astronauts about their symptoms while on the lunar surface; however, this evidence is sparse. Newer studies are now coming out, looking at the impact of lunar dust on human physiology, including studies on effects to the immune system. Additionally, there are new engineering efforts to attempt to mitigate the exposure to lunar dust from the space suits of astronauts returning to the lunar habitat after surface operations. Thus, developing an updated risk assessment, based on our current understanding of human physiology and our current resources for risk mitigation, is prudent to best estimate overall human health and performance risk for future Artemis missions. This project will lead to an updated and more accurate assessment of the risk of lunar dust exposure for exploration missions and will therefore allow mission planners to more accurately predict resources needed for these exploration-class missions.

D M Nusbaum↗
NASA NTRS2011

Automated Miniaturized Instrument for Space Biology Applications and the Monitoring of the Astronauts Health Onboard the ISS

Human space travelers experience a unique environment that affects homeostasis and physiologic adaptation. The spacecraft environment subjects the traveler to noise, chemical and microbiological contaminants, increased radiation, and variable gravity forces. As humans prepare for long-duration missions to the International Space Station (ISS) and beyond, effective measures must be developed, verified and implemented to ensure mission success. Limited biomedical quantitative capabilities are currently available onboard the ISS. Therefore, the development of versatile instruments to perform space biological analysis and to monitor astronauts' health is needed. We are developing a fully automated, miniaturized system for measuring gene expression on small spacecraft in order to better understand the influence of the space environment on biological systems. This low-cost, low-power, multi-purpose instrument represents a major scientific and technological advancement by providing data on cellular metabolism and regulation. The current system will support growth of microorganisms, extract and purify the RNA, hybridize it to the array, read the expression levels of a large number of genes by microarray analysis, and transmit the measurements to Earth. The system will help discover how bacteria develop resistance to antibiotics and how pathogenic bacteria sometimes increase their virulence in space, facilitating the development of adequate countermeasures to decrease risks associated with human spaceflight. The current stand-alone technology could be used as an integrated platform onboard the ISS to perform similar genetic analyses on any biological systems from the tree of life. Additionally, with some modification the system could be implemented to perform real-time in-situ microbial monitoring of the ISS environment (air, surface and water samples) and the astronaut's microbiome using 16SrRNA microarray technology. Furthermore, the current system can be enhanced substantially by combining it with other technologies for automated, miniaturized, high-throughput biological measurements, such as fast sequencing, protein identification (proteomics) and metabolite profiling (metabolomics). Thus, the system can be integrated with other biomedical instruments in order to support and enhance telemedicine capability onboard ISS. NASA's mission includes sustained investment in critical research leading to effective countermeasures to minimize the risks associated with human spaceflight, and the use of appropriate technology to sustain space exploration at reasonable cost. Our integrated microarray technology is expected to fulfill these two critical requirements and to enable the scientific community to better understand and monitor the effects of the space environment on microorganisms and on the astronaut, in the process leveraging current capabilities and overcoming present limitations.

Human space travelers↗
NASA NTRS1993

Longitudinal study of astronaut health: Mortality in the years 1959-1991

We conducted a historical cohort study of mortality among 195 astronauts who were exposed to space and medical sources of radiation between 1959 and 1991. Cumulative occupational and medical radiation exposures were obtained from the astronaut radiation exposure history data base. Causes of death were obtained from obligatory death certificates and autopsy reports that were on file in the medical records. A total of 18 deaths occurred during the 32-year follow-up period for which the all-cause standardized mortality ratio (SMR) was 142 (95 percent confidence interval 84 225). There was one cancer death in the buccal cavity and pharynegeal ICD-9 rubric whose occurrence was significantly beyond expectation. Mortality for coronary disease was 59 percent lower than expected (2 deaths; SMR = 41; 95 percent confidence limit 5 147). The crude death rate for 10 occupationally related accidents was 400 deaths per 100,000 person-years, which is an order of magnitude greater than accidental death rates in mining industries. The SMR of 1027 for fatal accidents was significantly beyond expectation (14 deaths; 95 percent confidence limit 561 1723) and was similar to SMRs for accidents among aerial pesticide applications. The 10-year cumulative risk of occupational fatalities based on the exponential, Weibull, Gompertz, and linear-exponential distributions was 10 percent. Mortality from motor vehicle accidents was slightly higher than expected but was not significant (1 death; SMR = 145; 95 percent confidence limit 2 808). Radiation exposures from medical procedures accounted for a majority of cumulative dose when compared with space radiation exposures. The results of the study do not confirm the impression that astronauts are at increased risk of cancer, but this does not obviate the need for further study. Overall, it was found that astronauts are at a health disadvantage as a result of catastrophic accidents.

Peterson, Leif E.↗
NASA NTRSDate not supplied

Determining the Importance of In-Flight Treadmill Running Capabilities for Maintaining Astronaut Health and Performance

BACKGROUND: Physical deconditioning induced via spaceflight is most effectively attenuated through in-flight exercise training. Throughout its evolution, NASA has implemented advancements to in-flight exercise countermeasures, culminating in the triad of devices currently used aboard the International Space Station (ISS): a treadmill (T2), cycle ergometer (CEVIS), and resistance exercise device (ARED). Despite high-quality exercise devices and prescriptions, many crewmembers experience reductions in both aerobic capacity (VO2peak pre-post mean change: -10%) and strength (knee isokinetic pre-post mean change: -15%). As NASA moves towards exploration missions, which will impose greater size, power, and time constraints on exercise systems in addition to physically demanding surface extravehicular activities (EVAs), providing robust capabilities to protect crew health and performance should be prioritized. OVERVIEW: Future missions to the Lunar and Martian surfaces will include EVAs requiring ambulation and greater physical exertion than those in Apollo missions. While the exercise device concepts planned for exploration missions include resistive and aerobic capabilities, they do not allow for ambulation. Specifically, the countermeasure planned for Artemis Lunar transit is a flywheel device, which provides both exercise modalities through a single resistive cable. While more robust than the flywheel, the devices planned for the Lunar orbital space station, and subsequent Mars habitats, will provide distinct aerobic and resistance modalities capable of achieving high intensities. However, these modalities do not include a treadmill. Recent research suggests that greater in-flight running intensity and volume attenuate decrements in aerobic capacity and strength; however, this has not been experimentally confirmed. The Exploration Exercise Treadmill Requirements study is currently underway, aiming to determine the effects of exercising without a treadmill on aerobic capacity, strength, bone density, and sensorimotor function during long-duration spaceflight. DISCUSSION: Providing running capabilities on future exploration missions may help to maintain astronaut physical ability, reduce injury, and promote health. Studies quantifying the effects of using exploration exercise devices are in progress, which will help provide critical recommendations on whether a treadmill is a necessary component of the in-flight training regime. This presentation will discuss the capabilities of exploration exercise devices and the potential implications of not having running capabilities during long-duration spaceflight.

Alyssa N Varanoske↗
NASA NTRS1988

Long-term follow up of astronaut health indices

Ground-based research and reevaluation of flight data is currently in progress in order to develop suitable and operationally acceptable medical standards for extended-duration manned space missions. The large amount of data obtained thus far constitutes a unique data base representative of the astronaut population. In this paper, preliminary 10-year findings of prospective studies established in 1977 are described, and results obtained from retrospective studies conducted on data accumulated prior to the 1977 establishment of medical selection standards are summarized.

Nicogossian, A. E.↗
NASA NTRS2018

Monitoring Astronaut Health with DNA Sequencing

In recent years microbe a plethora of microbe populations have been identified onboard the ISS (International Space Station). Approaches for real-time tracking of microbes for routine housekeeping and food/water safety monitoring will be critical for mission safety and crew health on future longer duration missions to the Moon or Mars. This work is a proof-of-concept study demonstrating an end-to-end phylogenetic identification and full genome sequencing effort of multiple microbial populations. Our methodology utilized the ISS flight-certified WetLab-2 molecular toolbox and the Biomolecule Sequencer projects for real-time end-to-end on-orbit microbial biological samples processing and molecular analysis with real time results generated utilizing only field "offline" analytic software. For this experiment we colony-cultured several ISS isolated microorganisms before generation of the pre-sequencing library via the automated VolTRAX device which enabled high library turnover with little wet-bench activity or potential future costly astronaut time. The pre-sequencing library is diluted in loading buffer and injected into the MinION sample port, drawn into the nanopore window by capillary action, and sequenced using the MinKnown. 16S and full genome alignment, nucleotide matching, gene identification, and phylogenetic sorting was accomplished utilizing the Epi2me software and the offline NCBI Blast viral, microbiome, and human somatic databases. In short, the methodologies developed herein replace the myriad of specific, often highly targeted microbiological tests used in the clinical laboratory, which would be difficult if not impossible to currently implement aboard the ISS or in deep space, with a single metagenomics test.

genomics↗
NASA NTRS2014

Protecting Astronaut Health at First Entry into Vehicles Visiting the international Space Station: Insights from Whole-Module Offgas Testing

NASA has accumulated considerable experience in offgas testing of whole modules prior to their docking with the International Space Station (ISS). Since 1998, the Space Toxicology Office has performed offgas testing of the Lab module, both MPLM modules, US Airlock, Node 1, Node 2, Node 3, ATV1, HTV1, and three commercial vehicles. The goal of these tests is twofold: first, to protect the crew from adverse health effects of accumulated volatile pollutants when they first enter the module on orbit, and secondly, to determine the additional pollutant load that the ISS air revitalization systems must handle. In order to predict the amount of accumulated pollutants, the module is sealed for at least 1/5th the worst‐case time interval that could occur between the last clean air purge and final hatch closure on the ground and the crew's first entry on orbit. This time can range from a few days to a few months. Typically, triplicate samples are taken at pre‐planned times throughout the test. Samples are then analyzed by gas chromatography and mass spectrometry, and the rate of accumulation of pollutants is then extrapolated over time. The analytical values are indexed against 7‐day spacecraft maximum allowable concentrations (SMACs) to provide a prediction of the total toxicity value (T‐value) at the time of first entry. This T‐value and the toxicological effects of specific pollutants that contribute most to the overall toxicity are then used to guide first entry operations. Finally, results are compared to first entry samples collected on orbit to determine the predictive ability of the ground‐based offgas test.

Meyers, Valerie↗
NASA NTRS2016

Meeting the Grand Challenge of Protecting Astronauts Health: Electrostatic Active Space Radiation Shielding for Deep Space Missions

This report describes the research completed during 2011 for the NASA Innovative Advanced Concepts (NIAC) project. The research is motivated by the desire to safely send humans in deep space missions and to keep radiation exposures within permitted limits. To this end current material shielding, developed for low earth orbit missions, is not a viable option due to payload and cost penalties. The active radiation shielding is the path forward for such missions. To achieve active space radiation shielding innovative large lightweight gossamer space structures are used. The goal is to deflect enough positive ions without attracting negatively charged plasma and to investigate if a charged Gossamer structure can perform charge deflections without significant structural instabilities occurring. In this study different innovative configurations are explored to design an optimum active shielding. In addition, to establish technological feasibility experiments are performed with up to 10kV of membrane charging, and an electron flux source with up to 5keV of energy and 5mA of current. While these charge flux energy levels are much less than those encountered in space, the fundamental coupled interaction of charged Gossamer structures with the ambient charge flux can be experimentally investigated. Of interest are, will the EIMS remain inflated during the charge deflections, and are there visible charge flux interactions. Aluminum coated Mylar membrane prototype structures are created to test their inflation capability using electrostatic charging. To simulate the charge flux, a 5keV electron emitter is utilized. The remaining charge flux at the end of the test chamber is measured with a Faraday cup mounted on a movable boom. A range of experiments with this electron emitter and detector were performed within a 30x60cm vacuum chamber with vacuum environment capability of 10-7 Torr. Experiments are performed with the charge flux aimed at the electrostatically inflated membrane structure (EIMS) in both charged and uncharged configurations. The amount of charge shielding behind and around the EIMS was studied for different combinations of membrane structure voltages and electron energies. Both passive and active shielding were observed, with active shielding capable of deflecting nearly all incoming electrons. The pattern of charge distribution around the structure was studied as well as the stability of the structures in the charge flow. The charge deflection experiments illustrate that the EIMS remain inflated during charge deflection, but will experience small amplitude oscillations. Investigations were performed to determine a potential cause of the vibrations. It is postulated these vibrations are due to the charge flux causing local membrane charge distribution changes. As the membrane structure inflation pressure is changed, the shape responds, and causes the observed sustained vibration. Having identified this phenomenon is important when considering electrostatically inflated membrane structures (EIMS) in a space environment. Additionally, this project included a study of membrane material impacts, specifically the impact of membrane thickness. Extremely thin materials presented new challenges with vacuum preparation techniques and rapid charging. The thinner and lighter membrane materials were successfully inflated using electrostatic forces in a vacuum chamber. However, care must be taken when varying the potentials of such lighter structures as the currents can cause local heating and melting of the very thin membranes. Lastly, a preliminary analysis is performed to study rough order of magnitude power requirements for using EIMS for radiation shielding. The EIMS power requirement becomes increasingly more challenging as the spacecraft voltage is increased. As a result, the emphasis is on the deflection of charges away from the spacecraft rather than totally stopping them. This significantly alleviates the initial power requirements. With modest technological development(s) active shielding is emerging to be a viable option.

Radiation↗