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A New Approach to Mission Classification and Risk Management for NASA Space Flight Missions

The NASA risk classification system is meant to uide space mission development from formulation through completion of implementation. It is also meant to be the basis on which program and project managers develop and implement appropriate mission assurance and risk management strategies for the mission. In order to be useful, the risk classification system needs to provide consistent and reproducible classification results so that missions may be designed with the appropriate components, subsystems, and testing philosophy, all of which impacts mission schedule and cost. In a cost-constrained environment, a clear, robust, and reproducible approach to mission implementation becomes more critical than ever before. Once a project's risk classification level is established, the managers can define the appropriate management controls, systems engineering processes, mission assurance requirements, safety, and testing for that mission. The current NASA mission classification system will be reviewed before a new system is proposed.NASA manages space flight missions according to a four-tiered classification which assumes increasing levels of risk. We argue that risk does not change between classes. What changes are the means available to reduce risk. In performance-driven missions, the project will spend money in order to maintain performance without reducing margins. In cost-constrained missions, performance will be reduced in order to stay within budget or to maintain schedule: measurement requirements may be traded, design life may be reduced, or both. We then propose a new approach to the classification of NASA space flight missions, based on an assessment of how flexible the requirements, how exquisite the measurements, how long the lifetime, and how rigid the budget.Our proposed approach makes possible a clearer differentiation between classification levels and more effective guidance to program and project managers.

Bordi, Francesco↗

Valuing Rigor in the Risk Management Process

NASA, as an organization, takes risk management (RM) seriously, and for most projects, the risk management process is exemplar. There can be challenges, though, with defining RM processes. For example, many different risk analysis methodologies are available, they can be applied with varying degrees of rigor, and they can have different value depending on how projects use them. In particular, risk analysis methodologies vary considerably in the level of quantitative detail, with more probabilistic techniques encouraged in some situations. We discussed these processes and methodologies with ten project managers (PM) at the NASA Goddard Space Flight Center (GSFC). Our intent was not to prove with some level of statistical significance that some are more helpful than others, but rather to obtain a general understanding of how projects are identifying, and thinking, about risks. This paper describes some of the available risk processes and methodologies, and provides some insights about the benefits that can gained from their use. We provide an in-depth discussion of one quantitative methodology, Probabilistic Risk Assessments (PRAs), and conclude with a few insights from observed best practices.

Dillon, Robin L.↗

"Making Safety Happen" Through Probabilistic Risk Assessment at NASA

NASA is using Probabilistic Risk Assessment (PRA) as one of the tools in its Safety & Mission Assurance (S&MA) tool belt to identify and quantify risks associated with human spaceflight. This paper discusses some of the challenges and benefits associated with developing and using PRA for NASA human space programs. Some programs have entered operation prior to developing a PRA, while some have implemented PRA from the start of the program. It has been observed that the earlier a design change is made in the concept or design phase, the less impact it has on cost and schedule. Not finding risks until the operation phase yields much costlier design changes and major delays, which can result in discussions of just accepting the risk. Risk contributors identified by PRA are not just associated with hardware failures. They include but are not limited to crew fatality due to medical causes, the environment the vehicle and crew are exposed to, the software being used, and the reliability of the crew performing required actions. Some programs have entered operation prior to developing a PRA, and while PRA can still provide a benefit for operations and future design trades, the benefit of implementing PRA from the start of the program provides the added benefit of informing design and reducing risk early in program development. Currently, NASA’s International Space Station (ISS) program is in its 20th year of on-orbit operations around the Earth and has several new programs in the design phase preparing to enter the operation phase all of which have active (or living) PRAs. These programs incorporate PRA as part of their Risk-Informed, Decision-Making (RIDM) process. For new NASA human spaceflight programs discussion begins with mission concept, establishing requirements, forming the PRA team, and continues through the design cycles into the operational phase. Several examples of PRA related applications and observed lessons are included.

Applications↗

Ground Risk Assessment Service Provider (GRASP) Development Effort as a Supplemental Data Service Provider (SDSP) for Urban Unmanned Aircraft System (UAS) Operations

NASA’s Unmanned Aircraft System (UAS) Traffic Management (UTM) project aims to enable the integration of new aviation paradigms such as Unmanned Aircraft Systems (UAS) while providing the necessary infrastructure for future concepts such as On-Demand Mobility (ODM) and Urban Air Mobility (UAM) operations in the National Airspace System (NAS). In order to do so, the UTM project has developed an architecture to allow communication among UAS operators, UAS Service Suppliers (USS), Air Navigation Service Providers (ANSP), and the public. As part of this framework, the Supplemental Data Service Providers (SDSP) are envisioned as model and/or data based services that disseminate essential or enhanced information to ensure safe operations within low-altitude airspace. These services include terrain and obstacle data, specialized weather data, surveillance, constraint information, risk monitoring, etc. This paper highlights the development efforts of a non-participant casualty risk assessment SDSP called Ground Risk Assessment Service Provider (GRASP) which assists operators with preflight planning. GRASP is based on the previously introduced UTM Risk Assessment Framework (URAF) and allows UAS operators to simulate and visualize potential non-participant casualty risks associated with their proposed flight. The risk assessment capability also allows operators to revise their flight plans if the casualty risks are determined to be above acceptable thresholds. GRASP is configured to account for future improvements including servicing airborne aircraft as part of NASA’s System-Wide Safety (SWS) project.

Ancel, Ersin↗

3D Representation of UAV-obstacle Collision Risk under off-nominal conditions

Safe operations of autonomous unmanned aerial vehicles (UAVs) in low-altitude airspace with beyond visual line-of-sight (BVLOS) flights demand robust risk monitoring of airspace as well as of people and property on ground. One of the safety critical factors for UAV flights is the risk of collision with static and dynamic obstacles in proximity to its flight path. This paper presents a detailed formulation of risk likelihood of obstacle collision incorporating the effects of off-nominal conditions introduced by component failures, degraded controllability and environmental disturbances such as wind gusts. The deviation in the planned trajectory caused due to wind is computed utilizing a point-mass 3D kinematic simulation model of the vehicle. Likelihood of risk for the flight plan is then analyzed based on generating the probability of collision for each point in the trajectory. The proposed risk factor is demonstrated on real flight data from experimental flights of an octocopter at NASA Langley Research Center in presence of simulated obstacles and wind conditions. Effect of varying wind conditions, distance from obstacles, level of controllability and obstacle measurement noise on the risk factor is demonstrated. The proposed approach enables risk-informed decision making for timely mitigation of current and future unsafe events in autonomous systems.

Portia Banerjee↗

Spaceflight Medical Evacuation Risk Assessment Principles - A Qualitative Investigation

BACKGROUND Future human space exploration beyond Low Earth Orbit (LEO) will require innovative solutions in many areas, primarily those that provide direct medical support to crew on long-duration missions and optimize their health and performance. The associated challenges therein will be numerous, including but not necessarily limited to extended one-way or "asynchronous" communication delays, minimal to non-existent resupply, and a prolonged transit time to "definitive care" ranging from 3-days to 9-months. At the same time, long-duration exploration spacecraft and crew will face restrictions on mass, power, volume, and data far more significant than that seen in current LEO settings. Given these limitations, medical risk assessment is of primary importance, especially evaluating the implications of a medical evacuation of an ill or injured crewmember. Such evacuations are complicated, potentially dangerous, and well may be impossible in certain phases of the mission. Regardless, such issues must be weighed against the risks of the injured crew remaining aboard a spacecraft with limited medical resources. OBJECTIVE This qualitative study drew from the experiences of subject matter experts (SMEs) in spaceflight and appropriate analog environments (i.e., military, disaster, and extreme environment fields) to identify unique principles common amongst medical evacuation considerations helpful in informing future risk assessment tools. Appropriate analog environments included austere operational settings where multiple factors (weather, logistics/limited resupply, denied/extreme environments, and patient condition) resulted in a limited ability to provide definitive local medical care. The fundamental principles in question revolved around scenarios where evacuation became a complicating yet necessary consideration and where life-threatening medical concerns had to be weighed against critical mission objective(s). The primary authors collected semi-structured data gathered through in-depth interviews with 16 subject matter experts (SMEs). Interview questions investigated how these SMEs consider and weigh the attendant risks present in medical evacuation scenarios. Among the critical questions posed were those that sought to understand how the SME balanced the challenges and requirements of medical evacuation (or keeping an injured patient "on-site" aka: "prolonged field care") against the evacuation operation's risks on impacting overarching mission success. The team analyzed interview transcripts for common themes and principles using the qualitative methods of thematic analysis based on consensus, co-occurrence, and comparison. As a result, nine primary risk consideration themes and nine contributing factor themes emerged, all of which will ideally inform future medical evacuation decision-making tools and operational decision-making for exploration class missions. Specific aims for this study included: 1. Identification of common principles used to assess risks and benefits of medical evacuations in extreme environments 2. Identification of common points of friction or complication and challenges in extreme environment evacuations

A T Almand↗

Outcomes of a NASA Human Research Program’s (HRP) Space Radiation Element-sponsored Mini-Technical Interchange Meeting/workshop on Cardiovascular Disease Risk from Space Radiation

The NASA HRP’s Space Radiation Element funds research to characterize and mitigate adverse health outcomes from space radiation including cardiovascular risks to astronauts to enable deep space exploration and sustained human presence in space. Non-cancer effects such as damage to the cardiovascular system have been observed at clinically relevant high doses of ionizing radiation. However, an association between lower doses and risk of cardiovascular disease (CVD) remains somewhat controversial, especially in relation to the existence of low dose thresholds, radiation quality, and dose-rate effects, as well as gaps in characterizing the mechanisms and major pathways of disease. To facilitate, accelerate, and incubate new ideas to characterize and mitigate this risk, the Element is planning to organize a series of miniature technical interchange meetings (Tiny-TIMs) to provide a venue for HRP-funded investigators and thought leaders to present ongoing work and engage in open discussion on presented results, limitations of current approaches, incorporating better experimental strategies, model systems, etc. The initial Tiny-TIM held during the NASA HRP Investigators’ Workshop earlier this year – Upping the ante on characterizing and mitigating cardiovascular disease risk from space radiation exposure – aimed to stimulate discussion on the current state of scientific knowledge of CVD risk from space-like radiation exposure. The Tiny-TIM consisted of two 90-minute sessions; the first session concentrated on current knowledge of CVD risk from space radiation and the second session focused on innovative ideas, newer approaches, and techniques to accelerate research. The second session was followed by an open spirited discussion amongst peers on the current issues impeding the characterization of CVD risk from space radiation. The Element facilitated the discussion using a set of pressing open questions/gaps in knowledge that need to be addressed by the scientific community. The outcomes of the Tiny-TIM will be presented along with a plan of proposed future workshops and other initiatives of the Space Radiation Element.

Janapriya Saha↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Services (xEVAS) suit is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared to the current EMU and Apollo era suits and additional features will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS suit progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury. History has shown that more suit injuries occur during training than in flight; therefore, currently planned training events to prepare for lunar missions and tasks during lunar surface EVAs were considered. Each scenario is ranked with likelihood and consequence scorings based on our current understanding of suit and application of Artemis design reference missions. The scoring allowed identification of the high-risk cases that will drive further work in suited injury. Mechanisms of injury, injury outcomes, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team; ergonomists; suit engineers; safety engineers; the flight operations directorate; flight doctors; astronauts; astronaut strength, conditioning, and rehabilitation specialists (ASCRS); and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using these, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/longdistance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Teresa Reiber↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Teresa Reiber↗

Aggregate Risk Tool for Human Space Flight

This project utilized Data fusion capabilities developed from the 2020-2022 Information Fusion (IFDA) IRAD to enhance functionality of a Human Spaceflight (HSF) Aggregate Risk Product developed by the JSC Flight Safety Office. The tool compiles and presents risk data from multiple Program and Commercial Provider vehicles to provide a holistic assessment of residual risk to Program Managers and Technical Authorities prior to HSF Launches. The aggregation or coupling of risks from multiple sources (Examples: PRA, variances, anomaly data bases, Program Risk Management data bases, technical review board minutes, Hazard Analysis, etc.) when analyzed, identify potential areas of elevated risk in components, systems or mission phases that would otherwise be undetected by nonintegrated program risk management tools and possesses.

Patrick Huckaby↗

Climate and Human Impacts on Hydrological Processes and Flood Risk in Southern Louisiana

Satellite observations of coastal Louisiana indicate an overall land loss over recent decades, which could be attributed to climate and human-induced factors, including sea level rise (SLR). Climate induced hydrological change (CHC) has impacted the way flood control structures are used, altering the spatiotemporal water distribution. Based on “what-if” scenarios, we determine relative impacts of SLR and CHC on increased flood risk over southern Louisiana and examine the role of water management, via flood control structures, in mitigating flood risk over the region. Our findings show that CHC has increased flood risk over the past 28 years. The number of affected people increases as extreme hydrological events become more exceptional. Water management reduces flood risk to urban areas and croplands, especially during exceptional hydrological events. For example, currently (i.e., 2016-2020 period), CHC-induced flooding puts an additional 73km2 of cropland under flood risk at least half of the time (median flood event) and 65km2 once a year (annual flood event), when compared to a past period (1993-1997). A ten- to twenty-fold increase relative to SLR-induced flooding. CHC also increases population vulnerability in southern Louisiana to flooding; additional 9900 residents currently live under flood risk at least half of the time, and that number increases to 27,400 for annual flood events. Residents vulnerable to SLR induced flooding is lower (6000 and 3300 residents, respectively). Conclusions are that CHC is a major factor that should be accounted for flood resilience and that water management interventions can mitigate risks to human life and activities.

Augusto Getirana↗

Risk Trade-Space Analysis for Safe Human Expeditions to Mars

We assessed the integrated safety, health, and performance risk to crews on long-duration missions, specifically to Mars. Using a systems approach rather than one focused on individual countermeasures, we examined the trade space around several such risks to identify high-potential risk mitigation strategies and characterize aspects of Mars mission architectures that could lower aggregated risk. Current Mars Design Reference missions would require durations well over two years and would increase crew exposure to radiation and microgravity well beyond ISS levels, likely resulting in significantly reduced performance beyond our current capability to mitigate that could jeopardize mission success. A “fast Mars transit” round-trip mission concept was studied using an innovative flight dynamics approach to quantify the minimum total mission energy required for a Mars transit with total mission duration less than 400 days. This approach holds promise for sending humans to Mars and returning them safely with acceptable, potentially mitigatable, exposure to microgravity and radiation using current or near-term technologies. The fast transit concept would also result in fewer time-driven vehicle failures and enable sustainable deployment of humans and infrastructure to Mars on a regular cadence, allowing steady exploration and colonization of Mars. Finally, we conclude that reliance on the Low Earth Orbit (LEO) mission operations paradigm – i.e., one of near-complete real-time dependence on experts at Mission Control to manage the combined state of the mission, vehicle, and crew – is high risk given the communication delays and limited resupply of any Mars mission, and this risk is not eliminated by the shorter missions durations of fast transit scenarios. Based on historical trends, it is highly likely that the crew will face a high-consequence problem of uncertain origin during Mars transit when ground support will be greatly reduced. While it may be possible to reduce anomaly rates through improved reliability analysis and testing, and to reduce anomaly impacts through added robustness, such mitigations address only known failure modes and known uncertainties. Therefore, a radical shift in the Human-Systems Integration Architecture (HSIA) that defines the operational paradigm, systems design, and human-systems interactions is required to improve the risk posture to an acceptable level regardless of mission duration.

Mars↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Tessa Reiber↗

Machine Learning for the Validation of Expert-Elicited Causal Risk Diagrams

Exposure to spaceflight poses risk to human health in complex ways. To help manage this risk, the Human Systems Risk Board (HSRB) at the National Aeronautics and Space Administration (NASA) maintains a set of causal diagrams that attempt to explain how spaceflight hazards generate health risks and lead to adverse outcomes both in-mission, immediately post-mission, and over the long term. These causal risk diagrams are formulated as directed acyclic graphs (DAGs) and can function as knowledge graphs of connected risks and outcomes. These DAGs have proven useful for communication, and, through network analysis, have allowed for the identification of structurally important factors in the risk network. However, the utility these DAGs provide is directly proportional to their verisimilitude, making assessment of this trait using empirical data – whether from actual human spaceflight or various spaceflight analogue exposures and model organisms – a high priority. In this research we explore the use of machine learning algorithms to learn DAG structure from empirical data as a means of evaluating human-elicited DAG structures. To do so, we test several different graph structure-learning algorithms on data concerning changes in the bones of rats and mice after exposure to either spaceflight or a spaceflight analogue. We explore potential methods for indexing the similarity between each algorithm’s output DAG with all the others and with that of the expert-elicited DAG. We discuss next steps in this ongoing line of research and open science initiatives underway to complete them.

directed acyclic graphs↗

Medical Risk Estimates and Clinical Capability Needs for A Long Duration Artemis Mission

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. DISCUSSION: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for an extended duration Artemis mission of approximately 9 months, with phases including outbound transit, 3 months on the Lunar Gateway space station, 3 months on the Lunar surface with EVAs, 3 months on Gateway (simulating the return phase of a Mars mission), and transit back to Earth. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care – RTDC), and an estimate of crew time lost due to medical conditions (Task Time Lost – TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk.

W Thompson↗

Quantifying Risk to Improve Medical System Design for Long Duration Artemis Missions: A Demonstration of NASA's IMPACT Tradespace Analysis Tool

BACKGROUND NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. A greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the evacuation of ill or injured crew. Mass, volume, and power will be limited while higher demands will be placed on the crews to manage medical events. NASA’s Moon to Mars exploration strategy outlines increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human system risk attributable to medical conditions and use these estimates to advance medical system design. METHODS IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and tradespace analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; a large increase in the number of medical resources and the flexibility of their use; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to mimic a foundational exploration Artemis mission. The DRM profile includes outbound transit on Orion, Gateway space station rendezvous in lunar orbit, 6 months on the Lunar surface with extravehicular activity (EVA), return rendezvous with Gateway, and transit back to Earth. RESULTS/DISCUSSION: Overall, IMPACT successfully quantified medical risk and derived an optimal medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to medical risk were decompression sickness, trauma, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions and performed as expected. This demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Arian Anderson↗

Medical Risk Estimates and Clinical Capability Needs for a Late Artemis Mission

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. DISCUSSION: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for an extended duration Artemis mission of approximately 9 months, with phases including outbound transit, 3 months on the Lunar Gateway space station, 3 months on the Lunar surface with EVAs, 3 months on Gateway (simulating the return phase of a Mars mission), and transit back to Earth. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care –RTDC), and an estimate of crew time list due to medical conditions (Task Time Lost –TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk.

A Anderson↗

Plausible Biological Mechanisms Underlying Sex Differences in Radiation-Induced Lung Cancer Risk

Some epidemiological studies suggest that women are at greater risk for radiation-induced lung cancer than men, but this observation is not consistent across all studies. A scientific committee formed by the National Council on Radiation Protection and Measurement evaluated evidence for a sex difference in lung cancer risk from radiation exposuresby reviewing animal studies and assessing the biological plausibility that such a difference might exist. The committee identified four mechanisms that could potentially result in greater radiogenic lung cancer risks for women. The first of these is that radiation exposure increases the relative risk for a molecular subtype of spontaneous lung cancer that occurs predominantly in women. The second is that is that sex chromosome or gene expression differences between men and women places women at greater risk. The third is that hormonal differences between men and women, particularly for estrogen levels, puts women at greater risk. The fourth mechanism is that sex differences in immune system function underlie a sex difference in radiation associated lung cancer risk.None of these mechanisms hasyet been proven to play a role in radiogenic lung cancer risk.

radiation↗