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NASA NTRS2010

Visual Impairment/Intracranial Pressure Risk Assessment

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

Fogarty, Jennifer A.↗

NASA NTRS2011

Cancer Risk Estimates from Space Flight Estimated Using Yields of Chromosome Damage in Astronaut's Blood Lymphocytes

To date, cytogenetic damage has been assessed in blood lymphocytes from more than 30 astronauts before and after they participated in long-duration space missions of three months or more on board the International Space Station. Chromosome damage was assessed using fluorescence in situ hybridization whole chromosome analysis techniques. For all individuals, the frequency of chromosome damage measured within a month of return from space was higher than their preflight yield, and biodosimetry estimates were within the range expected from physical dosimetry. Follow up analyses have been performed on most of the astronauts at intervals ranging from around 6 months to many years after flight, and the cytogenetic effects of repeat long-duration missions have so far been assessed in four individuals. Chromosomal aberrations in peripheral blood lymphocytes have been validated as biomarkers of cancer risk and cytogenetic damage can therefore be used to characterize excess health risk incurred by individual crewmembers after their respective missions. Traditional risk assessment models are based on epidemiological data obtained on Earth in cohorts exposed predominantly to acute doses of gamma-rays, and the extrapolation to the space environment is highly problematic, involving very large uncertainties. Cytogenetic damage could play a key role in reducing uncertainty in risk estimation because it is incurred directly in the space environment, using specimens from the astronauts themselves. Relative cancer risks were estimated from the biodosimetry data using the quantitative approach derived from the European Study Group on Cytogenetic Biomarkers and Health database. Astronauts were categorized into low, medium, or high tertiles according to their yield of chromosome damage. Age adjusted tertile rankings were used to estimate cancer risk and results were compared with values obtained using traditional modeling approaches. Individual tertile rankings increased after space flight and analysis of follow up samples indicated that the tertile rankings remained in the high category for more than 50% of the individuals assessed so far. Crewmembers that shift and remain in the high category are projected to have increased life-time cancer risk.

George, Kerry A.↗

NASA NTRS2008

Science Goals in Radiation Protection for Exploration

Space radiation presents major challenges to future missions to the Earth s moon or Mars. Health risks of concern include cancer, degenerative and performance risks to the central nervous system, heart and lens, and the acute radiation syndromes. The galactic cosmic rays (GCR) contain high energy and charge (HZE) nuclei, which have been shown to cause qualitatively distinct biological damage compared to terresterial radiation, such as X-rays or gamma-rays, causing risk estimates to be highly uncertain. The biological effects of solar particle events (SPE) are similar to terresterial radiation except for their biological dose-rate modifiers; however the onset and size of SPEs are difficult to predict. The high energies of GCR reduce the effectiveness of shielding, while SPE s can be shielded however the current gap in radiobiological knowledge hinders optimization. Methods used to project risks on Earth must be modified because of the large uncertainties in projecting health risks from space radiation, and thus impact mission requirements and costs. We describe NASA s unique approach to radiation safety that applies probabilistic risk assessments and uncertainty based criteria within the occupational health program for astronauts and to mission design. The two terrestrial criteria of a point estimate of maximum acceptable level of risk and application of the principle of As Low As Reasonably Achievable (ALARA) are supplemented by a third requirement that protects against risk projection uncertainties using the upper 95% confidence level (CL) in radiation risk projection models. Exploration science goals in radiation protection are centered on ground-based research to achieve the necessary biological knowledge, and in the development of new technologies to improve SPE monitoring and optimize shielding. Radiobiology research is centered on a ground based program investigating the radiobiology of high-energy protons and HZE nuclei at the NASA Space Radiation Laboratory (NSRL) located at DoE s Brookhaven National Laboratory in Upton, NY. We describe recent NSRL results that are closing the knowledge gap in HZE radiobiology and improving exploration risk estimates. Linking probabilistic risk assessment to research goals makes it possible to express risk management objectives in terms of quantitative metrics, which include the number of days in space without exceeding a given risk level within well defined confidence limits, and probabilistic assessments of the effectiveness of design trade spaces such as material type, mass, solar cycle, crew selection criteria, and biological countermeasures. New research in SPE alert and risk assessment, individual radiation sensitivity, and biological countermeasure development are described.

Cucinotta, Francs A.↗

NASA NTRS2016

Coupled CFD-PBE Predictions of Renal Stone Size Distributions in the Nephron in Microgravity

In this paper, a deterministic model is developed to assess the risk of critical renal stone formation for astronauts during space travel. A Population Balance Equation (PBE) model is used to compute the size distribution of a population of nucleating, growing and agglomerating renal calculi as they are transported through different sections of the nephron. The PBE model is coupled to a Computational Fluid Dynamics (CFD) model that solves for steady state flow of urine and transport of renal calculi along with the concentrations of ionic species, calcium and oxalate, in the nephron using an Eulerian two-phase mathematical framework. Parametric simulation are performed to study stone size enhancement and steady state volume fraction distributions in the four main sections of the nephron under weightlessness conditions. Contribution of agglomeration to the stone size distribution and effect of wall friction on the stone volume fraction distributions are carefully examined. Case studies using measured astronaut urinary calcium and oxalate concentrations in microgravity as input indicate that under nominal conditions the largest stone sizes developed in Space will be still considerably below the critical range for problematic stone development. However, results also indicate that the highest stone volume fraction occurs next to the tubule and duct walls. This suggests that there is an increased potential for wall adhesion with the possibility of evolution towards critical stone sizes.

Microgravity↗

NASA NTRS2016

Coupled CFD-PBE Predictions of Renal Stone Size Distributions in the Nephron in Microgravity

Crystal Growth↗

NASA NTRS2024

Behavioral Makers to Assess During Selection for Active and Non-Active Astronauts

INTRODUCTION: NASA and our international partners seek to stay ahead of the evolving nature of the astronaut role. Spaceflight comes with various risks to team and individual. NASA has worked with its international partners in developing selection guidelines for minimal behavioral competencies needed upon selection. Training should be provided on the remaining behavioral competencies required for spaceflight. We will provide an overview of the process of identifying competencies important to assess as part of a multi-method selection program for active and non-active astronauts. TOPIC: NASA, ESA, CSA, and JAXA agency representatives used their vast combined knowledge and experience to develop competency requirement standards that future selection programs should assess when selecting astronauts. The astronaut role is expanding to include astronauts whose purposes are quite varied. NASA and its international partners identified the need to identify what competencies are required for anyone who will be experiencing the incredible demands, risks, and unique circumstances associated with spaceflight. Competencies include those required for individual and team functioning within the isolated, confined, and extreme environment. This need grew out of greater commercialization of spaceflight and other budding spaceflight prospects. 1. Each agency rated previously defined spaceflight required competencies (not important 0, somewhat important .5, or extremely important 1) to assess during selection. We did this for short duration (<14 days) and for long duration (<14 days) missions as some competencies appear to become of greater importance with longer duration missions. 2. We rated competencies for non-active crew and revisited previous ratings for active crew. 3. We compared agency ratings for non-active/active and short-duration/long-duration requirements and discussed in ratings until consensus was reached. We will use ratings to compile selection standards for active and non-active astronauts. APPLICATION: Our working group has vast operational experience and knowledge of the risk factors present during spaceflight that can disrupt individual and team functioning. Selection is one of the most important countermeasures for mitigating risk to individual and team health and performance. Our work should inform future programs for selecting crewmembers for short- and long-duration spaceflight among active and non-active crews.

Alexa Baxley↗

NASA NTRS2000

Toxicological Risks During Human Space Exploration

The goal of toxicological risk assessment of human space flight is to identify and quantify significant risks to astronaut health from air pollution inside the vehicle or habitat, and to develop a strategy for control of those risks. The approach to completing a toxicological risk assessment involves data and experience on the frequency and severity of toxicological incidents that have occurred during space flight. Control of these incidents depends on being able to understand their cause from in-flight and ground-based analysis of air samples, crew reports of air quality, and known failures in containment of toxic chemicals. Toxicological risk assessment in exploration missions must be based on an evaluation of the unique toxic hazards presented by the habitat location. For example, lunar and Martian dust must be toxicologically evaluated to determine the appropriate control measures for exploration missions. Experience with near-earth flights has shown that the toxic products from fires present the highest risk to crew health from air pollution. Systems and payload leaks also present a significant hazard. The health risk from toxicity associated with materials offgassing or accumulation of human metabolites is generally well controlled. Early tests of lunar and Martian dust simulants have shown that each posses the potential to cause fibrosis in the lung in a murine model. Toxicological risks from air pollutants in space habitats originate from many sources. A number of risks have been identified through near-earth operations; however, the evaluation of additional new risks present during exploration missions will be a challenge.

James, John T.↗

NASA NTRS2011

The Extravehicular Suit Impact Load Attenuation Study for Use in Astronaut Bone Fracture Prediction

The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fracture of the proximal femur is a traumatic injury that would likely result in loss of mission if it were to happen during spaceflight. The low gravity exposure causes decreases in bone mineral density which heightens the concern. Researchers at the NASA Glenn Research Center have quantified bone fracture probability during spaceflight with a probabilistic model. It was assumed that a pressurized extravehicular activity (EVA) suit would attenuate load during a fall, but no supporting data was available. The suit impact load attenuation study was performed to collect analogous data. METHODS: A pressurized EVA suit analog test bed was used to study how the offset, defined as the gap between the suit and the astronaut s body, impact load magnitude and suit operating pressure affects the attenuation of impact load. The attenuation data was incorporated into the probabilistic model of bone fracture as a function of these factors, replacing a load attenuation value based on commercial hip protectors. RESULTS: Load attenuation was more dependent on offset than on pressurization or load magnitude, especially at small offsets. Load attenuation factors for offsets between 0.1 - 1.5 cm were 0.69 +/- 0.15, 0.49 +/- 0.22 and 0.35 +/- 0.18 for mean impact forces of 4827, 6400 and 8467 N, respectively. Load attenuation factors for offsets of 2.8 - 5.3 cm were 0.93 +/- 0.2, 0.94 +/- 0.1 and 0.84 +/- 0.5, for the same mean impact forces. Reductions were observed in the 95th percentile confidence interval of the bone fracture probability predictions. CONCLUSIONS: The reduction in uncertainty and improved confidence in bone fracture predictions increased the fidelity and credibility of the fracture risk model and its benefit to mission design and operational decisions.

Lewandowski, Beth E.↗

NASA NTRS2015

Menstrual Cycle Control in Female Astronauts and the Associated Risk of Venous Thromboembolism

Venous thromboembolism (VTE) is a common and serious condition affecting approximately 1‐2 per 1000 people in the USA every year. There have been no documented case reports of VTE in female astronauts during spaceflight in the published literature. Some female astronauts use hormonal contraception to control their menstrual cycles and it is currently unknown how this affects their risk of VTE. Current terrestrial risk prediction models do not account for the spaceflight environment and the physiological changes associated with it. We therefore aim to estimate a specific risk score for female astronauts who are taking hormonal contraception for menstrual cycle control, to deduce whether they are at an elevated risk of VTE. A systematic review of the literature was conducted in order to identify and quantify known terrestrial risk factors for VTE. Studies involving analogues for the female astronaut population were also reviewed, for example, military personnel who use the oral contraceptive pill for menstrual suppression. Well known terrestrial risk factors, for example, obesity or smoking would not be applicable to our study population as these candidates would have been excluded during astronaut selection processes. Other risk factors for VTE include hormonal therapy, lower limb paralysis, physical inactivity, hyperhomocysteinemia, low methylfolate levels and minor injuries, all of which potentially apply to crew members LSAH data will be assessed to identify which of these risk factors are applicable to our astronaut population. Using known terrestrial risk data, an overall estimated risk of VTE for female astronauts using menstrual cycle control methods will therefore be calculated. We predict this will be higher than the general population but not significantly higher requiring thromboprophylaxis. This study attempts to delineate what is assumed to be true of our astronaut population, for example, they are known to be a healthy fit cohort of individuals, and combine physiological impacts of spaceflight (cephalic fluid shifts, lower limb inactivity) to understand specific risks associated with hormonal contraception.

Jain, Varsha↗

NASA NTRS2000

Space Radiation Absorbed Dose Distribution in a Human Phantom Torso

The flight of a human phantom torso with head that containing active dosimeters at 5 organ sites and 1400 TLDs distributed in 34 1" thick sections is described. Experimental dose rates and quality factors are compared with calculations for shielding distributions at the sites using the Computerized Anatomical Male (CAM) model. The measurements were complemented with those obtained from other instruments. These results have provided the most comprehensive data set to map the dose distribution inside a human and to assess the accuracy of radiation transport models and astronaut radiation risk.

Badhwar, G. D.↗

NASA NTRS2018

Investigating Microbiome Differences Between Red Romaine Lettuce Grown from Sanitized and Unsanitized Seeds

The International Space Station (ISS) as an integral component for the discovery and development of advanced robotics, materials, communications, medicine, agriculture, and environmental science due to it currently being the world's only microgravity laboratory of its kind. Because the ISS is a contained system with confined quarters, much research has been undertaken to assess and diminish the number of microbiological risks associated with astronauts inhabiting the station for extended periods of time. Notable microbiological risk factors include drinking water, air, and food. As an avenue for both mental/emotional respite and a source of fresh produce for astronauts, a vegetable production system has been employed on the ISS. In order to understand the microbial risks involved with a "pick and eat" vegetable system on the International Space Station (ISS), this study aims to compare microbial differences between sanitized and unsanitized seeds by tracking and identifying seedborne microbes throughout the development of red romaine lettuce (Lactuca sativa)-a plant species that has already been grown on the ISS.

Polanco, Jonilee A.↗

NASA NTRSDate not supplied

Development of a THOR Anthropometric Test Device Lumbar Spine Injury Risk Function

Currently, the Brinkley Dynamic Response Criteria (BDRC) is used to assess the risk of thoraco-lumbar spinal injury for astronauts. The BDRC has been validated for predicting injury in military aircraft ejections (Brinkley, 1968; Brinkley and Schaffer, 1971). The objective of this study was to use the injurious data behind the BDRC and subinjurious human-volunteer data to develop an injury risk function for the Test device for Human Occupant Restraint (THOR) to predict probability of thoraco-lumbar spine injury during space vehicle landings.

Jessica Wells↗

NASA NTRS2010

The Value of Biomedical Simulation Environments to Future Human Space Flight Missions

With the ambitious goals to send manned missions to asteroids and onto Mars, substantial work will be required to ensure the well being of the men and women who will undertake these difficult missions. Unlike current International Space Station or Shuttle missions, astronauts will be required to endure long-term exposure to higher levels of radiation, isolation and reduced gravity. These new operation conditions will pose health risks that are currently not well understood and perhaps unanticipated. Therefore, it is essential to develop and apply advanced tools to predict, assess and mitigate potential hazards to astronaut health. NASA s Digital Astronaut Project (DAP) is working to develop and apply computational models of physiologic response to space flight operation conditions over various time periods and environmental circumstances. The collective application and integration of well vetted models assessing the physiology, biomechanics and anatomy is referred to as the Digital Astronaut. The Digital Astronaut simulation environment will serve as a practical working tool for use by NASA in operational activities such as the prediction of biomedical risks and functional capabilities of astronauts. In additional to space flight operation conditions, DAP s work has direct applicability to terrestrial biomedical research by providing virtual environments for hypothesis testing, experiment design, and to reduce animal/human testing. A practical application of the DA to assess pre and post flight responses to exercise is illustrated and the difficulty in matching true physiological responses is discussed.

Mulugeta, Lealem↗

NASA NTRSDate not supplied

Performance Risk Model (PRisM) Proof-of-Concept: An Operational Decision Support Tool to Predict Crew Performance in Space from Available Performance Tests

The Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) team at NASA Glenn Research Center has developed a range of tools to evaluate astronaut health during spaceflight and to optimize the medical set required for missions. Among these, the Performance Risk Model (PRisM) represents a novel advancement, extending CHP-PRA’s focus beyond medical systems into the domain of human performance. Such tool could be pivotal in optimizing astronaut capabilities during space travel, thereby enhancing overall mission success. PRisM leverages data from well-established performance assessments conducted during previous crewed space missions and Earth analogs to strategically predict outcomes for planned tasks, even when direct performance testing has not been conducted for those specific tasks. To evaluate performance, PRisM references the various metrics outlined in NASA-STD-3001 and employs a methodology to integrate different performance scales. This framework analyzes the contribution of various human system task categories (HSTCs) to task execution and compares these contributions to the HSTCs’ involvement in other known tests. The model further employs a Monte Carlo simulation to sample performance scores from their distribution in operationally relevant tests such as those in Mulavara et al. (2018) and, by leveraging similarities in HSTC involvement, transfers this knowledge to actual mission tasks, such as those outlined in the "Human Exploration of Mars: Preliminary List of Crew Tasks”. The current PRisM proof-of-concept includes analyses of the impact of exercise and specific medications on astronauts’ performance, with provisions to incorporate additional countermeasures as data becomes available. Furthermore, the tool is customizable to include any system necessary to fully encompass the domain of human systems and can be adapted to evaluate performance for any spaceflight activities as requested by operational stakeholders. PRisM has the potential to assist the Human Research Program in exploring the capabilities trade space for optimized crew performance.

performance modeling↗

NASA NTRS2015

Assessing the Effect of Spaceflight on the Propensity for Astronauts to Develop Disk Herniation

A previous study [1] reported the instantaneous risk of developing a Herniated Nucleus Pulosus (HNP) was higher in astronauts who had flown at least one mission, as compared with those in the corps who had not yet flown. However, the study only analyzed time to HNP after the first mission (if any) and did not account for the possible effects of multiple missions. While many HNP's occurred well into astronauts' careers or in some cases years after retirement, the higher incidence of HNPs relatively soon after completion of space missions appears to indicate that spaceflight may lead to an increased risk of HNP. The purpose of this study was to support the Human System Risk Boards assessment of back pain, assess the risk of injury due to dynamic loads, and update the dataset analyzed which contained data through December 31, 2006.

Feiveson, Alan H.↗

NASA NTRS2011

Assessing the Likelihood of Rare Medical Events in Astronauts

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

Myers, Jerry G., Jr.↗

NASA NTRS2002

Efficiency of a radiophotoluminescence glass dosemeter for low-earth-orbit space radiation

Chips of a radiophotoluminescence glass dosemeter (RPLG) were used for measurements of space radiation during a 9.8 d Shuttle-Mir mission (STS-91) at an altitude of 400 km and an inclination of 51.65 degrees. Two of RPLG chips were put into each of 59 positions in or on a life-size human phantom. The RPLG values equivalent to 137Cs gamma ray absorbed doses were found to be systematically lower than those of a Mg2SiO4:Tb thermoluminescence dosemeter (TDMS). In comparison with the organ or tissue absorbed dose and dose equivalent values that were estimated using a combination of TDMS and plastic nuclear track detectors, the efficiencies of the RPLG chips were about 80% for the water absorbed dose and about 40% for the dose equivalent. Whereas the percentage values will change during different missions, such additional information obtained from small RPLG chips is useful for improving the reliability of radiation dosimetry in space.

NASA Discipline Radiation Health↗

NASA NTRSDate not supplied

In-Depth Modeling and Simulation Analysis of Artemis Missions Using the Impact Probabilistic Risk Assessment Tool

BACKGROUND The Artemis campaign is a Moon exploration program with a series of six planned missions, five of which will be crewed. These five crewed missions will contain a single mission segment (space flight), or multiple mission segments involving space flight (Orion), lunar landing (LTV) and/or space habitat (Gateway). Each crewed segment faces the risk of unique medical conditions, necessitating medical sets/kits tailored to those specificities. To support and enable a data-driven and evidence-based decision-making process through out a mission’s life cycle, a software tool called IMPACT was developed. Using probabilistic risk assessment (PRA) methodologies, IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a novel tool built for analyzing the possibility of encountering complex medical risks during space flight, and for identifying the medical resources and capabilities needed to treat those potential at-risk medical conditions. IMPACT achieves this by performing hundreds of thousands of Monte Carlo simulations of missions to build aggregate pictures of medical risk. During an extended simulation modeling phase, IMPACT generated analytical results for medical risks, and the medical resources and capabilities to address those risks, for every segment of every crewed Artemis mission. This presentation will highlight the reliability, consistency and validity of IMPACT’s computational modeling techniques and will showcase the library of analytical outcomes generated for the Artemis missions. OVERVIEW During the early stages of IMPACT’s design, architecture and technical requirements collection, “scenarios” (use cases) - achievement goals required for acceptance testing, were identified by stakeholders. IMPACT successfully completed the scenario testing requirements and undertook an extensive operational run phase utilizing a wide range of input combinations with a goal of delivering a cohesive, trustworthy, reliable, vast, and diverse body of evidence. The intent of these modeling runs was to validate consistency in output, ensure solidity of executable operations and to streamline processes by identifying areas requiring efficiency improvements. Using the many missions of Artemis, IMPACT ran variations of operational runs to assess the output for acceptable, as well as unusual characteristics. This rigorous long-term “shakedown” analysis was implemented to help build a collective body of evidence to aid in securing a high level of confidence, reliability, and validity in the output, whether from the applicational components of IMPACT, or the entirety of the operational process. ANTICIPATED ANALYSIS AND CONCLUSION This presentation will discuss the various categories of input criteria; the comparisons in the application of these input criteria to various Artemis missions; the preparation and collection of the body of evidence, and reliability of the computational modeling techniques. This paper serves as an initial analytical overview of IMPACT’s probabilistic risk assessment (PRA) medical risk outputs covering Artemis missions and is not intended to be deemed the official medical response for the Artemis campaign.

Crew Composition↗