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Posted on 12/05/2001 1:54:38 PM PST by RightWhale

NASA Report: Space Travel 'Inherently Hazardous' to Human Health

By Leonard David Senior Space Writer

posted: 11:50 am ET 05 December 2001

WASHINGTON -- According to a new study created for NASA the medical risks -- both physical and psychological -- of long treks beyond Earth orbit remain daunting and a far greater challenge than the public has been led to believe.

After 40 years of rocketing humans skyward, information on stresses to the body due to space travel has been poorly collected, nor fully analyzed. Today, not enough is known about the dangers of prolonged travel to enable humans to venture into deep space in a safe and sane manner.

However, the new, no-holds-barred study says part of the problem comes from "underreporting" by space travelers about their health woes. Also, there is too much data privacy and confidentiality between astronauts and flight surgeons.

Sobering conclusion

The more than 300-page report, Safe Passage: Astronaut Care for Exploration Missions, was released by The National Academy of Sciences (NAS) Institute of Medicine and authored by a specially convened Committee on Creating a Vision for Space Medicine During Travel Beyond Earth Orbit. A blue ribbon panel of 14 medical doctors, clinical psychologists and health care specialists compiled the report.

The study group was led by John Ball, executive vice president emeritus for the American College of Physicians of Havre de Grace, Maryland. The report, issued by the National Academy Press, was edited by Ball and Charles Evans, Jr., study director and Institute of Medicine senior advisor for biomedical and clinical research.

"Space travel is inherently hazardous. The risks to human health of long duration missions beyond Earth orbit, if not solved, represent the greatest challenge to human exploration of deep space," the committee noted. Furthermore, the development of solutions "is complicated by lack of a full understanding of the nature of the risks and their fundamental causes."

New questions

In the report's foreword, Kenneth Shine, President of the Institute of Medicine, the organization that put together the committee, cautions that deep space exploration, such as a journey to Mars, stirs up new questions about the health of expeditionary crews.

"Some of the physiologic effects of shorter periods in space such as loss of bone calcium are likely to continue indefinitely during longer missions," Shine said. Furthermore, psychological and mental health issues -- spurred by stuffing people from diverse social and cultural background into tight quarters and sending them outward from Earth -- will grow increasingly important, he said.

"For prolonged missions, it will not be feasible to return an acutely ill individual to Earth in a timely manner," Shine said. Not only should the report help NASA, but also others concerned about the care of individuals in isolated locations on Earth, he said.

NASA shortfalls

Ball, as panel chair, said the report is a unique, first-of-its-kind National Academies assessment. The committee sought to bring about a "fresh perspective" in looking at the health of space medicine today, he explains in the report's preface.

That outlook, Ball said, led the group to identify two specific areas where NASA falls short.

The first area involves behavioral and cultural understandings, including crew selection and training. Human interactions aboard a spacecraft, isolated in time and space from Earth, "may well be one of the more serious challenges to exploratory missions by humans," the study group found.

The other area is the collection of clinical data on astronauts.

In this arena, a new ethical approach is needed, Ball said. Too much emphasis has been placed on confidentiality of astronaut clinical data. Overly protective policies focused on astronaut privacy and non-disclosure of medical information has resulted in "lost opportunities" to help unravel the intricacies of human physiological adaptations to space.

In addition, the culture of the astronauts, a spirit de corps resting on stoicism and a 'can-do' attitude, "further reinforces the individual's reluctance to report medical information," the report explains.

Astronauts should be thought of as a unique population of research participants, the committee observed. As such, a high priority for NASA is to assure that space crews reside in a safe work environment. Health related data collected in-flight is essential to creating and maintaining that work environment.

Following four decades of human space travel, "a paucity of useful clinical data have been collected and analyzed," the committee reported. "It is unlikely that all effects of microgravity are known, and surprises may yet be in store as humans venture longer and farther into space."

ISS as test bed

The group reviewed hundreds of pages of NASA policies and procedures, Ball said. A practiced eye was cast on the evidence, in the hope of helping NASA tailor a vision for health care as astronauts move outward on long-duration sojourns, he said.

To this end, two themes run throughout the report.

First, not enough is yet known about the risks to human health during space stints of over a year, nor how best to mitigate risks for those traveling and working in deep space. Secondly, everything reasonable should be done to gain the needed data before humans can be dispatched on long-haul space treks.

Research involving bed rest studies, or using analog environments on Earth, the panel noted, are limited in their value to predict certain effects of microgravity and isolation on humans.

There is no substitute for clinical research being done on the spot in space. In this regard, the International Space Station (ISS) represents "the single most important test bed for that research," the study group reported.

However, using the ISS in this role has a problem.

A limited international consensus exists on the correct steps for the collection and analysis of astronaut medical data gleaned from space station research. "The potential for conflict among the national space agencies and International Space Station partners is high," the study cautions.

True risks

The committee points out that NASA is undergoing two transitions "to the unknown."

Experienced gained from more than a 100 short-duration shuttle hops is now being overtaken by the long-duration stays on the space station. Also, there is a transition occurring as the emphasis on the machinery of spaceflight makes a conceptual shift to the biology of spaceflight.

"The challenges afforded by these twin transitions offer NASA strategic opportunity to reexamine its processes and structure and to build on its successes," the panel reports.

But early on, there is a need for NASA to tell it like it is.

And that is, there are health risks of long-duration missions beyond Earth orbit. Not only should the public get the message, but so too should space flyers.

"The successes of short-duration space missions may have led to misunderstanding of the true risks of space travel by the public. Public understanding is necessary both for support of long-duration missions and in the event of a catastrophe," pointed out the panel of experts.

The public must be prepared for the possibility that "all countermeasures may tragically fail, that a crew may not return from a prolonged mission, or that individuals may not be able to function physically or mentally upon their return," the study group warned.

Solving vexing issues

Among a suite of recommendations, the committee urged NASA to:

Develop a comprehensive health care system for astronauts;
Create a strategic health care research plan, one designed to increase the knowledge base about the risks to astronaut health;
Give priority to understanding the effects of living conditions and behavioral interactions on the well-being and performance of crews on long-duration missions;
Accelerate the melding of engineering and health science cultures; and
Establish an "organizational component" headed by a person with authority and accountability for astronaut health issues, an official who would oversee policy-making, day-to-day operations, and budgetary needs.

"None of the committee members is a practicing engineer, and none is a physicist. Thus, we do not believe that our conclusions and recommendations should replace those of others. We hope, instead, that this report will add to the richness of NASA's approach to solving some of the most vexing issues," Ball said

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