jected, however, to be moderate to severe concerns that affect astronaut health on the International Space Station (ISS), and except for radiation protection and bone mineral density loss, the degree of severity of the other health and safety challenges have yet to be estimated for exploration-class missions. Many of these issues and challenges are directly related to or are completely tied to known human physiological adaptations to space travel. Separation of these issues from the discussions of physiological adaptations in Chapter 2 is in many cases artificial. Similar concerns, issues, and topics on medical, surgical, rehabilitative, and behavioral health in this chapter and in Chapters 4 and 5 must also be considered in the continuum of clinical research and health care for astronauts to begin building the infrastructure and health care system (Chapter 7) needed for human exploration of deep space. The committee has chosen to separate these topics into chapters to place the emphasis on clinical research (Chapters 2 to 5), health care (Chapters 3 to 5), and opportunities and ethical and infrastructure concerns (Chapters 6 and 7) that it believes is necessary to promote the needed attention to the safe passage and the health of astronauts during travel beyond Earth orbit and into deep space.

BOX 3–1 Major Health and Medical Issues During Spaceflight

Health or Medical Issue

GRD

AIR

STS

ISS

EXP

Radiation protection

G

G

G

Y

R

Hearing conservation

G

G

G

R

TBD

Cardiovascular

G

G

G

Y

TBD

Muscle

G

G

G

Y

TBD

Bone loss

G

G

G

Y

TBD

Neurovestibular

Y

NA

G

R

TBD

Habitability

NA

G

Y

Y

TBD

Extravehicular activity risk

NA

G

Y

Y

TBD

Medical care

Y

NA

Y

Y

TBD

Diversity (age, gender, etc.)

Y

NA

Y

Y

TBD

Psychological issues

Y

G

G

Y

TBD

Workers’ compensation

Y

G

G

Y

TBD

Abbreviations: GRD, ground; AIR, airflight; STS, space shuttle; ISS, International Space Station; EXP, exploration-class mission; G, green, little or no risk; Y, yellow, moderate risk; R, red, severe risk; TBD, to be determined; NA, not applicable.

Source: Williams, 2000.



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