BOX 3–2 Potential Methods of Risk Assessment and Screening

Physiological profiling. Physiological profiling consists of profiling of the central nervous system; cardiovascular system; pulmonary system; musculoskeletal system; eyes, ears, nose, and throat; gastrointestinal system; and genitourinary system and gynecological health and profiling for endurance, strength, and adaptive ability.

Psychosocial profiling. Psychosocial profiling evaluates individuals for moods or traits that are positively selected and traits that lead to rejection. Are there behavioral signs and symptoms that validly and reliably predict maladaptive or disruptive behavioral interactions?

Health status profiling. Past medical events and current signs and symptoms are used as part of health status profiling. Individuals with disorders such as migraine and hypertension and individuals who have had keratoplasty are excluded from astronaut training.

Markers to assist in profiling. Such markers include the results of laboratory studies, genetic profiling, and imaging studies and family history.

the extreme environment of extended-duration space travel or habitation beyond Earth.

Health Risk Assessment

Individuals differ in their susceptibilities to disease, vulnerabilities to environmental assaults, and abilities to recover from injury. Current potential methods of risk assessment and screening (Box 3–2) rely heavily on the identification of preclinical disease or conditions known to predispose an individual to illness. For example, certain abnormal lipid profiles are an identified risk factor for atherosclerosis, elevated blood pressure is an identified risk factor for stroke and heart disease, and osteoporosis is a risk factor for hip fracture.

As a result of the Human Genome Project, investigators are also identifying DNA sequences that correlate with an increased risk for a particular disease or syndrome, and the basis for this increased risk is being elucidated. The presence of DNA or RNA sequences indicative of a potential health risk as well as those indicative of a preferential pharmacodynamic or other response to treatment may be an integral part of the standard of care in the future. Breast cancer (Box 3–3) and colon cancer are two diseases for which

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