A prior IOM report entitled Safe Passage (IOM, 2001c) is recommended as background reading for this study. Despite the fact that it focused on the immediate dangers to the health and safety of astronauts aboard a future mission to Mars, it examined many issues of relevance to the present study, including the role of the astronauts as research subjects and the need for a comprehensive health care system for astronauts.

Presently, the IOM, through activities including studies and workshops undertaken at the National Academies under the auspices of its standing Committee on Aerospace Medicine and Medicine in Extreme Environments (CAMMEE), provides NASA’s Chief Health and Medical Officer independent technical advice relevant to aerospace medicine, including medical care of space travelers. A May 2001 CAMMEE meeting included a presentation by scientific staff from the JSC on the LSAH that stimulated considerable discussion and a request by the CAMMEE for additional information at a future meeting. In early fall of the same year, NASA’s Chief Health and Medical Officer wrote a letter to the IOM project officer that described some tentative findings from a recent analysis of the LSAH database by JSC scientists and requested that CAMMEE examine the LSAH and make appropriate medical, scientific, and administrative recommendations for improving the study, as well as recommendations relative to the data trends identified to date. CAMMEE in turn organized the present Committee on the Longitudinal Study of Astronaut Health (CLSAH), which convened for the first time in conjunction with the January 2003 meeting of CAMMEE. NASA had performed some further analysis of the LSAH database in the interim, and after presentation of those analyses, CLSAH’s task was revised and expanded to yield the following charge to the committee: