1
Introduction

Extending the spatial and temporal boundaries of human space flight is an important goal for the nation and for the National Aeronautics and Space Administration (NASA). However, human space flight remains an endeavor with substantial risks, and these risks must be identified, managed, and mitigated appropriately to achieve the nation’s goals in space. The Bioastronautics Roadmap (BR) is the result of extensive, commendable efforts on the part of NASA to prioritize research efforts to meet these challenges. It is a broad and complex document that has been developed with care and thought and has evolved over time as the thinking at NASA has progressed regarding its role. During the time this committee was active, the Bioastronautics Critical Path Roadmap of April 2004 (NASA, 2004) evolved into the Bioastronautics Roadmap of February 9, 2005 (NASA, 2005). The former contained 50 risks, 5 cross-cutting areas, and 1,414 “enabling questions” for the three Design Reference Missions: the International Space Station (ISS), the lunar mission, and Mars. The latter contains 45 risks, the same 5 cross-cutting areas, and 1,360 research and technology questions. Other changes occurred as well, as NASA reviewed and revised its own efforts, and in response to the committee’s interim report of 2005 (IOM, 2005). For example, the concepts of “requirements” and “operating bands” were strengthened considerably as the BR evolved. Thus, the committee faced a considerable challenge in responding to its charge to review the BR and its related thought processes because these were dynamic and evolving during most of the review process. How-



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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap 1 Introduction Extending the spatial and temporal boundaries of human space flight is an important goal for the nation and for the National Aeronautics and Space Administration (NASA). However, human space flight remains an endeavor with substantial risks, and these risks must be identified, managed, and mitigated appropriately to achieve the nation’s goals in space. The Bioastronautics Roadmap (BR) is the result of extensive, commendable efforts on the part of NASA to prioritize research efforts to meet these challenges. It is a broad and complex document that has been developed with care and thought and has evolved over time as the thinking at NASA has progressed regarding its role. During the time this committee was active, the Bioastronautics Critical Path Roadmap of April 2004 (NASA, 2004) evolved into the Bioastronautics Roadmap of February 9, 2005 (NASA, 2005). The former contained 50 risks, 5 cross-cutting areas, and 1,414 “enabling questions” for the three Design Reference Missions: the International Space Station (ISS), the lunar mission, and Mars. The latter contains 45 risks, the same 5 cross-cutting areas, and 1,360 research and technology questions. Other changes occurred as well, as NASA reviewed and revised its own efforts, and in response to the committee’s interim report of 2005 (IOM, 2005). For example, the concepts of “requirements” and “operating bands” were strengthened considerably as the BR evolved. Thus, the committee faced a considerable challenge in responding to its charge to review the BR and its related thought processes because these were dynamic and evolving during most of the review process. How-

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap ever, the committee recognizes that the ongoing changes represent progress that is both necessary and appropriate, and it acknowledges the continued focus on this approach as a management tool for bioastronautics. The committee’s comments are, therefore, based on the Bioastronautics Roadmap version of February 9, 2005, the current version at the time of this writing (NASA, 2005), referred to as the BR. The February 2005 baseline version of the BR used by the committee for its review is enclosed as a CD in the cover of this report. Both the baseline BR and the interactive version that relates to specific risks and Design Reference Missions are available on-line at http://bioastroroadmap.nasa.gov. The Bioastronautics Roadmap was developed collaboratively by NASA’s Office of Biological and Physical Research and the Office of Space Flight with the concurrence of the Office of the Chief Health and Medical Officer. NASA describes the document as “the framework used to identify and assess the risks of crew exposure to the hazardous environments of space” (NASA, 2005). According to the baseline BR, the BR also “guides the prioritized research and technology development that, coupled with operational space medicine, will inform” the following: The development of medical standards and policies The specifications of requirements for the human system The implementation of medical operations The BR also provides information that helps establish operating bands—or exposure limits—for humans exposed to risks during space travel and develop countermeasures to maintain the health and functioning of the crew within those limits and technologies to improve the safety and productivity of human space flight. Operating bands represent an acceptable range of performance or functioning, specifically for life support and habitation systems. Exposure limits describe an acceptable maximum decrement or change in a human physiological or behavioral parameter that impacts the performance of assigned tasks or has implications for lifetime medical status. The BR was created to facilitate and support the successful accomplishment of the three Design Reference Missions described in the President’s space initiative of January 14, 2004 (White House, 2004). The stated goal of the BR is “to reduce risk through effective and efficient mitigation solutions developed from a focused research and technology development strategy” (NASA, 2005). The contents of the BR are the identified

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap risks; the research and technology questions associated with these risks; and the deliverables—the desired outcomes or solutions to these questions. Major processes of the BR include risk identification and risk assessment. The context in which these risks are identified include the mission requirements for the three Design Reference Missions as well as the organization and systems within NASA and the external organizations and systems that govern NASA (e.g., executive and legislative branches of government, federal budget). Efforts to understand and manage the risks associated with human space flight have been ongoing at NASA for many years, and specific activities related to the development of a roadmap began in the early 1990s. The process of risk identification that resulted in the BR commenced in 1997 in brainstorming sessions involving NASA and non-NASA experts who rated risks within their own discipline areas. With guidance from NASA and other advisory reports (see Appendix A), 150 risks were identified. More recently, and after several iterations, the list was culled to the 45 risks that are the focus of the current BR. The BR currently identifies 31 human health–related risks and 14 risks related to systems performance and efficiency clustered in 5 cross-cutting areas: human health and countermeasures, radiation health, behavioral health and performance, autonomous medical care, and advanced human life support technologies. The final risks and related research questions were identified by discipline-specific teams using internal NASA and external advisory committee reports, as well as other recent research findings. The Bioastronautics Science Management Team, which includes NASA scientists, managers, and flight surgeons, and the National Space Biomedical Research Institute (NSBRI) director reviewed and discussed the risks and provided oversight for the project. In the spring of 2004, NASA held several consensus workshops, which included the research community and NASA operations communities (flight surgeons, astronauts, and the medical office), to address the sample size needed for research related to the risks identified, the use of animal models, and the ranking of biomedical risks from the point of view of astronauts and flight surgeons. In addition, NASA sought comments on the BR from the relevant research communities in a web-based query. Risk assessment and rating are described in the BR for two general types of risk: human health risks and system performance/efficiency risks. The ratings for the human health risks derive from the analysis of the likelihood of occurrence of each risk, the severity of the consequences should a

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap TABLE 1-1 Bioastronautics Roadmap Risk Rating Categories and Priority Definitions Risk Rating Priority Human Health Risks System Performance or Efficiency Risks 1 Risk of serious adverse health or performance consequences, and there is no mitigation strategy that has been validated in space or demonstrated on Earth. Considerable potential for improvement in mitigation efficiency in many areas; proposed missions may be infeasible without improvements. 2 Risk of serious adverse health or performance consequences, and there is no mitigation strategy that has been validated in space. Considerable potential for improvement in mitigation efficiency in a few areas. 3 Health and performance consequences are known or suspected but will not affect mission success due to effective mitigation strategies that have been validated in space. Minimum potential or limited need for improvement in mitigation efficiency.   SOURCE: NASA (2005, Table 7-2). given event occur, and the status of efforts to mitigate each risk. For the systems risks, the criterion is improved efficiency. Input from the iterative process described above, including results of the workshops, fed into this risk assessment. Table 1-1 shows the risk rating categories and priority definitions used in the BR. The intent of this risk rating process is to aid communication and decision making by demonstrating the consensus on the relative importance of each risk. The same criteria were applied to all 45 risks in the current BR. THE PRESIDENT’S INITIATIVE On January 14, 2004, President George W. Bush announced his vision for space exploration (White House, 2004). The President’s plan for con-

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap tinued human and robotic space exploration is summarized in Box 1-1. The BR refers to three scenarios in the plan as “Design Reference Missions” and describes them as follows: (1) a one-year mission to the International Space Station (ISS); (2) a one-month stay on the lunar surface; and (3) a 30-month journey to Mars and back. CHARGE TO THE COMMITTEE In 2003, NASA asked the Institute of Medicine (IOM), in collaboration with the Division on Engineering and Physical Sciences of the National Academies, to conduct a review of the BR. Specifically, NASA asked the committee to (1) conduct a comprehensive assessment and report of the strengths and weaknesses of the content and processes of the Bioastronautics Roadmap as applied to the missions described in the President’s exploration initiative and (2) identify the unique challenges for accomplishing its goals and objectives. Specific questions for the committee to answer included—but were not limited to—the following: How can the BR better capture and describe the critical risks and key research and technology issues for risk reduction and management so as to provide a framework for informed decisions regarding resource allocation? Does the BR use an appropriate method of risk assessment and expression of risk assessment? Does it adequately communicate the methods underlying risk assessment and the resulting activities for different mission scenarios? How well does the BR address different types of risk (e.g., health, engineering) and their impact? Are the categories of critical research issues and the metrics used to analyze them appropriate (risk assessment and characterization, mechanistic/process research, countermeasure development, and medical diagnosis and treatment)? Are efficiency and technology issues properly and adequately addressed? In September 2004, the committee released its preliminary report to NASA entitled Preliminary Considerations Regarding NASA’s Bioastronautics Critical Path Roadmap (IOM, 2005). That document presented the committee’s preliminary conclusions about the strengths and weaknesses of

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap BOX 1-1 President Bush’s Vision for U.S. Space Exploration The President’s plan for steady human and robotic space exploration is based on the following goals: 1. First, America will complete its work on the International Space Station by 2010, fulfilling our commitment to our 15 partner countries. The United States will launch a re-focused research effort on board the International Space Station to better understand and overcome the effects of human space flight on astronaut health, increasing the safety of future space missions. To accomplish this goal, NASA will return the Space Shuttle to flight consistent with safety concerns and the recommendations of the Columbia Accident Investigation Board. The Shuttle’s chief purpose over the next several years will be to help finish assembly of the Station, and the Shuttle will be retired by the end of this decade after nearly 30 years of service. 2. Second, the United States will begin developing a new manned exploration vehicle to explore beyond our orbit to other worlds—the first of its kind since the Apollo Command Module. The new spacecraft, the Crew Exploration Vehicle, will be developed and tested by 2008 and will conduct its first manned mission no later than 2014. The Crew Exploration Vehicle will also be capable the April 2004 version of the BR. The present report builds on those preliminary conclusions and provides recommendations to NASA about how to address the issues identified by the committee. The present report refers to the February 9, 2005, version of the BR. METHODOLOGY Responding to NASA’s request, the committee approached its task with enthusiasm and a strong sense of commitment to the goals of NASA overall and to its most visible images, the astronauts. The efforts of the committee were buoyed by the excitement associated with the President’s exploration initiative of January 2004. The committee included members with a broad range of relevant expertise, and it supplemented that expertise by holding eight meetings in either open session (see Appendix B) or executive session,

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap of transporting astronauts and scientists to the International Space Station after the Shuttle is retired. 3. Third, America will return to the Moon as early as 2015 and no later than 2020 and use it as a stepping stone for more ambitious missions. A series of robotic missions to the Moon, similar to the Spirit Rover that is sending remarkable images back to Earth from Mars, will explore the lunar surface beginning no later than 2008 to research and prepare for future human exploration. Using the Crew Exploration Vehicle, humans will conduct extended lunar missions as early as 2015, with the goal of living and working there for increasingly extended periods. The extended human presence on the Moon will enable astronauts to develop new technologies and harness the Moon’s abundant resources to allow manned exploration of more challenging environments. An extended human presence on the Moon could reduce the costs of further exploration, since lunar-based spacecraft could escape the Moon’s lower gravity using less energy at less cost than Earth-based vehicles. The experience and knowledge gained on the Moon will serve as a foundation for human missions beyond the Moon, beginning with Mars. NASA will increase the use of robotic exploration to maximize our understanding of the solar system and pave the way for more ambitious manned missions. Probes, landers, and similar unmanned vehicles will serve as trailblazers and send vast amounts of knowledge back to scientists on Earth. where experts from NASA and elsewhere presented their views on relevant content of the BR; by individual meetings between subgroups of the committee, NASA personnel, and outside experts; by more than 60 hours of deliberations in executive session; and by countless hours of independent reading, analysis, and team writing. This report represents the synthesis of these efforts and the collective agreement of committee members. OVERALL ASSESSMENT OF THE BIOASTRONAUTICS ROADMAP The committee’s comments focus on areas in which improvement seems necessary and most valuable, but the committee wishes to emphasize that the present document demonstrates that NASA has considered many of the key factors carefully and is handling many aspects of this complex

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A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA’s Bioastronautics Roadmap challenge appropriately. The committee was impressed by the progress that appeared in the BR during the course of its review. The reader should not lose sight of these many positives when reading the following analyses, conclusions, and recommendations, which focus on opportunities for improvement. The current version of the BR is a useful first step, but it will not be adequate to achieve its stated goals unless the recommendations provided here are incorporated into the document and into the thinking and actions of NASA management. The BR must constantly be updated and maintained, the resulting action plans that flow from the BR must be supported by adequate allocation of resources both to NASA and within NASA, and the action plans must be implemented fully. If these criteria are met, the committee believes that the BR will be an effective mechanism to mitigate the risks to human health and thus contribute to ensuring mission success during extended space flight. STRUCTURE OF THE REPORT The report has been structured according to the committee’s charge insofar as the BR content (Chapter 2) and process (Chapter 3) are concerned. Chapter 4 deals with issues relevant to the BR context and thus addresses what the committee views as the unique challenges faced by NASA in accomplishing the roadmap’s goals and objectives. Specific questions posed in the charge are addressed in the relevant sections of this report. The Summary presents the committee’s finding and recommendations, highlighted throughout the report. REFERENCES IOM (Institute of Medicine). 2005. Preliminary Considerations Regarding NASA’s Bioastronautics Critical Path Roadmap. Washington, DC: The National Academies Press. NASA (National Aeronautics and Space Administration). 2005. Bioastronautics Roadmap—a risk reduction strategy for human space exploration. On-line [available: http://ston.jsc.nasa.gov/collections/TRS/-techrep/Sp-2005-6113.pdf]. Accessed 1/6/2006. White House. 2004. President Bush announces new vision for space exploration program. Remarks by the President on U.S. space policy. On-line [available: http://www.whitehouse.gov/news/releases/2004/01/20040114-3.html]. Accessed 5/26/05.