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Review of NASA’s Human Research Program Evidence Books A Letter Report Committee on NASA’s Research on Human Health Risks Board on Health Sciences Policy

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THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was requested by the National Aeronautics and Space Administration and supported by Award No. NNH08CC26B, T.O. #2, between the National Academy of Sciences and the National Aeronautics and Space Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624- 6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2008 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested Citation: IOM (Institute of Medicine). 2008. Review of NASA’s human research program evidence books: A letter report. Washington, DC: The National Academies Press.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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COMMITTEE ON NASA’S RESEARCH ON HUMAN HEALTH RISKS DANIEL R. MASYS (Chair), Vanderbilt University Medical Center, Nashville, TN CHRISTOPHER HART, Federal Aviation Administration, Washington, DC CHARLES E. LAND, National Cancer Institute, Rockville, MD GLORIA LEON, University of Minnesota–Twin Cities, Minneapolis THOMAS F. OLTMANNS, Washington University, St. Louis SUZANNE OPARIL, University of Alabama at Birmingham, ERIC S. ORWOLL, Oregon Health & Science University, Portland JAMES A. PAWELCZYK, Pennsylvania State University, University Park CAROL SCOTT-CONNER, University of Iowa, Iowa City MICHAEL SILVERSTEIN, University of Washington, Seattle SCOTT TRAPPE, Ball State University, Muncie, IN LAURENCE R. YOUNG, Massachusetts Institute of Technology, Cambridge Liaison, Committee on Aerospace Medicine and the Medicine of Extreme Environments DAVID E. LONGNECKER, Association of American Medical Colleges, Washington, DC IOM Staff CATHARYN T. LIVERMAN, Study Director BRUCE M. ALTEVOGT, Study Director FRANKLIN T. BRANCH, Research Associate JUDITH L. ESTEP, Program Associate ANDREW M. POPE, Director, Board on Health Sciences Policy v

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Independent Report Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Jay Buckey, Dartmouth-Hitchcock Medical Center Louis Anthony (Tony) Cox, Jr., Cox Associates James Lackner, Brandeis University Walter Schimmerling, Consultant Peter Suedfeld, University of British Columbia Warren Zapol, Massachusetts General Hospital Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by John R. Ball, American Society for Clinical Pathology, appointed by the Institute of Medicine, who was responsible for making certain that an independent examination of this report was carried out in accordance vii

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with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. viii