Review of NASA's Evidence Reports on Human Health Risks: 2014 Letter Report (2015)

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Revieww of NASA’s N s Evideence Reeports on Huuman Health Riskks 2014 LETTER REPORT Committtee to Review w NASA’s EEvidence Reeports on Humman Health R Risks Board B on Heealth Sciencees Policy Carol E. H. Scott--Conner, Danniel R. Masyys, Catharyn C T. Liverman, and a Margareet A. McCoyy, Editors 

THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • 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. This project was supported by Contract NNH13CK19B, Task Order NNH13CK20D, between the National Academy of Sciences and the National Aeronautics and Space Administration. The views presented in this publication are those of the editors and attributing authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number-13: 978-0-309-31451-0 International Standard Book Number-10: 0-309-31451-8 Additional copies of this report available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2015 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Suggested citation: IOM (Institute of Medicine). 2015. Review of NASA’s evidence reports on human health risks: 2014 letter report. Washington, DC: The National Academies Press. 



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COMMITTEE TO REVIEW NASA’S EVIDENCE REPORTS ON HUMAN HEALTH RISKS CAROL E. H. SCOTT-CONNER (Chair), University of Iowa Carver College of Medicine, Iowa City DANIEL R. MASYS (Vice Chair), University of Washington, Seattle SUSAN A. BLOOMFIELD, Texas A&M University, College Station KAREN S. COOK, Stanford University, Stanford, CA SUNDARESAN JAYARAMAN, Georgia Institute of Technology, Atlanta CHERYL NICKERSON, Arizona State University, Tempe JAMES A. PAWELCZYK, Pennsylvania State University, University Park ROBERT L. SATCHER, University of Texas MD Anderson Cancer Center, Houston RANDALL SHUMAKER, University of Central Florida, Orlando JACK STUSTER, Anacapa Sciences, Inc., Santa Barbara, CA GAYLE E. WOLOSCHAK, Northwestern University Feinberg School of Medicine, Chicago, IL LAURENCE R. YOUNG, Massachusetts Institute of Technology, Cambridge IOM Staff CATHARYN T. LIVERMAN, Study Director MARGARET A. MCCOY, Study Director CLAIRE F. GIAMMARIA, Research Associate JUDITH L. ESTEP, Program Associate ANDREW M. POPE, Director, Board on Health Sciences Policy v 



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 National Research Council’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 C. BUCKEY, Dartmouth-Hitchcock Medical Center MARY L. CUMMINGS, Duke University PETER A. HANCOCK, University of Central Florida CHRISTINE E. KASPER, Uniformed Services University of the Health Sciences DAVID M. KLAUS, University of Colorado Boulder ANDREW LIU, Massachusetts Institute of Technology Man Vehicle Lab DEAN M. OLSON, Wright State University NEAL PELLIS, Universities Space Research Association Although reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the report be- fore its release. The review of this report was overseen by GLORIA LEON, University of Minnesota, who served as the Coordinator and MARCIA J. RIEKE, University of Arizona, who served as the Monitor. vii 

viii REVIEWERS Appointed by the Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review com- ments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. 

Contents COMMITTEE’S TASK AND OVERARCHING ISSUES 2 THE NASA HUMAN RESEARCH ROADMAP 5 RISK OF ADVERSE HEALTH EFFECTS DUE TO ALTERATIONS IN HOST-MICROORGANISM INTERACTIONS 5 RISK OF CREW ADVERSE HEALTH EVENT DUE TO ALTERED IMMUNE RESPONSE 15 RISK OF INADEQUATE DESIGN OF HUMAN AND AUTOMATION/ROBOTIC INTEGRATION 22 RISK OF INADEQUATE HUMAN-COMPUTER INTERACTION 27 RISK OF INCOMPATIBLE VEHICLE/HABITAT DESIGN 32 RISK OF INADEQUATE CRITICAL TASK DESIGN 39 RISK OF PERFORMANCE ERRORS DUE TO TRAINING DEFICIENCIES 46 SUMMARY 54 REFERENCES 57 ix 

x CONTENTS APPENDIXES A Meeting Agendas 71 B Committee Biographical Sketches 75