Review of NASA's Evidence Reports on Human Health Risks 2017 Letter Report (2018) / Chapter Skim
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Risk of Adverse Health Outcomes and Decrements in Performance Due to In-Flight Medical Conditions
Risk of Adverse Health Outcomes and Decrements in Performance Due to In-Flight Medical Conditions
Pages 27-34
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From page 27... ...
for a Transit Mission to Mars (emphasis added) is used to highlight the fact that such a ConOps does not currently exist, though relevant work that is available includes the 2009 Space Medicine Exploration Medical Condition List, the predictive Integrated Medical Model, an Exploration Medical Conditions Concept of Operations and Exploration Medical Capability Element updated in 2014, and Telemedicine Operational Concepts for Human Exploration Missions, also from 2014.
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From page 28... ...
The strengths of this report include the thorough description of NASA's exploration medical capabilities work, the discussion of constraints regarding medical capabilities, the depth and detail of data provided on pharmaceutical bioavailability and shelf life, the summary of approaches to training and simulation, and the narrative on planetary dust. However, these strengths are offset to some extent by substantial issues of risk context that are at best unclear, and at worst confusing.
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From page 29... ...
) should address the numerous potential work tasks and risks of Mars surface operations, which include construction, the operation of excavation equipment, maintenance inside and outside the surface habitat, mechanized traverses to conduct geological/biological research, the deployment of solar and possibly nuclear electric facilities and distribution busses, the operation of well-drilling rigs and coring devices, and the loading of fuel produced on the surface to propel the ascent vehicle to Mars orbit at the end of the surface phase.
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From page 30... ...
. • Additional data and discussion about the prevalence of similar risks and mitigation strategies in partial gravity environments, as the nature of the health risks in a number of areas is reasonably well understood in microgravity.
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From page 31... ...
An example is using the monitoring of urinary calcium to target exercise and pharmaceutical countermeasures to individuals showing patterns of excretion associated with future health problems, rather than having the same countermeasures done by everyone. Because all of the commonly used terms, such as "individualized" or "personalized medicine," and "precision medicine," are unclear with respect to whether they incorporate genetic and genomic data, the committee recommends that HRP simply and explicitly describe genetic data in any context in which they are used or investigated and not rely on there being a common understanding of these more generally used and imprecise terms.
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From page 32... ...
Are There Any Additional Gaps or Aspects to Existing Gaps That Are Not Addressed for This Specific Risk? The committee suggests that NASA consider adding the following to the list of existing gaps: • The development of a fundamental health risk matrix for explo ration missions, with associated risk mitigation measures di rected to key phases of the operations: Earth launch, zero-G, transit, landing G, partial-G at destination, remote launch, zero-G transit, and landing.
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From page 33... ...
The report addresses in its introductory section the interaction of risks and tradeoffs involved in provisioning limited medical capability for missions affected by long communications latency and an inability to provide medical evacuations. In addition the detailed sections on bone fracture, dust exposure, and renal stone formation address risk interactions for those conditions.
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From page 34... ...
Additional input from those with operational medical care delivery experience, particularly NASA flight surgeons and physician astronauts, could do much to help portray the value -- and limits -- of real-world experience in formulating the research and development agenda for this area of focus in NASA's HRP. The Mars expedition task analysis that is currently being conducted by Stuster and colleagues for NASA's Human Factors & Behavioral Performance Element (under NASA Grant Number NNX15AW34G)
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