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Review of NASAâs Evidence Reports on Human Health Risks 2 0 1 5 L E T T E R R E P O R T Committee to Review NASAâs Evidence Reports on Human Health Risks Board on Health Sciences Policy Carol E. H. Scott-Conner, Daniel R. Masys, and Catharyn T. Liverman, Editors Institute of Medicine
THE NATIONAL ACADEMIES PRESS ⢠500 Fifth Street, NW ⢠Washington, DC 20001 This project was supported by Contract NNH13CK19B, Task Order NNH13CK20D, between the National Academy of Sciences and the National Aeronautics and Space Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-38061-4 International Standard Book Number-10: 0-309-38061-8 Digital Object Identifier: 10.17226/21844 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. Copyright 2016 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Review of NASAâs evidence reports on human health risks: 2015 letter report. Washington, DC: The National Academies Press. doi: 10.17226/21844.
The Na ational Acade emy of Sciennces was estaablished in 18863 by an Act of Conngress, signed d by Presidentt Lincoln, as a private, noongovernmenttal institu ution to advisee the nation on issues relaated to sciencce and technoology. Membe ers are electe ed by their peeers for outsttanding contribbutions to ressearch. Dr. Ralph R J. Cicerrone is presideent. The Na ational Acadeemy of Enginneering was eestablished inn 1964 under the chharter of the National N Acaddemy of Sciennces to bring the practice es of enggineering to advising the nation. Membe ers are electe ed by their peers for extraordinary contribuutions to engiineering. Dr. C. D. Mote, Jr., is president. The Naational Acade emy of Medic cine (formerlly the Institutte of Medicin ne) was esstablished in 1970 under the charter off the Nationa l Academy off Scienc ces to advise the nation on n medical and d health issuees. Members are ele ected by theiir peers for diistinguished ccontributionss to medicine and heealth. Dr. Victor J. Dzau iss president. The thhree Academies work together as the N National Acaddemies of Sciencces, Engineerring, and Medicine to pro ovide indepenndent, objecttive analysis and a advice to o the nation aand conduct o other activitie es to solv ve complex problems and inform publicc policy decissions. The Academies also enc courage education and ressearch, recoggnize anding contrib outsta butions to kno owledge, and d increase pub blic undersstanding in matters m of scie ence, enginee ering, and me edicine. Learn more about the t National Academies A off Sciences, En ngineering, and Mediciine at www.n national-acad demies.org.
COMMITTEE TO REVIEW NASAâS 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 C. PATRICK DUNNE, Dunne Solutions, Framingham, MA BRAD HOLSCHUH, University of Minnesota, Twin Cities MICHAEL J. JOYNER, Mayo Clinic, Rochester, MN JAMES A. PAWELCZYK, Pennsylvania State University, University Park K. P. SANDEEP, North Carolina State University, Raleigh ROBERT L. SATCHER, JR., University of Texas, Houston JACK STUSTER, Anacapa Sciences, Santa Barbara, CA SCOTT TRAPPE, Ball State University, Muncie, IN PETER D. WAGNER, University of California, San Diego 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 CLAIRE F. GIAMMARIA, Research Associate JUDITH L. ESTEP, Program Associate SOPHIE YANG, Research Assistant 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. 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: ELDON W. ASKEW, University of Utah DENNIS R. HELDMAN, The Ohio State University SUSAN R. HOPKINS, University of California, San Diego DAVID KIRSCH, Duke University Medical Center JOANNE LUPTON, Texas A&M University NEAL W. POLLOCK, Duke University Medical Center FRANK A. SLOAN, Duke University JOHN B. WEST, University of California, San Diego Although reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by GLORIA LEON, University of Minnesota, who served as the coordinator. She was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the fi- nal content of this report rests entirely with the authoring committee and the institution. vii
Contents COMMITTEEâS TASK AND OVERARCHING ISSUES 2 THE NASA HUMAN RESEARCH ROADMAP 4 RISK OF IMPAIRED PERFORMANCE DUE TO REDUCED MUSCLE MASS, STRENGTH, AND ENDURANCE 5 RISK OF REDUCED PHYSICAL PERFORMANCE CAPABILITIES DUE TO REDUCED AEROBIC CAPACITY 12 RISK OF ORTHOSTATIC INTOLERANCE DURING RE-EXPOSURE TO GRAVITY 17 RISK OF INJURY AND COMPROMISED PERFORMANCE DUE TO EVA OPERATIONS 22 RISK OF DECOMPRESSION SICKNESS 31 RISK OF PERFORMANCE DECREMENT AND CREW ILLNESS DUE TO AN INADEQUATE FOOD SYSTEM 40 RISK FACTOR OF INADEQUATE NUTRITION 47 SUMMARY 53 REFERENCES 55 ix
x CONTENTS APPENDIXES A Meeting Agendas 61 B Committee Biographical Sketches 65
