Review of NASA's Longitudinal Study of Astronaut Health (2004) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-8
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Presently the IOM, through activities including studies and workshops undertaken at the National Academies under the auspices of its standing Committee on Aerospace Medicine and the Medicine of Extreme Environments (CAMMEE) , provides NASA's Chief Health and Medical Officer independent technical advice relevant to aerospace medicine, including medical care of space travelers.
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NASA had performed some further analysis of the LSAH database in the interim, and after presentation of those analyses, CLSAH's task was revised and expanded to yield the following charge to the committee: Examine NASA's Longitudinal Study of Astronaut Health (LSAH) and make appropriate medical, scientific, and administrative recommendations for improving the study, as well as recommendations relative to the data trends identified to date, inclusion of astronauts from NASA's international partners, appropriate follow up of findings, and medical care of current and former astronauts, mission specialists, and other space travelers.
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. A follow up study is using digital photography and computer image analysis to better quantify cataract incidence and progression using a group of current and former military pilots as controls.
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A retrospective review of LSAH data showed no significant difference between the astronauts and the comparison participants in clinical thyroid disease but that elevations of TSH during flight had been common, with gradual return to normal after return to earth. Anion exchange filters are now a standard component of the drinking water systems on the space shuttle, and transient elevations in TSH no longer occur.
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The committee is not convinced, given the low power of the study, that traditional "statistical significance" should be the sole trigger for concern, so in addition, it recommends that routine surveillance for unexpected and sentinel events be carried out by the oversight committee described below.
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Occupational health clinics at other NASA centers, Federal Aviation Agency medical examiners, or private primary care providers could be given a standard protocol.
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The JSC Occupational Health Clinic provides no treatment for former employees. Participants are simply told the results of their physical exams and lab tests and referred to their private physicians for treatment of any suspected conditions.
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After reviewing the history and policies of the Departments of Energy, Defense, and Veterans Affairs in somewhat analogous cases involving beryllium, nuclear weapons tests, and Agent Orange, respectively, the committee's final recommendation was to reiterate a suggestion of the committee that authored Safe Passage (IOM, 2001c)
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