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Fall/Winter 2001 Vol. 1 No. 2

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Space Shuttle Atlantis (photo courtesy NASA) To Infinity and Beyond

What It Takes to Keep Astronauts Safe and Sound on Long Space Missions

Space travel today is dramatically different from what it was when John Glenn orbited the Earth three times in 1962 and Neil Armstrong set foot on the moon's barren surface more than 30 years ago. And the changes will continue as flights to the International Space Station begin to include guests, and human missions to the moon, Mars, and beyond become a strong possibility in the 21st century.

On journeys of long duration, the health risks and challenges inherent in space travel -- including loss of bone density, excessive radiation exposure, and behavioral adaptation to being confined in potentially hazardous living conditions -- are greatly increased. Because of this, NASA asked the Institute of Medicine for additional perspective on its health care research, to help "create a vision" of clinical care for astronauts during and following long missions beyond Earth's orbit.

Astronaut Takao Doi on space shuttle Columbia (photo courtesy NASA) The IOM report's overarching message is that before sending humans into deep space for long periods of time, NASA must learn more about the risks to human health and life posed by such missions and how to effectively mitigate those risks. NASA must also clearly and candidly communicate these risks to astronauts, scientists, and the general public.

Unlike other kinds of health research, clinical information relevant to space travel can be collected only from astronauts. One way to deal with the ethical issues that might arise from conducting such research is to consider the spacecraft as a workplace environment and apply occupational health principles to the research. In a workplace model of health care, the individual's safety and health would be weighed against the needs of those who are to benefit from the research.

Astronauts Daniel Tani and Dominic Gorie (photo courtesy NASA) Beyond studying astronaut physiology, consideration must be given to behavioral and social factors that may come into play. A mission to and from Mars, for example, could take three years to complete and involve a diverse crew of men and women inhabiting a confined space. NASA must conduct more research on behavioral health, including coping strategies and interpersonal dynamics under stressful conditions. With the mission's success depending in large part on individuals working and living in a healthy team environment, selection and training of the crew will take on far greater significance.

NASA also needs to focus more sharply on man-machine interactions and what makes an environment habitable over the long term. The agency could benefit greatly from facilitating the steady convergence of engineering and biology that is already under way.

By developing and instituting a comprehensive health care system for astronauts, NASA can create a knowledge base for decision-making that will allow long-duration exploration of deep space to proceed while offering travelers a healthier environment -- and a safe passage.   -- Saira Moini

Safe Passage: Astronaut Care for Exploration Missions. Committee on Creating a Vision for Space Medicine During Travel Beyond Earth Orbit, Board on Health Sciences Policy, Institute of Medicine (2001, 318 pp.; ISBN 0-309-07585-8; available from National Academy Press, tel. 1-800-624-6242; $80.00 plus $4.50 shipping for single copies).

The panel was chaired by John R. Ball, executive vice president emeritus, American College of Physicians, Havre de Grace, Md. The study was funded by NASA.

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Copyright 2001 by the National Academy of Sciences