Review of NASA's Space Flight Health Standards Letter Report (2007) / Chapter Skim
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Letter Report
Letter Report
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Given the amount of planning and effort needed to design the exploration architecture and carry out these goals, it is imperative that the best currently available evidence on preventing and mitigating health risks be incorporated into the design and mission plans from the earliest stage possible. Through the delineation of human space flight health standards, NASA is taking the steps that will foster mission success, mitigate in-flight health risks to the extent currently feasible, and outline a research agenda that will more fully foster crew health and mission success on increasingly longer-duration space flights to more distant destinations.
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The initial space flight health standards -- along with the more detailed program and project-level requirements -- set the operational criteria for protecting human health for crew members while in flight. Refining those criteria and relating them to the type and duration of each mission is an inherent strength of the iterative and ongoing nature of the standards-setting process.
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NEXT STEPS The remainder of this report delineates the committee's findings and gives recommendations related to these issues for next steps that NASA staff should consider in their quest to foster mission success and maintain the health and well-being of space crew members. The committee notes that there are opportunities for improvement, especially in the following areas: enhanced input to the standards setting process; strengthened review of the evidence; increased research and validation to support standards development; clearly defined mechanisms for appeals, updates and the development of new standards; and use of an integrated systems approach to explore potential relationships among individual standards.
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In particular, it would be valuable to involve national and international experts in analog environments, experts from the Air Force and other military services that address flight health issues, prior astronauts, and experts in specific relevant areas of study (e.g., behavioral health, risk assessment, and risk characterization) from other federal agencies, nonprofit organizations, and academia.
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Space crew members are well informed about the risks they face, are involved in efforts to mitigate that risk, and should be fully engaged in the occupational health decisions regarding all aspects of their missions. The challenge in developing space flight health standards is to determine an acceptable level of risk that provides maximum feasible protection of crew health and safety without jeopardizing mission success or "overengineering" either the technical or medical solutions that mitigate these risks.
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As more data become available through subsequent space flight missions and other relevant research, increasingly sophisticated risk assessment methodologies will offer the potential to refine the NASA standards. The EPA's IRIS (Integrated Risk Information System)
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NASA should ensure that the documentation of each space flight health standard includes a detailed assessment of the evi dence on which the standard is based and its quality, the gaps in knowledge associated with the risk assessment, and the future research that is required to further validate the standard. Increasing the Evidence Base A paucity of data is the major challenge that faces risk assessments of space mission hazards, particularly for long-duration efforts such as lunar habitation or a Mars mission.
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Improving data availability and enhancing the opportunities for data sharing will strengthen the validity and integrity of the NASA standards-setting process. Continual care should be exercised to ensure that standard setting is data driven and that standards are not based on opinion unsupported by the appropriate research.
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The committee urges that the behavioral health standard be expanded to include measures of group dynamics and interpersonal relationships, using quantitative and qualitative behavioral health assessment methodologies. Further, the committee believes that documented mechanisms should be established for initiating new standards and expanding existing standards.
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The committee urges NASA to consider how the individual space flight health standards are interrelated and to address potential additive, synergistic, or aggregate effects that may result when physiological changes or decrements occur in multiple body systems or when there is the potential for multiple hazardous exposures. The knowledge base for this area is relatively scant, but as data become increasingly available, NASA should continue to reexamine individual standards while exploring the consequences of their interrelationships.
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OLTMANNS, Washington University JAMES PAWELCZYK, Pennsylvania State University RUSSELL B RAYMAN, Aerospace Medical Association CAROL SCOTT-CONNER, University of Iowa RHEA SEDDON, Vanderbilt University Medical Center MICHAEL SILVERSTEIN, University of Washington GEORGE PEACH TAYLOR, JR., PricewaterhouseCoopers WARREN M
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. Draft: Space flight health standards for human performance.
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Working Lunch Overview of NASA Health and Medical Standards Mike Duncan, Chief of the Space Medicine Division Office of Space Life Sciences, Johnson Space Center Discussion 1:00 – 2:00 NASA Health and Medical Standards Setting David Liskowsky, Director, Bioethics and Transition to Practice Office of the Chief Health and Medical Officer, NASA Headquarters • Historical Experience (Radiation and Toxicology) • Development of Standards Setting Process • Current Process • Current Standards 2:00 – 3:00 Discussion 3:00 Adjourn Open Session Tuesday, November 14th – Room 201 OPEN SESSION 8:30 – 8:45 a.m.
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Anderson, Association of Military Surgeons of the United States Roy DeHart, Vanderbilt University Lawrence A Palinkas, University of Southern California Rosemary Sokas, University of Illinois at Chicago Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release.
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