NASA/SP–2005–6113 

Bioastronautics Roadmap 

A Risk Reduction Strategy for Human Space Exploration 

February 2005
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NASA/SP–2005–6113 

Bioastronautics Roadmap 

A Risk Reduction Strategy for Human Space Exploration 

Previously published under JSC 62577 

February 2005
Available from: 

This is a living document that undergoes periodic revision. 

Subsequent revisions are available at http://bioastroroadmap.nasa.gov/

NASA Center for AeroSpace Information National Technical Information Service 

7121 Standard Drive 5285 Port Royal Road 

Hanover, MD 21076-1320 Springfield, VA 22161 

This report is also available in electronic form at http://ston.jsc.nasa.gov/collections/TRS 
NASA/SP–2004–6113 i

DOCUMENT NUMBER: 

NASA/SP–2005–6113

DATE: February 2, 2005

Bioastronautics Roadmap 

A Risk Reduction Strategy for Human Space Exploration 
NASA/SP–2005–6113 ii

DOCUMENT NUMBER 

NASA/SP–2004–6113

DOCUMENT CHANGE/ 

REVISION LOG 

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CHANGE/ 

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AFFECTED 

BASIC 02/02/05 Baselined Version ALL 

Altered pages must be typed and distributed for insertion. 
NASA/SP–2005–6113 iii

TABLE OF CONTENTS 

Section Page 

EXECUTIVE SUMMARY.........................................................................................................................................1

1.0 INTRODUCTION.........................................................................................................................................7

2.0 ROADMAP HISTORY ................................................................................................................................7

2.1 RISK ASSESSMENT AND MANAGEMENT.......................................................................................................8

2.2 BIOASTRONAUTICS CRITICAL PATH ROADMAP BASELINE DOCUMENT .......................................................8

2.3 BIOASTRONAUTICS STRATEGY ....................................................................................................................9

2.4 BIOASTRONAUTICS SCIENCE MANAGEMENT TEAM.....................................................................................9

3.0 ROADMAP CONTROL AND CONFIGURATION .................................................................................9

4.0 ROADMAP GOALS AND OBJECTIVES ...............................................................................................10

5.0 KEY ELEMENTS OF THE ROADMAP .................................................................................................11

5.1 SETTING REFERENCE MISSION REQUIREMENTS.........................................................................................12

5.2 RISK IDENTIFICATION................................................................................................................................12

5.2.1 Risk Data Sheets ..................................................................................................................................14

5.3 IDENTIFICATION OF RESEARCH AND TECHNOLOGY QUESTIONS ................................................................14

5.4 DEFINING DELIVERABLES .........................................................................................................................15

5.5 ASSESSING READINESS LEVELS.................................................................................................................17

6.0 ROADMAP RISKS AND RESEARCH AND TECHNOLOGY QUESTIONS ....................................18

7.0 RISK ASSESSMENT AND RATING RESULTS....................................................................................24

7.1 RISK ASSESSMENT AND RATING................................................................................................................24

7.2 RISK RATING RESULTS..............................................................................................................................25

8.0 RISK ASSESSMENT AND MANAGEMENT.........................................................................................30

8.1 ROADMAP INTEGRATION AND INTERACTION .............................................................................................30

8.2 USING A PROJECT APPROACH....................................................................................................................31

9.0 FORWARD WORK....................................................................................................................................31

9.1 BENEFIT/COST ANALYSIS..........................................................................................................................31

9.2 METRICS ...................................................................................................................................................32

10.0 CONCLUSIONS .........................................................................................................................................32

APPENDICES 

A. RISK DATA SHEETS ......................................................................................................................................... A-1 

B. SPACE FLIGHT FACTOR INTERACTIONS ...................................................................................................... B-1 

C. EXPLORATION SYSTEMS MISSION DIRECTORATE SCHEDULES AND MILESTONES ............................. C-1 

D. ACRONYMS....................................................................................................................................................... D-1 

E. GLOSSARY........................................................................................................................................................ E-1 

F. REFERENCES .................................................................................................................................................. F-1 
NASA/SP–2005–6113 iv

INDEX OF TABLES AND FIGURES

Tables Page 

TABLE 5-1: ROADMAP REFERENCE MISSIONS (AS OF JULY 2003) ................................................................................12

TABLE 5-2: ROADMAP CROSSCUTTING AREAS AND DISCIPLINE TEAMS.......................................................................13

TABLE 5-3: RESEARCH & TECHNOLOGY QUESTION CATEGORIES ................................................................................14

TABLE 5-4: AREAS TO WHICH ROADMAP DELIVERABLES CONTRIBUTE .......................................................................15

TABLE 5-5: COUNTERMEASURE/TECHNICAL READINESS LEVELS ................................................................................17

TABLE 6-1: RISKS AND R&TQ FOR EACH DISCIPLINE AND CROSSCUTTING AREA.......................................................18 

TABLE 6-2: CROSSCUTTING AREA: HUMAN HEALTH AND COUNTERMEASURES ..........................................................19

TABLE 6-3: CROSSCUTTING AREA: AUTONOMOUS MEDICAL CARE .............................................................................21

TABLE 6-4: CROSSCUTTING AREA: BEHAVIORAL HEALTH AND PERFORMANCE...........................................................21

TABLE 6-5: CROSSCUTTING AREA: RADIATION HEALTH .............................................................................................22

TABLE 6-6: CROSSCUTTING AREA: ADVANCED HUMAN SUPPORT TECHNOLOGY ........................................................23

TABLE 7-1: INPUT AND WORKSHOPS FOR RISK RATING ANALYSIS AND DELIBERATIONS ............................................25

TABLE 7-2: RISK RATING CATEGORIES ........................................................................................................................27

TABLE 7-3: RISK RATING RESULTS FOR HUMAN HEALTH RISKS..................................................................................28

TABLE 7-4: RISK RATING RESULTS FOR SYSTEM PERFORMANCE/EFFICIENCY RISKS...................................................29

Figure Page 

FIGURE 5-1: THE BIOASTRONAUTICS ROADMAP PROCESS FLOW CHART .....................................................................11
NASA/SP–2005–6113 1 

Executive Summary 

Bioastronautics as a discipline is the study of biological and medical effects of space flight 

on humans. It is represented by an ongoing set of collaborative relations, spanning research 

and technology development, operational, and policy issues related to the health and 

performance of the human during space flight missions, and afterwards. Bioastronautics 

activities are carried out across several Mission Directorates and a Staff Office, (i.e., the 

Exploration Systems Mission Directorate, the Space Operations Mission Directorate, and the 

Office of the Chief Health and Medical Officer). The Bioastronautics Exploration Research 

and Technology Office at Johnson Space Center, has responsibility for the Roadmap as a 

product. 

In Bioastronautics the human is considered to be a critical system of space flight in the same 

way that propulsion, thermal, and power are critical systems of space flight. Like those 

systems, the operating bands1

 and requirements for the performance and health of the human 

system must be understood, controlled, and specified, as well as optimally integrated with 

other systems. The human system includes all of the crewmembers, both individually and 

collectively, and their requirements for physical and behavioral health in the context of the 

defined missions. The requirements for the missions are the result of an iterative 

developmental process based on the increased knowledge and technology maturation that 

results from addressing the risks associated with the human system. 

The Bioastronautics Roadmap guides the prioritized research and technology development 

that, coupled with operational space medicine, will inform: (1) the development of medical 

standards and policies; (2) the specification of requirements for the human system; and (3) 

the implementation of medical operations. The Roadmap provides information that helps (1) 

establish tolerances (i.e. operating bands or exposure limits)2

 for humans exposed to the 

effects of space travel and develop countermeasures to maintain crew health and function 

within those limits; and (2) develop technologies that make human space flight safe and 

productive. 

The Roadmap is the framework used to identify and assess the risks of crew exposure to the 

hazardous environments of space. It guides the implementation of research and technology 

strategies to prevent or reduce those risks and defines processes for accommodating new 

information and technology development. As a research management tool for risk 

identification, assessment, and reduction, the Roadmap provides information for making 

informed decisions about determining research priorities, setting exposure standards, and 

allocating resources. The outcome-driven nature of the Roadmap makes it amenable for 

 

1 Operating bands represent an acceptable range of performance or functioning that is bounded at both the upper and lower limits and anything outside those limits 

is unacceptable. Operating bands are used in the Roadmap for the system performance and efficiency risks associated with life support and habitation systems. 

Exposure limits are used for the human health risks and refer to setting an acceptable maximum decrement or change in a physiological or behavioral parameter, 

as the result of exposure to a space flight factor over a given length of time (e.g. life time radiation exposure). Exposure limits are based on the impact the 

decrement or exposure has on the capability to perform assigned tasks, and its implication for lifetime medical status. 

2 As defined in the Bioastronautics Strategy (NASA Headquarters, January 2003), “Acceptable levels of risk define the tolerances, i.e., exposure limits or desirable 

operating bands, for the human -system.” 
NASA/SP–2005–6113 2 

assessing the focus, progress and success of the research and technology program with regard 

to ensuring the vitality, health and productivity of the human system. The Roadmap is also a 

tool for communicating the inherent risks and complexities, priorities, and progress 

associated with human aspects of exploration missions. As pointed out by the National 

Research Council however, no set of guidelines or procedures can substitute for scientific 

fairness, rigor, and flexibility in coping with dynamic risk situations (Fineberg, Committee 

on Risk Characterization, National Academy Press, 1996). 

Bioastronautics Roadmap Objectives 

The goal of the Roadmap is to reduce risk through effective and efficient mitigation solutions 

developed from a focused research and technology development strategy. The Roadmap 

objectives are to: 

• Identify and assess risks for human space exploration missions 

• Prioritize research and technology, and communicate those priorities 

• Guide solicitation, selection and development of NASA research and technology 

(ground and flight) and allocation of resources for development of exploration 

mission deliverables 

• Assess progress towards reduction and management of risks through appropriate 

development of deliverables and products 

• Deliver the appropriate products and knowledge for developing: 

- Standards 

- Requirements 

- Clinical tools and capabilities for diagnosis and treatment of illness 

and injury 

- Inputs to mission, task, and vehicle design 

- Countermeasures 

- Training and in-flight medical protocols 

- Specific technologies 

- Components and systems with increased efficiencies 

Bioastronautics Roadmap Contents 

The key elements of the Roadmap represent both content and process. The basic contents are 

the risks, their associated research and technology questions, and the deliverables. Its major 

processes include risk identification and assessment. 

Mission requirements provide the context for identification and assessment of risks. The 

development of mission requirements for the human system will follow an iterative path 

among the collaborating Mission Directorates and Staff Offices as research, policies, and 

capabilities converge. The Roadmap defined three Reference Missions to provide the context 

to identify and assess the risks in the interim: 

1. A one-year International Space Station (ISS) mission 

2. A month-long stay on the lunar surface 
NASA/SP–2005–6113 3 

3. A 30-month journey to Mars 

 

For purposes of the Roadmap, a risk is defined as the conditional probability of an adverse 

event from exposure to the space flight environment; a risk factor is defined as a 

predisposing condition that contributes to an adverse outcome. The Roadmap focuses on two 

types of risks: health and medical risks, and engineering technology and system performance 

risks. 

The research and technology questions (R&TQ) in the Roadmap represent issues that must 

be sufficiently addressed either to resolve questions or retire a risk, or to inform an accepted 

risk decision. Deliverables are the specific products that have been identified as desirable 

outcomes or solutions to the R&TQ, and have date-specific expectations and mission 

milestones associated with their development. For planning purposes, two of the key dates 

driving Bioastronautics research and technology deliverable development are: (1) the 

retirement of the Space Shuttle in 2010; and (2) the end of NASA’s commitments to the ISS 

in 2016. The Roadmap is the integrated product of all of these elements and illustrates the 

strategy for optimizing human health and performance to enable exploration missions. 

Five crosscutting areas integrate the 15 individual disciplines comprising the Roadmap. The 

crosscutting areas are: Human Health and Countermeasures (HHC), Behavioral Health and 

Performance (BHP), Radiation Health (RH), Autonomous Medical Care (AMC), and 

Advanced Human Support Technologies (AHST). HHC mainly addresses development of 

countermeasures for the deleterious physiological effects of space flight as well as 

establishment of medical standards and requirements. The focus of BHP is to optimize 

psychosocial and behavioral functioning of the crew and ensure their overall readiness to 

perform. RH focuses on setting the requirements for radiation shielding and monitoring, and 

reducing the uncertainties for predicting cancer and other radiation health risks with the aim 

of increasing allowable crew time in space. AMC addresses the capability to monitor, 

diagnose and treat injury or illness during missions, with an emphasis on increasing the use 

of autonomous operations. AHST focuses on engineering requirements and solutions for 

human habitats. 

Bioastronautics Roadmap Processes 

All of the Roadmap risks were identified initially through deliberations by discipline teams 

which included review of recent research results as well as previous advisory committee 

reports. The Risk Data Sheets (RDS) were developed to serve as the database for the 

Roadmap. 

Risk assessment was derived through an iterative process of analysis and deliberations 

among key stakeholders including: the discipline teams, the Bioastronautics Science 

Management Team (BSMT), the Chief Health and Medical Officer (CHMO), the Astronaut 

Office, flight surgeons, and research management. The last set of deliberations included a 

review of comments provided by the research community in response to a Web based query. 
NASA/SP–2005–6113 4 

The BSMT adopted a numerical categorization to communicate the relative priorities across 

the 45 risks. Each risk was assessed for each of the three Reference Missions for nominal 

conditions and operations only – similar assessment of additive or cascading risks is left as 

future work. In addition, five overarching issues were identified: 

• The need for ground-based integrated testing involving humans and spacecraft 

systems (Environmental Life-Support testing, countermeasure evaluation and 

validation, and end-to-end testing) 

• Actual risks must be operationally based, not research-based 

• Key human system requirements (e.g., radiation shielding, habitability standards, 

etc.) should be incorporated into spacecraft and mission designs early in the 

process 

3⁄4 Designers and bioastronautics experts should work together to optimize 

accommodation of the human element 

• All Human Health and Performance support hardware (Exercise equipment, 

environmental monitoring hardware, medical diagnostic and therapeutic 

equipment) must be designed to assure reliability 

• An integrated approach is required to develop efficient engineering solutions for 

the human support systems that avoid excessive resource costs (i.e. efficient in the 

sense of low mass, low power consumption, low consumables requirements, high 

reliability, and low maintenance) 

Risk Assessment and Management 

Assessment and management of the Roadmap research and risks depends on development, 

selection and implementation of the right mitigation strategies and other identified Roadmap 

deliverables. The Roadmap uses a project management approach to achieve its objectives. 

The Bioastronautics Roadmap Control Panel (BRCP) is responsible for maintaining the 

content of the Roadmap (and its companion Web site – http://bioastroroadmap.nasa.gov). 

The Human System Working Group (HSWG) has responsibility for the risk mitigation 

approval process and approves the baseline document. In addition, the HSWG assesses and 

baselines exposure limits for human health and performance, and operating bands for life 

support and habitation systems, and then recommends adoption of those limits and bands to 

the CHMO. The CHMO is responsible for developing the standards and requirements for the 

human system. The Exploration Systems Mission Directorate (ESMD) and Space Operations 

Mission Directorate (SOMD) solicit and fund the research and technology development 

activities. 

Forward work for the Roadmap includes: identification of the deliverables for each of the 

exploration missions; revision of the Roadmap as mission requirements are better defined; 

assessment of the consequences of second-order, additive, or cascading risk manifestations; 

development of program evaluation tools and metrics; re-establishment of the BRCP; 

continued development of risk assessment and quantification tools; and, better definition of 

an implementation plan. 
NASA/SP–2005–6113 5 

Conclusions 

The following conclusions were derived from recent Roadmap refinement activities: 

1. Given the time constraints, the Roadmap activities must focus on operational issues, 

and solutions to operational problems, to support an outcome-oriented approach. 

2. High priority health and medical issues for a mission to Mars include: (a) maintaining 

behavioral health and psychosocial functioning; (b) providing radiation protection; 

(c) addressing the requirements for AMC capabilities; (d) minimizing bone loss; (e) 

maintaining sensory motor capability to perform tasks after landing; (f) ensuring 

adequate nutrition; (g) monitoring and controlling environmental contaminants; and, 

(h) providing efficient and reliable health and medical support hardware. For a lunar 

mission the health and medical issues are: (a) development of environmental life 

support and habitation technologies; (b) providing capabilities for remote medical 

care; and (c) providing adequate radiation protection. 

3. The identified set of risks includes some that have been well documented and proven 

and others that have not been documented. Further quantification of risks, where 

appropriate, is an important priority. For example, in the near term it is important to 

determine whether or not serious cardiac dysrhythmia is a risk associated with 

prolonged space flight. 

4. While a one-year stay on the ISS presents a generally lower risk than the other two 

missions, the ISS is an important research platform for reducing the risks for Moon 

and Mars missions. 

5. It is imperative that a new paradigm be adopted to accomplish the objectives of the 

Roadmap that further integrates flight and ground activities and optimizes flight 

resources as it emphasizes the human system. The Roadmap will use a project 

management approach to meet its goals and objectives and effectively manage its 

risks. 

6. Effective measures of success in identifying and assessing risk must be defined with a 

clear goal, and project teams along with management must use these defined 

measures to assess and communicate progress. 

7. Participation of the key stakeholders in the deliberation process is integral for risk 

identification and assessment. It is essential that astronauts and flight surgeons 

participate in the continued evolution of the Roadmap. 

8. Communication, integration, and coordination among intramural and extramural 

biomedical researchers, technology developers, flight surgeons, astronauts and NASA 

management and the field centers are essential for the success of the Roadmap. 
NASA/SP–2005–6113 6 

9. It is a recommendation of the BMST that a strategy be developed to address the five 

overarching issues for the human system. 

 
NASA/SP–2005–6113 7

1.0 INTRODUCTION 

Bioastronautics as a discipline is the study of biological and medical effects of space flight 

on humans. It encompasses research, operations, and policies related to the risks associated 

with human space flight. The human is as much an integral system of space flight as are 

propulsion, thermal, or power; and operating bands and exposure limits for the human system 

must be defined and controlled (through countermeasures and other means) to ensure its 

overall performance and functioning within the larger spacecraft system. “Operating bands” 

define an acceptable level of performance and functioning for the life support and habitation 

risks in the Roadmap that is bounded at the upper and lower levels; anything outside those 

limits is unacceptable. “Exposure limits” are used for the human health risks and specify an 

acceptable maximum change (whether increment or decrement) in a physiological or 

behavioral parameter, as the result of exposure to a space flight factor over a given length of 

time (e.g. life time radiation exposure). Exposure limits are based on the impact the exposure 

has on the capability to perform assigned tasks, and its implication for lifetime medical 

status. 

The Roadmap was established to be the framework for identifying and assessing the risks of 

crew exposure to the hazardous environments of space. As a research management tool for 

risk identification, assessment, and reduction, the Roadmap provides information for making 

informed decisions about determining research priorities, setting exposure limits, and 

allocating resources. The Roadmap is an outcome-driven strategy for delivering products to 

understand, prevent, and reduce the risks that potentially limit human space flight today, and 

enable exploration. The Bioastronautics operational and research communities will work 

together to establish standards, define safe operating bands or duration-based exposure limits 

to the space environment for the human system, develop technologies that make human 

space flight safe and productive, and develop countermeasures that maintain crew capability 

and function during and after space flight. It is important to provide this information to 

mission planners who establish requirements for space vehicles and habitats. Ensuring the 

health, safety and performance of those exposed to the space environment requires a research 

and technology portfolio that spans clinical, basic and applied research and technology 

development activities, as well as the operational and policy issues related to human space 

flight. 

The Roadmap will evolve to accommodate new information and technology development, 

and will enable formal critical path analyses in the future taking into account benefits and 

costs associated with alternative critical paths and risk reduction options. 

2.0 ROADMAP HISTORY 

The Johnson Space Center (JSC) Space and Life Sciences Directorate (SLSD) first initiated 

the Bioastronautics Roadmap in 1997, as the “Critical Path Roadmap.” In 1998, participation 

was expanded to include the National Space Biomedical Research Institute (NSBRI) and 

other members of the external community. The Roadmap began as an iterative approach by 

discipline experts to identify, analyze, and prioritize the most critical (in the sense of 

important for the health and performance of the crews during and following space flight) 
NASA/SP–2005–6113 8 

risks confronting human space flight missions. Those risks were based on the most 

challenging scenario, a human expedition to Mars. The risks and associated research and 

technology issues were derived using a deliberative process among discipline experts who 

drew upon recent published research results as well as various advisory committee reports 

(e.g., NASA Advisory Council, 1992; National Academy of Sciences (NAS) 1987, 1998; 

National Research Council (NRC) 1993; National Academy of Engineering (NAE) 1997, 

NASA Countermeasure Task Force, 1997; National Council on Radiation Protection (NCRP) 

1989, 1997, 2000). 

2.1 Risk Assessment and Management 

Risk assessment was based first on the relative ranking by the discipline experts of an 

identified risk within a discipline. A set of criteria was used to estimate the likelihood of an 

event and the severity of the consequence(s) of a risk, as well as its mitigation status. As a 

second step, a separate panel of experts categorized the relative importance of risks across all 

disciplines, using the discipline experts’ assessment and ranking. The basis for identifying 

and assessing the risks was developed over several years and included: 

• Establishing a configuration control process 

• Developing and publishing the Bioastronautics Strategy (January 2003) 

• Adopting and testing several risk assessment and communication tools 

• Developing NASA Research Announcements (NRAs) and task selection procedures 

based on the Roadmap 

• Developing a Web based tool for communicating the risks and research questions - 

http://bioastroroadmap.nasa.gov

2.2 Bioastronautics Critical Path Roadmap Baseline Document 

In 2000, the Bioastronautics Critical Path Roadmap, as it was then called, was baselined and 

put under configuration control. A total of 55 risks and 250 research questions were 

documented (BCPR Baseline Document Rev D). The designated discipline team leads 

submitted specific change requests based on new knowledge of risks and questions, and 

those were reviewed and dispositioned by the configuration control panel. Corresponding 

updates to the baseline document and to the companion Web site were implemented. Several 

subsequent NRA cycles reflected the priorities identified in the document and helped focus 

on investigator-initiated tasks that were deemed to be relevant and congruent with the risks, 

research questions, and their priorities. Analyses of program gaps and strengths were 

undertaken to assist the decision-making process for selection and resource allocation. In 

2002, NASA began an effort to prioritize research for the ISS. The Research Maximization 

and Prioritization Task Force (ReMAP) reviewed the Roadmap approach and products and 

utilized the Roadmap in their deliberations of the ISS research priorities for the Office of 

Biological and Physical Research (OBPR). 
NASA/SP–2005–6113 9 

2.3 Bioastronautics Strategy 

The Bioastronautics Strategy was developed and signed in January 2003 by the three 

collaborating Program Offices: the Office of the Chief Health and Medical Officer 

(OCHMO), the OBPR, and the Office of Space Flight. The strategy established the goals and 

objectives for Bioastronautics based on the risk reduction framework of the Roadmap. 

NASA’s Strategic Plan was released in March 2003 and emphasized the role of 

Bioastronautics in understanding and controlling the human health risks as it set the goal of 

extending the boundaries and duration of human space flight. In October 2003, the OBPR 

Enterprise Strategy was published and the Roadmap’s outcome-driven risk reduction and 

management framework served as the basis for several of the organizing questions found in 

the Enterprise Strategy. In addition, the NASA Space Flight Enterprise, published in 

November 2003, emphasized the collaborative nature of Crew Health and Safety Program 

priorities and the OBPR research strategy for effective and efficient risk mitigation solutions. 

2.4 Bioastronautics Science Management Team 

The Bioastronautics Science Management Team (BSMT), composed of individuals 

representing Bioastronautics stakeholders, was established in 2003 to provide oversight to 

the process that would align the Roadmap with exploration mission scenarios. Its members 

represented the Office of Space Flight, the former OBPR, the Office of the Chief Health and 

Medical Officer, and at JSC, the Space and Life Sciences Directorate, the Astronaut Office, 

the Space Medicine & Health Care Systems Office, the Habitability and Environmental 

Factors Office, the Human Adaptation and Countermeasures Office, and the National Space 

Biomedical Research Institute (NSBRI). The BSMT was responsible for setting the initial 

reference mission characteristics that define the context of the risks for the purpose of the 

Roadmap, reviewing and analyzing the risks and associated questions, developing risk 

assessment criteria, and participating in the risk rating process. The BSMT utilized discipline 

teams, or in some cases, multi-disciplinary teams, for the initial identification of the risks, 

updating those risks and associated questions relative to the three reference missions, 

assessment of the risk’s likelihood and consequences, providing information on the Risk 

Data Sheets, and participation in workshops and conferences. The role of the BSMT in the 

Roadmap revision process ended with the baselining of the current document. 

3.0 ROADMAP CONTROL AND CONFIGURATION

The Bioastronautics Roadmap is a result of a detailed development and review process. 

With the establishment of the Vision for Space Exploration, the Roadmap is in use by the 

Agency elements in support of exploration. 

The Human Systems Working Group (HSWG) was established by the ESMD and SOMD, 

with the concurrence of the CHMO, to support human systems research, technology and 

operations monitoring the alignment of the human system activities with the Vision for Space 
NASA/SP–2005–6113 10 

Exploration, promoting cooperation and communication among Mission Directorates and 

Administration Staff Offices, and coordinating the risk mitigation processes and procedures 

for the human system. The HSWG has responsibility, as documented in its charter 

(December 2004), for the risk mitigation approval process, for approval of the baseline 

Roadmap content, and for establishing the change and configuration control process for this 

Roadmap. 

The Johnson Space Center (JSC) Space Life Sciences Directorate (SLSD) is responsible for 

supporting and maintaining the content of the Bioastronautics Roadmap and the companion 

Web site (http://bioastroroadmap.nasa.gov). 

4.0 ROADMAP GOALS AND OBJECTIVES 

On January 14, 2004, the President announced a new vision for America’s civil space 

program with the following goals: returning the Space Shuttle safely to flight; completing the 

ISS; phasing out the Space Shuttle when ISS is complete (about 2010); sending a human 

expedition to the Moon as early as 2015, but no later than 2020; conducting robotic missions 

to Mars to prepare for future human expeditions; sending a human expedition to Mars on or 

about the year 2025; and conducting robotic exploration across the solar system. Previously, 

the Bioastronautics Strategy focused on three reference missions representative of those 

outlined by the President. The Strategy identified three specific goals for the Bioastronautics 

Roadmap: reduce and manage risk; increase risk reduction efficiency; and, return benefits to 

Earth. 

The Roadmap is a systematic approach to prevent, control, eliminate or reduce the known 

risks to crew health, safety and performance during and after long-duration human space 

flight. As a management tool, the Roadmap is used to inform the decision-making process. 

Its goal is to reduce risk through effective and efficient mitigation solutions using a focused 

research and technology development strategy. Its objectives are to: 

• Identify and assess risks for human space exploration missions 

• Prioritize research and technology, and communicate those priorities 

• Guide solicitation, selection and development of NASA research and technology 

(ground and flight) and allocation of resources for development of exploration 

mission deliverable 

• Assess progress toward reduction and management of risks through appropriate 

development of deliverables and products 

• Deliver the appropriate products and knowledge for developing: 

- Standards 

- Requirements 

- Clinical tools and capabilities for diagnosis and treatment of illness 

and injury 
NASA/SP–2005–6113 11

- Inputs to mission, task, and vehicle design 

- Countermeasures 

- Training and in-flight medical protocols 

- Specific technologies 

- Components and systems with increased efficiencies 

5.0 KEY ELEMENTS OF THE ROADMAP 

The key elements of the Roadmap and their inter-relations are shown in the process flowchart in 

Figure 5-1, and are described in the following section. 

Mission Requirements

Risks

Research & Technology 

Questions

Deliverables

Risk Factors

Tasks

Risk Mitigation 

Requirements

Risk/Benefit Analysis

Risk Target Met? 

Implement

Deliverables

Yes

No

Human Standards &

Requirements

Cross-cutting Areas 

& Discipline Teams

BSMT

Health Policy 

Leaders

Consensus 

Workshop

(Astronauts, Flight 

Surgeons, 

Researchers)

Research Community 

&

Advisory Committees

Bioastronautics Roadmap

Flow Chart

Deliberative Processes

Review Processes Deliverables

HSWG

CHMO: TMP

ESMD: OAG

Figure 5-1: The Bioastronautics Roadmap Process Flow Chart
NASA/SP–2005–6113 12 

5.1 Setting Reference Mission Requirements 

For the purposes of the Roadmap, three Reference Missions were developed to set the context for 

risk identification and assessment. Mission requirements are the basis for identifying risks and 

determining their relative priorities, and for establishing medical standards for crew health and 

performance. The development of mission requirements for the human system follows an iterative 

path among collaborating NASA Mission Directorates (Exploration Systems and Space Flight 

Operations) and a Staff Office (Chief Health and Medical Office). The recently chartered Human 

System Working Group provides oversight for integration and coordination of the risk-based 

deliverables and requirements for the human system. 

 

This version of the Roadmap was based on three Reference Missions. These Reference Missions, as 

described in Table 5-1, illustrate some typical parameters used for mission planning purposes and 

closely predicted the goals of the President’s 2004 Space Exploration Vision. Future work will reexamine the Roadmap as necessary with regard to selected mission scenarios as they are further 

developed and additional mission characteristics are defined. For example, reference missions 

involving artificial gravity, either as a countermeasure or a design of the transport vehicle itself (i.e. 

a spinning vehicle), are not addressed here, but may be incorporated in the future. For the purpose 

of this document, the ISS mission is based on a one-year rotation of the crew. Other durations are 

not considered here. 

Table 5-1: Roadmap Reference Missions (as of July 2003) 

Parameters Reference Missions 

 ISS (1-yr) Moon (30-d) Mars (30-m) 

Crew Size 2+ 4-6 6 

Launch Date NET 2006 NET 2015, NLT 2020 NET 2025-2030 

Mission Duration 12 Months 10-44 Days 30 Months 

Outbound Transit 2 Days 3-7 Days 4-6 Months 

On-Site Duration 12 Months 4-30-days 18 Months 

Return Transit 2 Days 3-7 Days 4-6 Months 

Communication lag time 0 + 1.3 Seconds+ 3-20 Minutes+ 

Hypogravity 0-G 1/6-G for up to 30 

days 

1/3-G for up to 18 

months 

Internal Environment 14.7 psi TBD TBD 

EVA 0-4 per mission 2-3 week; 4-15/person 2-3/week; 180/person 

5.2 Risk Identification 

The discipline teams identified the important biomedical, human health, and system 

performance/efficiency risks for human space flight for each of the Reference Missions. For 

purposes of the Roadmap, a risk is defined as the conditional probability of an adverse event from 

exposure to the space flight environment; a risk factor is defined as a predisposing condition that 

contributes to an adverse outcome. Intervening at the level of the risk factor can change the outcome 

(i.e. the likelihood or severity of risk consequences). Attempts were made by the discipline teams to 

capture the risk statements at a uniform level and in a consistent manner. Greater specificity was to 

be represented by the research questions associated with each of the risks. The complex and diverse 

nature of all the risks and issues represented by the human system adapting to space flight makes 

this a challenging endeavor. 
NASA/SP–2005–6113 13 

Risks were derived from the deliberations of experts representing the various disciplines involved in 

Bioastronautics. Fifteen discipline teams are represented in the Roadmap and are organized by five 

crosscutting areas essential for ensuring the health and safety of the crew: 

• Human Health and Countermeasures (HHC) 

• Behavioral Health and Performance (BHP) 

• Radiation Health (RH) 

• Autonomous Medical Care (AMC) 

• Advanced Human Support Technology (AHST) 

Table 5-2 illustrates the crosscutting areas and the associated disciplines and gives a brief 

description of each crosscutting area. 

Table 5-2: Roadmap Crosscutting Areas and Discipline Teams 

Crosscutting Areas Discipline Teams 

Human Health and Countermeasures (HHC): 

Focuses on understanding, characterizing, and 

counteracting the body's adaptation to 

microgravity, enabling healthy astronauts to 

accomplish mission objectives and return to normal 

life following a mission. 

Bone Loss 

Cardiovascular Alterations 

Environmental Health 

Immunology & Infection 

Skeletal Muscle Alterations 

Sensory-Motor Adaptation 

Nutrition 

Autonomous Medical Care (AMC): 

The capability to provide medical care during a 

mission with little or no real-time support from 

Earth. Crew medical officers or other 

crewmembers provide routine or emergency 

medical care using available resources. The local 

resources in an autonomous system augment and 

support the caregiver. Additionally, part of 

creating an autonomous medical care system 

includes preventing or reducing the likelihood of 

conditions before a mission starts, thus reducing 

the capabilities and consumables needed in the 

medical system. 

Clinical Capabilities 

Behavioral Health and Performance (BHP): 

Focuses on maintaining the psychosocial and 

psycho-physiological functions of the crew 

throughout space flight missions and providing an 

optimal set of countermeasures. 

Behavioral Health & Performance and Space 

Human Factors (Cognitive) 

Radiation Health (RH): 

Defines the research strategy and develops risk 

projection thereby increasing allowable crew time 

in space, and reducing uncertainty for cancer and 

other radiation risks.

Radiation 

Advanced Human Support Technologies (AHST): 

Focuses on developing efficient, reliable and 

autonomous technologies and systems to support 

human habitation in spacecraft and planetary 

dwellings. These technologies include: food and 

life support systems, environmental monitoring and 

Advanced Environmental Monitoring & Control 

Advanced Extravehicular Activity 

Advanced Food Technology 

Advanced Life Support 

Space Human Factors Engineering 
NASA/SP–2005–6113 14 

control systems, EVA technologies, and human 

factors solutions through integrated testing in 

appropriate facilities

5.2.1 Risk Data Sheets 

Risk Data Sheets (RDS) provide the database for the Roadmap and were developed to record all 

relevant risk identification information (see Appendix A). The information includes risk title, 

description, risk factors, current and projected countermeasures and other deliverables, the risk 

rating or assessment for each Reference Mission, risk justification, the associated research and 

technology questions (R&TQ) and their priorities for each Reference Mission, and important 

references. Appendix A contains all of the RDS’s for all 45 risks, organized by crosscutting area. 

5.3 Identification of Research and Technology Questions 

The Research and Technology Questions (R&TQ) encompass issues that should be sufficiently 

addressed to mitigate and retire risks. Discipline teams originally identified these questions by 

reviewing reports from previous NASA advisory committees and results from NASA’s 

Bioastronautics research program. Each discipline team prioritized the set of R&TQ for each risk, by 

Reference Mission, based on a “1-5” priority ranking of relative importance3

. The discipline teams 

updated the questions during the revision process that resulted in Rev. E, based on instructions from 

the BSMT designed to ensure consistency and quality in the questions (i.e. that questions are 

answerable, specific, and measurable). Each team streamlined questions to eliminate redundancies, 

developed new questions as appropriate, and eliminated existing questions that may have been 

answered. Question Categories were developed for program assessment purposes. Some categories 

are specific to a given crosscutting area, while others relate to multiple areas (See Table 5-3). 

 

3 Forward work will include development of additional criteria to assess and prioritize the R&TQ for each of the exploration missions, emphasizing for example, mission impact, 

temporal priorities, and interdependencies. 
NASA/SP–2005–6113 15 

Table 5-3: Research & Technology Question Categories 

Category Crosscutting Areas 

Countermeasures 

Mechanisms 

Medical Diagnosis & Treatment 

Risk Assessment 

Training 

Autonomous Medical Care(AMC); Behavioral 

Health and Performance(BHP); Human Health and 

Countermeasures(HHC) 

Treatment 

Prevention (selection and countermeasures) 

Monitoring 

Diagnosis 

Informatics (crosscutting) 

Radiation Health(RH) 

Design Tools 

Operations and Training 

Requirements/Specifications 

Technologies 

Advanced Human Support Technologies(AHST) 

5.4 Defining Deliverables 

Roadmap deliverables are specific products that have been identified as desirable outcomes or 

solutions to the R&TQ. They have date-specific expectations associated with them in order to meet 

exploration mission milestones. Some of the research and technology deliverables may be used to 

develop requirements for the human system, such as countermeasures; others may be used to 

develop standards or knowledge that informs policy recommendations for crew health and safety. 

Table 5-4 lists the different categories of deliverables and some specific examples. Appendix C 

shows the proposed schedules of deliverables for the five crosscutting areas at a top level. 

Table 5-4: Areas to which Roadmap Deliverables Contribute

Category Definition/Examples 

Reducing uncertainties associated with risk 

Underlying processes/mechanisms 

Modeling 

Risk assessment and characterization 

Knowledge Maturation 

Example: Reduce uncertainties in radiation measurement 

Fitness for duty criteria 

Flammability standards 

Crew screening and selection criteria (individual, group, 

psychological, genetic) 

Habitability standards 

Permissible Exposure Limits - radiation, muscle mass and 

strength, bone loss 

Standards 

Example: SMACs 

Requirements Health and performance monitoring requirements 

Air monitoring requirements 
NASA/SP–2005–6113 16 

Exercise requirements 

Shielding requirements 

Nutritional requirements 

Pharmacological requirements 

Habitability requirements 

Artificial gravity requirements 

Flight Rules 

Exercise protocol 

Countermeasures Pharmacological regimen 

Stress reduction strategies 

Health and medical status diagnosis and treatment 

Post-landing rehabilitation 

Models 

Performance indicators 

Diagnostic tools to quantify changes 

Human System 

Assessment/Diagnostic/Treatment 

Tools 

Example: Automated recording devices to capture, store, and 

download physiological data 

Expert systems 

In-flight operational training 

Ground support training Training and Credentialing 

Maintenance training 

Treatment protocol 

Maintenance protocol In-flight Protocols Example: Capabilities to meet increasing requirement for 

autonomous medical care 

Design Tools Tools to model complex mission task and productivity 

Sensors/monitors/instruments 

Improved packaging/design 

Technologies Informatics & Communication 

Example: Sensors for noise levels, sleep loss instruments, food 

systems, pharmaceuticals 

EVA suit 

Water quality sensor suite 

Countermeasures suite Components/Subsystems/Systems 

Waste management system 
NASA/SP–2005–6113 17 

5.5 Assessing Readiness Levels 

Readiness refers to the level of maturity of the countermeasure or technology being developed by a task or 

project. Two methods are used to determine readiness, one for countermeasures and one for technology 

deliverables, as shown in Table 5-5. The readiness levels are used for several purposes: to gauge risk 

mitigation status; to assess progress in developing countermeasures and technologies; to evaluate current 

program tasks; and to rate risks. Roadmap activities must focus on operational issues and solutions to 

operational problems to support an outcome-oriented approach. To support that, Bioastronautics research is 

focusing more on CRL/TRL levels of 4 or greater. Research findings are incorporated into operational 

procedures through a process defined as the “Transition to Medical Practice Review Process,” as issued by 

the OCHMO. [Note: In the RDS field entitled ‘Projected Countermeasures or Mitigations and Other 

Deliverables’, the TRL/CRL specified for each deliverable is the current (FY 2005) level of readiness”.] 

Table 5-5: Countermeasures Readiness Level (CRL)/Technology Readiness Level (TRL) 

TRL Definition TRL/CRL 

Score CRL Definition CRL Category 

Basic principles observed 1 Phenomenon observed and 

reported. Problem defined. 

Technology concept and/or 

application formulated 2 

Hypothesis formed, 

preliminary studies to define 

parameters. Demonstrate 

feasibility. 

Analytical and experimental 

critical function/proof-ofconcept 3 

Validated hypothesis. 

Understanding of scientific 

processes underlying 

problem. 

Basic Research 

Component and/or 

breadboard validation in 

lab 

4 

Formulation of 

countermeasures concept 

based on understanding of 

phenomenon. 

Component and/or 

breadboard in relevant 

environment 

5 

Proof of concept testing and 

initial demonstration of 

feasibility and efficacy. 

Research to Prove 

Feasibility 

System/subsystem model or 

prototype demonstration in 

relevant environment 

6 

Laboratory/clinical testing 

of potential countermeasure 

in subjects to demonstrate 

efficacy of concept. 

Subsystem prototype in a 

space environment 7 

Evaluation with human 

subjects in controlled 

laboratory simulating 

operational space flight 

environment. 

Countermeasure 

Development 

System completed and flight 

qualified through 

demonstration 

8 

Validation with human 

subjects in actual 

operational space flight to 

demonstrate efficacy and 

operational feasibility. 

Countermeasure 

Demonstration 

System flight proven 

through mission operations 9 

Countermeasure fully 

flight-tested and ready for 

implementation. 

Countermeasure Operations 
NASA/SP–2005–6113 18 

6.0 ROADMAP RISKS AND RESEARCH AND TECHNOLOGY QUESTIONS 

This section presents summary information for the risks and research and technology 

questions. The deliberative processes for risk rating identified five overarching issues that are 

important for defining and reducing risks. These include: 

• The need for ground-based integrated testing involving humans and spacecraft 

systems (environmental life support testing, countermeasure evaluation and 

validation, and end-to-end testing) 

• Actual risks must be operationally based, not research-based 

• Key human system requirements (e.g., radiation shielding, habitability standards, 

etc.) should be incorporated into spacecraft and mission designs early in the 

process 

3⁄4 Designers and bioastronautics experts should work together to optimize 

the accommodation of the human element 

• All Human Health and Performance support hardware (Exercise equipment, 

environmental monitoring hardware, medical diagnostic and therapeutic 

equipment) must be designed to assure reliability 

• An integrated approach is required to develop efficient engineering solutions for 

the human support systems that avoid excessive resource costs (i.e. efficient in the 

sense of the following: low mass, low power consumption, low consumables 

requirements, high reliability, and low maintenance) 

While an informal assessment indicates that progress has been made toward answering some 

of the questions, a complete formal analysis remains to be done. Future work includes 

assessing what questions have been sufficiently or partially answered, and how that 

contributes to mitigating and retiring a risk. In addition, priorities among the questions 

should continue to be assessed and understood in terms of mission relevance and impact. 

Table 6-1: Risks and R&TQ for Each Discipline and Crosscutting Area 

Crosscutting Area Discipline Total No. Total No. EQs 

Risks ISS Lunar Mars 

Bone Loss 4 29 29 29 

Cardiovascular 

Alterations 

2 21 21 21 

Environmental 

Health 

1 11 11 11 

Immunology & 

Infection 

3 25 25 25 

Skeletal Muscle 

Alterations 

2 28 28 28 

Sensory-Motor 

Adaptation 

3 42 45 43 

1 12 12 12 

Human Health and 

Countermeasures 

Nutrition 

Totals 16 168 171 169 
NASA/SP–2005–6113 19 

7 73 73 75 Autonomous Medical 

Care 

Clinical 

Capabilities 

Totals

7 73 73 75 

4 33 33 33 

Behavioral Health and 

Performance 

Behavioral Health 

& Performance and 

Space Human 

Factors (Cognitive) 

Totals

4 33 33 33 

4 41 41 41 Radiation Health Radiation 

Totals 4 41 41 41 

Advanced 

Environmental 

Monitoring & 

Control 

5 27 27 27 

Advanced 

Extravehicular 

Activity 

1 14 14 14 

Advanced Food 

Technology 

1 15 15 15 

Advanced Life 

Support 

5 62 62 62 

2 18 18 18 

Advanced Human 

Support Technologies 

Space Human 

Factors Engineering 

Totals

14 136 136 136 

Totals 45 451 454 454 

The total number of risks and R&TQ for each of the three Reference Missions is shown above in 

Table 6-1. The specific risks and risk descriptions for each of the disciplines are shown below in 

Tables 6-2 through 6-6, organized by the five crosscutting areas. 

Table 6-2: Crosscutting Area: Human Health and Countermeasures (HHC) 

Risk No. Discipline Risk Title Risk Description 

1 Bone Loss Accelerated Bone 

Loss and Fracture 

Risk 

 Osteoporosis associated with age-related bone loss 

may occur at an earlier age due to failure to recover 

bone lost during space flight. 

2 Bone Loss Impaired Fracture 

Healing 

Bone fractures incurred during and immediately 

after long duration space flight may require a 

prolonged period for healing, and the bone may be 

incompletely restored due to changes in bone 

metabolism associated with space flight. 

3 Bone Loss Injury to Joints 

and Intervertebral 

Structures 

The risk of fascia, tendon, and/or ligament overuse, 

and traumatic injury or joint dysfunction upon return 

to normal/partial gravity may increase due to 

prolonged mission duration. Hypogravity changes to 

intervertebral discs may increase the risk of rupture, 
NASA/SP–2005–6113 20 

with attendant back pain, and possible neurological 

complications. 

4 Bone Loss Renal Stone 

Formation 

The potential for renal stone formation may be 

increased due to elevated urine calcium 

concentration associated with bone resorption 

during exposure to hypogravity and to decreased 

urine volume during periods of dehydration. 

5 Cardiovascular 

Alterations 

Occurrence of 

Serious Cardiac 

Dysrhythmias 

Serious cardiac dysrhythmias may occur due to 

prolonged exposure to hypogravity or asymptomatic 

cardiac disease. 

6 Cardiovascular 

Alterations 

Diminished 

Cardiac and 

Vascular 

Function 

Diminished cardiac function, orthostatic or postural 

hypotension, and the impaired ability to perform 

strenuous tasks on a planetary surface may occur 

due to prolonged exposure to hypogravity. 

7 Environmental 

Health 

Define 

Acceptable 

Limits for 

Contaminants in 

Air and Water 

Crew health and performance may be jeopardized 

due to the inability to define acceptable limits for 

contaminants. 

8 Immunology & 

Infection 

Immune 

Dysfunction, 

Allergies and 

Autoimmunity 

Atopic and autoimmune diseases may occur due to 

long-term space flight effects on immune-regulatory 

pathways or on specific immune cells. 

9 Immunology & 

Infection 

Interaction of 

Space flight 

Factors, 

Infections and 

Malignancy 

Increased risk of infections or cancers may result 

from immune dysfunction caused by the interaction 

of space flight factors. 

10 Immunology & 

Infection 

Alterations in 

Microbes and 

Host Interactions 

Alterations in microbes and host interactions due to 

exposure to space flight conditions may result in 

previously innocuous microorganisms endangering 

the crew and life support systems. 

11 Skeletal Muscle 

Alterations 

Reduced Muscle 

Mass, Strength, 

and Endurance 

Performance of mission related physical activities 

may be impaired due to loss of muscle mass, 

strength, and endurance associated with prolonged 

exposure to hypogravity. 

12 Skeletal Muscle 

Alterations 

Increased 

Susceptibility to 

Muscle Damage 

Risk of injury to skeletal muscle and associated 

connective tissues may be increased due to 

remodeling and weakening associated with 

prolonged exposure to hypogravity. 

13 Sensory-Motor 

Adaptation 

Impaired 

Sensory-Motor 

Capability to 

Perform 

Operational 

Tasks During 

Flight, Entry, and 

Landing 

Operational performance may be impaired by spatial 

disorientation, perceptual illusions, and/or 

disequilibrium which may occur during and after gtransitions due to maladaptation of the sensorymotor systems to the new gravito-inertial 

environment. 

14 Sensory-Motor 

Adaptation 

Impaired 

Sensory-Motor 

Capability to egress the vehicle in an emergency or 

to perform post landing tasks may be compromised 
NASA/SP–2005–6113 21 

Capability to 

Perform 

Operational 

Tasks After 

Landing and 

Throughout ReAdaptation 

by impaired movement and coordination caused by 

long-term exposure to microgravity. 

15 Sensory-Motor 

Adaptation 

Motion Sickness Crew work capacity, vigilance, and motivation may 

be impaired by motion sickness symptoms occurring 

during and after g transitions. 

16 Nutrition Inadequate 

Nutrition 

Maintenance of astronaut health depends on a food 

system that provides all of the required nutrients. 

Table 6-3: Crosscutting Area: Autonomous Medical Care (AMC) 

Risk No. Discipline Risk Title Risk Description 

17 Clinical 

Capabilities 

Monitoring and 

Prevention 

The risk of serious medical events may increase due 

to inadequate monitoring and prevention 

capabilities. 

18 Clinical 

Capabilities 

Major Illness and 

Trauma 

Lack of capability to treat major illness and injuries 

increases the risk to crew health and mission. 

19 Clinical 

Capabilities 

Pharmacology of 

Space Medicine 

Delivery 

Diminished drug efficacy due to reduced shelf life 

and alterations in pharmacodynamics and 

pharmacokinetics may compromise treatment 

capabilities. 

20 Clinical 

Capabilities 

Ambulatory Care Impaired performance and increased risk to crew 

health and mission may occur due to lack of 

capability to diagnose and treat minor illnesses. 

21 Clinical 

Capabilities 

Rehabilitation on 

Mars 

Crew capability to function after landing on Mars 

may be compromised due to space flight 

deconditioning and lack of a remote, selfadministered, rehabilitation program. 

22 Clinical 

Capabilities 

Medical 

Informatics, 

Technologies, 

and Support 

Systems 

Limited communication capability during space 

flight results in the compromised ability to provide 

medical care, and may have adverse consequences 

for crew health. 

23 Clinical 

Capabilities 

Medical Skill 

Training and 

Maintenance 

Inability to perform required medical procedures 

may result from inadequate crew medical skills or 

medical training. 
NASA/SP–2005–6113 22 

Table 6-4: Crosscutting Area: Behavioral Health and Performance (BHP) 

Risk No. Discipline Risk Title Risk Description 

24 Behavioral 

Health & 

Performance 

and Space 

Human Factors 

(Cognitive) 

Human 

Performance 

Failure Due to 

Poor 

Psychosocial 

Adaptation 

Human performance failure may occur due to 

problems associated with adapting to the space 

environment, interpersonal relationships, group 

dynamics, team cohesiveness, and pre-mission 

preparation. 

25 Behavioral 

Health & 

Performance 

and Space 

Human Factors 

(Cognitive) 

Human 

Performance 

Failure Due to 

Neurobehavioral 

Problems 

Human performance failure may occur due to 

conditions such as depression, anxiety, or other 

psychiatric and cognitive problems. 

26 Behavioral 

Health & 

Performance 

and Space 

Human Factors 

(Cognitive) 

Mismatch 

between Crew 

Cognitive 

Capabilities and 

Task Demands 

Human performance failure may occur due to 

inadequate design of tools, interfaces, tasks, and 

information support systems. Task saturation may 

also occur due to compromises in crew health, 

human factors, and cognitive capabilities. 

27 Behavioral 

Health & 

Performance 

and Space 

Human Factors 

(Cognitive) 

Human 

Performance 

Failure Due to 

Sleep Loss and 

Circadian 

Rhythm 

Problems 

Human performance failure may occur due to 

circadian disruption, and acute or chronic 

degradation of sleep quality and quantity. 

Table 6-5: Crosscutting Area: Radiation Health (RH) 

Risk No. Discipline Risk Title Risk Description 

28 Radiation Carcinogenesis Increased cancer morbidity or mortality risk in 

astronauts may be caused by occupational radiation 

exposure. 

29 Radiation Acute and Late 

CNS Risks 

Acute and late radiation damage to the central 

nervous system (CNS) may lead to changes in motor 

function and behavior, or neurological disorders. 

This may be caused by occupational radiation 

exposure or the combined effects of radiation and 

other space flight factors. 

30 Radiation Chronic and 

Degenerative 

Tissue Risks 

Radiation exposure may result in degenerative tissue 

diseases (non-cancer or non-CNS) such as cardiac, 

circulatory, or digestive diseases, as well as 

cataracts. This may be caused by occupational 

radiation exposure or the combined effects of 

radiation and other space flight factors. 

31 Radiation Acute Radiation 

Risks 

Acute radiation syndromes may occur due to 

occupational radiation exposure 
NASA/SP–2005–6113 23 

Table 6-6: Crosscutting Area: Advanced Human Support Technology (AHST) 

Risk No. Discipline Risk Title Risk Description 

32 Advanced 

Environmental 

Monitoring & 

Control 

Monitor Air 

Quality 

Lack of timely chemical and microbial detection in 

the crew atmosphere, or elsewhere in the air 

processing system, can lead to delayed response by 

the crew or by automated response equipment, 

leading to increased hazards to the crew. 

33 Advanced 

Environmental 

Monitoring & 

Control 

Monitor External 

Environment 

Failure to detect hazards external to the habitat (e.g., 

dust, fuel contaminants) can lead to lack of remedial 

action, and poses an increased risk to the crew. 

34 Advanced 

Environmental 

Monitoring & 

Control 

Monitor Water 

Quality 

Lack of timely information about the build-up of 

chemicals or microbial growth in the crew water 

supply, or elsewhere in the water reclamation 

system, can lead to a delayed response by the crew, 

or the automated response equipment, and pose a 

hazard to the crew. 

35 Advanced 

Environmental 

Monitoring & 

Control 

Monitor 

Surfaces, Food, 

and Soil 

Lack of timely information, or failure to detect the 

presence of harmful chemicals or microbial growth 

on surfaces, food supplies, or soil (required for plant 

growth) can pose a crew health hazard. 

36 Advanced 

Environmental 

Monitoring & 

Control 

Provide 

Integrated 

Autonomous 

Control of Life 

Support Systems 

Lack of stable, reliable, efficient process control for 

the life support system can pose a hazard to crew 

health or create an excessive crew workload. 

37 Advanced 

Extravehicular 

Activity 

Provide Space 

Suits and 

Portable Life 

Support Systems 

EVA performance and crew health may be 

compromised by inadequate EVA systems. 

38 Advanced Food 

Technology 

Maintain Food 

Quantity and 

Quality 

Crew nutritional requirements may not be met and 

crew health and performance compromised due to 

inadequate food acceptability, preparation, 

processing, and storage systems. 

39 Advanced Life 

Support 

Maintain 

Acceptable 

Atmosphere 

Crew health may be compromised due to inability of 

currently available technology to monitor and 

control spacecraft atmosphere. Risk may be 

mitigated by development of new technologies that 

will be integrated into the life support systems. 
NASA/SP–2005–6113 24 

40 Advanced Life 

Support 

Maintain 

Thermal Balance 

in Habitable 

Areas 

Crew health may be compromised due to inability of 

currently available technology to provide crew 

module thermal control. Risk may be further 

mitigated by development of new technologies that 

will be integrated into the thermal control system. 

41 Advanced Life 

Support 

Manage Waste Crew health may be compromised due to inability of 

currently available technology to adequately process 

solid wastes reliably with minimum power, mass, 

volume. Inadequate waste management can also lead 

to contamination of planetary surfaces. 

42 Advanced Life 

Support 

Provide and 

Maintain 

Bioregenerative 

Life Support 

Systems 

Sustaining crew health and performance may be 

compromised by lack of bioregenerative systems. 

43 Advanced Life 

Support 

Provide and 

Recover Potable 

Water 

Crew health may be compromised due to inability of 

currently available technology to adequately provide 

and recover potable water. 

44 Space Human 

Factors 

Engineering 

Mismatch 

Between Crew 

Physical 

Capabilities and 

Task Demands 

Human performance failure may occur due to 

human factors inadequacies in the physical work 

environments (e.g., workplaces, equipment, 

protective clothing, tools and tasks). 

45 Space Human 

Factors 

Engineering 

Poorly Integrated 

Ground, Crew, 

and Automation 

Functions 

Mission performance failure may occur without 

adequate operational concepts, design requirements, 

and design tools for integration of multiple factors 

that affect mission performance, such as groundcrew interaction, communication time, and level of 

automation. 

7.0 RISK ASSESSMENT AND RATING RESULTS 

This section describes the methods and results for rating the Roadmap risks. It includes the 

definition of the criteria used to rate the two general types of risks: human health risks and 

system performance/efficiency risks. The ratings for the human health risks were derived 

from an analysis of the likelihood of its occurrence, the severity of its consequence should it 

occur, and the risk mitigation status. The system performance risks were assessed in terms of 

improved efficiency. These results are summarized and the conclusions are discussed. 

7.1 Risk Assessment and Rating 

The process of analysis and deliberations used to assess and rate the relative importance of 

the identified risks incorporated several steps as described below and shown in Table 7-1. 

(1) Discipline experts provided the initial risk assessment information and analysis. 

(2) The BSMT utilized that data as input for conducting the rating of relative risk priority 

using the red/yellow/green, 5X5 classification. 
NASA/SP–2005–6113 25 

(3) Representatives from the OCHMO along with other representatives of health policy 

and management participated in the risk rating process. The criteria for rating the 

Roadmap risks followed a workshop held to analyze the requirements for human 

subject participation in the Roadmap risk reduction strategy. Those two criteria 

included: likelihood of the risk to compromise a mission to Mars, and the need for the 

related research to be conducted on ISS. 

(4) A workshop determined the number of human subjects required to conduct 

exploration research. The workshop included approximately 60 representatives from 

the Bioastronautics research community. The set of 50 risks from the Roadmap were 

assessed using various criteria (e.g., current level of risk mitigation status, types of 

experiments required to reduce risk, human or nonhuman research requirements, 

ground and flight requirements, and long or short duration requirements) to determine 

the number of subjects required for risk reduction purposes (NASA Workshop 

Report, May 12-13, 2004). 

(5) Representatives from the Astronaut Office, the Space Medicine and Health Care 

Office, and the BSMT participated in a workshop to derive a consensus rating of the 

Roadmap risks. One conclusion of that workshop was the determination to use a 

different rating scheme (other than the red/yellow/green tool) to assess the relative 

importance among the risks. There were several changes made to the risks and 

questions and three overarching issues were identified (need for functioning, reliable 

medical support hardware, incorporation of medical requirements and issues into 

vehicle design and architecture, and the Roadmap risks and questions must be 

operationally focused). In addition, related Roadmap issues were discussed (e.g., the 

time required for research, the interface between research and operations, and the 

peer review process). 

(6) The last steps involved deliberations among the BSMT and a sub-group of that, at 

several Roadmap workshops. The results of all of the previous workshops were 

utilitzed during those deliberation as well as input from the public. This process 

developed a consensus rating of the 45 risks, using a 1/2/3 categorization indicating 

the relative importance of the risks. Results from all of the deliberative processes 

identified five overarching issues as previously discussed in Section 6.0. 

Table 7-1: Input and Workshops for Risk Rating Analysis and Deliberations 

Risk Rating Input and Workshops Date 

Discipline Teams Jan – Feb 2004 

BSMT Mar – April 2004 

Animal Workshop – research community April 2004 

Human Subjects Workshop – research 

community 

May 2004 

Public Comment Query April – June, 2004 

Astronaut Office, Flight Surgeons, BSMT May 2004 

Health and Medical Policy June 2004 

BSMT August 2004 
NASA/SP–2005–6113 26 

Sub-BSMT Group December 2004 

7.2 Risk Rating Results 

The 45 Roadmap risks are considered to be the most important to the human system for longduration space flight, whether in LEO or on exploration missions. The risk-rating criteria 

adopted by the BSMT were used to determine the relative importance of each risk with 

respect to the Reference Missions. As shown in Table 7-2, the criteria were based on a 

qualitative assessment derived from an understanding of the risk’s likelihood, severity of 

impact, and mitigation status. Two sets of criteria were used: one for the human healthrelated risks, a second, for the system performance/efficiency-related risks. Since the 

outcome illustrates relative importance, the tool aids both risk communication and decisionmaking processes, guiding research planning and resource allocation. 

It is also important to note that the risk rating was not an attempt to assess flight readiness. 

The Priority 1/2/3 categories used for the various ratings were applied consistently across all 

45 risks for each of the three Reference Missions. 

The categories for designating the priority status of each risk are shown in Table 7-2. Table 

7-3 shows results for rating the human health risks; Tables 7-4 shows the results for the 

system performance and efficiency risks. 
NASA/SP–2005–6113 27 

Table 7-2: Risk Rating Categories and Priority Definitions 

Risk Rating 

Priority 

Human Health Risks System Performance/Efficiency Risks 

1 

Risk of serious adverse health or 

performance consequences, and there is 

no mitigation strategy that has been 

validated in space or demonstrated on 

Earth. 

Considerable potential for improvement in 

mitigation efficiency in many areas; 

proposed missions may be infeasible 

without improvements. 

2 

Risk of serious health or performance 

consequences, and there is no mitigation 

strategy that has been validated in space. 

Considerable potential for improvement in 

mitigation efficiency in a few areas. 

3 

Health and performance consequences are 

known or suspected, but will not affect 

mission success due to effective 

mitigation strategies that have been 

validated in space. 

Minimum potential or limited need for 

improvement in mitigation efficiency. 

Acronyms for Human Health Risks (See Table 7-3 below) 

AMC Autonomous Medical Care 

BHP Behavioral Health and Performance 

BHP\SHF Behavioral Health & Performance and Space Human Factors (Cognitive) 

Bone Bone Loss 

Cardio Cardiovascular Alterations 

Clinical Clinical Capabilities 

EH Environmental Health 

HHC Human Health and Countermeasures 

II Immunology & Infection 

Muscle Skeletal Muscle Alterations 

RH Radiation Health 

SM Sensory-Motor Adaptation 

Acronyms for System Performance/Efficiency Risks (See Table 7-4 below) 

AEMC Advanced Environmental Monitoring & Control 

AEVA Advanced Extravehicular Activity 

AFT Advanced Food Technology 

AHST Advanced Human Support Technologies 

ALS Advanced Life Support 

SHFE Space Human Factors Engineering 
NASA/SP–2005–6113 28

Table 7-3: Risk Rating Results for Human Health Risks 

Risk 

Number 

CC 

Area Discipline Risk Title ISS Priority (1-yr) Mo

1 HHC Bone Accelerated Bone Loss and Fracture Risk 2 2 HHC Bone Impaired Fracture Healing 3 3 HHC Bone Injury to Joints and Intervertebral Structures 3 4 HHC Bone Renal Stone Formation 3 5 HHC Cardio Occurrence of Serious Cardiac Dysrhythmias 2 6 HHC Cardio Diminished Cardiac and Vascular Function 2 7 HHC EH Define Acceptable Limits for Contaminants in Air and Water 3 8 HHC II Immune Dysfunction, Allergies and Autoimmunity 2 9 HHC II Interaction of Space flight Factors, Infections and Malignancy 2 

10 HHC II Alterations in Microbes and Host Interactions 3 11 HHC Muscle Reduced Muscle Mass, Strength, and Endurance 2 12 HHC Muscle Increased Susceptibility to Muscle Damage 3 13 HHC SM Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and Landing 2 14 HHC SM Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout Re-Adaptation 2 15 HHC SM Motion Sickness 3 16 HHC Nutrition Inadequate Nutrition 3 17 AMC Clinical Monitoring and Prevention 2 18 AMC Clinical Major Illness and Trauma 2 19 AMC Clinical Pharmacology of Space Medicine Delivery 2 20 AMC Clinical Ambulatory Care 3 21 AMC Clinical Rehabilitation on Mars N/A 22 AMC Clinical Medical Informatics, Technologies, and Support Systems 3 23 AMC Clinical Medical Skill Training and Maintenance 3 24 BHP BHP\SHF Human Performance Failure Due to Poor Psychosocial Adaptation 1 25 BHP BHP\SHF Human Performance Failure Due to Neurobehavioral Problems 1 26 BHP BHP\SHF Mismatch between Crew Cognitive Capabilities and Task Demands 2 27 BHP BHP\SHF Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems 3 28 RH Radiation Carcinogenesis 2 29 RH Radiation Acute and Late CNS Risks 2 30 RH Radiation Chronic and Degenerative Tissue Risks 2 31 RH Radiation Acute Radiation Risks 3 
NASA/SP–2005–6113 29

Table 7-4: Risk Rating Results for System Performance/Efficiency Risks 

Risk 

Number 

CC 

Area Discipline Risk Title ISS Priority (1-yr) Mo

32 AHST AEMC Monitor Air Quality 2 33 AHST AEMC Monitor External Environment 2 34 AHST AEMC Monitor Water Quality 2 35 AHST AEMC Monitor Surfaces, Food, and Soil 2 36 AHST AEMC Provide Integrated Autonomous Control of Life Support Systems 3 37 AHST AEVA Provide Space Suits and Portable Life Support Systems 3 38 AHST AFT Maintain Food Quantity and Quality 2 39 AHST ALS Maintain Acceptable Atmosphere 3 40 AHST ALS Maintain Thermal Balance in Habitable Areas 3 41 AHST ALS Manage Waste 3 42 AHST ALS Provide and Maintain Bioregenerative Life Support Systems 3 43 AHST ALS Provide and Recover Potable Water 3 44 AHST SHFE Mismatch Between Crew Physical Capabilities and Task Demands 2 45 AHST SHFE Poorly Integrated Ground, Crew, and Automation Functions 2 
NASA/SP–2005–6113 30 

8.0 RISK ASSESSMENT AND MANAGEMENT 

Assessment and management of the Roadmap research and risks depends on development, 

selection and implementation of the right mitigation strategies. Those strategies are the result 

of an approach based on integration, project management, and configuration control. 

8.1 Roadmap Integration and Interaction 

An integrated Roadmap approach must be used to achieve effective and efficient risk 

reduction solutions. An integrated approach includes interdisciplinary teams composed of 

research, engineering, and operational perspectives in the definition and assessment of 

progress made toward risk reduction. This point is further emphasized by one of the 

conclusions from the deliberative process specifically, the need to improve the interface 

between research and operations in such areas as, the transition from research to operations, 

research facilitating operations, and hardware development. Delivering an integrated, 

validated suite of technologies, standards, and operations concepts for future reference 

missions will reduce the programmatic risk of the human system. 

The research strategy must also reflect the integrated nature inherent in the risks and 

questions. There are considerable interdependencies and interactions among the risks, risk 

factors, and research questions. (The risks and questions are listed in the Risk Data Sheets in 

Appendix A.) The research strategy must also incorporate the development and application 

of a more refined set of decision criteria that augments the current risk priorities and 

establishes relevant “weighting” among the entire set of risks with regard to those criteria. 

Such criteria will include for example: mission impact and relevance, temporal priorities 

(including long lead time), interdependencies, benefit/cost analysis, and 

practicality/feasibility. 

Another aspect of integration is the inclusion of the engineering, technology-focused efforts 

represented by the Life Support and Habitation programs. These activities include: Advanced 

Food Technology (AFT), Advanced Life Support (ALS), Advanced Environmental 

Monitoring and Control (AEMC), Space Human Factors Engineering (SHFE) and Advanced 

Extravehicular Activities (AEVA) systems. All of these are important components of the 

system ensuring that the crew can live and work in space vehicles or surface dwellings. 

Integration and management of the integration also exists at the level of ground and flight 

testing. Capabilities such as the Advanced Integration Matrix (AIM) will provide the means 

to study and optimize system-level interfaces and interactions and help ensure that the 

technologies and countermeasures for the human system meet the needs of the program for 

the exploration missions. In addition, ground studies should be used when possible because 

of resource constraints associated with in-flight testing and validation. The Roadmap strategy 

for the human system risks utilizes space flight for those mitigation solutions most requiring 

it. 
NASA/SP–2005–6113 31 

8.2 Using a Project Approach 

The Roadmap uses a project management approach to achieve its objectives. Project 

management imposes discipline on research activities and focuses on schedules and 

deliverables while maintaining quality and cost control. Project management teams foster 

valued integration and commitment from the participating experts and stakeholders. Project 

management teams also contribute to the development and use of effective metrics to assess 

current status and measure progress in reducing risk and answering the R&TQ. 

9.0 FORWARD WORK 

It is the nature of the Roadmap to continue to evolve. For example, risk information will 

continue to be modified and updated, as research results are known and implemented 

Forward work includes: 

• Development of a Roadmap implementation plan 

• Reestablishment of the BRCP 

• Identification of the deliverables for each of the exploration missions 

• Continued development of risk assessment and quantification tools, including risk 

uncertainties, level of evidence, temporal priorities, as well as assessment of overall 

relative risk 

• Development of program evaluation tools and metrics to assess progress made toward 

risk reduction for the human system and to evaluate the overall success of the 

activities related to Bioastronautics research 

• Recommendations for development of acceptable exposure limits for crew health and 

performance, and operating bands for life support and habitation elements 

• Re-examination of questions and their priorities in terms of mission impact as those 

missions are further defined 

• Applying the risk and question priorities to research solicitation and selection and the 

appropriate allocation of resources 

• Assessment of the confounding effects of risks upon risks, such as additive or 

cascading risk manifestations 

9.1 Benefit/Cost Analysis 

The prioritization risks and the selection of effective countermeasures and efficient risk 

mitigation strategies are closely tied to exposure limits and acceptable levels of risk. 

Benefit/cost analysis allows balancing of resources along with potential improvements in risk 

reduction or mitigation efficiencies to avoid investments that are of marginal value. 

Prioritization may also represent the need for improvement in a given countermeasure or 

technology. For example, a serious health risk may already be adequately addressed with a 

low-tech countermeasure. Although there is room for improvement in the countermeasure 

technically, it adequately controls the risk as is, and may therefore not require resources. 
NASA/SP–2005–6113 32 

9.2 Metrics 

Effective measures of success must start with a clear definition of the goal. In the technology 

areas, metrics such as mass, power, volume and self-sufficiency are already available and are 

being used in project planning and management. Measurable targets such as operating bands 

and exposure limits will be developed and, after appropriate review, may be used as metrics 

to assess the effectiveness of space flight countermeasures. Project teams and management 

must use these defined measures to assess and communicate progress. Measures of outcome 

and progress should address exit criteria for the risks as well as their associated questions and 

be reported to and reviewed by the HSWG.

10.0 CONCLUSIONS 

The following conclusions were derived from the recent Roadmap refinement activity and 

discussions: 

1. Given the time constraints, the Roadmap activities must focus on operational issues, 

and solutions to operational problems, to support an outcome-oriented approach. 

2. High priority health and medical issues for a mission to Mars include: (a) maintaining 

behavioral health and psychosocial functioning; (b) providing radiation protection; 

(c) addressing the requirements for AMC capabilities; (d) minimizing bone loss; (e) 

maintaining sensory-motor capability to perform tasks after landing; (f) ensuring 

adequate nutrition; (g) monitoring and controlling environmental contaminants; and, 

(h) providing efficient and reliable health and medical support hardware. For a lunar 

mission the health and medical issues are: (a) development of environmental life 

support and habitation technologies; (b) providing capabilities for remote medical 

care for major illness and trauma; and (c) providing adequate radiation protection. 

3. The identified set of risks includes some that have been well documented and proven 

and others that have not been documented. Further quantification of risks, where 

appropriate, is an important priority. For example, in the near term it is important to 

determine whether or not serious cardiac dysrhythmia is a risk associated with 

prolonged space flight. 

4. While a one-year stay on the ISS presents a generally lower risk than the other two 

missions, the ISS is an important platform for reducing the risks for Moon and Mars 

missions. 

5. It is imperative that a new paradigm be adopted to accomplish the objectives of the 

Roadmap that further integrates flight and ground activities and optimizes flight 

resources as it emphasizes the human system. The Roadmap will meet its goals and 

objectives, and effectively manage its risks by using a project management approach. 
NASA/SP–2005–6113 33 

6. Effective measures of success in identifying and assessing risk must be defined with a 

clear goal, and project teams and management must use these defined measures to 

assess and communicate progress. 

7. Participation of the key stakeholders in the deliberation process is integral for risk 

identification and assessment. It is essential that astronauts and flight surgeons 

participate in the continued evolution of the Roadmap. 

8. Communication, integration, and coordination among intramural and extramural 

biomedical researchers, technology developers, flight surgeons, astronauts and NASA 

management and the field centers are essential for the success of the Roadmap. 

9. It is the recommendation of the BSMT that a strategy be developed to address the five 

overarching issues for the human system. 

In conclusion, Bioastronautics has evolved over the past eight years as a strategy for guiding 

research and technology development and helping inform policy and operations that are 

based on risk assessment and risk reduction solutions that ensure the health, safety, and 

performance of the human system in exploration missions. It is the intent to continue this 

process with a focus toward making possible the more complex and challenging operations 

for humans living and working in more distant and dangerous space and planetary 

environments. 

*************************************************************************** 
APPENDIX A: RISK DATA SHEETS
NASA/SP-2005-6113 A-2

Risk Title: Accelerated Bone Loss and Fracture Risk

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Bone Loss

Risk Number : 1

Risk Description : Osteoporosis associated with age-related bone loss may occur at an earlier age due to failure to

recover bone lost during space flight.

Context / Risk

Factors :

This risk may be influenced by age, baseline bone mass density (BMD), gender, nutrition, or muscle

loss.

Justification /

Rationale :

Crewmembers lose bone during long-duration space flight, especially in weight bearing

bones.Calcium and bone metabolism are altered, and failure to recover lost bone (mission- and age

related), can lead to increased risk of fractures at a younger age. ISS crewmembers will be affected

to varying degrees. Mitigation strategies are under investigation for ISS missions. Bone loss is not

considered a significant problem on a 30-day mission to the Moon. Exploration (Mars) crews will

be affected to varying degrees.

Risk Rating : ISS: Priority 2

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Nutrition

• Exercise (resistive and aerobic)

• Crew Screening and preparation

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Biophysical modalities [CRL 5]

• Crew Screening [CRL 1]

• Exercise and fitness regimens [CRL 6-7]

• Hormone replacement therapy [CRL 1]

• Nutrition [CRL 4]

• Pharmacological (including bisphosphonates) [CRL 7]

• Rehabilitation strategies [CRL 3]

• Spacesuit design [CRL 1]

• Artificial gravity

Research &

Technology

Questions [With

Mission Priority]:

No. Question

1a

What is the relative risk of sustaining a traumatic and/or stress fracture for a given

decrement in bone mineral density, or alteration in bone geometry, in an astronautequivalent population who are physically active? [ISS 3, Lunar 5, Mars 1]

1b

Will a period of rapid bone loss in hypogravity be followed by a slower rate of loss

approaching a basal bone mineral density (BMD)? What are the estimated site-specific

fracture risks as one approaches basal BMD? [ISS 2, Lunar 5, Mars 1]

1c

Is there an additive or synergistic effect of gonadal hormone deficiency in men or

women on bone loss during prolonged exposure to hypogravity? [ISS 1, Lunar 5,

Mars 5]

1d

What biophysical modalities, nutritional modifications, and pharmacological agents

(alone or in combination) will most effectively minimize the decrease in bone mass due

to extended hypogravity exposure? [ISS 1, Lunar 5, Mars 1]

1e

What are the specifics of the optimal exercise regimen with regard to mode, duration,

intensity and frequency, to be followed during exposure to hypogravity so as to

minimize decreases in bone mass? Is impact loading an essential element and, if so,

how can it be produced in hypogravity? [ISS 1, Lunar 3, Mars 1]
NASA/SP-2005-6113 A-3

1f

What combination of exercise, biophysical modalities, nutritional modifications, and/or

pharmacological agent(s) is most effective, efficient (minimal crew time), and safe in

preventing bone loss during exposure to hypogravity? [ISS 1, Lunar 5, Mars 1]

1g

What are the important predictors for estimating site-specific bone loss and fracture risk

during hypogravity exposure, including, but not limited to ethnicity, gender, genetics,

age, baseline bone density and geometry, nutritional status, fitness level and prior

microgravity exposure? [ISS 1, Lunar 5, Mars 1]

1h Does the hypogravity environment change the nutritional requirements for optimal

bone health? [ISS 3, Lunar 3, Mars 2]

1i What diagnostic tools can be utilized during multi-year missions to monitor and

quantify changes in bone mass and bone strength? [ISS 2, Lunar 5, Mars 1]

1j

What systemic adaptations to hypogravity are important contributory factors to bone

loss, evaluations of which are essential for effective countermeasure development (e.g.,

fluid shifts, altered blood flow, immune system adaptations)? [ISS 3, Lunar 5, Mars 2]

1k

Are hypogravity-induced changes in bone density, geometry, and architecture

reversible upon encountering partial gravity exposure, or on return to full gravity (1-

G)? [ISS 1, Lunar 5, Mars 1]

1l

What regimen (exercise, pharmacological, nutritional, or biomechanical including

impact loading or artificial gravity exposure) will most effectively hasten restoration of

bone mass and/or bone strength (geometry and architecture) to pre-flight values in

returning crewmembers? [ISS 2, Lunar 5, Mars 2]

Related Risks : Bone Loss

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Cardiovascular Alterations

Diminished Cardiac and Vascular Function

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Rehabilitation on Mars

Important

References : Bikle DD, Sakata T, Halloran BP. The impact of skeletal unloading on bone formation. Gravit

Space Biol Bull. 2003 Jun;16(2):45-54. Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12959131
NASA/SP-2005-6113 A-4

Cancedda R, Muraglia A. Osteogenesis in altered gravity. Adv Space Biol Med. 2002;8:159-76.

Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12951696

Heer M, Kamps N, Biener C, Korr C, Boerger A, Zittenman A, Stehle P, Drummer C. Calcium

metabolism in microgravity. Eur J Med Res. 1999 Sep 9;4(9): 357-60. Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10477499

Jennings RT, Bagian JP. Musculoskeletal injury review in the U.S. space program. Aviat Space

Environ Med. 1996 Aug; 67(8): 762-6.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8853833

Schneider SM, Amonette WE, Blazine K, Bentley J, Lee SM, Loehr JA, Moore AD Jr, Rapley M,

Mulder ER, Smith SM. Training with the International Space Station interim resistive exercise

device. Med Sci Sports Exerc. 2003 Nov;35(11):1935-45.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=14600562

Shapiro JR, Schneider V. Countermeasure development: future research targets. J Gravit Physiol.

2000 Jul;7(2):P1-4.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12697548

Cena H, Sculati M, Roggl C. Nutritional concerns and possible countermeasures to nutritional

issues related to space flight. Eur J Nutr. 2003 Apr;42(2):99-110. Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12638031

Risk Title: Impaired Fracture Healing

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Bone Loss

Risk Number : 2

Risk Description : Bone fractures incurred during and immediately after long duration space flight may require a

prolonged period for healing, and the bone may be incompletely restored due to changes in bone

metabolism associated with space flight.

Context / Risk

Factors :

Space flight associated bone loss may increase the risk of traumatic and stress fractures. Inflight

risk of injury should be minimized through design of hardware and procedures. Risks may vary

between individuals.

Justification /

Rationale :

Bone loss associated with space flight may result in additional risk of fracture. Threat to crew

health and mission will depend on fracture site, severity and treatment options available. Risk of

fracture on ISS is considered extremely low. Risk of fracture on a Lunar mission is low. For a Mars

Mission, there is a risk of serious health or performance consequences may be greater because of

lack of return capability.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Minimize bone loss to lessen fracture risk

• Rehabilitation procedures

• Crew return capability

• Hardware design and procedures to reduce the likelihood of injury
NASA/SP-2005-6113 A-5

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Biomechanical and pharmacological measures to promote more rapid healing [CRL 5]

• Ultrasound and electrical stimulation [CRL 2] [Lunar] [Mars]

• Minimize bone loss

• Development of treatment options [Lunar] [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

2a Is the rate of fracture healing and the integrity of the healed fracture altered under

hypogravity or unloaded conditions? [ISS 1, Lunar 1, Mars 1]

2b

Are there site-specific differences or differences in healing diaphyseal bone versus

metaphyseal bone under microgravity or partial-gravity conditions? [ISS 3, Lunar 3,

Mars 3]

2c Which cellular and biochemical changes in bone cell biology alter fracture healing

under microgravity conditions? [ISS 4, Lunar 4, Mars 4]

2d Does the presence of microgravity-induced alteration in bone remodeling and/or

osteoporosis affect fracture callus remodeling? [ISS 2, Lunar 2, Mars 2]

2e How do changes in skeletal muscle-bone interactions during space flight contribute to

altered fracture healing in microgravity? [ISS 4, Lunar 4, Mars 4]

2f Do biophysical modalities play a role in improving fracture healing in a microgravity

environment? [ISS 2, Lunar 2, Mars 2]

2g Do biophysical modalities play a role in improving fracture healing in the presence of

bone loss in a microgravity environment? [ISS 2, Lunar 2, Mars 2]

2h

Are there anabolic agents, growth factors, or cytokines that will speed fracture repair

during microgravity in combination with active bone loss due to unloading? [ISS 1,

Lunar 1, Mars 1]

2i What technologies will be used to diagnose fractures of the axial and appendicular

skeleton in a space environment? [ISS 1, Lunar 1, Mars 1]

2j Will different technologies be needed to treat either open or closed fractures in a space

environment? [ISS 1, Lunar 1, Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery
NASA/SP-2005-6113 A-6

Important

References : Durnova GN, Burkovskaia TE, Vorotnikova EV, Kaplanskii AS, Arustamov OV. [The effect of

weightlessness on fracture healing of rats flown on the biosatellite Cosmos-2044]. Kosm Biol

Aviakosm Med. 1991 Sep-Oct;25(5):29-33. Russian.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8577136

Kaplansky AS, Durnova GN, Burkovskaya TE, Vorotnikova EV. The effect of microgravity on

bone fracture healing in rats flown on Cosmos-2044. Physiologist. 1991 Feb;34(1 Suppl):S196-9.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2047441

Kirchen ME, O'Connor KM, Gruber HE, Sweeney JR, Fras IA, Stover SJ, Sarmiento A, Marshall

GJ. Effects of microgravity on bone healing in a rat fibular osteotomy model. Clin Orthop. 1995

Sep;(318):231-42.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7671522

Risk Title: Injury to Joints and Intervertebral Structures

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Bone Loss

Risk Number : 3

Risk Description : The risk of fascia, tendon, and/or ligament overuse, and traumatic injury or joint dysfunction upon

return to normal/partial gravity may increase due to prolonged mission duration. Hypogravity

changes to intervertebral discs may increase the risk of rupture, with attendant back pain, and

possible neurological complications.

Context / Risk

Factors :

This risk may be influenced by age, loss of muscle strength, state of fitness and conditioning, prior

history of injuries, or task related impact on joints and intervertebral structures.

Justification /

Rationale :

Hypogravity-induced changes to intervertebral disks and ligaments may increase risk of rupture

and/or injury, with attendant back pain, and possible neurological complications. This risk is most

significant for a Mars mission.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 2

Current

Countermeasures : • Musculoskeletal Fitness

• Post-injury and Post-flight Rehabilitation

• Work injury avoidance patterns and design of equipment and tasks to reduce likelihood of injury

• Training

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Improved fitness and conditioning regimens

Research &

Technology

Questions [With

Mission Priority]:

No. Question

3a What is the cause of the back pain commonly experienced by crewmembers upon

return to 1-G? [ISS 2, Lunar 3, Mars 2]

3b Is damage to joint structure, intervertebral discs, or ligaments incurred during or

following hypogravity exposure? [ISS 2, Lunar 3, Mars 1]

3c

What countermeasures will protect joint and intervertebral soft tissues (e.g. discs and

ligaments) from microgravity or partial gravity-related damage? [ISS 2, Lunar 2,

Mars 1]

3d What rehabilitative measures will hasten recovery of soft tissue damage in a partial

gravity environments, or upon return to Earth's gravity? [ISS 2, Lunar 2, Mars 1]
NASA/SP-2005-6113 A-7

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Renal Stone Formation

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Important

References : Foldes I, Kern M, Szilagyi T, Oganov VS. Histology and histochemistry of intervertebral discs of

rats participated in space flight. Acta Biol Hung. 1996;47(1-4):145-56.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9123987

Foldes I, Szilagyi T, Rapcsak M, Velkey V, Oganov VS. Changes of lumbar vertebrae after

Cosmos-1887 space flight. Physiologist. 1991 Feb;34(1 Suppl):S57-8.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2047467

Hutton WC, Malko JA, Fajman WA. Lumbar disc volume measured by MRI: effects of bed rest,

horizontal exercise, and vertical loading. Aviat Space Environ Med. 2003 Jan;74(1):73-8.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12546302

LeBlanc AD, Evans HJ, Schneider VS, Wendt RE 3rd, Hedrick TD. Changes in intervertebral

disc cross-sectional area with bed rest and space flight. Spine. 1994 Apr 1;19(7):812-7.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8202800

Maynard JA. The effects of space flight on the composition of the intervertebral disc. Iowa

Orthop J. 1994;14:125-33.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7719767

Oganov VS, Cann C, Rakhmanov AS, Ternovoi SK. [Study of the musculoskeletal system of the

spine in humans after long-term space flights by the method of computerized tomography] Kosm

Biol Aviakosm Med. 1990 Jul-Aug;24(4):20-1. Russian.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2214660

Pedrini-Mille A, Maynard JA, Durnova GN, Kaplansky AS, Pedrini VA, Chung CB, FedlerTroester J. Effects of microgravity on the composition of the intervertebral disk. Appl Physiol.

1992 Aug;73(2 Suppl):26S-32S

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1526953
NASA/SP-2005-6113 A-8

Stupakov GP, Mazurin YuV, Kazeikin VS, Moiseyev YB, Kaliakin VV. Destructive and adaptive

processes in human vertebral column under altered gravitational potential. Physiologist. 1990

Feb;33(1 Suppl):S4-7. Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2196601

Risk Title: Renal Stone Formation

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Bone Loss

Risk Number : 4

Risk Description : The potential for renal stone formation may be increased due to elevated urine calcium

concentration associated with bone resorption during exposure to hypogravity and to decreased

urine volume during periods of dehydration.

Context / Risk

Factors :

This risk may be influenced by environmental factors affecting mineral/fluid status, individual

propensity for urine calcium oxalate solubility patterns and stone formation.

Justification /

Rationale :

Space flight is associated with changes in urine chemistry (decreased urinary pH and citrate and

increased urinary calcium and phosphate) and composition (increased calcium oxalate and brushite

saturation, and increased concentration of undissociated uric acid) which likely contribute to the

increased renal stone risk observed during and after space flight. Mitigation strategies (potassium

citrate) are currently under investigation.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 3

Current

Countermeasures : • Good state of hydration

• Nutritional counseling

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Nutrition [CRL 4]

• Pharmacological agents (e.g., Potassium or Magnesium Citrate, bisphosphonates) [CRL 4-8]

• Urine solubility testing in flight

Research &

Technology

Questions [With

Mission Priority]:

No. Question

4a What diagnostic measures permit detection of renal calcification during extendedduration space flight? [ISS 4, Lunar 1, Mars 1]

4b What nutritional and/or pharmacological countermeasures adequately minimize risk of

stone formation in-flight and upon return to 1-G? [ISS 3, Lunar 2, Mars 2]

4c What is the time course of increased risk for renal stone formation abating upon return

to 1-G? [ISS 3, Lunar 3, Mars 2]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention
NASA/SP-2004-6113 A-9

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Important

References : Pak CY, Hill K, Cintron NM, Huntoon C. Assessing applicants to the NASA flight program for

their renal stone-forming potential. Aviat Space Environ Med. 1989 Feb;60(2):157-61.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2930428

Whitson PA, Pietrzyk RA, Morukov BV, Sams CF. The risk of renal stone formation during and

after long duration space flight. Nephron. 2001 Nov;89(3):264-70.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11598387

Whitson PA, Pietrzyk RA, Pak CY, Cintron NM. Alterations in renal stone risk factors after

space flight. J Urol. 1993 Sep;150(3):803-7.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8345588

Whitson PA, Pietrzyk RA, Pak CY. Renal stone risk assessment during Space Shuttle flights. J

Urol. 1997 Dec;158(6):2305-10.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9366381

Whitson PA, Pietrzyk RA, Sams CF. Space flight and the risk of renal stones. J Gravit Physiol.

1999 Jul;6(1):P87-8.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11543039

Whitson PA, Pietrzyk RA, Sams CF. Urine volume and its effects on renal stone risk in

astronauts. Aviat Space Environ Med. 2001 Apr;72(4):368-72.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11318017

Zerwekh JE. Nutrition and renal stone disease in space. Nutrition. 2002 Oct;18 (10):857-63.

Review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12361779

Risk Title: Occurrence of Serious Cardiac Dysrhythmias

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Cardiovascular Alterations

Risk Number : 5

Risk Description : Serious cardiac dysrhythmias may occur due to prolonged exposure to hypogravity or asymptomatic

cardiac disease.

Context / Risk

Factors :

Other physiological changes, such as altered neural and hormonal regulation, diminished cardiac

mass and cardiac remodeling, and fluid and electrolyte alterations, may affect occurence of

dysrhythmias. Flight duration, gender, and pre-existing cardiovascular disease are also risk factors.

Justification /

Rationale :

Cardiac rhythm disturbances have been observed on several occasions during space flight but the

occurrence of space flight induced arrhythmias has not been documented. Recent flight and ground

-based data demonstrate alterations in cardiac electrical activity, which may indicate altered cardiac

electrical stability. If space flight increases the risk of serious cardiac dysrhythmias this could lead

to syncope and/or death posing risk both to crewmembers and to the mission.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 2
NASA/SP-2005-6113 A-10

Current

Countermeasures : • Resuscitation equipment, including onboard defibrillator

• Crew medical screening

• Onboard monitoring

Projected

Countermeasures or

Mitigations & other

Deliverables:

Electrical cardioversion (Equipment currently on board, efficacy not demonstrated in space

environment) [CRL 1]

•

• Nutritional countermeasure [CRL 2]

• Pharmaceutical countermeasure [CRL 1]

Pre-flight and in-flight testing and monitoring to assess altered susceptibility to dysrhythmias

[CRL 7]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

5a Does space flight increase susceptibility to serious cardiac dysrhythmias? [ISS 1,

Lunar 1, Mars 1]

5b

What conditions of space flight (e.g., microgravity, disruption of physiological

rhythms, nutrition, environmental factors and radiation) may be responsible for cardiac

dysrhythmias, and what are the mechanisms involved? [ISS 1, Lunar 1, Mars 1]

5c Can risk of serious cardiac dysrhythmias be predicted for individual crewmembers?

[ISS 1, Lunar 1, Mars 1]

5d What countermeasures may prevent or reduce the occurrence of serious cardiac

dysrhythmias during long-term space flight? [ISS 1, Lunar 1, Mars 1]

5e Can susceptibility to, and occurrence of, serious cardiac dysrhythmias be effectively

diagnosed and treated during space flight? [ISS 1, Lunar 1, Mars 1]

5f Which cardiovascular diseases are likely to be aggravated by space flight, and what

mechanisms are involved? [ISS 1, Lunar 1, Mars 1]

5g

What screening methods on the ground and in-flight might identify crewmembers with

underlying cardiovascular disease, which may be aggravated by space flight? [ISS 1,

Lunar 1, Mars 1]

Related Risks : Cardiovascular Alterations

Diminished Cardiac and Vascular Function

Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Radiation

Acute and Late CNS Risks
NASA/SP-2005-6113 A-11

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Important

References : Fritsch-Yelle JM, Leuenberger UA, D'Aunno DS, Rossum AC, Brown TE, Wood ML, Josephson

ME, Goldberger AL. An Episode of Ventricular Tachycardia During Long-Duration Spaceflight.

The American Journal of Cardiology. 1998 June;81: 1391-1392.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9631987

Smith RF, Stanton K, Stoop D, Brown D, Januez W, King P. Vectorcardiographic Changes

During Extended Space flight (M093): Observations at Rest and During Exercise. In: Biomedical

Results of Skylab (NASA SP-377). Johnston RS and Dietlein LF, editors. Washington, DC:

NASA 339-350, 1977.

Rossum AC, Wood ML, Bishop Sl, Deblcok H, Charles JB. Evaluation of Cardiac Rhythym

Disturbances During Extravehicular Activity. The American Journal of Cardiology. 1997

April;79: 1153-1155.

Charles JB, Bungo MW, Fortner GW. Cardiopulmonary Function. In: Nicogossian A, Huntoon

C, Pool S, and (editors). Space Physiology and Medicine. 3rd ed. Philadelphia, PA: Lea &

Febiger, 286-304, 1994.

Risk Title: Diminished Cardiac and Vascular Function

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Cardiovascular Alterations

Risk Number : 6

Risk Description : Diminished cardiac function, orthostatic or postural hypotension, and the impaired ability to

perform strenuous tasks on a planetary surface may occur due to prolonged exposure to

hypogravity.

Context / Risk

Factors : This risk may be influenced by altered neural and hormonal regulation, flight duration, or gender.

Justification /

Rationale :

Some, but not all, studies suggest that prolonged exposure to microgravity may lead to reduction of

cardiac mass and reduced cardiac function. Carefully controlled inflight studies are required to

document this finding and determine the clinical signficance.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 2

Current

Countermeasures : • In flight exercise

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Artificial G exposure

• Drugs that affect cardiac mass and function

• Improved exercise and conditioning program

Research &

Technology

Questions [With

Mission Priority]:

No. Question

6a Does long-duration space flight lead to diminished cardiac function? If so, what

mechanisms are involved? [ISS 1, Lunar 1, Mars 1]

6b Is space flight induced diminished cardiac function reversible? [ISS 1, Lunar 1, Mars

1]

6c What is the extent of reduction in cardiac function and/or mass associated with longduration space flight? [ISS 1, Lunar 1, Mars 1]

6d Can susceptibility to reduced cardiac function be predicted for individual

crewmembers? [ISS 2, Lunar 2, Mars 2]
NASA/SP-2005-6113 A-12

6e What countermeasures may be effective in mitigating the occurrence of reduced cardiac

function or mass? [ISS 1, Lunar 1, Mars 1]

6f What are the physiological and environmental factors by which space flight decreases

orthostatic tolerance? [ISS 1, Lunar 1, Mars 1]

6g How does duration of space flight affect the severity and time course of orthostatic

intolerance, and what are the mechanisms? [ISS 2, Lunar 2, Mars 2]

6h Is orthostatic intolerance likely to develop on the surface of Mars or the moon? [ISS 1,

Lunar 1, Mars 1]

6i Can space flight induced orthostatic intolerance be predicted for individual

crewmembers? [ISS 1, Lunar 1, Mars 1]

6j What countermeasures can be developed to overcome or prevent orthostatic

intolerance? [ISS 1, Lunar 1, Mars 1]

6k What are the physiological and environmental factors by which space flight decreases

aerobic exercise capacity? [ISS 1, Lunar 1, Mars 1]

6l Is the observed decrease in exercise capacity directly related to duration of space flight?

[ISS 1, Lunar 1, Mars 1]

6m Can the degree of reduced aerobic exercise capacity be predicted for individual

crewmembers? [ISS 1, Lunar 1, Mars 1]

6n What countermeasures can be developed to overcome microgravity-induced reduction

in aerobic exercise capacity? [ISS 1, Lunar 1, Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Injury to Joints and Intervertebral Structures

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Important

References : Blomqvist LD, Lane CG, Wright SJ, Meny GM, Levine BD, Buckey JC, Peshock RM,

Weatherall P, Stray-Gundersen J, Gaffney FA, Watenpaugh DE, Arbeille P, and Baisch F.

Cardiovascular regulation in microgravity. In: Scientific Results of the German Spacelab Mission

D-2: Proceedings of the Norderney Symposium, edited by Sahm PR, Keller MH, and Schiewe B..

Koln, Germany: Wissenschaftliche Projektfuhrung D-2 (c/o Deutsches Zentrum fur Luft- und

Raumfahrt), 1994, p. 688-690.

Charles JB, Frey MA, Fritsch-Yelle JM, Fortner GW. Cardiovascular and Cardiorespiratory

Function. In Huntoon C, Antipov V, Grigoriev A (editors), Volume III, Book I (humans in Space)

Space Biology and Medicine, AIAA, Reston, VA, 1996.

The Neurolab Spacelab Mission: Neuroscience Research in Space: Results from the STS-90

Neurolab Spacelab Mission: Section 4 Blood Pressure Control. pp. 171-205. Buckey J and

Homick J (editors). NASA SP-2003-535, 2003.
NASA/SP-2005-6113 A-13

Risk Title: Define Acceptable Limits for Contaminants in Air and Water

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Environmental Health

Risk Number : 7

Risk Description : Crew health and performance may be jeopardized due to the inability to define acceptable limits for

contaminants.

Context / Risk

Factors :

This risk may be influenced by remoteness, crew health, or crew susceptibility to degree of system

closure.

Justification /

Rationale :

Excessive pollutant levels (including microbial contaminants) can jeopardize crew health and/or

impair mission success. The severity and likelihood of any adverse effects depends on the specific

pollutant and its measured concentration.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Identification of possible contaminants

• Restriction on types of materials allowed in flight

• Preflight off-gassing of certain materials

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Identification of possible contaminants

Research &

Technology

Questions [With

Mission Priority]:

No. Question

7a

What are the most likely sources of severe air and water pollution specific to ISS, lunar,

and Mars missions, and what methods can be used to control these sources over long

periods of time? [ISS 1, Lunar 1, Mars 1]

7b What are the tolerance limits in terms of quantity and type of microorganisms in air,

water, and food, and on surfaces? [ISS 1, Lunar 1, Mars 1]

7c What approaches to setting exposure standards may be used when insufficient data are

available to allow prediction of acceptable exposure levels? [ISS 1, Lunar 1, Mars 1]

7d

What is the requirement for determining how rapidly acceptable air quality can be

recovered after a severe pollution condition and what effect that recovery has on

humidity condensate and the water recovery system? [ISS 1, Lunar 1, Mars 1]

7e

Can automated real-time systems be used to monitor air and water quality for lunar and

Mars missions, and can the crew interpret results without ground support? [ISS 1,

Lunar 1, Mars 1]

7f

How can traditional limited-time exposure and human toxicological data be used to

predict acceptable values for inhalation exposures to single chemicals and/or mixtures?

[ISS 2, Lunar 2, Mars 2]

7g

What impact do space flight induced, biological, physiological, and immunological

changes have on the susceptibility of crewmembers to infectious agents and toxic

substances in the air and water? [ISS 2, Lunar 2, Mars 2]

7h

What are the effects of exposure to ultra fine and larger (respirable and non-respirable)

particles (e.g., lunar dust) on crew health, safety and performance? [ISS 3, Lunar 2,

Mars 2]

7i What are the interactions of microbes, chemicals and plants in CELSS on air quality?

[ISS 3, Lunar 2, Mars 2]

7j

To the extent that plants are critical to mission success, will the potential for

phytotoxicity be adequately addressed in the evaluation of air quality? [ISS 3, Lunar 3,

Mars 2]
NASA/SP-2005-6113 A-14

7k

Is there potential for increased heterogeneity in terms of the distribution of air

contaminants in the relatively larger lunar and Mars habitats? If so, what additional

monitoring resources and/or strategies are necessary to protect crew health? [ISS 3,

Lunar 2, Mars 2]

Related Risks : Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Alterations in Microbes and Host Interactions

Advanced Environmental Monitoring & Control

Monitor Air Quality

Monitor External Environment

Monitor Water Quality

Monitor Surfaces, Food, and Soil

Provide Integrated Autonomous Control of Life Support Systems

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Advanced Food Technology

Maintain Food Quantity and Quality

Advanced Life Support

Maintain Acceptable Atmosphere

Maintain Thermal Balance in Habitable Areas

Provide and Maintain Bioregenerative Life Support Systems

Important

References : Huntoon CL. Toxicological Analysis of STS-40 Atmosphere, NASA/JSC Memorandum, SD4/01

-93-251, July 6, 1991; Toxicological Analysis of STS-55 Atmosphere, NASA/JSC Memorandum

SD4-93-251, July 6, 1993.

James JT. Toxicological Assessment of Air Contaminants during the Mir 19 Expedition, 1996

James JT. Toxicological Assessment of Air Samples Taken after the Oxygen-Generator Fire on

Mir, NASA/JSC Memorandum SD2-97-513, April 10, 1997

Nicogossian AE, et al. Crew Health in the Apollo-Soyuz Test Project Medical Report, NASA SP411, 1977

Pool SL. Ethylene Glycol Treatise. NASA/JSC Memorandum SD2-97-542, September 15, 1997.

Risk Title: Immune Dysfunction, Allergies and Autoimmunity

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Immunology & Infection

Risk Number : 8

Risk Description : Atopic and autoimmune diseases may occur due to long-term space flight effects on immuneregulatory pathways or on specific immune cells.

Context / Risk

Factors :

This risk may be influenced by radiation, microgravity, isolation, stress (e.g., sleep deprivation,

extreme environments, and nutritional deprivation), or crewmember genetics.

Justification /

Rationale :

In vitro studies have demonstrated that contributing risk factors of space flight collectively have a

powerful effect upon the cells of the immune system: T cells, particularly CD4+ (helper) T cells, B

cells, NK cells, monocyte/ macrophages/dendritic cells, hematopoietic stem cells and cytokine

networks can be negatively affected. Alterations in one or more immune system regulatory network

(i.e. cells or cell products) could affect homeostasis, which could result in allergic (atopic) or

autoimmune disease. The relatively short time of the lunar mission (10-44 days) would tend to
NASA/SP-2005-6113 A-15

reduce the risk of developing immunodeficiency or atopic disease. The long-term exposure (>1

year) to deep-space radiation, to microgravity (> 2 years), and to other conditions of space flight

during a Mars mission would offer the greatest challenge to the host immune system.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 2

Current

Countermeasures : • Assessment of crewmembers for prior autoimmune or atopic disorders.

• Radiation shielding

• Monitor and limit exposure to radiation and other environmental factors

Projected

Countermeasures or

Mitigations & other

Deliverables:

Definition of surrogate markers of immune function that will allow for the monitoring of immune

cells and/or immune system compartments during a long-duration space flight

•

Definition of the background of crewmembers to identify individuals more likely to develop

autoimmune or atopic disease

•

• Detection systems for assessment of immune function [CRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

8a

What are the molecular and genetic mechanisms that are affected by space flight related

environments (e.g., radiation, microgravity, stress, isolation, sleep deprivation, extreme

environments, nutritional deficiency, and social interactions) that can result in the loss

of immunoregulation/immune tolerance and/or affect innate/acquired immunity,

respectively? [ISS 1, Lunar 1, Mars 1]

8b

Can the effects on immune function (innate/acquired immunity), or dysfunction (loss of

tolerance/immune surveillance) be summarized as a consequence of the conditions

relating to each mission and/or its duration (i.e., 1-year ISS, 30-day lunar, 30-month

Mars)? [ISS 1, Lunar 1, Mars 1]

8c What autoimmune diseases or allergies may affect astronauts exposed to space flight

environments of different missions and/or durations? [ISS 1, Lunar 1, Mars 1]

8d

Are there detection systems that can identify the first alterations in immune regulatory

networks (identify surrogate markers of immune function/dysfunction) so that

therapeutic interventions can be instituted? [ISS 2, Lunar 2, Mars 2]

8e What steps can be taken during space flight to modify immune function as it relates to

autoimmunity or atopic disease? [ISS 2, Lunar 2, Mars 2]

8f

Will it be possible to use immuno-regulatory agents to prevent immune imbalances

with respect to the development of atopic or autoimmune diseases? [ISS 1, Lunar 1,

Mars 1]

8g

Will nutritional supplements be able to modify immune responses by working in

concert with other immuno-modulators to reduce atopic and/or autoimmune disease?

[ISS 1, Lunar 1, Mars 1]

8h What pharmalogical agents used during long-term space flights, or interactions between

pharmalogical agents, negatively affect the immune system? [ISS 1, Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Interaction of Space flight Factors, Infections and Malignancy

Alterations in Microbes and Host Interactions

Nutrition

Inadequate Nutrition

Clinical Capabilities
NASA/SP-2005-6113 A-16

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Carcinogenesis

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Food Technology

Maintain Food Quantity and Quality

Important

References : Aviles H, Belay T, Vance M, Sonnenfeld G. Increased levels of catecholamines correlate with

decreased function of the immune system in the hindlimb-unloading rodent model of spaceflight

(Abstract 107). Gravit Space Biol Bull. 17:56, 2003.

Chinen J, Shearer WT. Immunosuppression induced by therapeutic agents and by environmental

conditions. In Stiehm ER, ed. Immunologic disorders in infants and children, 5th Edition.

Philadelphia: WB Saunders, in press, 2004.

Chitnis T, Khoory SJ. Role of costimulatory pathways in the pathogenesis of multiple sclerosis

and experimental autoimmune encephalitis. J Allergy Clin Immunol. 112:837-849, 2003.

Dicello JF. The impact of the new biology on radiation risks in space. Health Phys. 85:94-102,

2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

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Dicello JP. Cucinotta FA. Space radiation. Shankar Vinala Art No. sst036:1-8, 2003.

Fedorenko B, Druzhinin S, Yudaeva L, Petrov V,Akatov Y, Snigiryova G, Novitskaya N,

Shevchenko V, and Rubanovich A. Cytogenetic studies of blood lymphocytes from cosmonauts

after long-term space flights on Mir station. Adv Space Res. 27(2):355-9, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11642297

Graczyk PP. Caspase inhibitors as anti-inflammatory and antiapoptotic agent. Prog Med Chem.

39:1-72, 2003

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_uids=12536670

Greeneltch KM, Haudenschild CC, Keegan AD, Shi Y. The opioid antagonist naltrexone blocks

acute endotoxic shock by inhibiting tumor necrosis factor-alpha production. Brain Behav Immun.

18(5):476-84, 2004.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=15265541
NASA/SP-2005-6113 A-17

Gridley DS, Nelson GA, Peters LL, Kostenuik PJ, Bateman TA, Morony S, et al. Genetic models

in applied physiology: selected contribution: effects of spaceflight on immunity in the C57BL/6

mouse. II. Activation, cytokines, erythrocytes and platelets. J Appl Physiol. 94:2095-2103.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12506046

Gridley DS, Pecaut MJ, Dutta-Roy R, Nelson GA, Dose and dose rate effects of whole-body

proton irradiation on leukocyte populations and lymphoid organs: part I. Immunol Lett. 80:55-66,

2002.

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_uids=11716966

Grove DS, Pishak SA, and Matro AM. The effect of a 10-day spaceflight on the function,

phenotype, and adhesion molecule expression of splenocytes and lymph node lymphocytes. Exp

Cell Res. 219(1):102-9, 1995.

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_uids=7543050

Nelson RP Jr, Ballow M. Immunomodulation and immunotherapy: drugs, cytokines, cytokine

receptors and antibodies. J Allergy Clin Immunol. 11:S720-S743, 2003.

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_uids=12592317

Pecaut MJ, Gridley DS, Smith AL, Nelson GA Dose and dose rate effects of whole-body protonirradiation on lymphocyte blastogenesis and hematological variables: part II. Immunol Lett.

80:67-73, 2002.

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Rollings K, Reuben JM. Suppression of human anti-inflammatory plasma cytokines IL-10 and IL

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Risk Title: Interaction of Space flight Factors, Infections and Malignancy

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Immunology & Infection

Risk Number : 9

Risk Description : Increased risk of infections or cancers may result from immune dysfunction caused by the

interaction of space flight factors.

Context / Risk

Factors :

In addition to space flight related immune dysfunction, which can increase the risk of infections in

crewmembers, microgravity can also affect microorganisms in a variety of ways. Furthermore,

several neoplastic malignancies have been associated with a variety of human pathogens. This risk

may be influenced by immune dysfunction, latent viral infections, commensal organisms, or host

genetics.

Justification /

Rationale :

Every component of immune resistance to infection is compromised under space flight conditions.

As a result, bacterial, fungal, or viral infections may be more likely in space flight environments

(though this has not been documented). In particular, latent viruses (e.g., Epstein-Barr virus, herpes

simplex, polyomaviruses, and Hepatitis viruses) can become active and potentially initiate tumor

formation. The length and severity of space flight conditions on the Martian mission are expected to

pose the highest (though still low probability) risk for the development of immune cell-mediated

leukemias and lymphomas.
NASA/SP-2005-6113 A-19

Risk Rating : ISS: Priority 2

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Pre-flight quarantine (Health Stabilization Program)

• Radiation shielding.

• Monitoring exposure to radiation and other environmental factors

• Ongoing crew health monitoring

Onboard antibiotics, anti-viral and anti-fungal agents, immunizations, sterilization procedures,

use of clean vehicles

•

• Air and water monitoring

• Regular inflight 'housecleaning'

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Anti-microbial agents [CRL 4]

• Fusion proteins to block virus re-infection [CRL 6]

Molecular detection systems for surface, water and airborne pathogens (See AHST Risks 34, 36,

& 37) [CRL 7]

•

• Molecular diagnostic/detection kits and equipment to classify infectious agents [CRL 6]

• Pathogen-specific immunizations [CRL 2]

• Pre-flight crew screening for the presence of microorganisms [CRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

9a

What types of latent infections (e.g., viral infections) will become reactivated as a

function of space flight associated factors and pose the greatest threat to human health

as a function of compromised immunity resulting from space travel? [ISS 1, Lunar 1,

Mars 1]

9b

What commensal organisms have the potential of establishing a primary infection and

pose the greatest threat to human health as a function of compromised immunity

resulting from space travel? [ISS 1, Lunar 1, Mars 1]

9c

What diagnostic, environmental monitoring, or laboratory technologies need to be

developed for the identification of pathogenic microorganisms, and prevention or

diagnosis of infectious diseases while in space (e.g., bacterial, viral, or fungal typing in

real-time)? [ISS 1, Lunar 1, Mars 1]

9d

Will the severity of disease(s) resulting from latent infection reactivation, and/or

infections caused by commensal organisms (as a function of space flight associated

factors), be affected by the space mission and/or its duration (i.e., 1-year ISS, 30-day

lunar, 30-month Mars)? [ISS 1, Lunar 1, Mars 1]

9e

Are there neoplastic malignancies that may result from latent infection reactivation,

and/or infections caused by commensal organisms (as a function of space flight

associated factors), that will be affected by the space mission and/or its duration? [ISS

2, Lunar 2, Mars 2]

9f

Is it possible to predict the summary effects of each component condition and duration

of space flight that results in an infectious and/or neoplastic state? [ISS 2, Lunar 2,

Mars 2]

9g Will it be possible to develop nutritional supplements to augment anti-microbial and/or

anti-tumor therapies? [ISS 2, Lunar 2, Mars 2]

9h Will it be possible to restore immunity in a severely immunocompromised astronaut

with autologous stem cell transplants? [ISS 3, Lunar 3, Mars 3]
NASA/SP-2005-6113 A-20

9i

What steps can be taken during space flight to boost immune function, and what

antimicrobial therapies and immunological treatments can be used to prevent or cure

infections? [ISS 2, Lunar 2, Mars 2]

9j Will it be possible to use anti-viral, -bacterial, or -fungal agents aboard spaceships to

reduce pathogen burdens or to treat infections? [ISS 2, Lunar 2, Mars 2]

9k Will therapeutic agents aboard spacecraft function to reduce or treat tumor

development? [ISS 3, Lunar 3, Mars 3]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Alterations in Microbes and Host Interactions

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Carcinogenesis

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Surfaces, Food, and Soil

Advanced Food Technology

Maintain Food Quantity and Quality

Important

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NASA/SP-2005-6113 A-25

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Risk Title: Alterations in Microbes and Host Interactions

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Immunology & Infection

Risk Number : 10

Risk Description : Alterations in microbes and host interactions due to exposure to space flight conditions may result

in previously innocuous microorganisms endangering the crew and life support systems.

Context / Risk

Factors :

This risk may be influenced by extreme environments, isolation, microbial contamination,

microgravity, nutritional deprivation, radiation, sleep deprivation, or stress.

Justification /

Rationale :

Long-duration space flight may result in alterations in the host/microbe relationship that may lead to

a difficult to control, or severe, infection. In particular, the long-duration and severe nature of space

flight conditions on a Mars mission might increase the risk. The short-duration of the Lunar

mission is not likely to provide sufficient time for significant alterations in the host/microbe

relationship.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • In-flight environmental monitoring and bioburden reduction procedures (cleaning, filtering etc.)

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Comprehensive microbial identification technology [CRL 5]

• Pre-flight screening [CRL 7]

• Routine in-flight microbial identification/monitoring capability [CRL 6]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

10a

What technologies will monitor, detect, quantify or identify microorganisms that pose a

threat to human health during a mission as a countermeasure for preventing further

contamination or disease (e.g., bacterial, viral, or fungal typing in real-time)? [ISS 1,

Lunar 1, Mars 1]

10b

Does the spacecraft environment exert selective pressure on microorganisms that

presents the crew with increased health risks (e.g., Helicobacter and ulcers)? [ISS 1,

Lunar 1, Mars 1]

10c Does space flight alter microbial growth rates, mutation rates, or pathogenicity? [ISS 1,

Lunar 1, Mars 1]

10d Does space flight alter the exchange of genetic material between microorganisms? [ISS

1, Lunar 1, Mars 1]

10e Does space flight alter host:microbe balance? [ISS 1, Lunar 1, Mars 1]

10f

Do microorganisms associated with biological life support systems or biological waste

treatment systems enter the general spacecraft environment with consequent increase in

health risks? [ISS 3, Lunar 1, Mars 1]
NASA/SP-2005-6113 A-26

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Clinical Capabilities

Monitoring and Prevention

Radiation

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Surfaces, Food, and Soil

Advanced Life Support

Manage Waste

Important

References : Balan S, Murphy JC, Galaev I, Kumar A, Fox GE, Mattiasson B, Willson RC. Metal chelate

affinity precipitation of RNA and purification of plasmid DNA. Biotechnol Lett. 25:1111-1116,

2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12889823

Castro VA, Thrasher AN, Healy M, Ott CM, and Pierson DL. Microbial characterization during

the early habitation of the International Space Station. Microb Ecol. 47(2):119-26, 2004.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=14749908

DeWalt B, Murphy JC, Fox GE, Willson RC. Compaction agent clarification of microbial lysates.

Protein Expr Purif. 28:220-223, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12699684

Fukuda T, Fukuda K, Takahashi A, Ohnishi T, Nakano T, Sato M, Gunge N. Analysis of deletion

mutations of the rpsL gene in the yeast Saccharomyces cerevisiae detected after long-term flight

on the Russian space station. Mir Mutat Res. 470:125-132, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11027966

Horneck G, Rettberg P, Kozubek S, Baumstark-Khan C, Rink H, Schafer M, Schmitz C. The

influence of microgravity on repair of radiation-induced DNA damage in bacteria and human

fibroblasts. Radiat Res. 147:376-384, 1997.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9052686

Kacena, MA, Todd, P. Gentamicin: effect on E. coli in space. Microgravity Sci Technol. 12:135-

137, 1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11868575

Kobayashi H, Ishii N. Separation of DNA by free flow electrophoresis in space. Biol Sci Space.

Oct;15 Suppl:S129, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11799254
NASA/SP-2005-6113 A-27

Kourentzi KD, Fox GE, Willson RC. Hybridization-responsive fluorescent DNA probes

containing the adenine analog 2-aminopurine. Anal Biochem. 322:124-126, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=14705788

Kourentzi KD, Fox GE, Willson RC. Microbial detection with low molecular weight RNA. Curr

Microbiol. 43: 444-447, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11685514

Kourentzi KD, Fox GE, Willson RC. Microbial identification by immunohybridization assay of

artificial RNA labels. J Microbiol Methods. 49:301-306, 2002.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11869795

Lapchine L, Moatti N, Gasset G, Richoilley G, Templier J, Tixador R. Antibiotic activity in space

Drugs Exp Clin Res. 12: 933-938, 1986.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3569006

Murphy JC, Fox GE and Willson RC. RNA isolation and fractionation with compaction agents.

Anal Biochem. 295(2):143-8, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11488615

Murphy JC, Fox GE, Willson RC. Enhancement of anion-exchange chromatography of DNA

using compaction agents. J Chromatogr A. 984:215-221, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12564692

Murphy JC, Jewell DL, White KI, Fox GE, Willson RC. Nucleic acid separations using

immobilized metal affinity chromatography. Biotechnol Prog. 19:982-986, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12790665

Nickerson CA, Ott CM, Mister SJ, Morrow BJ, Burns-Keliher L, Pierson DL. Microgravity as a

novel environmental signal affecting Salmonella enterica serovar Typhimurium virulence. Infect

Immun. 68: 3147-3152, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10816456

Nickerson CA, Ott CM, Wilson JW, Ramamurthy R, LeBlanc CL, Honer zu Bentrup K,

Hammond T, Pierson DL. Low-shear modeled microgravity: a global environmental regulatory

signal affecting bacterial gene expression, physiology and pathogenesis. J Microbiol Methods.

54:1-11, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12732416

Nickerson CA, Ott CM, Wilson JW, Ramamurthy R, Pierson DL. Microbial responses to

microgravity and other low-shear environments. Microbiol Mol Biol Rev. 68(2):345-61, 2004.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=15187188

Pierson D. Microbial contamination of spacecraft. Gravit Space Biol Bull. 14: 1-6, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11865864
NASA/SP-2005-6113 A-28

Rabbow E, Rettberg P, Baumstark-Khan C, Horneck G. The SOS-LUX-LAC-FLUORO-Toxicity

-test on the International Space Station (ISS). Adv Space Res. 31(6):1513-24, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12971406

Sakano Y, Pickering KD, Strom PF, Kerkhof LJ. Spatial distribution of total, ammonia-oxidizing

and denitrifying bacteria in biological wastewater treatment reactors for bioregenerative life

support. Appl Environ Microbiol. 68: 2285-2293, 2002.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11976099

Starikov D, Boney C, Medelci N, Um JW, Larios-Sanz M, Fox GE, Bensaoula AN. Experimental

simulation of integrated optoelectronic sensors based on III nitrides. J Vac Sci Technol. 20:1815-

1820, 2002.

Wilson JW, Ott CM, Ramamurthy R, Porwollik S, McClelland M, Pierson DL, Nickerson CA.

Low-Shear modeled microgravity alters the Salmonella enterica serovar typhimurium stress

response in an RpoS-independent manner. Appl Environ Microbiol. 68:5408-5416, 2002.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12406731

Zhang Z, Willson RC, Fox GE. Identification of characteristic oligonucleotides in the bacterial

16S ribosomal RNA sequence dataset. Bioinformatics. 18:244-250, 2002.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11847072

Risk Title: Reduced Muscle Mass, Strength, and Endurance

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Skeletal Muscle Alterations

Risk Number : 11

Risk Description : Performance of mission related physical activities may be impaired due to loss of muscle mass,

strength, and endurance associated with prolonged exposure to hypogravity.

Context / Risk

Factors :

Decreased loading of skeletal muscle during space flight is associated with decreased muscle size,

reduced muscle endurance, and loss of muscle strength. The risk may be influence by sensory-motor

deficits, contractile protein loss, changes in contractile phenotype, reduced oxidative capacity, bone

loss, poor nutrition, or insufficient exercise.

Justification /

Rationale :

There is a growing database demonstrating that skeletal muscles, particularly postural muscles of

the lower limb, undergo atrophy and undergo structural and metabolic alterations during space

flight. These alterations, if unabated, may affect performance of mission tasks. Exercise

countermeasures have to-date not fully protected muscle integrity. ISS experience will guide

countermeasure strategies for Mars missions.

Risk Rating : ISS: Priority 2

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Cycle ergometer

• Moderate resistance exercise

• Treadmill

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Artificial gravity (e.g., centrifuge with exercise capabilities) [TRL 3]

New programs of heavy resistance exercise (e.g., expanded exercise and loading capabilities)

and/or biophysical interventions [TRL 6]

•

• Pharmacological interventions [TRL 2]
NASA/SP-2005-6113 A-29

• Biophysical interventions [TRL 4]

• New/improved programs of endurance exercise [TRL 6]

• Nutritional interventions [TRL 6]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

Global/Systemic

11a

Can any one or combination of non-invasive modalities (exercise regimens, artificial

gravity, etc.) protect or build skeletal muscle mass or maintain skeletal muscle strength

or preserve skeletal muscle endurance during an ISS, lunar, or Mars mission? [ISS 1,

Lunar 1, Mars 1]

11b

Can non-invasive countermeasures (resistive exercise, artificial gravity, etc.) aimed at

counteracting atrophy processes during an ISS, lunar, or Mars mission maintain those

deficits in skeletal muscle strength that appear to occur independently of the atrophy

process? [ISS 1, Lunar 1, Mars 1]

11c

What combination of non-invasive modalities (exercise regimens, etc.), nutritional and

micronutrient supplements, and hormonal or pharmacological interventions is most

effective and efficient in protecting or increasing skeletal muscle mass, strength, and

endurance prior to or during space flight? [ISS 1, Lunar 1, Mars 1]

11d

What hardware and/or technology is/are reliable and effective in preserving skeletal

muscle mass, strength, and endurance during an ISS, lunar, or Mars mission? [ISS 3,

Lunar 3, Mars 3]

11e

What technologies (e.g., ultrasound) can be used to monitor and quantify changes in

skeletal muscle size, strength, and endurance during space flight? [ISS 3, Lunar 3,

Mars 3]

11f

Does atrophy of the spinal musculature contribute to lower back pain in crewmembers

during space flight or upon returning from an ISS, lunar, or Mars mission? [ISS 3,

Lunar 3, Mars 3]

11g What are the effects of skeletal muscle atrophy on whole body metabolism (e.g., insulin

and glucose tolerance) during space flight? [ISS 1, Lunar 3, Mars 1]

11h What are the effects of skeletal muscle atrophy on thermoregulation during space

flight? [ISS 3, Lunar 3, Mars 3]

11i What assistance devices/technologies can compensate for losses in skeletal muscle

strength and endurance during space flight? [ISS 3, Lunar 3, Mars 3]

11j

Is the skeletal muscle atrophy, loss in skeletal muscle strength, and reduction in skeletal

muscle endurance that occurs during an ISS, lunar, or Mars mission completely

reversible upon return to Earth? [ISS 3, Lunar 3, Mars 3]

11k

What prescription modality(ies) (exercise regimens, physical therapy, etc.) facilitate

recovery of skeletal muscle mass, strength, and endurance in crewmembers returning

from an ISS, lunar, or Mars mission? [ISS 1, Lunar 1, Mars 1]

Nutrition

11l

What are the nutritional and micronutrient requirements to maintain skeletal muscle

mass during ISS, lunar, or Mars missions? (See also 16g and 16h) [ISS 3, Lunar 3,

Mars 3]

Skeletal Muscle/Cellular

11m

What cellular processes/signaling pathways (e.g. protein turnover) in skeletal muscle

can be identified and targeted (pharmacological, gene therapy, hormones, etc.) to

prevent or attenuate fiber atrophy, loss of skeletal muscle strength, and reductions in

skeletal muscle endurance during ISS, lunar, or Mars missions? [ISS 3, Lunar 3, Mars

3]

11n

Is the capacity of skeletal muscle to grow or regenerate (satellite cells) compromised

during or after a mission because of space flight conditions (e.g., radiation exposure,

reduced skeletal muscle tension)? [ISS 3, Lunar 2, Mars 1]

Cardiovascular
NASA/SP-2005-6113 A-30

11o

Does skeletal muscle atrophy of the lower extremity musculature (i.e. muscle pump)

affect cardiovascular function (e.g., orthostatic hypotension) during an ISS, lunar, or

Mars mission? [ISS 1, Lunar 1, Mars 1]

Bone/Tendon

11p

Does site-specific skeletal muscle atrophy contribute to the accelerated rate of bone loss

in the central and peripheral skeleton because of countermeasures targeting select

muscle groups and/or reduced forces at the tendon insertion sites during space flight?

[ISS 1, Lunar 2, Mars 1]

11q

What are the temporal relationships between the changes in structure and function of

the bone, tendon, skeletal muscle, skeletal muscle-tendon interface, and skeletal muscle

-bone interactions during space flight? [ISS 2, Lunar 2, Mars 2]

11r

How does the atrophy process affect the structural and functional properties of

connective tissue (tendons), the fiber-tendon interface and the tendon-bone interface

during space flight? [ISS 2, Lunar 2, Mars 2]

Sensory-Motor

11s

How do the deficits in skeletal muscle mass associated with space flight affect the

structural/functional properties of the sensory system and motor nerves? [ISS 1, Lunar

1, Mars 1]

11t To what extent do alterations in the sensory-motor system contribute to deficits in

skeletal muscle strength and endurance during space flight? [ISS 3, Lunar 3, Mars 3]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Skeletal Muscle Alterations

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Radiation

Chronic and Degenerative Tissue Risks

Advanced Food Technology

Maintain Food Quantity and Quality
NASA/SP-2005-6113 A-31

Important

References : Adams GR, Caiozzo VJ, Baldwin KM. Skeletal muscle unweighting: spaceflight and groundbased models. J Appl Physiol 95:2185-201, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=14600160

Antonutto G, Capelli C, Girardis M, Zamparo P, di Prampero PE. Effects of microgravity on

maximal power of lower limbs during very short efforts in humans. J Appl Physiol 86: 85-92,

1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9887117

Convertino VA, Doerr DF, Stein SL. Changes in size and compliance of the calf after 30-days of

simulated microgravity. J Appl Physiol. Mar; 66(3):1509-12, 1989.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=2708266

di Prampero PE, Narici MV. Muscles in microgravity: from fibers to human motion. J Biomech.

36(3):403-412, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12594988

Edgerton VR, Zhou MY, Ohira Y, Klitgaard H, Jiang B, Bell G, Harris B, Saltin B, Gollnick PD,

Roy RR, et al. Human fiber size and enzymatic properties after 5 and 11 days of space flight. J

Appl Physiol. May; 78(5):1733-9, 1995

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7649906

Fitts RH, Riley DR, Widrick JJ. Physiology of a microgravity environment invited review:

microgravity and skeletal muscle. J Appl Physiol. 89: 823-39, 2000 (Review).

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10926670

LeBlanc A, Lin C, Shackelford L, Sinitsyn V, Evans H, Belichenko O, Schenkman B,

Kozlovskaya I, Oganov, V, Bakulin, A, Hedrick T, Feeback D. Muscle volume, MRI relaxation

times (T2) and body composition after space flight. J Appl Physiol. 89: 2158-2164, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11090562

McCall GE, Goulet C, Boorman GI, Roy RR, Edgerton VR. Flexor bias of joint position in

humans during spaceflight. Exp Brain Res. 152: 87-94, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12844202

Narici M, Kayser B, Barattini P, Cerretelli P. Changes in electrically evoked skeletal muscle

contractions during 17-day space flight and bed rest. Int J Sports Medicine. 18: S290-S292, 1997.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9391835

Zhou MY, Klitgaard H, Saltin B, Roy RR, Edgerton VR, Gollnick PD. Myosin heavy chain

isoforms of human muscle after short-term space flight. J Appl Physiol. May; 78(5):1740-4,

1995.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7649907

Risk Title: Increased Susceptibility to Muscle Damage

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Skeletal Muscle Alterations
NASA/SP-2005-6113 A-32

Risk Number : 12

Risk Description : Risk of injury to skeletal muscle and associated connective tissues may be increased due to

remodeling and weakening associated with prolonged exposure to hypogravity.

Context / Risk

Factors :

Decreased loading of the musculoskeletal system during space flight is associated with skeletal

muscle atrophy, changes in structural proteins, and remodeling of associated connective tissues (i.e.,

intramuscular, skeletal muscle tendon interface, etc.). This risk may be influenced by neural

factors, oxidative capacity, nutrition, or exercise.

Justification /

Rationale :

Skeletal muscle and associated connective tissue remodeling and weakening that result from

hypogravity exposure lead to a greater likelihood of sustaining skeletal muscle and/or connective

tissue damage and soreness ,which could result in an inability or reduced ability to perform missiondirected activities. The risk will increase with mission duration.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Cycle ergometer

• Moderate resistance exercise

• Treadmill

• Conditioning

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Artificial gravity (e.g., centrifuge with exercise capabilities) [TRL 3]

New programs of heavy resistance exercise (e.g., expanded exercise and loading capabilities)

and/or biophysical interventions [TRL 6]

•

• Pharmacological interventions [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

12a

What prescription guidelines and compliance factors facilitate increased resistance to

skeletal muscle and associated connective tissue injury in crewmembers prior to space

flight? [ISS 3, Lunar 3, Mars 3]

12b What hardware and/or technology is/are effective in preserving muscle structure during

an ISS mission? [ISS 3, Lunar N/A, Mars N/A]

12c What hardware and/or technology is/are effective in preserving muscle structure during

a lunar mission? [ISS N/A, Lunar 3, Mars N/A]

12d What hardware and/or technology is/are effective in preserving muscle structure during

a Mars mission? [ISS N/A, Lunar N/A, Mars 3]

12e

Do countermeasure paradigms that counteract skeletal muscle atrophy processes during

an ISS mission improve the structure-function properties of connective tissue systems?

[ISS 2, Lunar N/A, Mars N/A]

12f

Do countermeasure paradigms that counteract skeletal muscle atrophy processes during

a lunar mission improve the structure-function properties of connective tissue systems?

[ISS N/A, Lunar 2, Mars N/A]

12g

Do countermeasure paradigms that counteract skeletal muscle atrophy processes during

a Mars mission improve the structure-function properties of connective tissue systems?

[ISS N/A, Lunar N/A, Mars 2]

12h

Do countermeasures that minimize atrophy processes and strengthen skeletal muscle

tendon properties that are performed in states of unloading prevent injury from

occurring during a mission and upon return to weight bearing states (e.g., 1-G)? [ISS 1,

Lunar 1, Mars 1]

12i

What are the prescription guidelines and compliance factors needed for

countermeasures (exercise, AG, etc.) during space flight to minimize susceptibility to

skeletal muscle damage? [ISS 1, Lunar 1, Mars 1]
NASA/SP-2005-6113 A-33

12j

If a skeletal muscle injury occurs during space flight, what hardware and/or technology

(e.g., strength measurement, muscle/connective tissue damage marker(s), pain surveys,

diagnostic ultrasound) can be used to determine when it is safe for a crewmember to

resume exercise or perform dynamic activities associated with the mission (e.g.,

EVA/exploration)? [ISS 1, Lunar 1, Mars 1]

12k

What are the assistance devices/technologies that can compensate for a skeletal muscle

and/or associated connective tissue injury during space flight? [ISS 3, Lunar 3, Mars

3]

12l

What prescription guidelines and compliance factors facilitate injury-free skeletal

muscle rehabilitation in crewmembers returning from an ISS mission? [ISS 1, Lunar

N/A, Mars N/A]

12m

What prescription guidelines and compliance factors facilitate injury-free skeletal

muscle rehabilitation in crewmembers returning from a lunar mission? [ISS N/A,

Lunar 1, Mars N/A]

12n

What prescription guidelines and compliance factors facilitate injury-free skeletal

muscle rehabilitation in crewmembers returning from a Mars mission? [ISS N/A,

Lunar N/A, Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Clinical Capabilities

Monitoring and Prevention

Ambulatory Care

Rehabilitation on Mars

Radiation

Chronic and Degenerative Tissue Risks

Important

References : Adams GR, Caiozzo VJ, Baldwin KM. Skeletal muscle unweighting: spaceflight and groundbased models. J Appl Physiol. 95:2185-201, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=14600160

Antonutto G, Capelli C, Girardis M, Zamparo P, di Prampero PE. Effects of microgravity on

maximal power of lower limbs during very short efforts in humans. J Appl Physiol. 86: 85-92,

1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9887117

di Prampero PE, Narici MV. Muscles in microgravity: from fibers to human motion. J Biomech.

36(3):403-412, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12594988
NASA/SP-2005-6113 A-34

Edgerton VR, Zhou MY, Ohira Y, Klitgaard H, Jiang B, Bell G, Harris B, Saltin B, Gollnick PD,

Roy RR, et al. Human fiber size and enzymatic properties after 5 and 11 days of space flight. J

Appl Physiol. May; 78(5):1733-9, 1995

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7649906

Fitts RH, Riley DR, Widrick JJ. Physiology of a microgravity environment invited review:

microgravity and skeletal muscle. J Appl Physiol. 89: 823-39, 2000 (Review).

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10926670

LeBlanc A, Lin C, Shackelford L, Sinitsyn V, Evans H, Belichenko O, Schenkman B,

Kozlovskaya I, Oganov, V, Bakulin, A, Hedrick T and Feeback, D. Muscle volume, MRI

relaxation times (T2) and body composition after space flight. J Appl Physiol. 89: 2158-2164,

2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11090562

McCall GE, Goulet C, Boorman GI, Roy RR, Edgerton VR. Flexor bias of joint position in

humans during spaceflight. Exp Brain Res. 152: 87-94, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12844202

Narici M, Kayser B, Barattini P, Cerretelli P. Changes in electrically evoked skeletal muscle

contractions during 17-day space flight and bed rest. Int J Sports Medicine. 18: S290-S292, 1997.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9391835

Tidball JG, Quan DM. Reduction in myotendinous junction surface area of rats subjected to 4-

day space flight. J Appl Physiol. Jul; 73(1):59-64, 1992.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1506399

Zhou MY, Klitgaard H, Saltin B, Roy RR, Edgerton VR, Gollnick PD. Myosin heavy chain

isoforms of human muscle after short-term space flight. J Appl Physiol. May; 78(5):1740-4,

1995.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7649907

Baldwin KM, Edgerton VR, Roy RR. Muscle loss in space: physiological consequences.

Encyclopedia of Space Sciences and Technology. Vol. 2; H. Mark, M. Salkin and A. Yousef

(eds). John Wiley & Sons, Inc. Hoboken NJ, 2003, pp. 149-166.

NASA, Space Life Sciences, Final Report Task Force on Countermeasures, (Chair, Kenneth M.

Baldwin) May 1997. Appendix E-26.

Risk Title: Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Sensory-Motor Adaptation

Risk Number : 13

Risk Description : Operational performance may be impaired by spatial disorientation, perceptual illusions, and/or

disequilibrium which may occur during and after g-transitions due to maladaptation of the sensorymotor systems to the new gravito-inertial environment.

Context / Risk

Factors :

This risk may be exacerbated by vehicle/habitat designs that do not maintain consistent architectural

frames of reference or those presenting ambiguous visual orientation cues. It may also be

exacerbated by low visibility situations (smoke, landing weather, poor lighting), environmental

vibration, or unstable support surfaces (floors, seats).
NASA/SP-2005-6113 A-35

Justification /

Rationale :

Transitions between gravitational and dynamic acceleration environments are associated with

sensory-motor adaptation mechanisms and potential adverse sensory conflict reactions. These may

be problematic during periods requiring crew control of vehicles or other complex systems. These

mechanisms and reactions are expressed with a high degree of individual variability due to crew

training, crew experience, and other factors not well understood. Crew performance of routine and

critical actions during launch, landing, and the periods immediately following these events may be

compromised.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 2

Current

Countermeasures : Landing

• Heads Up Display

• Education and Training

In-Flight

Vehicle architecture and layout to establish a sense of artificial vertical for individual modules

(luminous exit placards to mark emergency egress paths, rack orientation and module layout,

surface labels)

•

• Preflight education and training in module simulators

• EVA training in neutral buoyancy

• Virtual reality techniques

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Auto-land capability on lunar or Mars landing and return vehicles [Lunar] [Mars]

• Determine efficacy of re-adaptation head movements during entry [CRL 2]

• Improved standards for workstation and spacecraft interior architecture [CRL 4]

• Improved teleoperator displays [CRL 2]

Pre-flight or in-flight g- specific pre-adaptation techniques, (e.g., artificial gravity) [CRL 2]

[Lunar] [Mars]

•

• Pre-flight visual orientation training for IVA activities using VR techniques[CRL 2-5]

• Preflight training, including high fidelity simulators [CRL 2] [Lunar] [Mars]

Spatial ability tests should be developed and validated to predict and improve individual

performance [CRL 2]

•

• Evaluate in-flight landing rehearsal simulators [CRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

13a What are the physiological bases for spatial disorientation, perceptual illusions, and

vertigo? [ISS 1, Lunar 1, Mars 1]

13b

What combinations of visual, vestibular, and haptic cues cause spatial disorientation,

perceptual illusions, and vertigo during and after g-transitions? [ISS 2, Lunar 2, Mars

2]

13c Can g-transition-related spatial disorientation, perceptual illusions, and vertigo be

predicted from mathematical models? [ISS 3, Lunar 3, Mars 3]

13d

What individual physiological and behavioral characteristics contribute to the large

inter-individual differences in neurovestibular symptoms and signs? [ISS 1, Lunar 1,

Mars 1]

13e What individual physiological and behavioral characteristics will best predict

susceptibility and adaptability? [ISS 3, Lunar 3, Mars 3]
NASA/SP-2005-6113 A-36

13f What is the physiological basis for context-specific-adaptation? [ISS 1, Lunar 1, Mars

1]

13g

To what extent can neurovestibular adaptation to weightlessness and/or artificial

gravity take place in context-specific fashion, so crewmembers can be adapted to

multiple environments and switch between them without suffering disorientation or

motion sickness? [ISS 2, Lunar 2, Mars 2]

13h

What preflight training techniques (e.g., virtual reality simulations, parabolic flight) can

be used to alleviate the risks of spatial disorientation, perceptual illusions, and vertigo

as astronauts launch, enter, and adapt to 0-G? [ISS 2, Lunar 2, Mars 2]

13i

What in-flight training techniques (e.g., virtual reality simulations, treadmill with

vibration isolation system, artificial gravity) can be used to alleviate the risks of

vertigo, disorientation, and perceptual illusions as astronauts land and (re)adapt to

Earth, Moon, or Mars gravity? [ISS 3, Lunar 3, Mars 3]

13j Is adaptation to the lunar gravity environment sufficient to reduce incidence of landing

vertigo upon return to Earth? [ISS N/A, Lunar 3, Mars N/A]

13k

What artificial gravity exposure regimens (g-level, angular velocity, duration, and

repetition) will ameliorate the physiological and vestibular deconditioning associated

with hypogravity during transit phases of a mission in order to increase the capability to

perform operational tasks during flight, entry and landing? [ISS N/A, Lunar 5, Mars

5]

13l What level of supervisory control will mitigate the landing vertigo risk in landing on

the Moon, Mars, and Earth? [ISS 4, Lunar 4, Mars 4]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness

Clinical Capabilities

Monitoring and Prevention

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Radiation

Acute and Late CNS Risks

Space Human Factors Engineering
NASA/SP-2005-6113 A-37

Mismatch Between Crew Physical Capabilities and Task Demands

Important

References : Guedry FE and AJ Benson. Coriolis cross-coupling effects: Disorienting and nauseogenic or not?

Aviation, Space, and Environmental Medicine. 49(1): 29-35, 1978.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=304719

Young L, Hecht H, Lune LE, Sienko KH, Cheung CC, Kavelaars J. Artificial gravity: head

movements during short radius centrifugation. Acta Astronautica. 49(3-10): 215-226, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11669111

Young LR. Artificial gravity considerations for a Mars exploration mission. In B. J. M. Hess &

B. Cohen (Eds.), Otolith function in spatial orientation and movement. 871 (pp. 367-378), 1999

NY, NY Academy of Sciences.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10372085

Baldwin, et al. (1997) NASA Task Force on Countermeasures, Final Report. Appendix E

McCluskey, R., Clark, J., Stepaniak, P. (2001) Correlation of Space Shuttle Landing Performance

with Cardiovascular and Neurological Dysfunction Resulting from Space flight. (Significant

correlation between post-flight neurovestibular signs and shorter, faster, harder landings.)

Paloski, W. H., & Young, L. R. (1999). Artificial gravity workshop: Proceedings and

recommendations. NASA/NSBRI Workshop Proceedings.

Reschke, M. F., J. J. Bloomberg, et .al. (1994). Neurophysiological Aspects: Sensory and Sensory

-Motor Function. Space Physiology and Medicine. A. E. Nicogossian, Lea and Febiger.

Shelhamer M, and DS Zee. (2003) Context-specific adaptation and its significance for

neurovestibular problems of space flight. Journal of Vestibular Research. 13:345-362.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12638031

Risk Title: Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and

Throughout Re-Adaptation

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Sensory-Motor Adaptation

Risk Number : 14

Risk Description : Capability to egress the vehicle in an emergency or to perform post landing tasks may be

compromised by impaired movement and coordination caused by long-term exposure to

microgravity.

Context / Risk

Factors :

This risk may be exacerbated by duration of microgravity exposure, cardiovascular deconditioning,

muscle atrophy, orthostatic intolerance, relative hypovolemia, diminished aerobic capacity, and/or

poor task, equipment or vehicle/habitat design.

Justification /

Rationale :

Following prolonged microgravity exposure, several deconditioned physiological systems must

readapt. Crewmembers may be unable to accomplish certain postflight physical activities involving

upright posture, locomotion, and handling loads. Current methods of postflight rehabilitation may

not be optimal to restore sensory-motor function.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 2

Current

Countermeasures : Quantitative post-flight tests of spontaneous, positional and positioning nystagmus, postural

stability, dynamic visual acuity, and gait [TRL/CRL 8]

•

• Traditional clinical rehabilitation techniques
NASA/SP-2005-6113 A-38

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Balance prostheses (e.g., tactile vest) [TRL/CRL6]

g-specific pre-adaptation for Mars landing (e.g., short radius intermittent or large radius

continuous artificial gravity) and return to Earth [CRL 2] [Mars]

•

General or g-specific pre-adaptation techniques, (e.g., in-flight or pre-flight artificial gravity;

sensory-motor generalization training techniques [CRL 2]

•

Improved EVA suits designed to mechanically mitigate fracture risk in the event of falls [TRL 2]

[Mars]

•

Pre-flight or in-flight g- specific pre-adaptation techniques, (e.g., artificial gravity) [CRL2,

TRL1] [Lunar]

•

Quantitative post-flight tests of gaze stability, and locomotion and corner turning stability [TRL

6, CRL 6]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

14a What are the physiological bases for disruption of balance, locomotion, and eye-head

coordination following g-transitions? [ISS 1, Lunar 1, Mars 1]

14b Can disruption of balance, locomotion, and eye-head coordination following gtransitions be predicted from mathematical models? [ISS 3, Lunar 3, Mars 3]

14c

What individual physiological and behavioral characteristics contribute to the large

inter-individual differences in neurovestibular symptoms and signs? [ISS 1, Lunar 1,

Mars 1]

14d What individual physiological and behavioral characteristics will best predict

susceptibility and adaptability? [ISS 3, Lunar 3, Mars 3]

14e What is the physiological basis for context-specific-adaptation? [ISS 1, Lunar 1, Mars

1]

14f How can voluntary head movements during entry and landing be used to accelerate readaptation? [ISS 3, Lunar 3, Mars 3]

14g

What in-flight training techniques (e.g., virtual reality simulations, treadmill with

vibration isolation system, artificial gravity) can be used to alleviate the risks of

impaired balance control and movement coordination as astronauts land and (re)adapt

to Earth, Moon, or Mars gravity? [ISS 3, Lunar 3, Mars 3]

14h

Is adaptation to the lunar gravity environment sufficient to reduce incidence of sensorymotor balance and coordination problems upon return to Earth? [ISS N/A, Lunar

TBD, Mars N/A]

14i

What artificial gravity exposure regimens (g-level, angular velocity, duration, and

repetition) will ameliorate the physiological and vestibular deconditioning associated

with hypogravity during surface operation phases of a mission? [ISS N/A, Lunar TBD,

Mars TBD]

14j

What artificial gravity exposure regimens (g-level, angular velocity, duration, and

repetition) will ameliorate the physiological and vestibular deconditioning associated

with hypogravity during transit phases of a mission in order to increase the capability to

perform operational tasks after landing and throughout readaptation? [ISS N/A, Lunar

N/A, Mars TBD]

14k

How can traditional clinical vestibular rehabilitation techniques be employed to

usefully accelerate readaptation following g-transitions? [ISS TBD, Lunar TBD, Mars

TBD]

14l

What objective assessment techniques can be used to determine crew readiness to

return to normal activities following g-transitions? [ISS TBD, Lunar TBD, Mars

TBD]
NASA/SP-2005-6113 A-39

14m

How can preflight or in-flight sensory-motor training or sensory aids improve postlanding postural and locomotor control and orthostatic tolerance? [ISS TBD, Lunar

TBD, Mars TBD]

14n To what extent can crewmembers "learn how to learn" by adapting to surrogate sensory

-motor rearrangements? [ISS TBD, Lunar TBD, Mars TBD]

14o

What are the relative contributions of sensory-motor adaptation, neuromuscular

deconditioning, and orthostatic intolerance to postflight neuro-motor coordination,

ataxia, and locomotion difficulties? [ISS TBD, Lunar TBD, Mars TBD]

14p What posture, locomotion, and gaze deficits result from transition to lunar gravity (1/6-

G) or Mars gravity (3/8-G)? [ISS TBD, Lunar TBD, Mars TBD]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Motion Sickness

Clinical Capabilities

Monitoring and Prevention

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Radiation

Acute and Late CNS Risks

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands

Important

References : Bloomberg JJ, Mulavara AP. (2003) Changes in walking strategies after space flight. IEEE

Engineering in Medicine and Biology Magazine. 22(2): 58-62.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12733460

Guedry FE and AJ Benson. Coriolis cross-coupling effects: Disorienting and nauseogenic or not?

Aviation, Space, and Environmental Medicine. 49(1): 29-35, 1978.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=304719
NASA/SP-2005-6113 A-40

Paloski WH, Reschke MF, Black FO, Doxey DD, Harm DL. Recovery of postural equilibrium

control following spaceflight. Sensing and Controlling Motion: Vestibular and Sensorimotor

Function. B. Cohen, D. L. Tomko and F. E. Guedry. NY, Annals of the NY Academy of Sciences

656: 747-754, 1992.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1599180

Young LR. Artificial gravity considerations for a Mars exploration mission. In B. J. M. Hess &

B. Cohen (Eds.), Otolith function in spatial orientation and movement. 871 (pp. 367-378), 1999

NY, NY Academy of Sciences.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10372085

Baldwin, et. al. (1997) NASA Task Force on Countermeasures, Final Report. Neurovestibular

Countermeasures Appendix E-26

Homick, J. L. and E. F. Miller. (1975). Apollo flight crew vestibular assessment. Biomedical

results of Apollo. R. S. Johnston and L. F. Deitlein, US Government Printing Office. NASA SP368: 323-340.

Lackner JR and, DiZio P. (2000) Human orientation and movement control in weightlessness and

artifical gravity environments. Exp. Brain Res. 130: 2-26.

Richards JT, Clark JB, Oman CM and Marshburn TH. (2002) Neurovestibular Effects of LongDuration Space flight: A Summary of Mir Phase 1 Experiences, NSBRI/NASA technical report,

p. 1-33, also Journal of Vestibular Research. 11(3-5): 322.

Risk Title: Motion Sickness

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Sensory-Motor Adaptation

Risk Number : 15

Risk Description : Crew work capacity, vigilance, and motivation may be impaired by motion sickness symptoms

occurring during and after g transitions.

Context / Risk

Factors :

This risk is influenced by individual susceptibilities, spacecraft size and room available for

movement. It does not appear to be correlated with susceptibility to terrestrial motion sickness.

Symptoms are repeatable but often attenuated from flight to flight.

Justification /

Rationale :

Space motion sickness (SMS) is a common component of human space flight. For Shuttle crews,

70% experience symptoms for the first 2-4 days in 0-g, with emesis occurring in 10-20%, and many

experience similar symptoms for hours to days after landing. Several crewmembers have remained

symptomatic during flight for up to two weeks. Current anti-motion sickness treatment with IM

Promethazine is highly effective and allows nominal space flight operations in spite of the high

incidence of SMS. However, this drug has potentially significant side effects that may further

complicate acute adaptation to space flight and prevent regular prophylactic use. Readaptation

motion sickness may occur during entry and landing, prompting similar symptoms and possible

impairment. In both situations, head movements, which may be required for normal operations,

may be provocative.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 3

Current

Countermeasures : • Oral Promethazine/Ephedrine

• Oral Scopolamine/Dexedrine (rare)

• IM Promethazine

• Head and body movement restriction, heads-up-display (HUD) for landing

Projected

Countermeasures or

Mitigations & other

Deliverables:

New administration methods of medicines for rapid, reliable relief with fewer side effects [CRL

6]

•
NASA/SP-2005-6113 A-41

• Techniques to quantify cognitive deficits as a side effect of medication [CRL 6]

Technique for providing a form of stroboscopic vision to reduce incidence of motion sickness

[CRL 4]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

15a What are the physiological mechanisms that trigger vomiting in space motion sickness?

[ISS 1, Lunar 1, Mars 1]

15b What is the physiological basis of the emetic linkage between vestibular and emetic

centers? [ISS 2, Lunar 2, Mars 2]

15c

What individual physiological and behavioral characteristics contribute to the large

inter-individual differences in neurovestibular symptoms and signs? [ISS 1, Lunar 1,

Mars 1]

15d What individual physiological and behavioral characteristics will best predict

susceptibility and adaptability? [ISS 3, Lunar 3, Mars 3]

15e What is the physiological basis for context-specific-adaptation? [ISS 1, Lunar 1, Mars

1]

15f

To what extent can neurovestibular adaptation to weightlessness and/or artificial

gravity take place in context-specific fashion, so crewmembers can be adapted to

multiple environments and switch between them without suffering disorientation or

motion sickness? [ISS 3, Lunar 3, Mars 3]

15g What preflight training techniques (e.g., virtual reality simulations, parabolic flight) can

be used to alleviate the risks of space motion sickness? [ISS 4, Lunar 4, Mars 4]

15h

What in-flight training techniques (e.g., virtual reality simulations, treadmill with

vibration isolation system, artificial gravity) can be used to alleviate the risks of space

motion sickness as astronauts land and (re)adapt to Earth, Moon, or Mars gravity? [ISS

4, Lunar 4, Mars 4]

15i Is adaptation to the lunar gravity environment sufficient to reduce incidence of motion

sickness upon return to Earth? [ISS N/A, Lunar 4, Mars N/A]

15j

How does susceptibility to motion sickness due to Coriolis forces and cross-coupled

canal stimuli vary as a function of g-levels between 0-G and 1-G, and also on RPM,

radius, and head orientation during AG? [ISS N/A, Lunar 1, Mars 1]

15k

What are the best methods for quantifying the symptoms and signs of motion sickness

and associated performance decrements and drug side effects in a non-intrusive way?

[ISS 2, Lunar 2, Mars 2]

15l

What better ways can be found to administer anti-motion sickness drugs to provide

more rapid and reliable relief, with fewer objectionable side effects? [ISS 3, Lunar 3,

Mars 3]

15m Do scopolamine and promethazine prevent or impair sensory-motor adaptation to 0-G?

[ISS 4, Lunar 4, Mars 4]

15n What new drugs will more specifically prevent nausea, fatigue, memory and vigilance

deficits without side effects? [ISS 4, Lunar 4, Mars 4]

15o Can drugs be developed to effectively block the emetic linkage without unacceptable

side effects? [ISS 4, Lunar 4, Mars 4]

15p Can operationally practical, non-pharmacologic techniques be developed that are

effective against motion sickness? [ISS 4, Lunar 4, Mars 4]

15q Is lunar gravity (1/6-G) or Mars gravity (3/8-G) adequate to prevent all cases of motion

sickness? [ISS 4, Lunar 4, Mars 4]

Related Risks : Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing
NASA/SP-2004-6113 A-42

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Clinical Capabilities

Monitoring and Prevention

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands

Important

References : Davis JR, JM Vanderploeg, et al. (1988) "Space motion sickness during 24 flights of the Space

Shuttle." Aviat Space Environ. Med. 59: 1185-1189.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3240221

Graybiel A, and Lackner JR. Treatment of severe motion sickness with antimotion sickness drug

injections. Aviat Space and Environ Med. 58: 773-776, 1987.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3632537

Guedry FE and AJ Benson. Coriolis cross-coupling effects: Disorienting and nauseogenic or not?

Aviation, Space, and Environmental Medicine, 49(1): 29-35, 1978.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=304719

Lackner JR and Graybiel A. Head movements made in non-terrestrial force environments elicit

motion sickness: implications for the etiology of space motion sickness. Aviat Space and Environ

Med. 57: 443-448, 1986.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3632537

Matsnev EI, IY Yakovleva, et al. (1983) "Space motion sickness: phenomenology,

countermeasures, and mechanisms." Aviat Space and Environ Med. 54: 312-317.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=6847567

Baldwin, et. al. (1997) NASA Task Force on Countermeasures, Final Report. Neurovestibular

Countermeasures Appendix E-26

Cowings PS. (1990) Autogenic-Feedback Training: A Preventive Method for Motion and Space

Sickness. In: (G. Crampton (ed.). Motion and Space Sickness. Boca Raton Florida: CRC Press.

Chapter 17, Pp.354-372

Oman CM, BK Lichtenberg et .al. (1990) Symptoms and signs of space motion sickness on

Spacelab-1. Motion and Space Sickness. G. H. Crampton. Boca Raton, FL, CRC Press: 217-246.

Reschke MF, JJ Bloomberg et al. (1994) Neurophysiological Aspects: Sensory and SensoryMotor Function. Space Physiology and Medicine. A. E. Nicogossian, Lea and Febiger.

Wood CD, Graybiel A. (1968). Evaluation of Sixteen Anti-motion Sickness Drugs Under

Controlled Laboratory Conditions. Aerosp Med. 39:1341-4.

Oman CM. (1990) "Motion sickness: a synthesis and evaluation of the sensory conflict theory."

Can J Physiol Pharmacol. 68: 294-303.
NASA/SP-2005-6113 A-43

Risk Title: Inadequate Nutrition

Crosscutting Area : Human Health and Countermeasures (HHC)

Discipline : Nutrition

Risk Number : 16

Risk Description : Maintenance of astronaut health depends on a food system that provides all of the required

nutrients.

Context / Risk

Factors :

Nutritional requirements for space include fluids, macronutrients, micronutrients and other elements

required to optimize health status. Requirements must take into account any changes in the sensory

system that might influence taste, smell, intake, and the role that countermeasure- and space flight

factor-induced alterations may have on nutrient requirements. This risk may be influenced by

psychosocial factors, elevated stress and boredom, or compliance with diet.

Justification /

Rationale :

Nutritional deficiencies may lead to an increased health risk as the duration of space flight

increases. Inadequate micronutrient or vitamin intake could adversely affect crew health.

Furthermore, adequate nutrition may play a role in counteracting the negative effects of space flight

(e.g., radiation, immune deficits, and bone and muscle loss). While all long duration crewmembers

have lost body mass, the cause of weight loss is not yet fully understood. For a Mars mission, there

are additional challenges to provide a variety of fresh, palatable, and nutritious foods.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Provision of adequate diet through use of proper food system and vitamin supplements

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Improved dietary compliance and counseling [CRL 4]

• Enhanced food system [CRL 4]

Diet and nutritional supplementation that ensures and/or enhances the effectiveness of other

countermeasures [CRL 4]

•

• Refined nutritional requirements [CRL 4]

• Understanding and implementing an acceptable food system [CRL 4]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

16a

What are the nutritional requirements for extended stay ISS missions, including (but

not limited to): calories, protein, calcium, iron, antioxidants, iodine, vitamin D, sodium,

potassium? [ISS 1, Lunar 1, Mars 1]

16b What are the potential impacts of countermeasures on nutritional requirements or

nutritional status? [ISS 1, Lunar 1, Mars 1]

16c What are the decrements in nutritional status due to long-term LEO, lunar, and

exploration missions? [ISS 1, Lunar 1, Mars 1]

16d What are the means of monitoring nutritional status during the mission? [ISS 3, Lunar

3, Mars 3]

16e What monitoring (biochemical, anthropometric, clinical assessments) during

rehabilitation is required? [ISS 3, Lunar 3, Mars 3]

16f What level of dietary counseling is needed for crewmembers during rehabilitation?

[ISS 3, Lunar 3, Mars 3]

16g

Can general nutrition, or specific nutrient countermeasures, mitigate the negative

effects of space flight on bone, muscle, cardiovascular and immune systems, and

protect against damage from radiation? [ISS 1, Lunar 1, Mars 1]

16h What is the role of adequate nutrition/weight maintenance on crew health (specifically

bone, muscle and cardiovascular adaptation)? [ISS 1, Lunar 2, Mars 1]

16i What level of dietary counseling is needed for crewmembers pre-flight? [ISS 1, Lunar

2, Mars 1]
NASA/SP-2005-6113 A-44

16j How does on-orbit exercise affect nutritional requirements and vice versa? [ISS 1,

Lunar 2, Mars 1]

16k Can general nutrition, or specific nutrient countermeasures, mitigate radiation-induced

carcinogenesis or cataractogenesis? [ISS 1, Lunar 1, Mars 1]

16l Are there long-term effects of disease risk post-flight, and can nutritional

countermeasures be preventative? [ISS 1, Lunar 2, Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Radiation

Carcinogenesis

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Food Technology

Maintain Food Quantity and Quality

Advanced Life Support

Provide and Maintain Bioregenerative Life Support Systems

Provide and Recover Potable Water

Important

References : NASA Johnson Space Center. Nutritional Requirements for International Space Station Missions

Up To 360 Days. JSC-28038; 1996.

Nutrition. 18:793-936, 2002. (volume dedicated to nutrition and space, >20 articles)

Risk Title: Monitoring and Prevention
NASA/SP-2005-6113 A-45

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 17

Risk Description : The risk of serious medical events may increase due to inadequate monitoring and prevention

capabilities.

Context / Risk

Factors :

This risk may be influenced by family history, medical history, and pre-flight or pre-mission

screening.

Justification /

Rationale :

The primary means to reduce the risk of life- and/or mission-threatening medical conditions is to

prevent those conditions from happening through screening and preventive strategies. The second

most effective means to reduce such risk is to monitor for medical conditions so that treatment can

be implemented at an early stage. Autonomous monitoring and care strategies need to be validated

in low earth orbit where support is assured. Because of increased distance and delay in

communication, the medical monitoring support for a lunar mission will transition from

predominately ground based to an autonomous system. For a mission to Mars, due to distance,

delay in communication and no return capability, real time monitoring and medical support will be

exclusively autonomous.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Annual and preflight comprehensive physical exams

• In-flight examination, monitoring and care

• Selection standards for space flight

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Additional screening criteria

• Better in flight health monitoring capability

A more autonomous, reliable suite of medical diagnostic and therapeutic clinical care hardware

and procedures [Lunar] [Mars]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

Health Tracking

17a What are the key parameters for health screening and early detection? [ISS 4, Lunar 2,

Mars 1]

17b

What resources and technologies are required for routine health monitoring, including

examination, laboratory, imaging and adaptation for operation in reduced-G

environments? [ISS 4, Lunar 2, Mars 1]

17c

What diagnostic imaging technologies and procedures need to be developed and/or

adapted to support the primary, secondary and tertiary prevention of illness and injury?

[ISS 3, Lunar 2, Mars 1]

17d What parameters and sensors are needed to monitor health and performance in

crewmembers performing EVA? [ISS 4, Lunar 2, Mars 2]

17e What are the investigations needed to discriminate between terrestrial and space flight

norms in order to allow early detection of illness and injury? [ISS 3, Lunar 2, Mars 2]

17f What is space-normal physiology? [ISS 4, Lunar 3, Mars 3]

17g What are the signs, symptoms or abnormal examination findings (including laboratory)

associated with illness and injury in reduced-G? [ISS TBD, Lunar TBD, Mars TBD]

17h How do alterations in space flight associated physiology interact across body systems?

[ISS 4, Lunar 3, Mars 3]

17i

What are the appropriate informatics tools to automate crew health monitoring in order

to free-up crew time (i.e. prompting screening and evaluations, off-nominal value

detection, intelligent diagnostic work-up)? [ISS 2, Lunar 1, Mars 1]

Prophylaxis/Disease Prevention
NASA/SP-2005-6113 A-46

17j

What are the ideal set of nutritional and medical prophylaxes, and primary and

secondary preventive measures to reduce the risk of space illness (such as medical

countermeasures for known conditions - e.g., bisphosphonates for loss of BMD)? [ISS

3, Lunar 2, Mars 2]

17k

What are the primary, secondary, and tertiary prevention strategies needed to mitigate

the risk of anticipated environmental exposures to radiation and toxic substances (i.e.

shielding, nutritional and medical prophylaxis such as agents to augment cellular

defenses, immune surveillance, etc.)? [ISS 2, Lunar 1, Mars 1]

17l

What are the essential technologies, resources, procedures, skills and training necessary

to provide effective primary prevention strategies to mitigate each of the conditions

listed in the SMCCB-approved Space Medicine Condition List (catalogued in the

online Patient Condition Database)? [ISS 4, Lunar 3, Mars 2]

17m

What are the essential technologies, resources, procedures, skills and training necessary

to provide effective secondary prevention strategies to mitigate each of the conditions

listed in the SMCCB-approved Space Medicine Condition List (catalogued in the

online Patient Condition Database)? [ISS 4, Lunar 3, Mars 2]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Alterations in Microbes and Host Interactions

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness

Nutrition

Inadequate Nutrition

Clinical Capabilities

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Medical Informatics, Technologies, and Support Systems
NASA/SP-2004-6113 A-47

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Air Quality

Monitor External Environment

Monitor Water Quality

Monitor Surfaces, Food, and Soil

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Important

References :

Risk Title: Major Illness and Trauma

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 18

Risk Description : Lack of capability to treat major illness and injuries increases the risk to crew health and mission.

Context / Risk

Factors :

Risk of trauma will vary according to mission activities and risk of illness will increase with

mission duration. Equipment and activities are designed to minimize risk of injury.

Justification /

Rationale :

For ISS, the risk for major trauma is considered low. For missions to the Moon and Mars, there is a

significant risk of trauma associated with EVA. There is a risk for development of major illness.

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • Return to Earth for definitive care

• On-board treatment capability (ventilator, IV fluids, medications, etc.)

• Preventive measures

Projected

Countermeasures or

Mitigations & other

Deliverables:

Autonomous capabilities for monitoring and treatment of identified conditions, because quick

return is not an option for missions to the Moon and Mars

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

18a

What are the essential technologies, resources, procedures, skills, and training

necessary to provide effective prevention strategies to mitigate each of the conditions

listed in the SMCCB-approved Space Medicine Condition List (catalogued in the

online Patient Condition Database)? [ISS 3, Lunar 1, Mars 1]

Major Illness Diagnosis
NASA/SP-2005-6113 A-48

18b

What are the technologies for employing decision support techniques for diagnostic

assistance of the crew medical personnel, emphasizing autonomy in decision-making

from ground resources and based on known space flight illnesses and injuries and

expedition analog experience? [ISS 2, Lunar 1, Mars 1]

18c What are the appropriate roles and resources required for telemedical consultation for

the diagnosis and management of major illnesses? [ISS 3, Lunar 2, Mars 1]

18d What resources are required for telemedical consultation, diagnosis, and management

of major trauma? [ISS 3, Lunar 2, Mars 1]

Major Illness Treatment

18e

What are the resources, procedures, and technologies required for treatment of major

illnesses, emphasizing autonomy from ground resources and based on known space

flight illnesses, injuries, and expedition analog experience, and how might they be

adapted for reduced-G operations? [ISS 2, Lunar 1, Mars 1]

18f What are the resources and procedures needed to perform basic and advanced

management of trauma? [ISS 3, Lunar 1, Mars 1]

18g

What are the specific techniques, resources, protocols, training curricula, skills, and

equipment (technology) necessary to implement palliative care protocols for in-flight

use? [ISS 4, Lunar 2, Mars 1]

18h What are effective management strategies for chronic pain in reduced-G

(pharmacologic and non-pharmacologic)? [ISS TBD, Lunar TBD, Mars TBD]

18i What procedures and protocols are necessary for rehabilitation after an acute medical

illness or trauma? [ISS 4, Lunar 3, Mars 1]

18j What are effective management strategies for acute pain in reduced-G (pharmacologic

and non-pharmacologic)? [ISS TBD, Lunar TBD, Mars TBD]

18k

What are the nutritional requirements for adequate red cell production in microgravity?

What are the contributory factors and how do they inter-relate in the development of

space anemia (radiation, unloading, nutrition, fluid shift, changes in sex hormones,

etc.)? [ISS 2, Lunar 2, Mars 2]

18l How can aplastic anemia be treated during space missions? [ISS 5, Lunar 5, Mars 3]

18m

What are the appropriate synergistic and alternative management strategies for reducing

the morbidity of major illnesses during space flight? [ISS TBD, Lunar TBD, Mars

TBD]

18n

What is the most effective means of conducting life support operations in the space

flight milieu, to include identification and modification of the resources and procedures

for reduced-G? [ISS 3, Lunar 2, Mars 1]

18o

What are the optimal resources and procedures for post-resuscitation management of

the ill/injured crewmember and modify for reduced-G operations? [ISS 2, Lunar 1,

Mars 1]

Decompression Illness (DCS) & Other Environmental Illness

18p

What is the most effective pre-EVA Decompression Sickness (DCS) prevention

strategy to include pre-breathe with various gases, exercise and other medical

measures? [ISS 5, Lunar TBD, Mars TBD]

18q What are the appropriate screening procedures to minimize predispositions for DCS?

[ISS 4, Lunar TBD, Mars TBD]

18r

What are the resources and techniques for early diagnosis of DCS signs and symptoms,

including the use of Doppler U/S and other bubble detection technologies? [ISS 4,

Lunar TBD, Mars TBD]

18s

What are the best methods for predicting DCS risk and for reducing the risk, based on

understanding of the physiological mechanism for bubble formation and propagation,

employing best available knowledge from flight and analog environment experience?

[ISS 4, Lunar TBD, Mars TBD]
NASA/SP-2005-6113 A-49

18t

What are the most effective yet safe, and energy- and space-efficient means of

managing DCS in the space flight milieu, including the use of hyperbaric oxygen

delivery and other promising technology, and how might they be adapted for reduced-G

operations? [ISS 3, Lunar 2, Mars 1]

18u

What is the actual risk of space-related DCS? (de novo physiological causes and acute

environmental insult - e.g., leaking module or damaged EMU etc.) [ISS 3, Lunar 3,

Mars 3]

18v What are the operational and medical impacts of off-nominal performance of DCS

countermeasures? [ISS 4, Lunar 3, Mars 3]

18w What are the risk factors that can increase the likelihood of DCS, such as the presence

of Patent Foramen Ovale (PFO)? [ISS 4, Lunar 3, Mars 2]

18x What is the likelihood of surviving an acute environmental insult severe enough to

cause damage to the vehicle or spacesuit? [ISS 2, Lunar 2, Mars 2]

18y

Is it possible and what are the DCS risk mitigation options for interplanetary EVA (e.g.,

moon and Mars) given that a tri-gas breathing mixture including argon is present? [ISS

4, Lunar 4, Mars 4]

18z What is the role of individual susceptibility, age and gender on the risk of DCS during

NASA operations involving decompression? [ISS 4, Lunar 3, Mars 3]

18aa

What are the available and new technologies needed to provide hyperbaric treatment

options on the ISS and future habitats (or vehicles) beyond LEO (e.g., on the moon or

Mars)? [ISS 3, Lunar 2, Mars 1]

18ab What is the correlation between the detection/existence of gas phase creation in the

bloodstream and development of clinically significant DCS? [ISS 4, Lunar 3, Mars 3]

18ac What are the monitoring, prevention, and treatment methods for clinical effects of

acute, excessive, radiation exposure? [ISS 3, Lunar 2, Mars 1]

18ad What are the signs and symptoms secondary to radiation and toxic chemical exposure

in reduced-G environments? [ISS 2, Lunar 1, Mars 1]

18ae What are the resources and procedures for the mitigation of toxic exposures? [ISS 3,

Lunar 1, Mars 1]

18af

What primary prevention strategies (such as crew screening and selection criteria)

should be developed and implemented to identify individuals who are at increased risk

for developing hypersensitivity or allergies to space flight compounds, exposures, or

payloads? [ISS 3, Lunar 2, Mars 2]

18ag

What secondary prevention strategies (i.e. countermeasures) should be developed and

implemented to prevent adverse reactions to toxic exposures (e.g., sleep, nutrition,

medication, stress reduction, shielding, protective equipment, etc.)? [ISS 3, Lunar 2,

Mars 2]

Surgical Management

18ah What resources and procedures are needed for the surgical management of major

illness, injury, and trauma? [ISS 3, Lunar 1, Mars 1]

18ai What are the appropriate roles and resources required for telemedical consultation for

the surgical management of major illnesses? [ISS 3, Lunar 2, Mars 1]

18aj What are the issues surrounding wound care, and how are they best resolved? [ISS 4,

Lunar 2, Mars 2]

18ak What are effective regional and local anesthesia strategies in reduced G? [ISS TBD,

Lunar TBD, Mars TBD]

18al What methods and new technologies are needed for blood replacement therapy in

space? [ISS 3, Lunar 2, Mars 1]

Medical Waste Management

18am What are the most effective means of management and disposal of medical waste

within the surgical milieu? [ISS 2, Lunar 1, Mars 1]

Related Risks : Bone Loss
NASA/SP-2005-6113 A-50

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Clinical Capabilities

Monitoring and Prevention

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Radiation

Carcinogenesis

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Important

References :

Risk Title: Pharmacology of Space Medicine Delivery

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 19

Risk Description : Diminished drug efficacy due to reduced shelf life and alterations in pharmacodynamics and

pharmacokinetics may compromise treatment capabilities.

Context / Risk

Factors :

Degraded shelf life may be related to the space radiation environment and other microgravity

factors. This risk may be influenced by limited or no re-supply, microgravity, or the radiation

environment.

Justification /

Rationale :

Medications returned from ISS have been shown to have decreased potency beyond what is

expected. Microgravity pharmacokinetics is not well understood.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current
NASA/SP-2005-6113 A-51

Countermeasures :

• Re-supply of medications on ISS

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Shielding of medications from space radiation

• Alteration in dose and formulation of medication

Research &

Technology

Questions [With

Mission Priority]:

No. Question

Pharmacodynamics/Pharmacokinetics

19a

What are the effects of space flight and reduced-G on the absorption, distribution,

metabolism, clearance, excretion, clinical efficacy, side effects and drug interactions for

medications used in primary, secondary and tertiary prevention of conditions stated in

the Space Medicine Condition List? [ISS 2, Lunar 2, Mars 1]

19b

How should the crew and medical team be trained and prepared to recognize and deal

with side effects and interaction effects of commonly used medications? [ISS 3, Lunar

3, Mars 2]

19c

What diagnostic, therapeutic and laboratory technologies are necessary to predict

(model) and manage medication side effects, interactions and toxicity during space

flight? [ISS 3, Lunar 3, Mars 3]

19d What effect does space adaptation have on drug bio-availability and how can efficacy

be enhanced? [ISS 2, Lunar 2, Mars 1]

Drug Stowage/Utilization/Replenishment

19e What is the effect of long-duration space flight on drug stability, and what measures

can be employed to extend the duration of drug efficacy? [ISS 3, Lunar 1, Mars 1]

19f What are the appropriate on-orbit/on-station means of drug and intravenous (IV) fluid

replenishment appropriate for space operations? [ISS 3, Lunar 1, Mars 1]

19g What are biomedical models for drug efficacy? [ISS 4, Lunar 3, Mars 3]

Drug Use Optimization

19h What are the optimal dosages and routes of administration for space flight/reduced-G

clinical effectiveness? [ISS 3, Lunar 2, Mars 2]

19i What are efficient means of monitoring drug levels for therapeutic effect and toxicity to

minimize cross-reaction and negative synergy? [ISS 4, Lunar 3, Mars 3]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Sensory-Motor Adaptation

Motion Sickness

Clinical Capabilities

Monitoring and Prevention
NASA/SP-2005-6113 A-52

Major Illness and Trauma

Ambulatory Care

Rehabilitation on Mars

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Chronic and Degenerative Tissue Risks

Important

References :

Risk Title: Ambulatory Care

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 20

Risk Description : Impaired performance and increased risk to crew health and mission may occur due to lack of

capability to diagnose and treat minor illnesses.

Context / Risk

Factors : Risks may vary depending on mission activities.

Justification /

Rationale :

Minor illnesses and injuries have been documented during space flight. Capability to diagnose and

treat minor medical conditions will ensure crew health remains good and the mission is not

impacted. Current ISS capability is acceptable for future ISS missions

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Crew Screening

• Crew training to recognize and treat medical conditions

• Design of equipment and procedures to reduce the likelihood of injury

• Medical kits with capability to diagnose and treat minor illnesses and injuries

• Limited telemedicine capability

• Real-time ground communication with medical experts

Projected

Countermeasures or

Mitigations & other

Deliverables:

• More extensive medical kit

• More extensive telemedicine capability

• On board autonomous medical diagnostic and therapeutic aids

Research &

Technology

Questions [With

Mission Priority]:

No. Question

Minor Illness Diagnosis

20a

What are the resources for establishing the diagnosis of minor illnesses, emphasizing

autonomous decision-making, based on known space flight illnesses, injuries, and

expedition analogs? How might they be adapted to reduced-G operations? [ISS 4,

Lunar 2, Mars 1]

20b What are the appropriate roles and resources required for telemedical consultation for

the diagnosis and management of minor illnesses? [ISS 4, Lunar 3, Mars 2]

Minor Illness Management
NASA/SP-2005-6113 A-53

20c

What are the resources and procedures required for treatment of minor illnesses,

emphasizing autonomy from ground resources and based on known space flight

illnesses and injuries and expedition analog experience, and how might they be adapted

for reduced-G operations? [ISS 4, Lunar 3, Mars 2]

20d

What are the appropriate synergistic and alternative management strategies for reducing

the morbidity of minor illnesses during space flight? [ISS TBD, Lunar TBD, Mars

TBD]

Minor Trauma Management

20e

What are the resources and procedures required for the treatment of minor trauma,

emphasizing autonomous decision-making, based on known space flight illnesses,

injuries, and expedition analogs? How might they be adapted to reduced-G operations?

[ISS 3, Lunar 1, Mars 1]

Related Risks : Bone Loss

Renal Stone Formation

Cardiovascular Alterations

Diminished Cardiac and Vascular Function

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Rehabilitation on Mars

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Important

References :

Risk Title: Rehabilitation on Mars

Crosscutting Area : Autonomous Medical Care (AMC)
NASA/SP-2005-6113 A-54

Discipline : Clinical Capabilities

Risk Number : 21

Risk Description : Crew capability to function after landing on Mars may be compromised due to space flight

deconditioning and lack of a remote, self-administered, rehabilitation program.

Context / Risk

Factors :

This risk may be influenced by sensory neural alterations and ability to autonomously perform

exercise program. This assumes functioning exercise hardware.

Justification /

Rationale :

This risk is unique to an exploration mission to Mars. Significant deconditioning can occur during

the transit to Mars and the crew must be able to self-administer a rehabilitation program en route

and once they arrive at Mars so that they can function as needed.

Risk Rating : ISS: N/A

Lunar: N/A

Mars: Priority 1

Current

Countermeasures : • Ground rehabilitation program and facilities [Mars]

• In flight exercise [Mars]

• Pre-flight conditioning [Mars]

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Countermeasures to neurovestibular effects [Mars]

• Improved exercise protocols [Mars]

• Autonomous medical monitoring capability [Mars]

• Structured, self-administered rehabilitation program (physical and psychological) [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

21a What are the primary, secondary and tertiary preventive strategies needed to ensure

post-landing performance for a Mars mission? [ISS N/A, Lunar N/A, Mars 1]

21b

What are the essential technologies, resources, protocols, skills and training necessary

for post landing rehabilitation (including psychological, cardiovascular, neurosensory,

musculoskeletal and nutritional)? [ISS N/A, Lunar N/A, Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Impaired Fracture Healing

Injury to Joints and Intervertebral Structures

Renal Stone Formation

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Diminished Cardiac and Vascular Function

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Increased Susceptibility to Muscle Damage

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness
NASA/SP-2005-6113 A-55

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Acute and Late CNS Risks

Acute Radiation Risks

Important

References :

Risk Title: Medical Informatics, Technologies, and Support Systems

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 22

Risk Description : Limited communication capability during space flight results in the compromised ability to provide

medical care, and may have adverse consequences for crew health.

Context / Risk

Factors :

Risk will be exacerbated by lack of recent training, limited communication capability, and lack of

real-time ground support.

Justification /

Rationale :

Lack of real-time ground support due to limited communication and limited telemedical capability

necessitates reliable, efficacious informatics capability and support. This is low priority for ISS,

moderate priority for a lunar mission, and high priority for a Mars mission.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Limited telemedicine capability

• On-board computer based training

• Real-time ground support

• Periodic on-orbit contingency drills

• Medical checklist and preflight training

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Development of autonomous medical support systems
NASA/SP-2005-6113 A-56

Research &

Technology

Questions [With

Mission Priority]:

No. Question

22a What decision support technologies are needed to support clinical care? [ISS 4, Lunar

2, Mars 1]

22b What informatics systems and technology are needed, both for crew and ground

support, to optimize medical care? [ISS 3, Lunar 1, Mars 1]

22c What are the impacts of communication latency on the ability to provide primary,

secondary and tertiary prevention during space flight? [ISS 4, Lunar 4, Mars 1]

Related Risks : Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Medical Skill Training and Maintenance

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Space Human Factors Engineering

Poorly Integrated Ground, Crew, and Automation Functions

Important

References :

Risk Title: Medical Skill Training and Maintenance

Crosscutting Area : Autonomous Medical Care (AMC)

Discipline : Clinical Capabilities

Risk Number : 23

Risk Description : Inability to perform required medical procedures may result from inadequate crew medical skills or

medical training.

Context / Risk

Factors : A physician may be required on a Mars crew.

Justification /

Rationale :

Illness and injuries are likely to occur. The crew must be able to diagnose and treat a variety of

conditions. Different mission scenarios will require a different level of expertise and autonomy.

For ISS, real time ground support is available and there is return capability. For a lunar mission the

crew must be trained more extensively because of reduced availability of ground support. The Mars

crew will require extensive training and support hardware because of lack of ground support and

return capability.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Limited telemedicine capability

• On-board computer based training

• Crew Medical Officer (CMO) training

• Real-time ground support

• Periodic on-orbit contingency drills

Projected

Countermeasures or

Mitigations & other

• More extensive medical training, including medical and surgical capabilities

• Autonomous medical support systems
NASA/SP-2005-6113 A-57

Deliverables:

Research &

Technology

Questions [With

Mission Priority]:

No. Question

23a What are the necessary clinical skills/knowledge for a space medicine physician? [ISS

4, Lunar 1, Mars 1]

23b How can the clinical skills and knowledge of space medical care providers be

maintained during missions? [ISS 2, Lunar 2, Mars 1]

23c

What is the optimum crew complement (size, skill sets, etc.) to provide the appropriate

medical care for the primary, secondary and tertiary care for the conditions in the Space

Medicine Condition List? [ISS 4, Lunar 3, Mars 1]

23d

What techniques can be used to train and maintain the skills of the crew medical

personnel to perform specific medical procedures when needed? [ISS 3, Lunar 1,

Mars 1]

Related Risks : Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Medical Informatics, Technologies, and Support Systems

Behavioral Health & Performance and Space Human Factors (Cognitive)

Mismatch between Crew Cognitive Capabilities and Task Demands

Space Human Factors Engineering

Poorly Integrated Ground, Crew, and Automation Functions

Important

References :

Risk Title: Human Performance Failure Due to Poor Psychosocial Adaptation

Crosscutting Area : Behavioral Health and Performance (BHP)

Discipline : Behavioral Health & Performance and Space Human Factors (Cognitive)

Risk Number : 24

Risk Description : Human performance failure may occur due to problems associated with adapting to the space

environment, interpersonal relationships, group dynamics, team cohesiveness, and pre-mission

preparation.

Context / Risk

Factors :

The isolated and confined nature of space flight, along with its potential hazards, pose human

performance related challenges. This risk may be influenced by boredom with available food, crew

autonomy and increased reliance on each other, crowding, distance from family and friends,

duration of flight, incompatible crewmembers, interpersonal tensions, mechanical breakdowns, poor

communications, scheduling constraints and requirements, sleep disturbances, or social isolation.

Justification /

Rationale :

Moderate likelihood/high consequence risk with low risk mitigation status. Serious interpersonal

conflicts have occurred in space flight. The failure of flight crews to cooperate and work effectively

with each other or with flight controllers has been a periodic problem in both US and Russian space

flight programs. Interpersonal distrust, dislike, misunderstanding and poor communication have led

to potentially dangerous situations, such as crewmembers refusing to speak to one another during

critical operations, or withdrawing from voice communications with ground controllers. Such

problems of group cohesiveness have a high likelihood of occurrence in prolonged space flight and

if not mitigated through prevention or intervention, they will pose grave risks to the mission. Lack

of adequate personnel selection, team assembly, or training has been found to have deleterious

effects on work performance in organizational research studies. The duration and distance of a

Mars mission significantly increases this risk. The distance also reduces countermeasure options

and increases the need for autonomous behavioral health support systems.
NASA/SP-2005-6113 A-58

Risk Rating : ISS: Priority 1

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Language and cultural training,

• Personal in-flight communications with Earth

• Post-flight debriefs

• Pre-flight training and teambuilding,

• Self-report monitoring of adaptation during mission with private psychological conference

• Select-out criteria

• In-flight and preflight psychological support

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Development of individual performance enhancement plan for each crewmember [CRL 1]

• Individual and team selection for long-duration missions [CRL 3]

• Monitoring & early detection of adaptation problems [CRL 3]

• Predictive model of adaptability to long-duration missions [CRL 1]

• Select-in criteria

Research &

Technology

Questions [With

Mission Priority]:

No. Question

24a

What are the fundamental behavioral and social stressors during long-duration missions

that will most likely affect crew performance, both individual and team, and how can

they be studied for elimination or accomodation in Earth analogue environments? [ISS

1, Lunar 1, Mars 1]

24b

What factors contribute to the breakdown of individual/team performance and mission

support coordination with regard to scheduling, prioritization of work activities, and

control of timelines? [ISS 1, Lunar 1, Mars 1]

24c

What behaviors, experiences, personality traits and leadership styles in crewmembers

most contribute to optimal performance? How are these factors related to performance

of individuals and teams? [ISS 2, Lunar 2, Mars 2]

24d What criteria can be identified during the selection process and be used to select and

assemble the best teams for long-duration missions? [ISS 2, Lunar 2, Mars 2]

24e

What factors in crew design, composition, dynamics and size will best enhance the

crew's ability to live and work in the space environment? How are these factors

different from shorter duration missions? [ISS 2, Lunar 2, Mars 2]

24f

How can attitudes and behaviors of agency management, ground controllers,

crewmembers and their families be modified to maintain and improve individual and

group performance? [ISS 2, Lunar 2, Mars 2]

Related Risks : Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Ambulatory Care

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation
NASA/SP-2005-6113 A-59

Acute and Late CNS Risks

Advanced Food Technology

Maintain Food Quantity and Quality

Space Human Factors Engineering

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : Kanas N. Psychiatric issues affecting long-duration space missions. Aviation Space &

Environmental Medicine. 69:1211-1216, 1998.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9856550

McCormick IA, Taylor AJ, Rivolier J, & Cazes G. (1985). A psychometric study of stress and

coping during the International Biomedical Expedition to the Antarctic (IBEA). J Human Stress.

11(4), 150-156.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3843117

Palinkas LA, Gunderson EK, Holland AW, Miller C, & Johnson JC. (2000) Predictors of

behavior and performance in extreme environments: the Antarctic space analogue program. Aviat

Space Environ Med. 71(6): 619-625.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10870821

Taylor AJ. (1998). Psychological adaptation to the polar environment. Int J Circumpolar Health.

57(1): 56-68.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9567576

Wood JA, Hysong SJ, Lugg DJ, & Harm DL. (2000) Is it really so bad? A comparison of positive

and negative experiences in Antarctic winter stations. Environment and Behavior. 32(1): 85-110.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11542948

Wood JA, Lugg DJ, Hysong SJ, Eksuzian DJ, & Harm DL. (1999) Psychological changes in

hundred-day remote Antarctic field groups. Environment and Behavior. 31(3): 299-337.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11542387

Connors MM, Harrison AA, and Faren RA. Living Aloft: Human requirements for extended

space flight. NASA SP-483, Washington, D.C., National Aeronautics and Space Administration,

1985.

Harrison AA, Clearwater YA, and McKay CA. (eds), From Antarctica to outer space: Life in

Isolation and Confinement. NY, NY Springer-Verlag, 1991.

Palinkas LA. (1991) Effects of physical and social environments on the health and well-being of

Antarctic winter-over personnel. Environment & Behavior. 23(6); 782-799.

Palinkas LA, & Gunderson EK. (1988) Applied anthropology on the ice: A multidisciplinary

perspective on health and adaptation in Antarctica (No. 88-21). San Diego: Naval Health

Research Center.

Risk Title: Human Performance Failure Due to Neurobehavioral Problems

Crosscutting Area : Behavioral Health and Performance (BHP)

Discipline : Behavioral Health & Performance and Space Human Factors (Cognitive)

Risk Number : 25

Risk Description : Human performance failure may occur due to conditions such as depression, anxiety, or other

psychiatric and cognitive problems.
NASA/SP-2005-6113 A-60

Context / Risk

Factors :

For long duration missions, inadequate countermeasures or failure of early detection of behavioral

health problems could result in more severe psychiatric problems. This risk may be influenced by

clinical capabilities, concern about health or loss of life or mission failure, lack of privacy,

differential vulnerability to neurobehavioral problems, duration of flight, environmental health,

loneliness and worry about family, nutrition, prolonged isolation and confinement, or trauma from

an unexpected event.

Justification /

Rationale :

Although infrequent, serious neurobehavioral problems involving stress and depression have

occurred in space flight, especially during long-duration missions. In some of these instances, the

distress has contributed to performance errors. In other instances, emotional problems led to

changes in motivation, diet, sleep and exercise-all critical to behavioral and physical health in-flight.

No matter how prepared crews are for long-duration flights, the US and Russian experiences reveal

that at least some subset of astronauts will experience problems with their behavioral health, which

will negatively affect their performance and reliability, posing risks both to individual

crewmembers and to the mission. The IOM report, Safe Passages, notes that Earth analogue studies

show an incidence rate ranging from 3-13 percent per person per year. The report transposes these

figures to 6-7 person crew on a 3-year mission to determine that there is a significant likelihood of

psychiatric problems emerging (p.106).

Risk Rating : ISS: Priority 1

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Crew medical officer behavioral medicine training pre-flight

• Detection at the time of failure

• Emergency response protocol on-orbit

• Individual pre-flight and post-flight evaluations

• Medication therapy, including during space flight

Opportunity for crewmembers to communicate with crew medical officer or health provider on

ground

•

• Select-in and select-out criteria

• Self monitoring of cognition on-orbit and post-flight

• Self-report monitoring during mission with private psychological conference

Projected

Countermeasures or

Mitigations & other

Deliverables:

Greater interaction and observation by behavioral specialist during astronaut professional training

[CRL 4]

•

Improved ability to safely and effectively manage an uncooperative crewmember during mission

[CRL 3]

•

• Improved capability for remote diagnosis [CRL 3]

• Improved diagnostic cognitive self-assessment [CRL 3]

• Individualized treatment algorithm developed pre-flight [CRL 5]

On-board information technologies as astronaut aids for management of stress reactions and

cognitive or emotional problems [CRL 3]

•

• On-board modalities of therapy [CRL 4]

On-board unobtrusive technologies as astronaut aids for valid detection of stress reactions and

cognitive or emotional problems [CRL 3]

•

• Predictive model for risk of neurobehavioral illness in-flight [CRL 3]

• Self monitoring of mood pre-flight, in-flight and post-flight [CRL 4]

• Updated behavioral medicine aeromedical standards [CRL 4]
NASA/SP-2005-6113 A-61

Research &

Technology

Questions [With

Mission Priority]:

No. Question

25a

What are the best select-out tools of astronaut candidates and best select-out tools for

selection of individuals to teams for specific missions to avoid possible

neuropsychiatric and psychological incompatibility with the mission and fellow team

members? [ISS 1, Lunar 1, Mars 1]

25b

What are the long-term effects of exposure to the space environment (microgravity,

isolation, stress) on human neurocognitive and neurobiological functions (from cellular

to behavioral levels of the nervous system)? [ISS 2, Lunar 2, Mars 2]

25c

What are the long-term effects of exposure to the space environment on human emotion

and psychological responses, including emotional reactivity, stress responses, longterm modulation of mood and vulnerability to affective and cognitive disorders? [ISS 3,

Lunar 3, Mars 3]

25d

What objective techniques and technologies validly and reliably identify when

astronauts are experiencing distress that compromises their performance capability in

space? [ISS 1, Lunar 1, Mars 1]

25e

What are the best behavioral, technological and pharmacological countermeasures for

managing cognitive dysfunction, neuropsychiatric and behavior problems in space?

[ISS 3, Lunar 3, Mars 3]

25f

What are the best behavioral, psychological, technological and pharmacological

countermeasures for managing emotional and stress-related problems in space? [ISS 3,

Lunar 3, Mars 3]

25g

What are the best techniques and technologies for identification and treatment of

cognitive disorders, neuropsychiatric and behavior problems in space? [ISS 4, Lunar 4,

Mars 4]

25h

What are the strategies for psychological stress management, and maintaining the

morale and acceptable functioning and safety of remaining crewmembers after an

adverse event during a mission? [ISS 3, Lunar 1, Mars 1]

Related Risks : Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Rehabilitation on Mars

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Acute and Late CNS Risks

Acute Radiation Risks

Advanced Food Technology

Maintain Food Quantity and Quality

Space Human Factors Engineering
NASA/SP-2005-6113 A-62

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : Ellis SR. Collision in space. Ergonomics in Design. 8;4-9, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12162316

Kanas N. Psychiatric issues affecting long-duration space missions. Aviation Space &

Environmental Medicine. 69:1211-1216, 1998.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9856550

Simpson S. Staying sane in space. Scientific American. 282:61-62, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10736838

Burrough, B. Dragonfly: NASA and the crisis aboard Mir. NY, Harper Collins, 1998.

Kanas N, Manzy D. Space Psychology and Psychiatry. El Segundo, CA, Microcosm Press, 2003.

Linenger JM. Off the Planet. NY, McGraw Hill, 2000.

Newkirk D. Almanac of Soviet Manned Space flight, Houston, TX, Gulf Publishing, 1990

Risk Title: Mismatch between Crew Cognitive Capabilities and Task Demands

Crosscutting Area : Behavioral Health and Performance (BHP)

Discipline : Behavioral Health & Performance and Space Human Factors (Cognitive)

Risk Number : 26

Risk Description : Human performance failure may occur due to inadequate design of tools, interfaces, tasks, and

information support systems. Task saturation may also occur due to compromises in crew health,

human factors, and cognitive capabilities.

Context / Risk

Factors :

The remote nature of space flight increases the likelihood and severity of consequences of error due

to task saturation, losing skills and knowledge, or failing to find information and training materials

in databases. Particularly on Moon and Mars missions, the distance and communication lags may

require an autonomous response to any malfunction that may increase the incidence of performance

error. This risk may be influenced by communication blackouts and lags, mission duration,

required levels of autonomy, time since training, time since last performing a task, or level of

support available from mission control on Earth.

Justification /

Rationale :

Crews require refresher training and information support systems for numerous tasks during 6-

month ISS missions (Evidence Level 4). Psychological literature documents increases in error with

time since learning, and decreases in error with correctly practicing the task (Evidence level 1).

Failure to correctly follow procedures has led to fatal accidents in commercial aviation, even with

greatly over-learned tasks (NTSB Reports-Level 2)

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Crew resilience is the countermeasure for schedule and interface problems

Mission Control provides training, information, and procedures as required to support crew

actions and decision-making

•

• Efforts by mission planners to maintain realistic workloads and schedules

Projected

Countermeasures or

Mitigations & other

Deliverables:

Design requirements for communications systems among crewmembers, between crew and

mission control, and among crew and intelligent agents, that reduce risk of mission failure [TRL

2]

•

• Onboard training systems that enable successful readiness to perform [TRL 2]
NASA/SP-2005-6113 A-63

• Tools for analyzing tasks to identify critical skills and knowledge [TRL 2]

• Tools for enabling crew autonomy with respect to information retrieval [TRL 2]

• Tools to enable self-assessment of readiness to perform [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

26a

What crew size and composition is required to provide the amount of information,

variety of skills, etc. required to accomplish the reference mission? [ISS 2, Lunar 1,

Mars 1]

26b What is required to counteract the negative effects of communications lags on human

performance? [ISS 1, Lunar 1, Mars 1]

26c

What information systems, interface designs, intelligent systems and other tools to

enable autonomy are required to enable human performance to be maintained at an

acceptable level over the reference missions? (Shared - Integrated Testing supports)

[ISS 2, Lunar 1, Mars 1]

26d

What types and techniques of training are required and within what timeframes, to

enable the crewmembers to accomplish the mission with increased effectiveness,

efficiency and safety? [ISS 1, Lunar 1, Mars 1]

26e

What principles of task design, procedures, job aids and tools and equipment, are

required to enable crewmembers to accomplish nominal and emergency perceptual and

cognitive tasks? [ISS 2, Lunar 1, Mars 1]

26f How can crewmembers and ground support personnel detect and compensate for

decreased cognitive readiness to perform? [ISS 1, Lunar 1, Mars 1]

26g What scheduling constraints are required to reduce the risk of human error due to

fatigue? (shared with Sleep and Circadian Rhythm) [ISS 2, Lunar 2, Mars 2]

26h What tools and techniques will maintain the crew's situational awareness at a level

sufficient to perform nominal and emergency tasks? [ISS 2, Lunar 1, Mars 1]

26i

What characteristics of equipment, tool and computer displays; instructions,

procedures, labels and warning; and human-computer interaction designs will maintain

critical sensory and cognitive capabilities? [ISS 2, Lunar 2, Mars 2]

26j What approaches to human computer interactions will maintain crew critical

capabilities to assess, control and communicate? [ISS 2, Lunar 2, Mars 2]

26k What decision-support systems are required to aid crew decision-making? [ISS 2,

Lunar 2, Mars 2]

26l

What design considerations are needed to accommodate effects of changes in gravity

on perception (Launch, lunar landing, lunar launch, Earth return)? [ISS N/A, Lunar 1,

Mars 1]

Related Risks : Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Clinical Capabilities

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Space Human Factors Engineering
NASA/SP-2005-6113 A-64

Mismatch Between Crew Physical Capabilities and Task Demands

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : Ellis SR. Collision in space. Ergonomics in Design. 8(1): 4-9, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12162316

Human Space flight: Mission Analysis and Design, eds. W.J. Larson, L.K. Pranke. McGraw Hill

Space Technology Series. 1999.

Sleep, performance, circadian rhythms and light-dark cycles during two space Shuttle flights.

Dijk DJ, Neri DF, Wyatt JK, Ronda JM, Riel E, Ritz-De Cecco A, Hughes RJ, Elliott AR, Prisk

GK, West JB, Czeisler CA. Am J Physiol Regul Integr Comp Physiol. 2001 Nov; 281(5):R1647-

64.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11641138

Handbook of Human Factors and Ergonomics (2nd ed), G. Salvendy, ed. John Wiley and Sons,

Inc. 1997.

Handbook of Human Factors Testing and Evaluation, 2nd ed. S. G. Charlton, T.G. O?Brien, eds.

2002.

Woolford B, Hudy CE, Whitmore M, Berman A, Maida J, and Pandya A. (2002) In Situ Training

Project: LMLSTP Phase III Report. In Lane, H.W., Sauer, R.L. and Feeback, D.L. (Eds.),

ISOLATION: NASA Experiments in Closed Environment Living. Advanced Human Life

Support Enclosed System Final Report. San Diego, CA: American Astronautical Society.

Risk Title: Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Crosscutting Area : Behavioral Health and Performance (BHP)

Discipline : Behavioral Health & Performance and Space Human Factors (Cognitive)

Risk Number : 27

Risk Description : Human performance failure may occur due to circadian disruption, and acute or chronic degradation

of sleep quality and quantity.

Context / Risk

Factors :

Circadian disruption, or acute or chronic degradation of sleep quality or quantity, is a known risk

during space flight. This risk may be influenced by artificial and transmitted ambient light

exposure, individual differences in vulnerability to sleep loss and circadian dynamics, or work shift

and sleep schedules.

Justification /

Rationale :

Loss of circadian entrainment to Earth-based light-dark cycles, and chronic reduction of sleep

duration in space, result in fatigue and jeopardize astronaut performance. Fatigue is a common

symptom in prolonged space flight. Every study of sleep in space, including those on US, Russian,

and European astronauts, has found that daily sleep is reduced to an average of 6 hours. It is reduced

even more when critical operations occur, such as nighttime Shuttle dockings on ISS, or during an

emergency (e.g., equipment failure). Astronaut sleep in space is also physiologically altered.

Additionally, the most frequent medications taken in-flight by astronauts are hypnotics for sleep

disturbances. Extensive ground-based scientific evidence documents that circadian disruptions and

restriction of sleep at levels commonly experienced by astronauts can severely diminish cognitive

performance capability, posing risks to individual astronaut safety and mission success.

Risk Rating : ISS: Priority 3

Lunar: Priority 3

Mars: Priority 2

Current

Countermeasures : • Bright light entrainment prior to launch

• Individual active noise cancellation at sleep

• Medications

Scheduling constraints, as documented in Ground Rules & Constraints document SSP 50261-2, to

protect sleep schedule and duration, and reduce crew fatigue

•
NASA/SP-2005-6113 A-65

• Self report monitoring during mission with personal physician conference

Projected

Countermeasures or

Mitigations & other

Deliverables:

Ability to monitor sleep, circadian and lighting parameters unobtrusively in order to predict

physiological and behavioral responses [CRL 7]

•

• Develop flight rule limits on critical operations during sleep period [CRL 4]

• Model of performance deficit based on sleep and circadian data [CRL 6]

• Personal lighting device (e.g., light visor) [CRL 6]

• Sleep/circadian rhythm non-photic adjustment tools pre- in- and post-flight [CRL 5]

• Sleep/circadian rhythm pharmacological interventions pre- in- and post-flight. [CRL 5]

• Sleep/circadian rhythm photic adjustment tools pre- in- and post-flight [CRL 7]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

27a

What are the acute and long-term effects of exposure to the space environment on

biological rhythmicity, sleep architecture (quantity and quality), and their relationship

to performance capability? [ISS 1, Lunar 1, Mars 1]

27b

Which countermeasures or combination of behavioral and physiological

countermeasures will optimally mitigate specific performance problems associated with

sleep loss and circadian disturbances during the reference missions? [ISS 1, Lunar 1,

Mars 1]

27c

What are the long-term effects of countermeasures employed to mitigate pre, - in- and

post-flight performance problems with sleep loss and circadian disturbances? [ISS 3,

Lunar 4, Mars 2]

27d

What are the best methods for in-flight monitoring of the status of sleep, circadian

functioning and light exposures for assessing the effects of sleep loss and circadian

dysrhythmia on performance capability that are also portable and non-intrusive in the

space flight environment? (e.g., actigraphy) [ISS 2, Lunar 2, Mars 2]

27e What work, workload, and sleep schedule(s) will best enhance crew performance and

mitigate adverse effects of the space environment? [ISS 1, Lunar 1, Mars 1]

27f

What individual biological and behavioral characteristics will best predict successful

adaptation to long-term space flight of sleep, circadian physiology and the

neurobehavioral performance functions they regulate? [ISS 4, Lunar 5, Mars 1]

27g

What mathematical and computational models should be used to predict performance

associated with sleep-wake, schedule, work history, light exposure and circadian

rhythm status and also provide guidelines for successful countermeasure strategies?

[ISS 1, Lunar 1, Mars 1]

Related Risks : Clinical Capabilities

Pharmacology of Space Medicine Delivery

Ambulatory Care

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Radiation

Acute and Late CNS Risks

Acute Radiation Risks

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands
NASA/SP-2005-6113 A-66

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : Akerstedt T. Work hours, sleepiness and the underlying mechanisms. J Sleep Res. 4: 15-22, 1995.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

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Belenky G, et al. Patterns of performance degradation and restoration during sleep restriction and

subsequent recovery: a sleep dose-response study. J Sleep Res. 12: 1-12, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12603781

Brainard GC, JP Hanifin, JM Greeson, B Byrne, G Glickman, E Gerner and MD Rollag. Action

spectrum for melatonin regulation in humans: evidence for a novel circadian photoreceptor. J

Neuroscience. 21: 6405-6412, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11487664

Cajochen C, SB Khalsa, JK Wyatt, CA Czeisler and DJ Dijk. EEG and ocular correlates of

circadian melatonin phase and human performance decrements during sleep loss. Am J Physiol.

277: R640-9, 1999.

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_uids=10484479

Czeisler CA, AJ Chiasera and JF Duffy. Research on sleep, circadian rhythms and aging:

applications to manned space flight. Exp Gerontol. 26: 217-232, 1991.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1915692

Czeisler CA, JF Duffy, TL Shanahan, EN Brown, JF Mitchell, DW Rimmer, JM Ronda, EJ Silva,

JS Allan, JS Emens, DJ Dijk and RE Kronauer. Stability, precision and near-24-hour period of

the human circadian pacemaker. Science. 284: 2177-2181, 1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10381883

Dijk, DJ, DF Neri, JK Wyatt, JM Ronda, E Riel, A. Ritz-De Cecco, RJ Hughes, AR Elliott, GK

Prisk, JB West and CA Czeisler. Sleep, performance, circadian rhythms and light-dark cycles

during two space shuttle flights. Am. J. Physiol. 281: R1647-64, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11641138

Elliott AR, SA Shea, DJ Dijk, JK Wyatt, E Riel, DF Neri, CA Czeisler, JB West and GK Prisk.

Microgravity reduces sleep-disordered breathing in humans. Am J Respir Crit Care Med. 164:

478-85, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11500354

Fuller CA, TM Hoban-Higgins, VY Klimovitsky, DW Griffin and AM Alpatov. Primate

circadian rhythms during space flight: results from cosmos 2044 and 2229. J Appl Physiol. 81:

188-193, 1996.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8828664

Gundel A, VV Polyakov and J Zulley. The alteration of human sleep and circadian rhythms

during space flight. J Sleep Res. 6: 1-8, 1997.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9125693
NASA/SP-2005-6113 A-67

Horowitz TS, BE Cade, JM Wolfe and CA Czeisler. Efficacy of bright light and sleep/darkness

scheduling in alleviating circadian maladaptation to night work. Am J Physiol. 281: E384-91,

2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11440916

Lockley SW, GC Brainard and CA Czeisler. High sensitivity of the human circadian melatonin

rhythm to resetting by short wavelength light. J. Clinical Endo and Metab. 88: 4502-5, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12970330

Monk TH, DJ Buysse, BD Billy, KS Kennedy and LM Willrich. Sleep and circadian rhythms in

four orbiting astronauts. J Biol Rhythms. 13: 188-201, 1998.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=9615283

Putcha L, BA Berens, TH Marshburn, HJ Ortega and RD Billica. Pharmaceutical use by U.S.

astronauts on space shuttle missions. Aviat Space Environ Med. 70: 705-708, 1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10417009

Rajaratnam SM and J Arendt. Health in a 24-h society. Lancet. 358: 999-1005, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11583769

Santy P, H Kapanka, J Davis and D Stewart. Analysis of sleep on Shuttle missions. Aviat Space

Environ Med. 59: 1094-1097, 1988.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3202794

Shearer WT, JM Reuben, JM Mullington, NJ Price, BN Lee, EO Smith, MP Szuba, HP Van

Dongen and DF Dinges. Soluble TNF-alpha receptor 1 and IL-6 plasma levels in humans

subjected to the sleep deprivation model of spaceflight. J Allergy & Clin Immunol. 107: 165-170,

2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11150007

Van Dongen HPA, G Maislin, JM Mullington and DF Dinges. The cumulative cost of additional

wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from

chronic sleep restriction and total sleep deprivation. Sleep. 26: 117-126, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12683469

Whitson PA, L Putcha, YM Chen and E Baker. Melatonin and cortisol assessment of circadian

shifts in astronauts before flight. J. Pineal Res. 18: 141-147, 1995.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7562371

Wright KP Jr., RJ Hughes, RE Kronauer, DJ Dijk and CA Czeisler. Intrinsic near-24-h

pacemaker period determines limits of circadian entrainment to a weak synchronizer in humans.

PNAS. 98: 14027-32, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11717461

Risk Title: Carcinogenesis

Crosscutting Area : Radiation Health (RH)

Discipline : Radiation
NASA/SP-2005-6113 A-68

Risk Number : 28

Risk Description : Increased cancer morbidity or mortality risk in astronauts may be caused by occupational radiation

exposure.

Context / Risk

Factors :

This risk may be influenced by other space flight factors including microgravity and environmental

contaminants. A Mars mission will not be feasible unless improved shielding is developed.

Justification /

Rationale : Exposure to space radiation increases the risk of developing cancer later in life.

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • Polyethylene shielding

• Mission design (altitude, vehicle attitude, timing of EVAÆs)

• Real-time monitoring

• Administrative radiation exposure limits (ALARA)

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Anti-oxidants [CRL 1]

• Gene therapy [CRL 1]

• Pharmaceuticals [CRL 1]

• Improved shielding and vehicle design to minimize radiation exposure [TRL 5]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

28a

What are the probabilities for increased carcinogenesis from space radiation as a

function of NASA's operational parameters (age at exposure, age, latency, gender,

tissue, mission, radiation quality, dose rate and exposure protraction)? [ISS 1, Lunar 1,

Mars 1]

28b

How can tissue specific probabilities for increased carcinogenesis risk from space

radiation be best evaluated? What molecular, genetic, epigenetic, abscopal (effect that

irradiation of a tissue has on remote non-irradiated tissue), and other factors contribute

to the tissue specificity of carcinogenic risk? [ISS 1, Lunar 1, Mars 1]

28c How can the individual's sensitivity to radiation carcinogenesis be estimated? [ISS 2,

Lunar 2, Mars 1]

28d How can effective biomarkers of carcinogenic risk from space radiation be developed

and validated? [ISS 3, Lunar 3, Mars 2]

28e

What are the most effective biomedical or dietary countermeasures to mitigate cancer

risks? By what mechanisms are the countermeasures expected to work, and do they

have the same efficiency for low- and high-LET radiation? [ISS 3, Lunar 3, Mars 1]

28f

How can animal models (including genetic models such as those developed by gene

targeting or the use of other transgenic approaches) of carcinogenesis be developed to

improve estimates of cancers from space radiation and what longitudinal studies are

needed? [ISS 2, Lunar 2, Mars 1]

28g

What improvements can be made to quantitative procedures or theoretical models in

order to extrapolate molecular, cellular, or animal results to determine the risks of

specific cancers in astronauts? How can human epidemiology data best support these

procedures or models? [ISS 3, Lunar 3, Mars 2]

28h

Are there significant combined effects from other space flight factors (microgravity,

stress, altered circadian rhythms, changes in immune responses, viral reactivation etc.)

that modify the carcinogenic risk from space radiation? [ISS 5, Lunar 5, Mars 3]

28i

What are the probabilities that space radiation will produce DNA damage at specific

sites, including clustered DNA damage? What is the likelihood that DNA damage will

increase the risk of carcinogenesis? [ISS 3, Lunar 3, Mars 2]
NASA/SP-2005-6113 A-69

28j

What mechanisms modulate radiation damage at the molecular level (e.g., repair, errors

in repair, signal transduction, gene amplification, bystander effects, tissue

microenvironment, etc.) that significantly impact the risk of cancers, modulate the

expression of radiation damage and decrease the radiation risk, and how can the

understanding of mechanisms be used to predict carcinogenic risks from space

radiation? [ISS 2, Lunar 2, Mars 1]

28k What space validation experiments could improve estimates of carcinogenic risks for

long-term deep-space missions? [ISS 5, Lunar 5, Mars 3]

28l What are the most effective shielding approaches to mitigate cancer risks? [ISS 1,

Lunar 1, Mars 1]

28m What new materials or active shielding methods can be used for reducing space

radiation cancer risks? [ISS 1, Lunar 1, Mars 1]

28n

What are the most effective approaches to integrate radiation shielding analysis codes

with collaborative engineering design environments used by spacecraft and planetary

habitat design efforts? [ISS 4, Lunar 1, Mars 1]

28o

What is the most effective approach to use data from robotic Mars probes on the

atmospheric, soil, and magnetic properties of the red planet for estimating

carcinogenesis risk, and designing effective shielding or biological countermeasures?

[ISS 5, Lunar 5, Mars 2]

28p

What are the critical nuclear interaction experimental data and predictive theoretical

models needed to complete radiation shielding analysis codes in support of exploration

spacecraft and planetary habitat designs? [ISS 5, Lunar 2, Mars 1]

Related Risks : Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Nutrition

Inadequate Nutrition

Clinical Capabilities

Pharmacology of Space Medicine Delivery

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Radiation

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor External Environment

Important

References : Alpen EL, Powers-Risius P, Curtis SB and DeGuzman R. Tumorigenic potential of high-Z, highLET charged-particle radiations. Radiation Research. 136: 382-391, 1993.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8278580

Berrington A, et al. 100 Years of observation of British radiologists: mortality from cancer and

other causes 1897-1997. Br J Radio 74: 507-519, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12595318
NASA/SP-2005-6113 A-70

Boice JD, et al. Radiation Dose and Leukemia Risk in Patients Treated for Cancer of the Cervix.

J National Cancer Institute. 79: 1295-1311, 1987.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=3480381

Cucinotta FA, Schimmerling W, Wilson JW, Peterson LE, Badhwar GD, Saganti P and Dicello

JF. Space Radiation Cancer Risks And Uncertainties For Mars Missions. Radiation Research.

156: 682-688, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11604093

National Academy of Sciences Space Science Board, Report of the Task Group on the Biological

Effects of Space Radiation. Radiation Hazards to Crews on Interplanetary Mission National

Academy of Sciences, Washington, D.C., 1997.

National Council on Radiation Protection and Measurements, Recommendations of Dose Limits

for Low Earth Orbit. NCRP Report 132, Bethesda MD, 2000.

Preston DL, et al. Radiation Effects on Breast Cancer Risk: A Pooled Analysis of Eight Cohorts.

Radiation Research. 158: 220-235, 2002.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12105993

Preston DL, et al. Studies of mortality of atomic bomb survivors Report 13: Solid cancer and

noncancer disease mortality: 1950-1997. Radiation Research. 160: 381-407, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12968934

Thompson DE, et al. Cancer Incidence in Atomic Bomb Survivors. Part II: Solid tumors, 1958-

1987. Radiation Research. 137: S17-S67, 1994.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8127952

Weiss HA, et al. Leukemia mortality after X-ray treatment for ankylosing spondylitis. Radiation

Research. 142: 1-11, 1995.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=7899552

National Council on Radiation Protection and Measurements, Uncertainties in Fatal Cancer Risk

Estimates used in Radiation Protection, NCRP Report 126, Bethesda MD, 1997.

Wing S, et al. Mortality Among Workers of the Oak Ridge National Laboratories- Evidence of

Radiation Effects in Follow Up Through 1984. Journal of the American Medical Association 265,

1397-1402, 1991.

Risk Title: Acute and Late CNS Risks

Crosscutting Area : Radiation Health (RH)

Discipline : Radiation

Risk Number : 29

Risk Description : Acute and late radiation damage to the central nervous system (CNS) may lead to changes in motor

function and behavior, or neurological disorders. This may be caused by occupational radiation

exposure or the combined effects of radiation and other space flight factors.

Context / Risk

Factors :

Radiation (space, medical diagnostic, atmospheric, experimental and nuclear sources including

propulsion systems) and synergistic effects of radiation with other space flight factors may affect

neural tissues, which in turn may lead to changes in function or behavior.

Justification /

Rationale :

Crew health and performance in-flight may be affected.This risk will be most significant during a

Mars mission, with a long travel time and no return capability.

Risk Rating : ISS: Priority 2

Lunar: Priority 2
NASA/SP-2005-6113 A-71

Mars: Priority 1

Current

Countermeasures : • Polyethylene shielding

• Avoidance of the South Atlantic Anomaly (SAA)

• ALARA, and monitoring of exposure limits

• Vehicle altitude and attitude changes

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Anti-oxidants [CRL 1]

• Hydrogenous shielding [TRL 5]

• Pharmaceuticals [CRL 1]

• Autonomous monitoring [Lunar] [Mars]

• Improved shielding materials [Lunar] [Mars]

• Pharmacological cellular protectants will be required [Lunar] [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

29a

Is there a significant probability that space radiation would lead to immediate or acute

functional changes in the CNS due to a long-term space mission and if so what are the

mechanisms of change? [ISS 3, Lunar 3, Mars 1]

29b

Is there a significant probability that space radiation exposures would lead to long-term

or late degenerative CNS risks? If so what are the mechanisms of change? [ISS 3,

Lunar 3, Mars 1]

29c

How does individual susceptibility including hereditary pre-disposition (Alzheimer's,

Parkinson's, apoE) and prior CNS injury (concussion or other) alter significant CNS

risks? [ISS 3, Lunar 3, Mars 1]

29d What are the most effective biomedical or dietary countermeasures to mitigate CNS

risks? By what mechanisms do the countermeasures work? [ISS 4, Lunar 4, Mars 1]

29e

How can animal models of CNS risks, including altered motor and cognitive function,

behavioral changes and late degenerative risks be best used for estimating space

radiation risks to astronauts? [ISS 4, Lunar 3, Mars 1]

29f

Are there significant CNS risks from combined space radiation and other physiological

or space flight factors (e.g., bone loss, microgravity, immune-endocrine systems or

other)? [ISS 5, Lunar 5, Mars 3]

29g

What are the molecular, cellular and tissue mechanisms of damage [DNA damage

processing, oxidative damage, cell loss through apoptosis or necrosis, changes in the

extra-cellular matrix, cytokine activation, inflammation, changes in plasticity, microlesion (clusters of damaged cells along heavy ion track) etc.] in the CNS? [ISS 4,

Lunar 3, Mars 1]

29h

What are the different roles of neural cell populations, including neuronal stem cells

and their integrative mechanisms in the morphological and functional consequences of

space radiation exposure? [ISS 2, Lunar 2, Mars 1]

29i Are there biomarkers for detecting damage or susceptibility to/for radiation-induced

CNS damage? [ISS 4, Lunar 3, Mars 2]

29j

What quantitative procedures or theoretical models are needed to extrapolate molecular,

cellular, or animal results to predict CNS risks in astronauts? How can human

epidemiology data best support these procedures or models? [ISS 4, Lunar 3, Mars 2]

29k What are the most effective shielding approaches to mitigate CNS risks? [ISS 1, Lunar

1, Mars 1]

29l What space validation experiments could improve estimates of CNS risks for long-term

deep-space missions? [ISS 5, Lunar 5, Mars 3]

Related Risks : Bone Loss
NASA/SP-2005-6113 A-72

Accelerated Bone Loss and Fracture Risk

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Sensory-Motor Adaptation

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Ambulatory Care

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Radiation

Carcinogenesis

Chronic and Degenerative Tissue Risks

Acute Radiation Risks

Important

References : Joseph JA, Hunt WA, Rabin BM and Dalton TK. Possible "Accelerated Striatal Aging" Induced

by 56Fe Heavy Particle Irradiation: Implications for Manned Space flights. Radiat Res. 130: 88-

93, 1992.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1561322

Lett JT and Williams GR. Effects Of LET On The Formation And Fate Of Radiation Damage To

Photoreceptor Cell Component Of The Rabbit Retina: Implications For The Projected Manned

Mission To Mars. In Biological Effects Of Solar And Galactic Cosmic Radiation, Part A (C.E.

Swenberg, G. Horneck and e.g., Stassinopoulos, Eds.) 185-201, Plenum Press, NY, NY: 1993.

National Academy of Sciences Space Science Board, HZE Particle Effects in Manned Space

flight, National Academy of Sciences U.S.A. Washington D.C., 1973.

National Academy of Sciences, NAS. National Academy of Sciences Space Science Board,

Report of the Task Group on the Biological Effects of Space Radiation. Radiation Hazards to

Crews on Interplanetary Mission National Academy of Sciences, Washington, D.C., 1997.

Rabin BM, Joseph JA, Shukitt-Hale B. and McEwen J. Effects of Exposure to Heavy Particles on

a Behavior Medicated by the Dopaminergic System. Adv. Space Res. 25, (10) 2065-2074, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11542858

Surma-aho O, et al. Adverse Long-Term Effects of Brain Radiotherapy in Adult Low-Grade

Glioma Patients. Neurology. 56: 1285-1290, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11376174
NASA/SP-2005-6113 A-73

Todd P. Stochastics of HZE-Induced Microlesions. Adv in Space Res. 9(10): 31-34, 1981.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11537310

Tolifon PJ and Fike JR. The radioresponse of the Central Nervous System: A Dynamic Process.

Radiat Res. 153: 357-370, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10798963

Risk Title: Chronic and Degenerative Tissue Risks

Crosscutting Area : Radiation Health (RH)

Discipline : Radiation

Risk Number : 30

Risk Description : Radiation exposure may result in degenerative tissue diseases (non-cancer or non-CNS) such as

cardiac, circulatory, or digestive diseases, as well as cataracts. This may be caused by occupational

radiation exposure or the combined effects of radiation and other space flight factors.

Context / Risk

Factors :

Radiation (space, medical diagnostic, atmospheric, experimental and nuclear sources including

propulsion systems) and synergistic effects of radiation cause increased DNS strand and tissue

degeneration, which may lead to acute or chronic disease of susceptible organ tissues. The risk may

also be influenced by

microgravity or physiological changes.

Justification /

Rationale :

Acute or chronic illness due to tissue degeneration may lead to mission impacts, or adverse health

consequences after return.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Polyethylene shielding

• Avoidance of the South Atlantic Anomaly (SAA)

• ALARA, and monitoring of exposure limits

• Vehicle altitude and attitude changes

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Anti-oxidants [CRL 1]

• Hydrogenous shielding [TRL 5]

• Pharmaceuticals [CRL 1]

• Autonomous monitoring [Lunar] [Mars]

• Improved shielding materials [Lunar] [Mars]

• Pharmacological cellular protectants [Lunar] [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

30a

What are the probabilities for degenerative tissue risks from protons and HZE ions as a

function of NASA's operational parameters (age at exposure, age and time after

exposure, gender, tissue, mission, radiation quality, dose rate)? [ISS 2, Lunar 2, Mars

1]

30b What are the mechanisms of degenerative tissues risks in the heart, circulatory,

endocrine, digestive, lens and other tissue systems? [ISS 2, Lunar 2, Mars 1]

30c How can the latency period for degenerative tissue risks, including sub-clinical

diseases, following space radiation exposures be estimated? [ISS 3, Lunar 3, Mars 1]
NASA/SP-2005-6113 A-74

30d

What are the most effective biomedical or dietary countermeasures to degenerative

tissue risks? By what mechanisms do the countermeasures work? [ISS 3, Lunar 3,

Mars 1]

30e

What quantitative procedures or theoretical models are needed to extrapolate molecular,

cellular, or animal results to predict degenerative tissue risks in astronauts? How can

human epidemiology data best support these procedures or models? [ISS 4, Lunar 4,

Mars 2]

Related Risks : Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Increased Susceptibility to Muscle Damage

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Pharmacology of Space Medicine Delivery

Radiation

Carcinogenesis

Acute and Late CNS Risks

Acute Radiation Risks

Important

References : Berrington A., et al. 100 Years of observation of British radiologists: mortality from cancer and

other causes 1897-1997. Br J Radio. 74:507-519, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12595318

Boivin JF, et al. Coronary Artery Disease Mortality in Patients Treated for Hodgkins Disease.

Cancer. 69: 1241-1247, 1992.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=1739922

Cucinotta FA, Manuel F, Jones,J, Izsard G, Murray J, Djojonegoro B. and Wear M. Space

Radiation and Cataracts in Astronauts. Radiation Research. 156: 460-466, 2001.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11604058

Hauptmann M, et. al. Mortality from Diseases of the Circulatory System in Radiologic

Technologists in the United States. American Journal of Epidemiology. 157: 239-248, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12543624

National Academy of Sciences Space Science Board, Report of the Task Group on the Biological

Effects of Space Radiation. Radiation Hazards to Crews on Interplanetary Mission National

Academy of Sciences, Washington, D.C., 1997.

National Council on Radiation Protection and Measurements, Recommendations of Dose Limits

for Low Earth Orbit. NCRP Report 132, Bethesda MD, 2000.
NASA/SP-2005-6113 A-75

Otake M, Neriishi K and Schull WJ. Cataract in atomic bomb survivors based on a threshold and

the occurrence of severe epilation. Radiation Research. 146: 339-348, 1996.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=8752314

Preston DL, et al. Studies of mortality of atomic bomb survivors Report 13: Solid cancer and

noncancer disease mortality: 1950-1997. Radiation Research. 160, 381-407, 2003.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12968934

Schimizu Y, et al. Studies of the Mortality of Atomic Bomb Survivors. Report 12, Part II: Noncancer mortality: 1950-1990. Radiation Research. 152: 374-389, 1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10477914

Stewart JR and Faiardo LF. Radiation-induced heart disease. Clinical and experimental aspects.

Radiological Clinical Journal of North America. 9: 511-531, 1971.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=5001977

Risk Title: Acute Radiation Risks

Crosscutting Area : Radiation Health (RH)

Discipline : Radiation

Risk Number : 31

Risk Description : Acute radiation syndromes may occur due to occupational radiation exposure.

Context / Risk

Factors :

Radiation (space, medical diagnostic, atmospheric, experimental and nuclear sources including

propulsion systems) and synergistic effects of radiation may place the crew at significant risk for

acute radiation sickness, such that the mission or crew survival may be placed in jeopardy.

Justification /

Rationale :

Crew health and performance may be impacted by acute solar events. Beyond Low Earth Orbit, the

protection of the Earth's atmosphere is no longer available, such that increased shielding and

protective mechanisms are necessary in order to prevent acute radiation sickness and impacts to

mission success or crew survival.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Polyethylene shielding

• Avoidance of the South Atlantic Anomaly (SAA)

• Vehicle altitude and attitude changes

• ALARA, and monitoring of radiation exposure limits

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Anti-oxidants [CRL 1]

• Hydrogenous shielding [TRL 5]

• Pharmaceuticals [CRL 1]

• Autonomous monitoring [Lunar] [Mars]

• Improved shielding materials [Lunar] [Mars]

• Pharmacological cellular protectants [Lunar] [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question
NASA/SP-2005-6113 A-76

31a How can predictions of acute space radiation events be improved? [ISS 5, Lunar 3,

Mars 3]

31b

Are there synergistic effects arising from other space flight factors (microgravity,

stress, immune status, bone loss, damage to intestinal cells reducing their ability to

absorb medication etc.) that modify acute risks from space radiation including

modifying thresholds for such effects? [ISS 4, Lunar 3, Mars 3]

31c

What are the molecular, cellular and tissue mechanisms of acute radiation damage

(DNA damage processing, oxidative damage, cell loss through apoptosis or necrosis,

cytokine activation, etc.)? [ISS 4, Lunar 3, Mars 3]

31d Does protracted exposure to space radiation modify acute doses from SPEs in

relationship to acute radiation syndromes? [ISS 4, Lunar 3, Mars 3]

31e

What are the most effective biomedical or dietary countermeasures to mitigate acute

radiation risks? By what mechanisms do the countermeasures work? [ISS 4, Lunar 3,

Mars 3]

31f

What quantitative procedures or theoretical models are needed to extrapolate molecular,

cellular, or animal results to predict acute radiation risks in astronauts? How can human

epidemiology data best support these procedures or models? [ISS 4, Lunar 3, Mars 3]

31g What are the most effective shielding approaches to mitigate acute radiation risks? [ISS

1, Lunar 1, Mars 1]

31h

What are the most effective "storm shelter" shielding approaches to protect against

large solar particle events in deep space or on planetary surfaces? [ISS 3, Lunar 1,

Mars 1]

Related Risks : Bone Loss

Accelerated Bone Loss and Fracture Risk

Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Nutrition

Inadequate Nutrition

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Pharmacology of Space Medicine Delivery

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Neurobehavioral Problems

Radiation

Carcinogenesis

Acute and Late CNS Risks

Chronic and Degenerative Tissue Risks

Advanced Environmental Monitoring & Control

Monitor External Environment
NASA/SP-2005-6113 A-77

Important

References : Ainsworth EJ. Early and late mammalian responses to heavy charged particles. Advances in

Space Research. 6: 153-165, 1986.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=11537215

National Council on Radiation Protection and Measurements, NCRP. Guidance on Radiation

Received in Space Activities, NCRP Report 98, NCRP, Bethesda (MD), 1989.

National Council on Radiation Protection and Measurements, Recommendations of Dose Limits

for Low Earth Orbit. NCRP Report 132, Bethesda MD, 2000.

Todd P, Pecautt MJ, Fleshner M. Combined effects of space flight factors and radiation on

humans. Mutation Res. 430: 211-219, 1999.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10631335

Risk Title: Monitor Air Quality

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Environmental Monitoring & Control

Risk Number : 32

Risk Description : Lack of timely chemical and microbial detection in the crew atmosphere, or elsewhere in the air

processing system, can lead to delayed response by the crew or by automated response equipment,

leading to increased hazards to the crew.

Context / Risk

Factors :

Chemical and microbial detection in the crew atmosphere, or elsewhere in the air processing

system, can indicate the buildup of microbial contaminants, hazardous chemicals, pre-combustion

reaction products, malfunction of life support equipment, or other hazardous events such as

accidental release from an experiment. This risk may be influenced by accidental events such as fire

or leak, or a malfunction in the life support system, which may be gradual or sudden.

Justification /

Rationale :

Technologies must be able to detect both anticipated and unanticipated events and identify the

problem source. Gradual buildup of toxic chemicals may take months, calling for highly sensitive

detection at slow intervals, perhaps daily. Leakage or pre-combustion events are expected to occur

more rapidly, requiring more rapid detection (minutes), though less sensitive detection may be

necessary. Existing technology is critical resource intensive and requires substantial improvement in

efficiency, reliability, and functionality. For example, no single technology currently can address all

Spacecraft Maximum Allowable Concentration (SMAC) chemicals, combustion in micro, lunar and

Martian gravity is very different from combustion on Earth and has different pre-combustion

indicators, and harmful foreign matter may be inadvertently brought in following extravehicular

activity (EVA). The same monitoring technology may be useful for helping diagnose crew health by

providing breath-monitoring data.

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • ISS Compound Specific Combustion Product Analyzer

• Crew indicators such as reports of odor, nausea

• Ground analysis of returned samples

• ISS Major Constituent Analyzer

• ISS Volatile Organic Analyzer

• Materials selection

• Scheduled maintenance and housekeeping

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Distributed network of rapid, smaller detectors [TRL 4]

• Highly sensitive somewhat slower analyzer suite [TRL 4]
NASA/SP-2005-6113 A-78

Research &

Technology

Questions [With

Mission Priority]:

No. Question

32a What technologies can be used to detect slow, gradual changes in the chemical and

microbial environment ?(work with Environmental Health) [ISS 1, Lunar 1, Mars 1]

32b What set of technologies and data can be used to quickly diagnose potentially

hazardous events from chemical data? [ISS 1, Lunar 1, Mars 1]

32c

How can environmental information be used to assist in-flight biomonitoring for health

and performance of the astronauts (supporting Biomedical monitoring)? [ISS 3, Lunar

3, Mars 3]

32d What technologies must be developed to rapidly detect and address fire in space? [ISS

1, Lunar 1, Mars 1]

32e How can technology help ensure that appropriate responses to hazardous events are

achieved in a timely manner? [ISS 2, Lunar 2, Mars 2]

32f

What set of technologies and data can be used to detect and diagnose hardware

malfunction, in such systems as life support or in situ resource utilization by assessment

of environmental (air, water, or surfaces) changes? (work with ALS) [ISS 2, Lunar 2,

Mars 2]

32g What technologies can detect both anticipated and unanticipated species and events?

[ISS 1, Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Clinical Capabilities

Monitoring and Prevention

Advanced Environmental Monitoring & Control

Monitor External Environment

Provide Integrated Autonomous Control of Life Support Systems

Advanced Life Support

Maintain Acceptable Atmosphere

Maintain Thermal Balance in Habitable Areas

Provide and Maintain Bioregenerative Life Support Systems

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands

Important

References : "Cabin Air Quality Dynamics on Board the International Space Station" J Perry, B Peterson, 33rd

International Conference on Environmental Systems, SAE#2003-01-2650, July 2003.

"Toxicological Assessment of the International Space Station Atmosphere with Emphasis on

Metox Canister Regeneration" J James, 33rd International Conference on Environmental

Systems, SAE#2003-01-2647, July 2003.

Advanced Technology for Human Support in Space, National Research Council Report, 1997.

Downloadable from http://peer1.nasaprs.com/peer_review/prog/nap.pdf

http://peer1.nasaprs.com/peer_review/prog/nap.pdf

NASA/JSC Toxicology Group Home Page http://www.jsc.nasa.gov/toxicology/

http://www.jsc.nasa.gov/toxicology/

Risk Title: Monitor External Environment

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Environmental Monitoring & Control
NASA/SP-2005-6113 A-79

Risk Number : 33

Risk Description : Failure to detect hazards external to the habitat (e.g., dust, fuel contaminants) can lead to lack of

remedial action, and poses an increased risk to the crew.

Context / Risk

Factors :

Potentially harmful substances may exist external to the habitat. They may be generated by the

spacecraft, such as fuel or hydraulic residue, or they may be native to the environment, such as

erosive or chemically reactive dust.

Justification /

Rationale :

Possible events include leakage of ammonia coolant, of cabin atmosphere, or of rocket propellant.

The lunar or Martian environment itself may have some hazard such as the chemical composition or

physical nature of the dust. It is expected that in some cases these can be readily detected during

extravehicular activity (EVA).

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • ISS Trace Gas Analyzer (TGA) using miniature quadrupole mass spectrometry technology

Procedures for decontamination and monitoring and cleanup following chemical exposure while

EVA

•

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Real-time radiation monitor [TRL 4]

• Second generation TGA [TRL 6]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

33a What sensors are required to monitor hazardous conditions in the extra-vehicular

environment? (work with AEVA) [ISS 1, Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Clinical Capabilities

Monitoring and Prevention

Radiation

Carcinogenesis

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Air Quality

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Important

References : "Trace Gas Analyzer for Extra-Vehicular Activity" T Abbasi, M Christensen, M Villemarette, M

Darrach, A Chutjian, 31st International Conference on Environmental Systems, SAE#2001-01-

2405, July 2001.

Risk Title: Monitor Water Quality

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Environmental Monitoring & Control

Risk Number : 34

Risk Description : Lack of timely information about the build-up of chemicals or microbial growth in the crew water

supply, or elsewhere in the water reclamation system, can lead to a delayed response by the crew, or

the automated response equipment, and pose a hazard to the crew.

Context / Risk This risk may be influenced by an accidental event such as a leak of ammonia from the cooling
NASA/SP-2004-6113 A-80

Factors : system into the water supply through the heat exchanger, or a malfunction in the life support

system, which may be gradual or sudden.

Justification /

Rationale :

Gradual buildup of toxic chemicals may take months, calling for highly sensitive detection at slow

intervals, perhaps daily. Leakage events are expected to occur more rapidly, requiring more rapid

detection (minutes), though less sensitive detection may be necessary. Technologies must be able to

detect both anticipated and unanticipated events and phenomena. Localized information is needed to

identify the problem source. Existing technology for ground-based measurement is massive, power

hungry, needs hazardous reagents, requires significant crew skill and time and is sensitive to micro,

lunar, or Martian gravity multiphase issues.

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • Crew report of odor or taste

• Ground analysis of returned samples

• Manual plate culturing at ambient temperature with visual estimate

• Water conductivity measurement

• ISS Total Organic Carbon Analyzer

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Compact online chemical water analyzer suite [TRL 3]

• Microbial analysis instrument [TRL 3]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

34a

What technologies can be used to detect slow, gradual changes in the chemical and

microbial environment? (work with ALS and Environmental Health) [ISS 1, Lunar 1,

Mars 1]

34b What set of technologies and data can be used to quickly diagnose potentially

hazardous events from chemical data? [ISS 1, Lunar 1, Mars 1]

34c

How can technology help ensure that appropriate responses to hazardous events are

achieved in a timely manner? (Needed for developing automated systems.) [ISS 2,

Lunar 2, Mars 2]

34d

What set of technologies and data can be used to detect and diagnose hardware

malfunction by assessment of environmental (air, water, or surfaces) changes? (work

with ALS) [ISS 1, Lunar 1, Mars 1]

34e What technologies can detect both anticipated and unanticipated species and events?

[ISS 1, Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Clinical Capabilities

Monitoring and Prevention

Advanced Life Support

Maintain Acceptable Atmosphere

Provide and Maintain Bioregenerative Life Support Systems

Provide and Recover Potable Water

Important

References : "ISS Potable Water Sampling and Chemical Analysis: Expeditions 4-6" D Plumlee, P Mudgett, J

Schultz, J James, 33rd International Conference on Environmental Systems, SAE#2003-01-2401,

July 2003.
NASA/SP-2005-6113 A-81

Advanced Technology for Human Support in Space, National Research Council Report, 1997.

Downloadable from http://peer1.nasaprs.com/peer_review/prog/nap.pdf

http://peer1.nasaprs.com/peer_review/prog/nap.pdf

AEMC Technology Development Requirements (1998) downloadable from

http://peer1.nasaprs.com/peer_review/prog/prog.html

http://peer1.nasaprs.com/peer_review/prog/prog.html

Characterization and Monitoring of Microbial Species in the International Space Station Drinking

Water. M LaDuc, 33rd International Conference on Environmental Systems, SAE#2003-01-2404,

July 2003.

NASA/JSC Toxicology Group Home Page http://www.jsc.nasa.gov/toxicology/

http://www.jsc.nasa.gov/toxicology/

Risk Title: Monitor Surfaces, Food, and Soil

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Environmental Monitoring & Control

Risk Number : 35

Risk Description : Lack of timely information, or failure to detect the presence of harmful chemicals or microbial

growth on surfaces, food supplies, or soil (required for plant growth) can pose a crew health hazard.

Context / Risk

Factors :

Low gravity environments allow for greater accumulation of liquids on surfaces by surface tension

and longer persistence of matter suspended in air, increasing the likelihood of surface impact.

Justification /

Rationale :

The area of contamination of surfaces in the space environment has received relatively little

attention to date. The risk is essentially unknown.

Risk Rating : ISS: Priority 2

Lunar: Priority 1

Mars: Priority 1

Current

Countermeasures : • Occasional manual plate culturing of samples from swabbed surfaces

• Regular and as needed housecleaning

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Detection and identification of surface contamination by optical interrogation [TRL 3]

• Reliable, repeatable sampling methods taking minimal crew time [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

35a

What technologies can be used to detect slow, gradual changes in the chemical and

microbial surface environment? (work with Environmental Health and ALS) [ISS 1,

Lunar 1, Mars 1]

35b What set of technologies and data can be used to quickly diagnose potentially

hazardous events from chemical data? [ISS 1, Lunar 1, Mars 1]

35c What technologies are required to meet the radiation monitoring requirements of a

mission? [ISS 2, Lunar 1, Mars 1]

35d What sample acquisition and preparation technologies can meet the requirements of the

gaseous, aqueous and solid-phase matrices monitoring? [ISS 1, Lunar 1, Mars 1]

35e What research is required to validate design approaches for multiphase flow for

monitoring systems in varying gravity environments? [ISS 1, Lunar 2, Mars 2]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Clinical Capabilities
NASA/SP-2005-6113 A-82

Monitoring and Prevention

Advanced Food Technology

Maintain Food Quantity and Quality

Advanced Life Support

Maintain Acceptable Atmosphere

Important

References : Advanced Technology for Human Support in Space, National Research Council Report, 1997.

Downloadable from http://peer1.nasaprs.com/peer_review/prog/nap.pdf

http://peer1.nasaprs.com/peer_review/prog/nap.pdf

AEMC Technology Development Requirements (1998) downloadable from

http://peer1.nasaprs.com/peer_review/prog/prog.html

http://peer1.nasaprs.com/peer_review/prog/prog.html

Risk Title: Provide Integrated Autonomous Control of Life Support Systems

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Environmental Monitoring & Control

Risk Number : 36

Risk Description : Lack of stable, reliable, efficient process control for the life support system can pose a hazard to

crew health or create an excessive crew workload.

Context / Risk

Factors :

Decreasing life support system mass by decreasing air or water buffer sizes (an economically

desirable objective) increases the potential for the system to become unstable. Additionally, longer

mission durations, such as with the Mars scenario, mean greater potential for the life support system

to become unstable.

Justification /

Rationale :

Automated control of life support is needed to minimize the crew workload. Industrial process

control technology is manufacturing-oriented (input/output) with a narrow range of time constants.

Space life support is an endless loop-recycling environment, with time constants ranging from fast

accidental incidents to life cycles of plant crops (months). Advances in process control technology

are needed for safe, efficient control of the life support system.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Manual and low level process control

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Automated control of life support, integrated with monitoring system [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

36a

How do we design an effective control system with flexibility, modularity, growth

potential, anti-obsolescence and accommodate varied, new, & unknown test articles,

taking advantage of standards? (work with Integrated Testing) [ISS 1, Lunar 1, Mars

1]

36b

How does a control system manage and plan for the long time constants of certain

biological processes that lead to changes days, months later; and reconciles between

discrete events, continuous processing and varying time constants? (work with

Integrated Testing) [ISS 1, Lunar 1, Mars 1]

36c

How do we assure that human situation awareness is at a high level when needed, while

offloading the crew workload for most of the time? (work with SHFE and Integrated

Testing) [ISS 2, Lunar 2, Mars 2]
NASA/SP-2005-6113 A-83

36d

How can a control system support strategic decisions; launch readiness/abort/return

home decisions and procedures? (work with SHFE and Integrated Testing) [ISS 1,

Lunar 1, Mars 1]

36e

How can we develop real time prognostic capabilities to predict failures before they

occur and degradations before they have impact? (work with ALS and Integrated

Testing) [ISS 1, Lunar 1, Mars 1]

36f How do we allocate efficiently and safely between space-based control and groundbased control? (work with SHFE and Integrated Testing) [ISS 1, Lunar 1, Mars 1]

36g In very large and complex systems, how can we synchronize system states across

subsystems? (work with Integrated Testing) [ISS 1, Lunar 1, Mars 1]

36h How do we trade between buffers and controls to ensure safe and reliable system?

(work with ALS and Integrated Testing) [ISS 1, Lunar 1, Mars 1]

36i

How can understanding process control help determine which sensors may be missing

and where sensors should be placed? (work with Integrated Testing) [ISS 1, Lunar 1,

Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Advanced Environmental Monitoring & Control

Monitor Air Quality

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Advanced Life Support

Maintain Acceptable Atmosphere

Provide and Maintain Bioregenerative Life Support Systems

Provide and Recover Potable Water

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : Advanced Technology for Human Support in Space, National Research Council Report, 1997.

Downloadable from http://peer1.nasaprs.com/peer_review/prog/nap.pdf

http://peer1.nasaprs.com/peer_review/prog/nap.pdf

AEMC Technology Development Requirements (1998) downloadable from

http://peer1.nasaprs.com/peer_review/prog/prog.html

http://peer1.nasaprs.com/peer_review/prog/prog.html

Final Report, Workshop on Advanced System Integration and Control for Life Support (ASICLS)

Monterey Plaza Hotel , 26-28 August 2003, Monterey, CA

NASA Advanced Environmental Monitoring and Control (AEMC) Program Review, Final

Report, USRA, August 1999. Also, AEMC review response sent to HQ Sept 1999.

Risk Title: Provide Space Suits and Portable Life Support Systems

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Extravehicular Activity

Risk Number : 37

Risk Description : EVA performance and crew health may be compromised by inadequate EVA systems.

Context / Risk This risk may be influenced by flight duration, lack of return and re-supply capability, limited on-
NASA/SP-2005-6113 A-84

Factors : board servicing capability, or dust contamination of suit bearings and joints.

Justification /

Rationale :

Long-duration crew stays on moon and Mars lead to increased EVA hardware use. Lunar and Mars

gravity levels cause suit weight to become a significant load on crewmembers. Hardware failures

could occur without the capability for equipment servicing and overhaul. Lunar and Mars dust

contamination leads to equipment failures and decreased suit mobility from contaminated bearings

and joints

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Dedicated water

• Limited maintenance

• Longer life rechargeable batteries

• Regenerable CO2 removal systems

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Cleaning and maintenance of soft goods (e.g., washing of LCVG)

• Dust removal and dust prevention [Lunar] [Mars]

• Increased on-orbit space suit service life

• Longer shelf and service life batteries

• Non-venting heat rejection system

• Reduced mass of suit and PLSS [Lunar] [Mars]

• Regenerable closed loop CO2 removal systems

Research &

Technology

Questions [With

Mission Priority]:

No. Question

37a What EVA system design and minimum prebreathe protocol can be developed to

reduce the risk of decompression sickness? [ISS N/A, Lunar 1, Mars 1]

37b What suit and PLSS technology must be developed to meet mission requirements for

EVA mobility? [ISS N/A, Lunar 1, Mars 1]

37c How do we protect against planetary surface dust through suit and airlock system

design? [ISS N/A, Lunar 1, Mars 1]

37d How do we protect against toxic fluids and contaminants? [ISS 2, Lunar 2, Mars 2]

37e How do we design space suits to fit multiple crewmembers of various sizes and shapes?

[ISS 1, Lunar 1, Mars 1]

37f How do we improve glove dexterity? [ISS 1, Lunar 1, Mars 1]

37g

What technologies can be developed to provide passive or active thermal insulation in

various environments, including deep-space and lunar vacuum? [ISS N/A, Lunar 1,

Mars 1]

37h What technologies must be developed to meet mission non-venting and noncontaminating requirements? [ISS N/A, Lunar 2, Mars 2]

37i

How do we provide and manage increased information to EVA crewmembers,

including suit parameters, systems status, caution and warning, video, sensor data,

procedures, text, and graphics? [ISS N/A, Lunar 2, Mars 2]

37j How do we achieve EVA and robotic interaction and cooperation? [ISS N/A, Lunar 1,

Mars 1]

37k What biomedical sensors are needed to enhance safety and performance during EVAs?

[ISS 4, Lunar 2, Mars 2]

37l How can space suit design accommodate a crewmember's physical changes from longduration exposure to microgravity? [ISS 4, Lunar 1, Mars 1]
NASA/SP-2005-6113 A-85

37m

What technology can be developed to monitor EVA crewmember thermal status and

provide auto-thermal control under both nominal operating and emergency conditions?

[ISS N/A, Lunar 1, Mars 1]

37n

Can a practical EMU containment receptacle for emesis be developed? If a vomiting

episode occurs, is there a way of refurbishing the suit during the mission? How can suit

life support systems be designed to be more resistant to vomiting episode? [ISS 1,

Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Sensory-Motor Adaptation

Motion Sickness

Clinical Capabilities

Monitoring and Prevention

Major Illness and Trauma

Ambulatory Care

Medical Informatics, Technologies, and Support Systems

Advanced Environmental Monitoring & Control

Monitor External Environment

Provide Integrated Autonomous Control of Life Support Systems

Advanced Life Support

Maintain Thermal Balance in Habitable Areas

Provide and Maintain Bioregenerative Life Support Systems

Important

References : Advanced Technology for Human Support in Space, Committee on Advanced Technology for

Human Support in Space, Aeronautics and Space Engineering Board, National Research Council,

National Academy Press, Washington DC, 1997.

Risk Title: Maintain Food Quantity and Quality

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Food Technology

Risk Number : 38

Risk Description : Crew nutritional requirements may not be met and crew health and performance compromised due

to inadequate food acceptability, preparation, processing, and storage systems.

Context / Risk

Factors :

This risk may be influenced by sub-standard food intakes, chemical or microbial contamination of

food, crew psychological and physiological changes, elevated stress and boredom, inadequate food

packaging, inadequate food processing/preservation, inadequate quantity of food, inadequate shelf

life, inadequate storage conditions and environmental control, inadequate variety, product

formulation, or undefined nutritional requirements.

Justification /

Rationale : There must be means to provide the crew a sufficient, balanced, nutritious diet.

Risk Rating : ISS: Priority 2

Lunar: Priority 3

Mars: Priority 1

Current

Countermeasures : • Hazard analysis critical control point processing

• Increased menu cycle and menu variety

• Menu developed based on daily nutritional requirements
NASA/SP-2005-6113 A-86

• Preflight food tasting and selection

• Vitamin and nutrient supplementation

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Assessment of food psychosocial importance [TRL 2]

• Determine effects of space radiation on food [TRL 1]

Development of extended shelf life food through improved food preservation technologies [TRL

2]

•

• Enhanced food system with increased variety and acceptability [TRL 4]

• Hazard analysis critical control point processing [TRL 4]

• High barrier and low mass food packaging materials [TRL 2]

• Refined nutritional requirements [TRL 4]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

38a What procedures (e.g., storage, processing, preparation, clean-up), such as HACCP,

need to be developed to assure a safe food system? [ISS 1, Lunar 1, Mars 1]

38b What are the allowable limits of microbial and chemical contamination in the food?

[ISS 1, Lunar 1, Mars 1]

38c How does space radiation affect the functionality and nutritional content of the crops

and stored staple ingredients for food processing? [ISS N/A, Lunar 1, Mars 1]

38d

What food processing technologies are required when using crops and stored staple

ingredients to ensure a food system that is nutritious, safe and acceptable? [ISS N/A,

Lunar 1, Mars 1]

38e

What food packaging materials will provide the physical and chemical attributes,

including barrier properties, to protect the food from the outside environment and

assure the 3-5 year shelf life? [ISS 1, Lunar 1, Mars 1]

38f

What food packaging material will be biodegradable, easily processed, or be lighter in

mass than the current packaging and can still provide the physical and chemical

attributes including barrier properties to protect the food from the outside environment

and assure the 3-5 year shelf life? [ISS 1, Lunar 1, Mars 1]

38g What food preservation technologies will provide prepackaged food items with a shelf

life of 3-5 years? [ISS 2, Lunar 2, Mars 2]

38h What are the impacts of reduced Gravity and atmospheric pressure on the food

processing activities? [ISS N/A, Lunar 2, Mars 1]

38i What are the impacts of reduced Gravity and atmospheric pressure on the food

preparation activities? [ISS 3, Lunar 2, Mars 1]

38j

What nutritional content and sensory attribute changes (including radiation-induced

effects) in the prepackaged food items will occur over the shelf life of the food? [ISS 2,

Lunar 2, Mars 2]

38k

What food system technology selection criteria will be used to effectively reduce the

use of critical resources such as air, water, thermal, biomass and solid waste processing,

during a mission? [ISS 2, Lunar 2, Mars 2]

38l What are the changes (taste, odor, etc.) that occur in crewmember's sensory perceptions

during space flight that would affect food acceptability? [ISS 3, Lunar 3, Mars 3]

38m

What are the physical and chemical requirements for each of the crops and stored staple

ingredient items to assure effective processing into acceptable, safe and nutritious food

ingredients? [ISS N/A, Lunar 2, Mars 2]

38n

What level of acceptability and/or variety (e.g., number of food items, length of menu

cycle) is required to provide for the psychosocial well-being of the crew? [ISS 3,

Lunar 3, Mars 2]
NASA/SP-2005-6113 A-87

38o

What modeling techniques can be used to measure the subjective portions of the food

system such as palatability, nutrition, psychological issues and variety? [ISS 3, Lunar

3, Mars 2]

Related Risks : Cardiovascular Alterations

Occurrence of Serious Cardiac Dysrhythmias

Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Immunology & Infection

Immune Dysfunction, Allergies and Autoimmunity

Interaction of Space flight Factors, Infections and Malignancy

Skeletal Muscle Alterations

Reduced Muscle Mass, Strength, and Endurance

Nutrition

Inadequate Nutrition

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Radiation

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Surfaces, Food, and Soil

Advanced Life Support

Maintain Thermal Balance in Habitable Areas

Manage Waste

Provide and Maintain Bioregenerative Life Support Systems

Provide and Recover Potable Water

Important

References : Isolation NASA Experiments in Closed-Environment Living Advanced Human Life Support

Enclosed System Volume 104SCIENCE AND TECHNOLOGY SERIES; A Supplement to

Advances in the Astronautical Sciences Edited by: Helen W. Lane, Richard L. Sauer, and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, California 92198 web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf.

web:%20%20http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Kerwin J, and Seddon R. (2002). Eating in Space - From an Astronaut's Perspective. Nutrition 18

(10):913-920.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12361788

M Perchonok, S French, B Swango, V Kloeris, D Barta, M Lawson, J Joshi. Advanced Food

Technology Workshop Report Volume I, NASA/CP-2003-212055, 2003.

M Perchonok, S French, B Swango, V Kloeris, D Barta, M Lawson, J Joshi. Advanced Food

Technology Workshop Report Volume II, NASA/CP-2003-212055, 2003.

NASA Johnson Space Center. Nutritional Requirements for International Space Station Missions

Up To 360 Days. JSC-28038; 1996.
NASA/SP-2005-6113 A-88

Perchonok M, and Bourland C. (2002). NASA food systems: past, present and future. Nutrition

18 (10):913-920.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12361787

Perchonok MH. (2002) "Shelf Life Considerations and Techniques" Food Product Development

Based on Experience; Catherine Side, editor. Iowa State University Press, pp. 59-74.

Safe Passage: Astronaut Care for Exploration Missions, Board on Health Sciences Policy,

Institute of Medicine, National Academy Press, Washington, DC, 2001

U. S. Food and Drug Administration. Hazard Analysis and Critical Control Point Principles and

Application Guidelines. http://www.cfsan.fda.gov/~comm/nacmcfp.html. August 1997.

http://www.cfsan.fda.gov/~comm/nacmcfp.html

U. S. Food and Drug Administration. Kinetics of Microbial Inactivation for Alternative Food

Processing Technologies. http://vm.cfsan.fda.gov/~comm/ift-toc.html. June 2000.

http://vm.cfsan.fda.gov/~comm/ift-toc.html

Risk Title: Maintain Acceptable Atmosphere

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Life Support

Risk Number : 39

Risk Description : Crew health may be compromised due to inability of currently available technology to monitor and

control spacecraft atmosphere. Risk may be mitigated by development of new technologies that will

be integrated into the life support systems.

Context / Risk

Factors :

This risk may be influenced by complexity of systems and increase in the number of systems (e.g.,

additional solid waste processing, plant growth, food processing, etc.), insensitivity of control

system to contaminants leading to toxic build-ups due to a closed system, remoteness, or severely

constrained resources (such as mass, power, volume, thermal, crew time).

Justification /

Rationale :

The inability to control and condition the atmosphere and maintain the makeup & composition,

limits the ability of the crew to perform basic functions and can present an immediate threat to the

health, life and success of crew and mission.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Consumables re-supply

Technology development to further close the air loop and increase carbon dioxide reduction,

which includes testing, modeling and analysis

•

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Bioregenerative Life Support [Lunar] [Mars]

• CO2 Moisture Removal System [TRL 4] [Lunar] [Mars]

• Improved Carbon Dioxide Removal and Reduction System [TRL 3-4]

• In-Situ Resource Utilization [Lunar] [Mars]

• Regenerable Trace Contaminant Control System [TRL 4]

• Better models to identify contaminant load [Lunar] [Mars]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

39a

What new developments are needed to meet all the requirements for controlling trace

contaminants, atmospheric pressure, O2 and CO2 partial pressure? [ISS 1, Lunar 1,

Mars 1]
NASA/SP-2005-6113 A-89

39b What method for closing the O2 loop is most effective in an integrated ECLS? [ISS 2,

Lunar 2, Mars 2]

39c What is the proper trace contaminant load and performance model to drive the design

and operation of a trace contaminant system? [ISS 2, Lunar 2, Mars 2]

39d Can viability and genetic integrity of the biological components be maintained for the

duration of different missions? [ISS 4, Lunar 3, Mars 2]

39e What are the effects of radiation on biological components of the life support system?

[ISS 3, Lunar 3, Mars 1]

39f

What research is required to validate design approaches for multiphase flow and

particulate flows for air revitalization systems in varying gravity environments? [ISS 3,

Lunar 3, Mars 3]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Radiation

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Air Quality

Monitor Water Quality

Monitor Surfaces, Food, and Soil

Provide Integrated Autonomous Control of Life Support Systems

Advanced Life Support

Maintain Thermal Balance in Habitable Areas

Manage Waste

Provide and Maintain Bioregenerative Life Support Systems

Important

References : Designing for Human Presence in Space: An Introduction to Environmental Control and Life

Support Systems, NASA RP-1324, 1994

Isolation, NASA Experiments in Closed-Environment Living, Advanced Human Life Support

Enclosed System Final Report, Volume 104, Science And Technology Series, A Supplement to

Advances in the Astronautical Sciences, Edited by Helen W. Lane, Richard L. Sauer and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, CA 92198. web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Space flight Life Support and Biospherics, Eckart, 1996

Risk Title: Maintain Thermal Balance in Habitable Areas

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Life Support

Risk Number : 40

Risk Description : Crew health may be compromised due to inability of currently available technology to provide crew

module thermal control. Risk may be further mitigated by development of new technologies that

will be integrated into the thermal control system.

Context / Risk

Factors :

This risk may be influenced by location on a planetary surface, orientation of the vehicle during

flight, orientation of vehicle and/or habitat on planetary surface, planetary environment

(temperature ranges & extremes, dust, seasonal variations, etc.), sources of heat from other elements

of the mission, and use or availability of local planetary resources.

Justification /

Rationale : Humans cannot live and work in space without a thermally controlled environment.
NASA/SP-2005-6113 A-90

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Thermal Control system

Projected

Countermeasures or

Mitigations & other

Deliverables:

Several advances are underway to improve the reliability and life, or decrease the mass, volume,

or power required for thermal control system hardware (e.g. heat rejection devices, heat transport

fluids, heat acquisition devices, heat transfer devices) [TRL 3-6]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

40a What heat transport fluids meet the requirements for specified missions? [ISS 1, Lunar

1, Mars 1]

40b What materials and designs will meet the heat acquisition (cold plates, heat exchangers,

cooling jackets, etc.) requirements for specified missions? [ISS 1, Lunar 1, Mars 1]

40c What materials and designs will meet the heat transport (pumps, two-phase loops, heat

pumps, etc.) requirements for specified missions? [ISS 1, Lunar 1, Mars 1]

40d What materials and designs will meet the heat rejection (radiators, sublimators,

evaporators, etc.) requirements for specified missions? [ISS 1, Lunar 1, Mars 1]

40e What materials and designs will meet the humidity control requirements for specified

missions? [ISS 1, Lunar 1, Mars 1]

40f What thermal system sensors will meet the requirements to provide monitoring and

data collection for specified missions? [ISS 2, Lunar 2, Mars 2]

40g What monitoring and control system hardware and design will meet the requirements

for specified missions? (AEMC) [ISS 2, Lunar 2, Mars 2]

Related Risks : Advanced Environmental Monitoring & Control

Monitor Air Quality

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Advanced Life Support

Maintain Acceptable Atmosphere

Important

References : Advanced Technology of Human Support in Space, Committee on Advanced Technology for

Human Support in Space, Aeronautics and Space Engineering Board, National Research Council,

National Academy Press, Washington DC, 1997.

Designing for Human Presence in Space: An Introduction to Environmental Control and Life

Support Systems, NASA RP-1234, 1994.

Isolation, NASA Experiments in Closed-Environment Living, Advanced Human Life Support

Enclosed System Final Report, Volume 104, Science And Technology Series, A Supplement to

Advances in the Astronautical Sciences, Edited by Helen W. Lane, Richard L. Sauer and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, CA 92198. web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Space flight Life Support and Biospherics, Eckart, 1996.

Risk Title: Manage Waste

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Life Support

Risk Number : 41
NASA/SP-2005-6113 A-91

Risk Description : Crew health may be compromised due to inability of currently available technology to adequately

process solid wastes reliably with minimum power, mass, volume. Inadequate waste management

can also lead to contamination of planetary surfaces.

Context / Risk

Factors :

This risk may be influenced by crew health, crew susceptibility to the degree of system closure,

mission duration, the microgravity environment, failure of other systems such as diminished or

failed power supply, or remoteness.

Justification /

Rationale :

Inadequate waste management can result in crew health and safety concerns, including reduced

performance and sickness. Inadequate waste management can also lead to contamination of

planetary surfaces, or significant increases in mission costs in terms of system mass, power, volume

and consumables.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Adsorbents are used for odor control

• Crew manually compacts waste and/or stores waste in bags

• Feces is mechanically compacted

Waste is returned to Earth in the Space Shuttle for disposal, or returned in expendable logistics

modules to be destroyed on entry

•

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Current practice though less than optimal may be adequate for the life of ISS

• Provide a system for adequately collecting waste . [TRL 2] [Lunar] [Mars]

• Provide a system for adequately transporting waste [TRL 2] [Lunar] [Mars]

Provide a system for processing waste for storage , resource recovery or disposal of trash

generated (including clothing) throughout the mission, reliably and efficiently with minimum

power, mass and volume. [TRL 2] [Lunar] [Mars]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

41a What system will meet the storage and/or disposal requirements for specified missions?

[ISS 1, Lunar 1, Mars 1]

41b What system will meet requirements for processing wastes to recover resources for

specified missions? [ISS 1, Lunar 1, Mars 1]

41c What waste management will handle complex waste streams such as packaging, paper,

etc. in order to meet mission requirements? [ISS 2, Lunar 2, Mars 2]

41d What waste management will handle medical wastes such as blood, tissues and

syringes etc. in order to meet mission requirements? [ISS 2, Lunar 2, Mars 2]

41e What system will meet the requirements for managing residuals for planetary

protection? [ISS 1, Lunar 1, Mars 1]

41f How can microbes and candidate crop species be engineered to perform better and

fulfill multiple functions in a bioregenerative system? [ISS 4, Lunar 3, Mars 1]

41g What are the interfaces between the biological and physical chemical life support

subsystems for a specified mission? [ISS 3, Lunar 3, Mars 1]

41h Can viability and genetic integrity of the biological components be maintained for the

duration of different missions? [ISS 4, Lunar 3, Mars 2]

41i How do partial and microgravity affect biological waste processing? [ISS 4, Lunar 3,

Mars 1]

41j What are the effects of radiation on biological components of the life support system?

[ISS 3, Lunar 3, Mars 1]

41k What sensors are required to monitor performance and provide inputs to control

systems (AEMC)? [ISS 2, Lunar 2, Mars 2]
NASA/SP-2005-6113 A-92

41l

What monitoring and control system can provide semi to total autonomous control to

relieve the crew of monitoring and control functions to the extent possible (AEMC)?

[ISS 2, Lunar 2, Mars 2]

41m

What studies need to be performed to determine whether or not recycling of solid waste

can be done cost effectively to provide building materials for habitability features

needed in subsequent phases of specified missions? [ISS 5, Lunar 3, Mars 3]

41n

What research is required to validate design approaches for multiphase flows for solid

waste management and resource recovery in varying gravity environments. [ISS 3,

Lunar 3, Mars 3]

41o What resources are required to manage waste disposal as an environmental risk during

long and remote missions (from EH)? [ISS 4, Lunar 3, Mars 1]

41p What system will meet requirements for processing wastes to recover water for

specified missions? [ISS 1, Lunar 1, Mars 1]

41q What system will meet requirements for processing wastes to recover CO2 for specified

missions? [ISS 1, Lunar 1, Mars 1]

41r What system will meet requirements for processing wastes to recover minerals for

specified missions? [ISS 1, Lunar 1, Mars 1]

41s

How should wastes be handled or stored to avoid perception such as bad odors or

unsightly appearance that would adversely affect crew quality of life and consequent

degradation in performance? [ISS 2, Lunar 2, Mars 2]

41t

What waste management systems will prevent release of biological material (cells or

organic chemicals that are signs of life) from contaminating a planetary surface, such as

the Martian surface, and compromising the search for indigenous life? [ISS N/A,

Lunar 4, Mars 1]

41u What management systems will prevent release of biological materials that could harm

indigenous biological communities? [ISS 3, Lunar 2, Mars 1]

41v

What is the probability that waste materials could become reservoirs for return of

indigenous life to Earth (i.e. backward contamination)? What systems can prevent this

from occurring? [ISS N/A, Lunar N/A, Mars 1]

41w

What is the probability that microorganisms in biological wastes such as food scraps or

feces could be altered or mutated by the space environment radiation to become

harmful or pathogenic? What can prevent this? [ISS 4, Lunar 3, Mars 2]

41x What containment vessels will be sufficient to prevent escape of stored waste at various

mission locations such as planetary surfaces or crew cabins? [ISS 4, Lunar 3, Mars 1]

Related Risks : Immunology & Infection

Alterations in Microbes and Host Interactions

Nutrition

Inadequate Nutrition

Radiation

Acute Radiation Risks

Advanced Life Support

Maintain Acceptable Atmosphere

Provide and Maintain Bioregenerative Life Support Systems

Provide and Recover Potable Water

Important

References : Advanced Technology of Human Support in Space, Committee on Advanced Technology for

Human Support in Space, Aeronautics and Space Engineering Board, National Research Council,

National Academy Press, Washington DC, 1997.

Designing for Human Presence in Space: An Introduction to Environmental Control and Life

Support Systems, NASA RP-1324, 1994.
NASA/SP-2005-6113 A-93

Isolation, NASA Experiments in Closed-Environment Living, Advanced Human Life Support

Enclosed System Final Report, Volume 104, Science And Technology Series, A Supplement to

Advances in the Astronautical Sciences, Edited by Helen W. Lane, Richard L. Sauer and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, CA 92198. web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Space flight Life Support and Biospherics, Eckart, 1996.

Risk Title: Provide and Maintain Bioregenerative Life Support Systems

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Life Support

Risk Number : 42

Risk Description : Sustaining crew health and performance may be compromised by lack of bioregenerative systems.

Context / Risk

Factors :

This risk may be influenced by the effect of radiation on plants, reduced atmospheric pressure,

reduced sunlight, limited availability of water, limits on power availability for artificial lighting,

reduced gravity, or remoteness.

Justification /

Rationale :

For ISS, the re-supply line is relatively short, on-board resources are limited for accommodating

bioregenerative systems, and the risk to crew performance and mission success is relatively low. For

the moon, bioregenerative systems would be advantageous to sustain long-term habitats on the

Lunar surface due to cost and contingencies required for re-supply. For Mars, very high life support

resupply costs would be necessary for a long-term Martian habitat without bioregenerative systems.

Bioregenerative systems would be the only means of producing food and a primary contributor for

CO2 removal, O2 production, and H2O purification and achieving high degree of autonomy.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Development of Vegetable Production Unit

• Screen acceptable cultivars for space systems

• Fresh fruit and vegetables included on current re-supply missions to ISS

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Integrated Bioregenerative / PC test bed [TRL 3] [Mars]

• Low pressure Martian greenhouse [TRL 3] [Mars]

• Mixed cropping systems for continuous production evaluated [TRL 5] [Lunar]

• Provide Vegetable Production Unit for ISS [TRL 5]

Scale system to meet all O2 and CO2 requirements for surface habitat, and to meet partial food

requirements. [CRL 6] [Mars]

•

Scale gravity-based salad production module to meet all water and O2 requirements for surface

missions, and to meet food requirements [TRL 4] [Lunar]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

42a

What are the optimal methods of plant growth for a specified mission, including

development of appropriate hardware, management of light, water, nutrients, gas

composition and pressure, trace contaminants, horticultural procedures and disease

risks? [ISS 2, Lunar 2, Mars 1]

42b How can microbes and candidate crop species be engineered to perform better and

fulfill multiple functions in a bioregenerative system? [ISS 4, Lunar 3, Mars 1]

42c What mechanized or automated systems are required for planting, harvesting,

monitoring, and controlling crops for a specified mission? [ISS 4, Lunar 3, Mars 2]
NASA/SP-2005-6113 A-94

42d Can viability and genetic integrity of the biological components be maintained for the

duration of different missions? [ISS 4, Lunar 3, Mars 2]

42e What are the interfaces between the biological and physical chemical life support

subsystems for a specified mission? [ISS 4, Lunar 3, Mars 1]

42f How do partial and microgravity affect plant growth and crop yield? [ISS 4, Lunar 3,

Mars 1]

42g What are the effects of radiation on biological components of the life support system?

[ISS 3, Lunar 3, Mars 1]

42h What percentage of crew food needs should be attributed to ALS plant products for

specified missions? [ISS 5, Lunar 3, Mars 2]

42i What capabilities and associated hardware are required for processing and storing plant

products for a specified mission? [ISS 5, Lunar 3, Mars 2]

42j Can the plant production rates and ALS functions be sustained for the duration of the

mission? [ISS 5, Lunar 3, Mars 1]

42k Can plant yields and ALS functions measured during low TRL (fundamental) testing be

scaled up for large bioregenerative systems? [ISS 5, Lunar 3, Mars 1]

42l

What sensors and monitoring systems will be required to measure environmental

conditions and crop growth parameters and health for a specified mission (AEMC)?

[ISS 3, Lunar 3, Mars 2]

42m What control system hardware and software technologies will be required to monitor

and control crop systems for a specified mission (AEMC)? [ISS 3, Lunar 3, Mars 2]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Nutrition

Inadequate Nutrition

Radiation

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Air Quality

Monitor Water Quality

Provide Integrated Autonomous Control of Life Support Systems

Advanced Extravehicular Activity

Provide Space Suits and Portable Life Support Systems

Advanced Life Support

Maintain Acceptable Atmosphere

Manage Waste

Provide and Recover Potable Water

Important

References : Advanced Technology of Human Support in Space, Committee on Advanced Technology for

Human Support in Space, Aeronautics and Space Engineering Board, National Research Council,

National Academy Press, Washington DC, 1997.

Designing for Human Presence in Space: An Introduction to Environmental Control and Life

Support Systems, NASA RP-1324, 1994.
NASA/SP-2005-6113 A-95

Isolation, NASA Experiments in Closed-Environment Living, Advanced Human Life Support

Enclosed System Final Report, Volume 104, Science And Technology Series, A Supplement to

Advances in the Astronautical Sciences, Edited by Helen W. Lane, Richard L. Sauer and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, CA 92198. web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Space flight Life Support and Biospherics, Eckart, 1996.

Wheeler RM, CL Mackowiak, GS Stutte, NC Yorio, LM Ruffe, JC Sager, RP Prince, BV

Peterson, GD Goins, WL Berry, CR Hinkle and WM Knott. 2003. Crop production for Advanced

Life Support Systems. Observations from the Kennedy Space Center Breadboard Project. NASA

Tech. Mem. 2003-211184. (58 pages).

Wheeler RM, GW Stutte, GV Subbarao and NC Yorio. 2001. Plant growth and human life

support for space travel. In: M. Pessarakli (ed.), 2nd Edition. Handbook of Plant and Crop

Physiology. pp. 925-941. Marcel Dekker Inc., NY.

Wheeler, R.M. and C. Martin-Brennan. 2000. Martian greenhouses: Concept and Challenges.

Proceedings from a 1999 Workshop. NASA Tech. Memorandum 208577.

Risk Title: Provide and Recover Potable Water

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Advanced Life Support

Risk Number : 43

Risk Description : Crew health may be compromised due to inability of currently available technology to adequately

provide and recover potable water.

Context / Risk

Factors :

This risk may be influenced by crew health, crew susceptibility to the degree of system closure, or

remoteness.

Justification /

Rationale :

Lack of potable water is a health risk. For Lunar and Mars missions, the lack of immediate resupply and increased reliance on water recovery systems compounds the risk.

Risk Rating : ISS: Priority 3

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Stored potable water onboard spacecraft

• Water recovery system performance monitored

• Re-supply of potable water from Earth

Projected

Countermeasures or

Mitigations & other

Deliverables:

• Biological systems [TRL 4]

• Possibility of in-situ resource utilization (cannot assign TRL until presence of water is confirmed)

• Redundant systems [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

43a What system meets all requirements for supplying potable water needs? [ISS 1, Lunar

1, Mars 1]

43b What mechanisms to collect and transport wastewater meet the mission requirements?

[ISS 1, Lunar 1, Mars 1]

43c

What methods for the removal of organic, inorganic and microbial contaminants in

wastewater meet all mission requirements for efficiency and reliability? [ISS 1, Lunar

1, Mars 1]

43d What method to store and maintain portability of recycled water meets all requirements

for specified missions? [ISS 1, Lunar 1, Mars 1]
NASA/SP-2005-6113 A-96

43e What sensors are required to provide water quality parameters, monitor performance

and provide inputs to a control system (AEMC)? [ISS 2, Lunar 2, Mars 2]

43f What control system meets all mission requirements (AEMC)? [ISS 2, Lunar 2, Mars

2]

43g How can microbes be engineered to perform better and fulfill multiple functions in a

bioregenerative system? [ISS 5, Lunar 3, Mars 1]

43h What are the interfaces between the biological and physical chemical life support

subsystems for a specified mission? [ISS 5, Lunar 3, Mars 1]

43i Can viability and genetic integrity of the biological components be maintained for the

duration of different missions? [ISS 5, Lunar 3, Mars 2]

43j How do partial gravity and microgravity affect biological water processing? [ISS N/A,

Lunar 3, Mars 1]

43k What are the effects of radiation on biological components of the life support system?

[ISS 3, Lunar 3, Mars 1]

43l What research is required to validate design approaches for multiphase flows for Water

recovery systems in varying gravity environments? [ISS 1, Lunar 1, Mars 2]

Related Risks : Nutrition

Inadequate Nutrition

Radiation

Acute Radiation Risks

Advanced Environmental Monitoring & Control

Monitor Water Quality

Provide Integrated Autonomous Control of Life Support Systems

Advanced Life Support

Manage Waste

Provide and Maintain Bioregenerative Life Support Systems

Important

References : Advanced Technology of Human Support in Space, Committee on Advanced Technology for

Human Support in Space, Aeronautics and Space Engineering Board, National Research Council,

National Academy Press, Washington DC, 1997.

Designing for Human Presence in Space: An Introduction to Environmental Control and Life

Support Systems, NASA RP-1234, 1994.

Isolation, NASA Experiments in Closed-Environment Living, Advanced Human Life Support

Enclosed System Final Report, Volume 104, Science And Technology Series, A Supplement to

Advances in the Astronautical Sciences, Edited by Helen W. Lane, Richard L. Sauer and Daniel

L. Feeback. Published for the American Astronautical Society by Univelt, Incorporated, P.O. Box

28130, San Diego, CA 92198. web: http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

http://lsda.jsc.nasa.gov/books/ground/chambers.pdf

Space flight Life Support and Biospherics, Eckart, 1996.

Risk Title: Mismatch Between Crew Physical Capabilities and Task Demands

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Space Human Factors Engineering

Risk Number : 44

Risk Description : Human performance failure may occur due to human factors inadequacies in the physical work

environments (e.g., workplaces, equipment, protective clothing, tools and tasks).

Context / Risk

Factors :

Physical elements such as habitats, work environments, equipment, protective clothing, or tools can

impact human performance in accomplishing tasks. Additionally, tasks not designed to
NASA/SP-2005-6113 A-97

accommodate human physical limitations, including changes in crew capabilities resulting from

mission and task duration factors, may lead to crew injury or illness or reduced effectiveness or

efficiency in nominal or predictable emergency situations. Performance may be further affected by

state of fitness (and effectiveness of exercise countermeasures), training, and changing gravitational

fields.

Justification /

Rationale :

Crew accommodations are designed based primarily on volume and mass considerations. Anecdotal

information from crew reports and extrapolations from physiological studies is available on impacts

of habitats, work environments, workplaces, equipment, protective clothing, tools and tasks on

human performance in space contexts. There is inadequate data on physical performance changes in

strength, stamina and motor skill as functions of time in space flight environments. Returning

crewmembers usually exhibit substantial physical and motor deficits. Performance will be enhanced

through incorporation of human factors into vehicle, task and equipment design.

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • Appropriate mission design

• Crew resiliency

• Crew training

Projected

Countermeasures or

Mitigations & other

Deliverables:

Measurement, analysis, modeling and design tools for optimizing environment, habitat,

workplace, equipment, protective clothing and task design [TRL 2]

•

Tools for analyzing physical tasks to determine allocations of functions between humans and

machines [TRL 2]

•

Research &

Technology

Questions [With

Mission Priority]:

No. Question

44a What are the effects of microgravity, 1/6-gravity, or 1/3-gravity on requirements for

habitable volume and architecture? [ISS 2, Lunar 2, Mars 2]

44b What designs of workspace, equipment, tool and clothing will accommodate

differences in crew anthropometry? [ISS 2, Lunar 2, Mars 2]

44c What are the effects of duration of exposure to microgravity, 1/6-gravity, 1/3-gravity on

human physical performance? [ISS 1, Lunar 1, Mars 1]

44d

What tools, equipment and procedures will enable crew physical performance to

accommodate the effects of exposure to different gravity levels? [ISS 2, Lunar 2,

Mars 2]

44e How can crewmembers and ground support personnel detect and compensate for

decreased physical readiness to perform during a mission? [ISS 2, Lunar 3, Mars 3]

44f What scheduling constraints are required to reduce the risk of human performance

failure due to physical fatigue to an acceptable probability? [ISS 2, Lunar 2, Mars 2]

44g What principles of task design and function allocation will result in operations concepts

that meet crew performance requirements for the mission? [ISS 2, Lunar 2, Mars 2]

44h What limitations are required on physical workload to enable crewmembers to

complete physical tasks with an acceptable probability? [ISS 1, Lunar 1, Mars 1]

44i What crew size, composition and task allocations are required to accomplish the

reference missions? [ISS 1, Lunar 1, Mars 1]

44j

What design considerations are needed to accommodate effects of changes in gravity,

including launch, reentry, lunar landing, lunar launch, Mars landing, Mars launch, and

Earth return? [ISS 1, Lunar 1, Mars 1]

Related Risks : Environmental Health

Define Acceptable Limits for Contaminants in Air and Water

Sensory-Motor Adaptation
NASA/SP-2005-6113 A-98

Impaired Sensory-Motor Capability to Perform Operational Tasks During Flight, Entry, and

Landing

Impaired Sensory-Motor Capability to Perform Operational Tasks After Landing and Throughout

Re-Adaptation

Motion Sickness

Behavioral Health & Performance and Space Human Factors (Cognitive)

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Advanced Environmental Monitoring & Control

Monitor Air Quality

Provide Integrated Autonomous Control of Life Support Systems

Space Human Factors Engineering

Poorly Integrated Ground, Crew, and Automation Functions

Important

References : An Ergonomics Case Study: Manual Material Handling in Microgravity. M. Whitmore & T. D.

McKay. Advances in Industrial Ergonomics and Safety VI. London: Taylor & Francis. 1994.

Ergonomic Evaluation of a Spacelab Glovebox. M. Whitmore, T. D. McKay, & F. E. Mount.

International Journal of Industrial Ergonomics, 16, pp. 155-164. 1995.

Human Space flight: Mission Analysis and Design, eds. W.J. Larson, L.K. Pranke. McGraw Hill

Space Technology Series. 1999.

Set Phasers on Stun, S. Casey, Agean Publishing, 1993.

Thornton WE, and Rummel JA. (1977). "Muscular Deconditioning and its Prevention in Space

flight," Biomedical Results from Skylab, pp. 175-182, NASA SP-377.

Webb Associates, (1978), Anthropometric Source Book, Vol. I. Anthropometry for Designers,

pp. 1-76, NASA RP 1024.

West JB. (2000). Physiology in microgravity. Journal of Applied Physiology. 89(1): 379-384.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=10904075

Risk Title: Poorly Integrated Ground, Crew, and Automation Functions

Crosscutting Area : Advanced Human Support Technologies (AHST)

Discipline : Space Human Factors Engineering

Risk Number : 45

Risk Description : Mission performance failure may occur without adequate operational concepts, design

requirements, and design tools for integration of multiple factors that affect mission performance,

such as ground-crew interaction, communication time, and level of automation.

Context / Risk

Factors :

This risk may be influenced by communication lag times, communication blackouts, or loss of skills

due to extended time since training.

Justification /

Rationale :

Inadequate design of human-automation systems is known to lead to human error, based on analysis

of incidents in the nuclear power industry and commercial aviation (Evidence Level 3). "Mode

error" has resulted in fatal accidents in commercial aviation (Evidence Level 2). At least two critical

collisions between ISS and SRMS have been avoided only by real-time monitoring and intervention

by mission control (Evidence Level 4).

Risk Rating : ISS: Priority 2

Lunar: Priority 2

Mars: Priority 1

Current

Countermeasures : • None (ad hoc engineering judgment is used)

Projected
NASA/SP-2005-6113 A-99

Countermeasures or

Mitigations & other

Deliverables:

• Reliability measures and data for human performance [TRL 2]

• Requirements for use of automated systems and for human-centered system design [TRL 2]

• Tools for analyzing task requirements [TRL 2]

Research &

Technology

Questions [With

Mission Priority]:

No. Question

45a What crew size and composition is required to accomplish the reference mission?

(Shared - Integrated Testing supports) [ISS 2, Lunar 1, Mars 1]

45b

What principles and algorithms for allocating tasks to human crewmembers, ground

support and onboard automated systems will reduce the probability of significant

errors? (Shared - Integrated Testing supports) [ISS 1, Lunar 1, Mars 1]

45c What automated tools and equipment are required to enable the crewmembers to

accomplish the mission? [ISS 2, Lunar 2, Mars 2]

45d

How do crew size, communications restrictions, crew skills, scheduling constraints and

reference mission task requirements affect the requirements for automation? [ISS 1,

Lunar 1, Mars 1]

45e

What combinations of crew, ground and on-board automation capabilities will increase

the likelihood of a successful mission? (Shared - Integrated Testing supports) [ISS 1,

Lunar 1, Mars 1]

45f What training and operational readiness assurance processes and implementations will

increase likelihood of mission success? [ISS 2, Lunar 2, Mars 2]

45g What principles of task assignment workload and automation need to be developed to

facilitate critical team performance? [ISS 2, Lunar 2, Mars 2]

45h

What tools and procedures are needed to determine the appropriate level of automation

and crew control for the various tasks in the reference missions? [ISS 1, Lunar 1,

Mars 1]

Related Risks : Clinical Capabilities

Medical Informatics, Technologies, and Support Systems

Medical Skill Training and Maintenance

Behavioral Health & Performance and Space Human Factors (Cognitive)

Human Performance Failure Due to Poor Psychosocial Adaptation

Human Performance Failure Due to Neurobehavioral Problems

Mismatch between Crew Cognitive Capabilities and Task Demands

Human Performance Failure Due to Sleep Loss and Circadian Rhythm Problems

Advanced Environmental Monitoring & Control

Provide Integrated Autonomous Control of Life Support Systems

Space Human Factors Engineering

Mismatch Between Crew Physical Capabilities and Task Demands

Important

References : Billings CE. Aviation Automation: The search for a human-centered approach. Erlbaum: 1997.

Ellis SR. Collision in space. Ergonomics in Design 8(1): 4-9, 2000.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list

_uids=12162316

Human Performance Measures Handbook V.J.Gawron. Lawrence Erlbaum Associates: 2000.

Human Space flight: Mission Analysis and Design, eds. W.J. Larson, L.K. Pranke. McGraw Hill

Space Technology Series. 1999.

Normal Accidents, Charles Perrow. 2001.

Sheridan TB. Humans and Automation: System Design and Research Issues. Wiley: 2003.
NASA/SP-2005-6113 A-100

The Effect of Automated Intelligent Advisors on Human Decision-making in Monitoring

Complex Mechanical Systems. K O'Brien, EM Feldman, & FE Mount. Proceedings of HCI

International 1993: 5th International Conference on Human-Computer Interaction. Elsevier

Science Publishers. 1993.
NASA/SP–2005–6113 B-1 

Appendix B: Space Flight Factor Interactions
NASA/SP–2005–6113 B-2 

Research and Technology Questions Influenced by 

Multiple Space Flight Factor Interactions 

R&TQs Research & Technology Question ENV IMM NUT PHAR

M PHYSIO PSYC RAD SLEEP STRESS 

1g What are the important predictors for 

estimating site-specific bone loss and 

fracture risk during hypogravity exposure, 

including, but not limited to ethnicity, 

gender, genetics, age, baseline bone 

density and geometry, nutritional status, 

fitness level and prior microgravity 

exposure? 

X X X 

1h Does the hypogravity environment change 

the nutritional requirements for optimal bone 

health? 

X X X 

1j What systemic adaptations to hypogravity 

are important contributory factors to bone 

loss, evaluations of which are essential for 

effective countermeasure development 

(e.g., fluid shifts, altered blood flow, immune 

system adaptations)? 

X X X 

5b What conditions of space flight (e.g., 

microgravity, disruption of physiological 

rhythms, nutrition, environmental factors 

and radiation) may be responsible for 

cardiac dysrhythmias, and what are the 

mechanisms involved? 

X X X X X X 

6f What are the physiological and 

environmental factors by which space flight 

decreases orthostatic tolerance? 

X X 

6k What are the physiological and 

environmental factors by which space flight 

decreases aerobic exercise capacity? 

X X 

7g What impact do space flight-induced 

biological, physiological, and immunological 

changes have on the susceptibility of 

crewmembers to infectious agents and toxic 

substances in the air and water? 

X X X 

8a What are the molecular and genetic 

mechanisms that are affected by space 

flight-related environments (e.g., radiation, 

microgravity, stress, isolation, sleep 

deprivation, extreme environments, 

nutritional deficiency, and social 

interactions) that can result in the loss of 

immunoregulation/immune tolerance and/or 

affect innate/acquired immunity, 

respectively? 

X X X X X X X X 

8b Can the effects on immune function 

(innate/acquired immunity), or dysfunction 

(loss of tolerance/immune surveillance) be 

summarized as a consequence of the 

conditions relating to each mission and/or 

its duration (i.e., 1-year ISS, 30-day lunar, 

30-month Mars)? 

X X X X X X X 

9a What types of latent infections (e.g., viral 

infections) will become reactivated as a 

function of space flight-associated factors 

and pose the greatest threat to human 

health as a function of compromised 

immunity resulting from space travel? 

X X X X X X X 
NASA/SP–2005–6113 B-3 

Research and Technology Questions Influenced by 

Multiple Space Flight Factor Interactions 

R&TQs Research & Technology Question ENV IMM NUT PHAR

M PHYSIO PSYC RAD SLEEP STRESS 

9d Will the severity of disease(s) resulting from 

latent infection reactivation, and/or 

infections caused by commensal organisms 

(as a function of space flight-associated 

factors), be affected by the space mission 

and/or its duration (i.e., 1-year ISS, 30-day 

lunar, 30-month Mars)? 

X X X X X X X 

9e Are there neoplastic malignancies that may 

result from latent infection reactivation, 

and/or infections caused by commensal 

organisms (as a function of space flightassociated factors), that will be affected by 

the space mission and/or its duration? 

X X X X X X X 

9f Is it possible to predict the summary effects 

of each component condition and duration 

of space flight that results in an infectious 

and/or neoplastic state? 

X X X X X X X 

10b Does the spacecraft environment exert a 

selective pressure on microorganisms that 

presents the crew with increased health 

risks (e.g., Helicobacter and ulcers)? 

X X X 

11g What are the effects of skeletal muscle 

atrophy on whole body metabolism (e.g., 

insulin and glucose tolerance) during space 

flight? 

 X 

11h What are the effects of skeletal muscle 

atrophy on thermoregulation during space 

flight? 

 X 

11n Is the capacity of skeletal muscle to grow or 

regenerate (satellite cells) compromised 

during or after a mission because of 

conditions (e.g., radiation exposure, 

reduced skeletal muscle tension)? 

 X X 

11t To what extent do alterations in the sensorymotor system contribute to deficits in 

skeletal muscle strength and endurance 

during space flight? 

 X 

14o What are the relative contributions of 

sensory-motor adaptation, neuromuscular 

deconditioning, and orthostatic intolerance 

to postflight neuro-motor coordination, 

ataxia, and locomotion difficulties? 

 X X 

16b What are the potential impacts of 

countermeasures on nutritional 

requirements or nutritional status? 

 X X 

16g Can general nutrition, or specific nutrient 

countermeasures, mitigate the negative 

effects of space flight on bone, muscle, 

cardiovascular and immune systems, and 

protect against damage from radiation? 

 X X X X 

16k Can general, or specific nutrient 

countermeasures, mitigate radiation induced 

carcinogenesis or cataractogenesis? 

 X X X 
NASA/SP–2005–6113 B-4 

Research and Technology Questions Influenced by 

Multiple Space Flight Factor Interactions 

R&TQs Research & Technology Question ENV IMM NUT PHAR

M PHYSIO PSYC RAD SLEEP STRESS 

17k What are the primary, secondary and 

tertiary prevention strategies needed to 

mitigate the risk of anticipated 

environmental exposures to radiation and 

toxic substances (i.e. shielding, nutritional 

and medical prophylaxis such as agents to 

augment cellular defenses, immune 

surveillance, etc.)? 

 X X X X X 

18k What are the nutritional requirements for 

adequate red cell production in 

microgravity? What are the contributory 

factors and how do they inter-relate in the 

development of space anemia (radiation, 

unloading, nutrition, fluid shift, changes in 

sex hormones, etc.)? 

X X X X X X 

18w What are the risk factors that can increase 

the likelihood of DCS, such as the presence 

of Patent Foramen Ovale (PFO)? 

X X 

18z What is the role of individual susceptibility, 

age and gender on the risk of DCS during 

NASA operations involving decompression? 

 X 

18ag What secondary prevention strategies (i.e. 

countermeasures) should be developed and 

implemented to prevent adverse reactions 

to toxic exposures (e.g., sleep, nutrition, 

medication, stress reduction, shielding, 

protective equipment, etc.)? 

X X X X X X 

19a What are the effects of space flight and 

reduced-G on the absorption, distribution, 

metabolism, clearance, excretion, clinical 

efficacy, side effects and drug interactions 

for medications used in primary, secondary 

and tertiary prevention of conditions stated 

in the Space Medicine Condition List? 

X X X 

24a What are the fundamental behavioral and 

social stressors during long-duration 

missions that will most likely affect crew 

performance, both individual and team, and 

how can they be studied for elimination or 

accomodation in Earth analogue 

environments? 

 X X X X X 

24b What factors contribute to the breakdown of 

individual/team performance and mission 

support coordination with regard to 

scheduling, prioritization of work activities, 

and control of timelines? 

 X X X 

25b What are the long-term effects of exposure 

to the space environment (microgravity, 

isolation, stress) on human neurocognitive 

and neurobiological functions (from cellular 

to behavioral levels of the nervous system)? 

X X X X X 

25c What are the long-term effects of exposure 

to the space environment on human 

emotion and psychological responses, 

including emotional reactivity, stress 

responses, long-term modulation of mood 

and vulnerability to affective and cognitive 

disorders? 

X X X X 

26b What is required to counteract the negative 

effects of communications lags on human 

performance? 

 X X 
NASA/SP–2005–6113 B-5 

Research and Technology Questions Influenced by 

Multiple Space Flight Factor Interactions 

R&TQs Research & Technology Question ENV IMM NUT PHAR

M PHYSIO PSYC RAD SLEEP STRESS 

27a What are the acute and long-term effects of 

exposure to the space environment on 

biological rhythmicity, sleep architecture 

(quantity and quality), and their relationship 

to performance capability? 

X X X X X 

27e What work, workload, and sleep schedule(s) 

will best enhance crew performance and 

mitigate adverse effects of the space 

environment? 

 X X 

28e What are the most effective biomedical or 

dietary countermeasures to mitigate cancer 

risks? By what mechanisms are the 

countermeasures expected to work, and do 

they have the same efficiency for low- and 

high-LET radiation? 

 X X X 

28h Are there significant combined effects from 

other space flight factors (microgravity, 

stress, altered circadian rhythms, changes 

in immune responses, viral reactivation etc.) 

that modify the carcinogenic risk from space 

radiation? 

X X X X X X 

29f Are there significant CNS risks from 

combined space radiation and other 

physiological or space flight factors (e.g., 

bone loss, microgravity, immune-endocrine 

systems or other)? 

X X X X 

31b Are there synergistic effects arising from 

other space flight factors (microgravity, 

stress, immune status, bone loss, damage 

to intestinal cells reducing their ability to 

absorb medication etc.) that modify acute 

risks from space radiation including 

modifying thresholds for such effects? 

X X X X X X 

38j What nutritional content and sensory 

attribute changes (including radiationinduced effects) in the prepackaged food 

items will occur over the shelf life of the 

food? 

X X X X X 

39e What are the effects of radiation on 

biological components of the life support 

system? (Maintain Acceptable Atmosphere) 

X X X 

41j What are the effects of radiation on 

biological components of the life support 

system? (Waste) 

X X X 

41w What is the probability that microorganisms 

in biological wastes such as food scraps or 

feces could be altered or mutated by the 

space environment radiation to become 

harmful or pathogenic? What can prevent 

this? 

X X X X 

42g What are the effects of radiation on 

biological components of the life support 

system? (Bio-regenerative Life Support 

Systems) 

X X X X 

43k What are the effects of radiation on 

biological components of the life support 

system? (Potable Water Systems) 

X X X X 
NASA/SP–2005–6113 C-1 

Appendix C: Exploration Systems Mission Directorate 

Schedules and Milestones
NASA/SP–2004–6113 C-2

HHP

HHC

AMCBHPRadiation

FY05-07 HHP Deliverables

2004 2005 2006 2007 2

1st CE

Demo

Technology 

Development

System 

& Dem

SRR SDR PDR

Requirements 

Development

Constellation

AG Short Radius Centrifuge 

Pilot Study Complete

Radiation Assessment for 

CEV concept complete 

Final requirements for exercise prescriptions

Dual Track TreadmillPrototype Available

Research on ISS to develop countermeasures to adverse effects of space flight in humans

Medical Concept of 

Operations for exploration 

IV Fluid Generation System 

(ISS) 

Computerized conflict 

management training 

Individualized Predictive 

Models for Fatigue 

Computerized depression 

management training 

Astronaut Select-in, S

out Criteria Validat

Preliminary Lunar 

Radiation Dose Limits

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-3

LSH

AEMC

ALSSHFE

FY05-07 LSH Deliverables

2004 2005 2006 2007 20

1st CE

Demo

Technology 

Development

System D

& Dem

SRR SDR PDR

Requirements 

Development

Constellation

Revised NASA STD-3000, HumanSystems Integration Standard

Reactive Plastic LiOH Carbon Dioxide Reduction Technology Options

ENose Air Monitor

Regenerable Trace 

Contaminant Control 

Solid Amine Swing Bed

Improved Food Packaging

Water Inorganics Monitor

Laser Air Monito

Miniature Mass Spectrometer Air Monitor

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-4

HHP Deliverables for Project Constellation 

Spiral 1: Crewed CEV Flight

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

1st CEV 

Demo

1st Uncrewed 

CEV Flt

Technology 

Development

System Development

& Demonstration

1st Crewed 

CEV Flt

Production & 

Deployment

Operations 

& Support

SRR SDR PDR

Requirements 

Development

CDR

HHP

HHC

AMCBHPRad

Constellation

Version: August 2004

Radiation Monitoring Requirements

Autonomous Medical Care 

Requirements Defined

Exercise Countermeasure 

HW Operational

Autonomous Medical Care 

System for CEV

Research on ISS to develop countermeasures to adverse effects of space flight in humans

Intervention & Treatment 

Protocols Verified

Pharmacokinetics testing 

complete

Exercise Protocol Validated

Astronaut Select-in, Selectout Criteria Validated 

Lunar CEV Radiation Shielding Requirements 

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-5

LSH Deliverables for Project Constellation 

Spiral 1: Crewed CEV Flight

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

1st CEV 

Demo

1st Uncrewed 

CEV Flt

Technology 

Development

System Development

& Demonstration

1st Crewed 

CEV Flt

Production & 

Deployment

Operations 

& Support

SRR SDR PDR

Requirements 

Development

CDR

LSH

SysEngEVA

AEMC

ALSSHFECRT

Constellation

Suit for

In-Space Ops

CEV Air Quality Sensor Suite

Integrated Test & Technology Maturation

Revised NASA-STD-6001

Flammability Standard

NASA-STD-3000 (HSIS) CEV HW/SW Requirements

CEV Air Revitalization

Technologies

CEV ThermalTechnologies

Req Definition

System Level 

Integrated Test

Version: July 2004

Flammability

Acceptance Criteria

In-space Maintenance Technologies

CEV Water Quality Sensor Suite

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-6

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

Technology 

Development

System Development

& Demonstration

Production & 

Deployment

Operation

& Suppor

SRR SDR PDR

Requirements 

Development

CDR

HHP Deliverables for Project Constellation 

Spiral 2: Moon

1st Human Moon Mi

Constellation Constellation

Version: August 2004

HHP

HHC

AMCBHPRad

Autonomous Medical Care 

System for Moon

Pharmacology/Nutrition Requirements

Research on ISS to develop countermeasures to adverse effects of space flight in humans

Exercise Countermeasure 

HW Operational

Intervention & Treatment 

Protocols Verified

Pharmacokinetics testing 

complete

Exercise Protocol Validated

Integrated Set 

Countermeasur

Optimal Protocol 

Radiation Monitoring Requirements

Astronaut Select-in, Selectout Criteria Validated 

Lunar Radiation Dose Limits

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-7

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

Technology 

Development

System Development

& Demonstration

Production & 

Deployment

Operation

& Suppor

SRR SDR PDR

Requirements 

Development

CDR

LSH Deliverables for Project Constellation 

Spiral 2: Moon

1st Human Moon Mi

Constellation Constellation

Integrated Test & Technology Maturation

External Environment Monitor Technology

HSIS Habitat Design Requirements Lunar Operational Requirements

Fire 

Detection/Suppression

System-2

Revision/Supplement

to NASA-STD-6001

Maintenance Technologies

Fabrication Technologies

Flt. Demo. Lunar Oxygen Extraction 

TechnologySelection

Integrated Testing

Req Definition

Air Revitalization, H2O Reclamation, and Waste Management Technologies 

Integrated Space Suit 

& PLSS System Test

Version: July 2004

Thermal System Technologies 

Internal Microbial Monitor Technology

LSH

SysEngEVA

AEMC

ALSSHFECRT

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-8

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

Technology 

Development

System Development

& Demonstration

SRR SDR PDR

Requirements 

Development

CDR

HHP Deliverables for Project Constellation 

Spiral N: Mars

Constellation

1st Human Mars 

Constellation

Pharmacology/Nutrition Requirements

Exercise System Requirements

AG Centrifuge Launch to ISS (not currently funded)

Validated selection & training requirements for Mars crew

Radiation Monitoring Requirements

AG Requirements for 

vehicle

Version: August 2004

HHP

HHC

AMCBHPRad

Autono

Car

Research on ISS to develop countermeasures to adverse effects of space flight in humans

Research on ISS to develop procedures/protocol

Integrated Set 

Countermeasur

Mars Radiation Dose Limits Approved

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 C-9

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 

Technology 

Development

System Development

& Demonstration

SRR SDR PDR

Requirements 

Development

CDR

LSH Deliverables for Project Constellation 

Spiral N: Mars

Constellation

1st Human Mars 

Constellation

Integrated Test & Technology Maturation

Req

Mars 

Automated Process Co

Plant Growth Chamber & Mars Env. Monitors

HSIS Reqts for Mars Habitat Tools for Team 

Fire 

Detection/Suppression

System-3

Modular FabrMaintenance 

Robotic Habitat

Tech

CO2 Reduction ISS Ops Results

Req Definition

Deliver ALS Technologies (Air, H2O, Waste, Thermal, 

Integrated Testing

Version: July 2004

LSH

SysEngEVA

AEMC

ALSSHFECRT

Mars ISRU Concepts

Draft: Under Review by Requirements Analysis Process
NASA/SP–2005–6113 D-1 

Appendix D: Acronyms
ACRONYMS 

NASA/SP–2005–6113 D-2 

0-G Zero Gravity 

1-G/1 X G One Gravity/Earth Gravity 

 

ACLS Advanced Cardiac Life Support 

AEMC Advanced Environmental Monitoring and Control 

AEVA Advanced Extravehicular Activity 

AFT Advanced Food Technology 

AG Artificial Gravity 

AHST Advanced Human Support Technology 

AIM Advanced Integration Matrix 

ALS Advanced Life Support 

AMC Autonomous Medical Care 

apoE apolipoprotein E 

ARC Ames Research Center 

ASICLS Advanced System Integration and Control for Life Support 

ATLS Advanced Trauma Life Support 

 

BCLS Basic Cardiac Life Support 

BCPR Bioastronautics Critical Path Roadmap 

BHP Behavioral Health and Performance 

BMD Bone Mineral Density 

BPO Bioastronautics Program Office 

BR Bioastronautics Roadmap 

BRCP Bioastronautics Roadmap Control Panel 

BSMT Bioastronautics Science Management Team 

BTLS Basic Trauma Life Support 

 

CCP Configuration Control Panel 

Cdr. Commander 

CELSS Closed Ecological Life Support System 

CEV Crew Explorative Vehicle 

CHMO Chief Health and Medical Officer 

CMRS CO2 Moisture Removal System 

CNS Central Nervous System 

CPCP Critical Path Control Panel 

CPR Cardiopulmonary Resuscitation 

CR Change Request 

CRL Countermeasure Readiness Level 

 

DCS Decompression Sickness 

DNA Deoxyribonucleic Acid 

DNR Do Not Resuscitate 

 

EBV Epstein-Barr Virus 

ECLS Environmental Control and Life Support 

EMU Extravehicular Mobility Unit 

Env Environment 

ESMD Exploration Systems Mission Directorate 

EVA Extravehicular Activity 

 

G, Gx Unit Of Measurement For Acceleration Of Gravity; Subscripts X, Y, and Z Indicate 

Direction Of Force; 1G = Earth Gravity 

 
ACRONYMS 

NASA/SP–2005-6113 D-3 

Hab Habitat 

HACCP Hazard Analysis and Critical Control Point 

HHC Human Health and Countermeasures 

HIV Human Immunodeficiency Virus 

HSWG Human Systems Working Group 

HTLV Human T-cell Leukemia Virus 

HZE High Mass and Energy 

 

IAA International Academy of Astronautics 

IEEE Institute of Electrical and Electronics Engineers, Inc. 

IgE Immunoglobulin E 

I&I Immunology and Infection 

IOM Institute of Medicine 

ISRU In-Situ Resource Utilization 

ISS International Space Station 

IV Intravenous 

 

JSC Johnson Space Center 

 

K citrate Potassium Citrate 

 

LAC Long Arm Centrifuge 

LCVG Liquid Cooling and Ventilation Garment 

LEO Low Earth Orbit 

LET Linear Energy Transfer 

LSA Lunar Surface Activities 

 

MC Medical Care 

MCC Mission Control Center 

MeV Megaelectron Volt 

MRI Magnetic Resonance Imaging 

 

N/A Not Applicable 

NAE National Academy of Engineering 

NAS National Academy of Science 

NASA National Aeronautics and Space Administration 

NCRP National Council on Radiation Protection 

NET No Earlier Than 

NLT No Later Than 

NRA NASA Research Announcement 

NRC National Research Council 

NSBRI National Space Biomedical Research Institute 

NTSB National Transportation and Safety Board 

 

OAG Operations Advisory Group 

OBPR Office Of Biological and Physical Research 

OCHMO Office of the Chief Health and Medical Officer 

 

PCD Patient Condition Database 

PFO Patent Foramen Ovale 

PLSS Portable Life Support System 

Plt. Pilot 

psi Pounds Per Square Inch 

 

RAD Radiation 
ACRONYMS 

NASA/SP–2005–6113 D-4 

RDS Risk Data Sheet 

ReMAP Reprioritization and Maximization Committee 

RH Radiation Health 

RNA Ribonucleic Acid 

rRNA Ribosomal RNA 

rpm Revolutions per Minute 

R&TQ Research & Technology Question 

 

SARS Severe Acute Respiratory Syndrome 

SHF Space Human Factors 

SHFE Space Human Factors Engineering 

Si Silicon 

SLS Spacelab Life Sciences 

SLSD Space Life Sciences Directorate 

SM Sensory-Motor 

SMAC Space Maximum Allowable Concentration 

SMCCB Space Medicine Configuration Control Board 

SMCL Space Medicine Condition List 

SOMD Space Operations Mission Directorate 

SP Special Publication 

SPE Solar Particle Event 

SRC Short Radius Centrifuge 

SRMS Shuttle Remote Manipulator System 

STI Scientific and Technical Information 

 

TBD To Be Determined 

TCCS Trace Contaminant Control System 

TGA Trace Gas Analyzer 

TMP Transition to Medical Practice 

TRL Technology Readiness Level 

TRS Technical Report Server 

 

U/S Ultrasound 

US/U.S.A. United States/United States of America 

UV Ultraviolet 

 

VPCAR Vapor Phase Catalytic Ammonia Removal 

VPU Vegetable Production Unit 
NASA/SP–2005–6113 E-1 

Appendix E: Glossary
GLOSSARY OF TERMS 

NASA/SP–2005–6113 E-2 

Bioastronautics The study of biological and medical effects of space flight on living organisms. 

 

Bioastronautics 

Roadmap 

The framework used to identify and assess the human systems risks associated with 

space flight missions and the prioritized research and technology questions required for 

delivering risk reduction solutions. 

 

Cascading Risk The relationship between interdependent risks, where one risk causes the occurrence of 

another.

 

Configuration 

Control 

A process for maintaining the content of, in this case, the Roadmap, by a group of 

experts who have the authority to review and approve changes to the content of the 

document, and its companion Web site (http://bioastroroadmap.nasa.gov.) 

 

Critical Characterized by requiring careful evaluation or alignment with other tasks because of 

occurrence at a particularly important juncture (not meant to imply a “showstopper” 

connotation). 

 

Critical Path The path of interdependent tasks or activities in a project that determine the overall time 

to complete the project. 

 

Critical Path 

Analysis (Method) 

A project management technique that identifies the shortest possible sequence of 

interdependent tasks/activities in a project having the longest overall duration, 

determining the shortest possible path to complete the project. 

 

Deliverables Specific products (including knowledge that leads to medical policy and standards) 

identified as desirable risk reduction solutions to the research and technology questions 

for the human system risks. 

 

Discipline Teams The 15 groups of experts representing Human Health and Sytem/Performance 

Efficiency disciplines (bone, muscle, immunology, cardiovascular, sensory motor 

function, behavior and performance, radiation, environmental, nutrition, clinical 

capabilities, advanced life support, advanced environmental monitoring, advanced 

EVA, space human factors, advanced food technology). 

 

Enabling Providing the means, knowledge, or opportunity to make possible. 

 

Exposure Limits Exposure limits are based on the impact the decrement or exposure has on the capability 

to perform assigned tasks, and its implication for lifetime medical status. Exposure 

limits are used for the human health risks and refer to setting an acceptable maximum 

decrement or change in a physiological or behavioral parameter, as the result of 

exposure to space flight factors over a given length of time (e.g. life time radiation 

exposure). 

 

Fitness for Duty Fitness for duty criteria provide a measure of the crewmember’s ability to perform a 

mission-related task or return to duty status. Examples include criteria for determining 

cardiovascular fitness for EVA, sensory motor functioning for vehicle egress or 

behavioral functioning for readiness to perform specific mission tasks. 

 

Human System The crewmembers, both individually and collectively, and their requirements for 

physical and psychological health and well-being to maximize efficiency and 

productivity, and the capabilities to accomplish mission goals in nominal and 

emergency situations. 

 

 
GLOSSARY OF TERMS 

NASA/SP–2005–6113 E-3 

Knowledge 

Maturation 

A type of deliverable from Bioastronautics research that results from an increased 

understanding of a risk, its estimation, causal mechanisms, and uncertainties; resulting 

in, and informing, the development of medical policies and human standards. 

 

Medical Standards The accepted level of performance for physiological, behavioral, and performancerelated functions used to set exposure-based limits for the human system, fitness-forduty criteria, and operating bands. 

 

Operating Bands Operating bands represent an acceptable range of performance or functioning that is 

bounded at both the upper and lower limits; anything outside those limits is 

unacceptable. Operating bands are used in the Roadmap for the system performance and 

efficiency risks associated with life support and habitation systems. 

 

Pacing Item Critical activity that will result in the delay of the project if not completed. 

 

Requirements A statement, or specification, of the condition that must be met through design, 

procedures, or other means. 

 

Research & 

Technology 

Questions 

Research and technology questions associated with the reduction of the Roadmap risks 

through risk mitigation solutions (including improved efficiency, performance, and 

knowledge that informs crew medical policies and standards). 

 

Risk The conditional probability of an adverse event occurring from exposure to the space 

flight environment. 

 

Risk Assessment The scientific analysis and characterization of adverse effects on environmental hazards; 

it may include quantitative or qualitative descriptors, but often excludes analysis of 

perceived risks, risk comparisons, and analysis of effects of decisions (NRC, 1996). 

 

Risk Factor A predisposing condition that contributes to an adverse outcome. 

 

Risk Management The systematic application of management policies, procedures, and practices to the 

tasks of identification and assessment of human system risks for exploration missions 

and the development, selection, monitoring, and implementation of risk mitigation 

solutions for the human system for exploration missions. 

 

Roadmap A detailed plan to guide progress toward a goal. 

 

Spiral 

Development 

Gradually maturing capability or technology that repeats a particular development cycle 

as it matures. 

 

Standards Standards for the human system are represented by exposure limits, fitness for duty 

criteria, or operating bands. Standards for crew health and performance are established 

by the Chief Health and Medical Officer of NASA; mission requirements are influenced 

and driven by such standards. 
NASA/SP–2005–6113 F-1 

Appendix F: References
NASA/SP–2005–6113 F-2 

 REFERENCES 

1. NASA Advisory Council, Aerospace Medicine Advisory Committee. Strategic 

Considerations for Support of Humans in Space and Moon/Mars Exploration 

Missions: Life Sciences Research and Technology Programs. Volumes I and II. 

June 1992. 

2. Space Science Board, National Research Council. A Strategy for Space Biology 

and Medical Sciences for the 1980s and 1990s. National Academy Press, 

Washington D.C., 1987. 

3. Aeronautics and Engineering Board, National Research Council. Advanced 

Technology for Human Support in Space. National Academy Press, Washington 

D.C., 1987. 

4. Space Studies Board, National Research Council. A Strategy for Research in 

Space Biology and Medicine in the New Century. National Academy Press, 

Washington D.C., 1998. 

5. NASA Office of Life and Microgravity Sciences and Applications. Task Force on 

Countermeasures: Final Report. May 1997. 

6. National Council on Radiation Protection and Measurements. Guidance on 

Radiation Received in Space Activities. Recommendations of the National Council 

on Radiation Protection and Measurements. NCRP Report No. 98.July 31, 1989.

7. Ball, J.R., and Evans, C.H., Board on Health Sciences Policy, Institute of 

Medicine. Safe Passage: Astronaut Care for Exploration Missions. National 

Academy Press, Washington, D.C., 2001. 

8. NASA Office of the Chief Health and Medical Officer, Bioastronautics Strategy, 

January 27, 2003. 

9. NASA Biological and Physical Research Enterprise Strategy, October 1, 2003. 

10. NASA Space Flight Enterprise Strategy, November 1, 2003. 

11. NASA Biological and Physical Research, Report by the Research and 

Maximization and Prioritization (ReMAP) Task Force to the NASA Advisory 

Council, August 2002. 

12. Understanding Risk: Informing Decisions in a Democratic Society, Stern, P.C., 

and Fineberg, H.V., (Editors), National Research Council, National Academy 

Press, Washington, DC., 1996. 

13. Shapanek, M.A., Williams, R.S., Nicogossian, A.E., NASA Headquarters, 

Chief Health and Medical Office, Medical Policy Handbook, September, 2001. 

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 February 2005 NASA Special Publication 

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Bioastronautics Critical Path Roadmap 

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13. ABSTRACT (Maximum 200 words)

The Bioastronautics Critical Path Roadmap is the framework used to identify and assess the risks to crews exposed to the hazardous 

environments of space. It guides the implementation of research strategies to prevent or reduce those risks. Although the BCPR 

identifies steps that must be taken to reduce the risks to health and performance that are associated with human space flight, the BCPR 

is not a “critical path” analysis in the strict engineering sense. The BCPR will evolve to accommodate new information and technology 

development and will enable NASA to conduct a formal critical path analysis in the future. As a management tool, the BCPR provides 

information for making informed decisions about research priorities and resource allocation. The outcome-driven nature of the BCPR 

makes it amenable for assessing the focus, progress and success of the Bioastronautics research and technology program. The BCPR is 

also a tool for communicating program priorities and progress to the research community and NASA management. 

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