NASA-STD-3001 Technical Brief

Relevant Technical 

Requirements

Longitudinal Health 

Surveillance (LHS)

OCHMO-TB-043

Rev A

NASA-STD-3001 Volume 1, Rev C

[V1 3018] Post-Mission Long-Term Executive Summary Monitoring

Longitudinal Health Surveillance (LHS), known 

at NASA as Occupational Surveillance, includes 

the medical procedures and actions taken to 

ensure the in-mission and long-term health of 

the astronaut. It also provides a mechanism to 

document any observed spaceflight-associated 

changes. LHS includes a wide variety of healthrelated topics that are performed pre-, in-, and 

post-mission. Training, countermeasures, and 

post-mission reconditioning should all be 

employed to help the crewmember achieve, 

maintain, and recoup their maximal health 

status. In addition, pre-mission measures help 

to reduce the need for more extensive inmission medical care, as well as mitigate the 

risks of spaceflight. By taking a prevention 

approach rather than a reactionary approach, 

total onboard resources and required mission 

capabilities can be lessened. 

Pre-mission In-mission Post-mission

Selection 

Standards

Health Stabilization Program

In-mission Medical

Treatment & Capabilities

Immediate Postlanding Care

Longitudinal Health Surveillance

The table below displays the interaction 

between five key elements that are necessary to 

promote crew health and performance: 

1. Crew Selection Standards OCHMO-TB034 Crew Selection and 

Recertification

2. Health Stabilization Program (HSP) –

OCHMO-TB-006 Health Stabilization 

Program (HSP) 

3. In-mission Medical Treatment & 

Capabilities – OCHMO-TB-033 

Spaceflight Experience and Medical 

Care 

4. Immediate Post-landing Medical Care 

– i.e., medical care post-flight/postmission

5. Longitudinal Health Surveillance –

covered in this technical brief
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Background

Prevalent Physiologic Changes Experienced due to Microgravity 

and Vehicle Design

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Rev A 2

Vision Changes/Loss

Muscular and 

Aerobic Decrements

Head and/or Nasal 

Congestion

Lower Back 

Tightness & Pain

Fluid Loss and 

Orthostatic 

Intolerance

Genitourinary Issues

Bone Loss and 

Renal Stones

Metabolic capacity 

deficits

Space Adaptation 

Syndrome

Vehicle Environmental Considerations 

(e.g. increased radiation exposure, 

atmospheric CO2, toxic chemicals, and VOCs; 

altered pressures & DCS)

Sensorimotor 

deconditioning

For more background information, reference OCHMOTB-033 Spaceflight Experience and Medical Care 

TREAT Astronauts Act (2017)

• Described by NASA as the authorization for “occupationally related medical 

monitoring, diagnosis, and treatment for our former astronauts who have completed 

at least one spaceflight mission.”

• Covers all conditions that NASA considers “potentially associated” with spaceflight

• Enhanced the Lifetime Surveillance of Astronaut Health, an established NASA effort

• More information at: https://www.nasa.gov/general/about-treat-astronauts-act/
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

NASA’s Procedures for Longitudinal Health Surveillance

NASA employs pre-, in-, and/or post-mission procedures for the following topics depending 

on mission duration and architecture. Each topic, if implemented, differs in the phase of 

the mission they are used, measurement parameters (e.g., vitals, lab tests, etc.), and 

deliverables (e.g., reports, electronic medical record submissions, downlinks, etc.).

Reference Data

3

Physical exam (pre-, in-, & 

post-) ECG (pre- & post-) Neurological assessment (pre-, in-, and post-)*

Neurovestibular Platform Test 

(pre- & post-)*

Hearing assessment (pre-, in-, & 

post-) Body mass measurement (in-)

Nutritional assessment (pre-, 

in-, & post-)

Dental exam, with 

orthopantomogram (pre-)

Eye examination (pre-, in-, & 

post-)*

Ultrasound imaging (pre-)* Photodocumentation of the skin 

(as required; in-, post-)

Laboratory testing (pre-, in-, 

post-)*

H. pylori and Tuberculosis 

testing (pre-)

MRSA nasal screen and 

suppression (pre- & post-)

Radiation monitoring /Personal 

Dosimetry (in- & post-)

Toxicological assessment, with 

air & water quality monitoring

(in-)

Microbial analysis (in-) EVA medical monitoring and 

prebreathe protocols (pre- & in-)

Psychiatric/Psychological status 

check (pre-, in-, & post-)

Cognitive assessment (pre- & 

post-)

Observation of training by 

behavioral health & 

performance team (pre-)

Bone densitometry (pre- & 

post-)

Functional fitness assessment 

(pre- & post-)*

Exercise (aerobic & resistive; 

in-)

Isokinetic testing, or equivalent (pre- & post-)* Aerobic functional capacity testing (pre-, in-, 

& post-)

Reference Documents

NASA-STD-3001 Volumes 1 & 2 – https://www.nasa.gov/directorates/esdmd/hhp/human-spaceflight-andaviation-standards/

NASA SD/Space Medicine Operations – MedBs and MRIDs

Summary of H.R.6076, 114th Congress – https://www.congress.gov/bill/114th-congress/house-bill/6076

NASA’s “TREAT Astronauts Act FAQs” – https://www.nasa.gov/hhp/treat-act

*Denotes topics that have additional information listed on the following page

12/05/2023

Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Reference Data

NASA’s Procedures for Longitudinal Health Surveillance

Additional information on select LHS topics

• Neurological & neurovestibular assessments

• Dynamic Posturography – pre- and post-mission (L-90/30 and R+8 days, resp.)

• Pre- & post-mission neurological assessment (performed in conjunction with physical exams) –

neurological signs & symptoms (e.g. headache, vertigo), motor performance (gaze/ocular 

movements, finger-to-nose test, drift), and gait & station (rising from chair, standing/Romberg, 

leg lift – hop, tandem/heel-to-nose walk, and dynamic equilibrium)

• Eye examinations

• Pre-mission – L-21/18 m and/or L-9/6 m

• MRI; eye exams (incl. visual acuity – distance & near; refraction – manifest & cycloplegic; 

threshold visual fields; Amsler grid; contrast sensitivity; pupil reflexes; extraocular 

muscle balance; biomicroscopy; dilated fundoscopic examination; retinal photography; 

tonometry; optical coherence tomography (high res), including SVP videography; optical 

biometry); contact lens / spectacle fitting; 2-D imaging ultrasound

• Less comprehensive eye exam on L-90/30 days

• In-mission – L+30 d, L+90 d, L+180 d, L+270 d, and/or R-30 d; or, as clinically indicated

• Visual testing with and without contrast sensitivity (incl. acuity – near and far; and Amsler Grid); 

fundoscopy; 2-D imaging ultrasound; OCT; tonometry

• Post-mission – 1-3 days post-landing, unless otherwise noted

• Eye exam immediately post-landing

• Comprehensive eye exam (details listed above); MRI; 2-D imaging ultrasound

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Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Reference Data

NASA’s Procedures for Longitudinal Health Surveillance

Additional information on select LHS topics

Additional information on select LHS topics

• Ultrasound imaging

• Pre-mission – <L-365 d, or as clinically indicated

• Abdominal and retroperitoneal ultrasound (males and 

females); pelvic ultrasound (females)

• Laboratory testing

• Pre-mission – L-90/30 d

• Blood collection – hematology, chemistry profile, 

ionized calcium, thyroid function, iron profile, and any 

special chemistries (e.g. C-reactive protein, serum 

lipids, mouse IgE allergen panel, etc.)

• Variable urine collection – urinalysis and pregnancy 

test

• Post-mission – R+0/1 d, R+3/7 d (as clinically indicated), and 

R+14/30 d

• R+0/1 days: blood collection (hematology, i-Stat 

parameters); urinalysis

• R+3/7: blood collection, as in pre-mission

• R+14/30: blood collection (as in pre-mission) and 

urinalysis

• Functional fitness assessment – L-6/9 m, l-90/30 d, R+5/7, and 

R+30

• Pre- & post-mission – sit and reach, bench press, push-ups, 

sit-ups, pull-ups, leg press, cone agility test, stand test, and 

hand grip

• Isokinetic testing – L-9/6 m, L-90/30 d, R+5 d, R+14 d, and R+30 d

• Pre-mission – concentric knee extension & flexion, 

concentric ankle plantarflexion & dorsiflexion, 

eccentric ankle plantarflexion & dorsiflexion, and 

concentric trunk extension & flexion

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Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Back-Up

6 12/05/2023

Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Original  Rev A

• Updated information and standards to be consistent with 

NASA-STD-3001 Volume 1 Rev C and Volume 2 Rev D.

Major Changes Between Revisions

7 12/05/2023

Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

NASA-STD-3001 Volume 1 Revision C

[V1 3018] Post-Mission Long-Term Monitoring Crewmembers returning from spaceflight shall be 

monitored longitudinally for health, behavioral health, and well-being parameters in a standardized 

manner. 

Referenced Technical Requirements

8

View the current versions of NASA-STD3001 Volume 1 & Volume 2 on the 

OCHMO Standards website

12/05/2023

Rev A
NASA-STD-3001 Technical Brief

OCHMO-TB-000 Longitudinal Health Surveillance (LHS)

NASA Office of the Chief Health & Medical Officer (OCHMO)

This Technical Brief is derived from NASA-STD-3001 and is for reference only.

It does not supersede or waive existing Agency, Program, or Contract requirements.

Reference List

1. About TREAT Astronauts Act. 2023. Available at: https://www.nasa.gov/general/about-treatastronauts-act/

1. Summary of H.R.6076, 114th Congress. Available at: https://www.congress.gov/bill/114thcongress/house-bill/6076

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Rev A