Safe Passage: Astronaut Care for Exploration Missions sets forth a vision for space medicine as it applies to deep space voyage. As space missions increase in duration from months to years and extend well beyond Earth's orbit, so will the attendant risks of working in these extreme and isolated environmental conditions. Hazards to astronaut health range from greater radiation exposure and loss of bone and muscle density to intensified psychological stress from living with others in a confined space. Going beyond the body of biomedical research, the report examines existing space medicine clinical and behavioral research and health care data and the policies attendant to them. It describes why not enough is known today about the dangers of prolonged travel to enable humans to venture into deep space in a safe and sane manner. The report makes a number of recommendations concerning NASA's structure for clinical and behavioral research, on the need for a comprehensive astronaut health care system and on an approach to communicating health and safety risks to astronauts, their families, and the public.

Radiation protection standards for space activities differ substantially from those applied to terrestrial working situations. The levels of radiation and subsequent hazards to which space workers are exposed are quite unlike anything found on Earth. The new more highly refined system of risk management involves assessing the risk to each space worker from all sources of radiation (occupational and non-occupational) at the organ level. The risk coefficients were applied to previous space and medical exposures (diagnostic x ray and nuclear medicine procedures) in order to estimate the radiation-induced lifetime cancer incidence and mortality risk. At present, the risk from medical procedures when compared to space activities is 14 times higher for cancer incidence and 13 times higher for cancer mortality; however, this will change as the per capita dose during Space Station Freedom and interplanetary missions increases and more is known about the risks from exposure to high-LET radiation. Peterson, Leif E. and Nachtwey, D. Stuart Johnson Space Center ...

This is the fourth in a series of five letter reports that provide an independent review of the more than 30 evidence reports that NASA has compiled on human health risks for long-duration and exploration spaceflights.This letter report reviews eight evidence reports and examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input.

NASA's long-range plans include possible human exploratory missions to the moon and Mars within the next quarter century. Such missions beyond low Earth orbit will expose crews to transient radiation from solar particle events as well as continuous high-energy galactic cosmic rays ranging from energetic protons with low mean linear energy transfer (LET) to nuclei with high atomic numbers, high energies, and high LET. Because the radiation levels in space are high and the missions long, adequate shielding is needed to minimize the deleterious health effects of exposure to radiation. The knowledge base needed to design shielding involves two sets of factors, each with quantitative uncertaintyâ€"the radiation spectra and doses present behind different types of shielding, and the effects of the doses on relevant biological systems. It is only prudent to design shielding that will protect the crew of spacecraft exposed to predicted high, but uncertain, levels of radiation and biological effects. Because of the uncertainties regarding the degree and type of radiation protection needed, a requirement for shielding to protect against large deleterious, but uncertain, biological effects may be imposed, which in turn could result in an unacceptable cost to a mission. It therefore is of interest to reduce these uncertainties in biological effects and shielding requirements for reasons of mission feasibility, safety, and cost.

More than four decades have passed since a human first set foot on the Moon. Great strides have been made in our understanding of what is required to support an enduring human presence in space, as evidenced by progressively more advanced orbiting human outposts, culminating in the current International Space Station (ISS). However, of the more than 500 humans who have so far ventured into space, most have gone only as far as near-Earth orbit, and none have traveled beyond the orbit of the Moon. Achieving humans' further progress into the solar system had proved far more difficult than imagined in the heady days of the Apollo missions, but the potential rewards remain substantial. During its more than 50-year history, NASA's success in human space exploration has depended on the agency's ability to effectively address a wide range of biomedical, engineering, physical science, and related obstacles-an achievement made possible by NASA's strong and productive commitments to life and physical sciences research for human space exploration, and by its use of human space exploration infrastructures for scientific discovery. The Committee for the Decadal Survey of Biological and Physical Sciences acknowledges the many achievements of NASA, which are all the more remarkable given budgetary challenges and changing directions within the agency. In the past decade, however, a consequence of those challenges has been a life and physical sciences research program that was dramatically reduced in both scale and scope, with the result that the agency is poorly positioned to take full advantage of the scientific opportunities offered by the now fully equipped and staffed ISS laboratory, or to effectively pursue the scientific research needed to support the development of advanced human exploration capabilities. Although its review has left it deeply concerned about the current state of NASA's life and physical sciences research, the Committee for the Decadal Survey on Biological and Physical Sciences in Space is nevertheless convinced that a focused science and engineering program can achieve successes that will bring the space community, the U.S. public, and policymakers to an understanding that we are ready for the next significant phase of human space exploration. The goal of this report is to lay out steps and develop a forward-looking portfolio of research that will provide the basis for recapturing the excitement and value of human spaceflight-thereby enabling the U.S. space program to deliver on new exploration initiatives that serve the nation, excite the public, and place the United States again at the forefront of space exploration for the global good.

A major objective of the International Space Station is learning how to cope with the inherent risks of human spaceflightâ€"how to live and work in space for extended periods. The construction of the station itself provides the first opportunity for doing so. Prominent among the challenges associated with ISS construction is the large amount of time that astronauts will be spending doing extravehicular activity (EVA), or "space walks." EVAs from the space shuttle have been extraordinarily successful, most notably the on-orbit repair of the Hubble Space Telescope. But the number of hours of EVA for ISS construction exceeds that of the Hubble repair mission by orders of magnitude. Furthermore, the ISS orbit has nearly twice the inclination to Earth's equator as Hubble's orbit, so it spends part of every 90-minute circumnavigation at high latitudes, where Earth's magnetic field is less effective at shielding impinging radiation. This means that astronauts sweeping through these regions will be considerably more vulnerable to dangerous doses of energetic particles from a sudden solar eruption. Radiation and the International Space Station estimates that the likelihood of having a potentially dangerous solar event during an EVA is indeed very high. This report recommends steps that can be taken immediately, and over the next several years, to provide adequate warning so that the astronauts can be directed to take protective cover inside the ISS or shuttle. The near-term actions include programmatic and operational ways to take advantage of the multiagency assets that currently monitor and forecast space weather, and ways to improve the in situ measurements and the predictive power of current models.