ALBERT

Description: Space radiation consists of energetic protons and other heavier ions. During the International Space Station program, chromosome aberrations in lymphocytes of astronauts have been analyzed to estimate received biological doses of space radiation. More specifically, pre-flight blood samples were exposed ex vivo to varying doses of gamma rays, while post-flight blood samples were collected shortly and several months after landing. Here, in a study of 43 crew-missions, we investigated whether individual radiosensitivity, as determined by the ex vivo dose–response of the pre-flight chromosome aberration rate (CAR), contributes to the prediction of the post-flight CAR incurred from the radiation exposure during missions. Random-effects Poisson regression was used to estimate subject-specific radiosensitivities from the preflight dose–response data, which were in turn used to predict post-flight CAR and subject-specific relative biological effectiveness (RBEs) between space radiation and gamma radiation. Covariates age, gender were also considered. Results indicate that there is predictive value in background CAR as well as radiosensitivity determined preflight for explaining individual differences in post-flight CAR over and above that which could be explained by BFO dose alone. The in vivo RBE for space radiation was estimated to be approximately 3 relative to the ex vivo dose response to gamma irradiation. In addition, pre-flight radiosensitivity tended to be higher for individuals having a higher background CAR, suggesting that individuals with greater radiosensitivity can be more sensitive to other environmental stressors encountered in daily life. We also noted that both background CAR and radiosensitivity tend to increase with age, although both are highly variable. Finally, we observed no significant difference between the observed CAR shortly after mission and at 〉 6 months post-mission.

Description: U.S. and non-Russian International Partner astronauts who participate in long-term International Space Station (ISS) expeditions perform submaximal cycle exercise tests before, during, and after space flight. The heart rate (HR) and oxygen uptake (VO2) responses to exercise are used to estimate peak VO2 (EVO2pk). Purpose: To determine if the following factors are associated with the preflight-to-post flight change in EVO2pk: gender, age, body weight (BW), number of aerobic exercise sessions/wk- during flight, length of flight, EVO2pk measured before and late during the flight, ISS Expedition number and time between landing and the first post flight test. Methods: Records of 37 ISS astronauts (30 male, BW=81.6 plus or minus 8.6 kg; 7 female BW=66.1 plus or minus 4.9 kg [mean plus or minus SD]), age 46 plus or minus 4 years, were retrospectively examined. Peak HR and VO2 were measured approximately 9 months before flight to establish the test protocol. The submaximal cycle test consisted of three 5-minute stages designed to elicit 25, 50, and 75% of VO2pk. EVO2pk was calculated using linear least-squares extrapolation of average HR and VO2 during the last minute of each stage to predict VO2 at maximal HR. VO2 was not measured during flight and was assumed to not be different from preflight. Testing was performed 45 days before launch, late during flight, and during the week after landing. A random-intercept multivariate model was used to determine which characteristics significantly contributed to post flight EVO2pk. Results: In-flight aerobic exercise averaged 5.4 plus or minus 1.2 sessions/wk. ISS flight duration averaged 163 plus or minus 39 d. Mean EVO2pk values were 3.41 plus or minus 0.64 L (raised dot) per minute before flight, 3.09 plus or minus 0.57 L (raised dot) per minute late in flight, and 3.02 plus or minus 0.65 L (raised dot) per minute after flight. Late- and after-flight values were lower (p less than 0.05) than preflight values and did not differ from each other. Time between landing and post flight testing was 4.5 plus or minus 1.6 days. The only factor significantly associated with the post flight EVO2pk value was the late-flight EVO2pk score. Conclusion: Testing performed late during a mission provides a prediction of EVO2pk after landing. This approach may be implemented during longer missions.

Description: In 2010, NASA implemented Lifetime Surveillance of Astronaut Health, a formal occupational surveillance program for the U.S. astronaut corps. Because of the nature of the space environment, space medicine presents unique challenges and opportunities for epidemiologists. One such example is the use of telemedicine while crewmembers are in flight, where the primary source of information about crew health is verbal communication between physicians and their crewmembers. Due to restricted medical capabilities, the available health information is primarily crewmember report of signs and symptoms, rather than diagnoses. As epidemiologists at NASA, Johnson Space Center, we have shifted our paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one in which we also incorporate reported symptomology as potential antecedents of disease. In this presentation we describe how characterization of reported signs and symptoms can be used to establish incidence rates for inflight immunologic events. We describe interdisciplinary data sources of information that are used in combination with medical information to analyze the data. We also delineate criteria for symptom classification inclusion. Finally, we present incidence tables and graphs to illustrate the final outcomes. Using signs and symptoms reported via telemedicine, the epidemiologists provide summary evidence regarding incidence of potential inflight medical conditions. These results inform our NASA physicians and scientists, and support evaluation of the occupational health risks associated with spaceflight.

Description: N/A

Description: Since the 2010 NASA authorization to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for data has greatly increased. Correspondingly, both the number and scope of requests have increased, from 142 requests fulfilled in 2011 to 224 in 2014, and with some datasets comprising up to 1 million data points. To meet the demand, the LSAH and LSDA Repositories project was launched, which allows active and retired astronauts to authorize full, partial, or no access to their data for research without individual, study-specific informed consent. A one-on-one personal informed consent briefing is required to fully communicate the implications of the several tiers of consent. Due to the need for personal contact to conduct Repositories consent meetings, the rate of consenting has not kept up with demand for individualized, possibly attributable data. As a result, other methods had to be implemented to allow the release of large datasets, such as release of only de-identified data. However the compilation of large, de-identified data sets places a significant resource burden on LSAH and LSDA and may result in diminished scientific usefulness of the dataset. As a result, LSAH and LSDA worked with the JSC Institutional Review Board Chair, Astronaut Office physicians, and NASA Office of General Counsel personnel to develop a "Remote Consenting" process for retrospective data mining studies. This is particularly useful since the majority of the astronaut cohort is retired from the agency and living outside the Houston area. Originally planned as a method to send informed consent briefing slides and consent forms only by mail, Remote Consenting has evolved into a means to accept crewmember decisions on individual studies via their method of choice: email or paper copy by mail. To date, 100 emails have been sent to request participation in eight HRP-funded studies. The development of the Remote Consent process, the laws allowing transmission of consent via electronic means, total metrics to date, and remaining challenges (e.g., response issues, use of International Partner data, biospecimens/genetic data) for the research use of LSAH/LSDA data will be described.

Description: Space medicine presents unique challenges and opportunities for epidemiologists, such as the use of telemedicine during spaceflight. Medical capabilities aboard the International Space Station (ISS) are limited due to severe restrictions on power, volume, and mass. Consequently, inflight health information is based heavily on crewmember (CM) self-report of signs and symptoms, rather than formal diagnoses. While CM's are in flight, the primary source of crew health information is verbal communication between physicians and crewmembers. In 2010 NASA implemented the Lifetime Surveillance of Astronaut Health, an occupational surveillance program for the U.S. Astronaut corps. This has shifted the epidemiological paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one that incorporates symptomatology and may gain a more population-based understanding of early detection of disease process.