ALBERT

Description: INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p 〈 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Description: Extravehicular activity (EVA) is at the core of a manned space exploration program. Some elements of exploration may be safely and effectively performed by robots, but certain critical elements will require the trained, assertive, and reasoning mind of a human crewmember. To effectively use these skills, NASA needs a safe, effective, and efficient EVA component integrated into the human exploration program. The EVA preparation time should be minimized and the suit pressure should be low to accommodate EVA tasks without causing undue fatigue, physical discomfort, or suit-related trauma. Commissioned in 2005, the Exploration Atmospheres Working Group (EAWG) had the primary goal of recommending to NASA an internal environment that allowed efficient and repetitive EVAs for missions that were to be enabled by the former Constellation Program. At the conclusion of the EAWG meeting, the 8.0 psia and 32% oxygen (O2) environment were recommended for EVA-intensive phases of missions. After re-evaluation in 2012, the 8/32 environment was altered to 8.2 psia and 34% O2 to reduce the hypoxic stress to a crewmember. These two small changes increase alveolar O2 pressure by 11 mmHg, which is expected to significantly benefit crewmembers. The 8.2/34 environment (inspired O2 pressure = 128 mmHg) is also physiologically equivalent to the staged decompression atmosphere of 10.2 psia / 26.5% O2 (inspired O2 pressure = 127 mmHg) used on 34 different shuttle missions for approximately a week each flight. As a result of selecting this internal environment, NASA gains the capability for efficient EVA with low risk of decompression sickness (DCS), but not without incurring the additional negative stimulus of hypobaric hypoxia to the already physiologically challenging spaceflight environment. This report provides a review of the human health and performance risks associated with the use of the 8.2 psia / 34% O2 environment during spaceflight. Of most concern are the potential effects on the central nervous system (CNS), including increased intracranial pressure, visual impairment, sensorimotor dysfunction, and oxidative damage. Other areas of focus include validation of the DCS mitigation strategy, incidence and treatment of transient acute mountain sickness (AMS), development of new exercise countermeasure protocols, effective food preparation at 8.2 psia, assurance of quality sleep, and prevention of suit-induced injury. Although missions proposing to use an 8.2/34 environment are still years away, it is recommended that these studies begin early enough to ensure that the correct decisions pertaining to vehicle design, mission operational concepts, and human health countermeasures are appropriately informed.

Description: Venous gas emboli (VGE) (gas bubbles in venous blood) are associated with an increased risk of decompression sickness (DCS) in hypobaric environments. A high grade of VGE can be a precursor to serious DCS. In this paper, we model time to Grade IV VGE considering a subset of individuals assumed to be immune from experiencing VGE. Our data contain monitoring test results from subjects undergoing up to 13 denitrogenation test procedures prior to exposure to a hypobaric environment. The onset time of Grade IV VGE is recorded as contained within certain time intervals. We fit a parametric (lognormal) mixture survival model to the interval-and right-censored data to account for the possibility of a subset of "cured" individuals who are immune to the event. Our model contains random subject effects to account for correlations between repeated measurements on a single individual. Model assessments and cross-validation indicate that this limited failure population mixture model is an improvement over a model that does not account for the potential of a fraction of cured individuals. We also evaluated some alternative mixture models. Predictions from the best fitted mixture model indicate that the actual process is reasonably approximated by a limited failure population model.

Description: A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

Description: Actual tissue nitrogen (N2) kinetics are complex; the uptake and elimination is often approximated with a single half-time compartment in statistical descriptions of denitrogenation [prebreathe(PB)] protocols. Air breaks during PB complicate N2 kinetics. A comparison of symmetrical versus asymmetrical N2 kinetics was performed using the time to onset of hypobaric decompression sickness (DCS) as a surrogate for actual venous N2 tension. METHODS: Published results of 12 tests involving 179 hypobaric exposures in altitude chambers after PB, with and without airbreaks, provide the complex protocols from which to model N2 kinetics. DCS survival time for combined control and airbreaks were described with an accelerated log logistic model where N2 uptake and elimination before, during, and after the airbreak was computed with a simple exponential function or a function that changed half-time depending on ambient N2 partial pressure. P1N2-P2 = (Delta)P defined decompression dose for each altitude exposure, where P2 was the test altitude and P1N2 was computed N2 pressure at the beginning of the altitude exposure. RESULTS: The log likelihood (LL) without decompression dose (null model) was -155.6, and improved (best-fit) to -97.2 when dose was defined with a 240 min half-time for both N2 elimination and uptake during the PB. The description of DCS survival time was less precise with asymmetrical N2 kinetics, for example, LL was -98.9 with 240 min half-time elimination and 120 min half-time uptake. CONCLUSION: The statistical regression described survival time mechanistically linked to symmetrical N2 kinetics during PBs that also included airbreaks. The results are data-specific, and additional data may change the conclusion. The regression is useful to compute additional PB time to compensate for an airbreak in PB within the narrow range of tested conditions.