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Space Medicine

Flight Surgeon

"Flight Surgeon" (FS) is an unfamiliar term in Japan; it is a vocation commonly known in the USA and in Europe where there are many pilots. The FS is a doctor specialized in the health care for pilots and astronauts and in the aerospace medical research.
In 2005, there are four Japanese FSs in charge of developing space medicine, and all of them belong to JAXA. Their primary role is to ensure the health and safety of the astronauts. Their work is mainly composed of selecting astronauts, periodic medical examinations, health monitoring of the astronauts before and during spaceflight, and postflight rehabilitation. This photograph (see right) shows the mission control center where FSs monitor astronauts' health condition.
Health care for long-duration spaceflights represents a large variety of unsolved and thus challenging problems which can only be approached by dedicated studies designed especially for these purposes. JAXA medical doctors, nurses and technicians are occupied in such studies.

Health Care for Astronauts

The health care for astronauts based on space medical research was first initiated in Japan on the three astronauts selected in 1985, and later on, on two more astronauts. So far, JAXA has participated in four manned space missions with them, slowly but steadily accumulating experience.
What is the difference, then, between the health care for astronauts and the regular medical examinations? The health care for astronauts is composed of the thorough medical examinations described below through the cooperation between NASA and the JAXA's FS.

4.1 Preflight medical care

Astronauts are examined annually to determine whether they may participated in spaceflight. The examination includes physical examinations performed by the FS, clinical laboratory tests (analyses of blood, urine and feces), electrocardiography, pulmonary function test, audio and visual examinations, and dental examinations. Additionally, simplified medical examinations are scheduled on the tenth and second days before launch.
Moreover, health stabilization program, which is characteristic in the health care for astronauts, is implemented. Astronauts are isolated from all but a few key persons about one week before launch to protect them from infectious diseases. During this week, the number of persons who have contact with the astronauts is minimized.

4.2. In-flight medical care

In view of the upcoming ISS era, NASA is presently setting up the Crew Health Care System(CHeCS) composed of the Health Maintenance System (HMS), Environmental Health System (EHS), and Countermeasures System (CMS). HMS includes Medical Kit; EHS includes water, air, microorganism and radiation monitors; CMS includes the treadmill, ergometer, resistant exercise device, and LBNP. All of these devices are scheduled to be installed.
In the present Space Shuttle Mission, the FSs monitor continuous in-flight safety and health care of the crew for 24 hours from Mission Control Center (MCC) in Houston. Additionally, the FS and crew discuss the medical problems in private once a day using a voice link, and the FS can provide medical instructions when necessary. Besides, the condition of life support system, the predicted amount of radiation exposure, and vital information such as electrocardiogram are taken into account for the health care. Through the previous experience of space flight, health care know-how has been accumulated such as the injection of medicine against space motion sickness, exercises for maintaining muscle strength and the ingestion of isotonic saline just before reentry. These countermeasures have shown significant effects in short-term spaceflight, but, for new longer-term flights, health care procedures should be established.

4.3. Space walk (Extravehicular Activity-EVA)

Extravehicular activity is one of the most exciting events for everyone, including the astronauts themselves. The Extravehicular Space Suit Mobility Unit (EMU) enables the astronauts to perform the EVA for six to seven hours with safety in the extremely perilous environment of space. The EMU is filled with 100% oxygen at 0.29atm. During the EVA, the astronaut's vital data, such as the electrocardiogram, is constantly monitored by FS from the ground. In the ISS, a total of one thousand hours per year of EVA will be necessary. The development of medicines which support these activities is indispensable.

4.4. Postflight medical care

In the present Space Shuttle flight program, the astronauts receive simple medical examinations by the FS in a specialized car docked to the shuttle on landing day immediately after space fight. They, then get off the Shuttle and receive medical examination and clinical laboratory tests at a clinic. Three days after landing, more detailed examinations are performed. If there are no irregular trends, this is followed by an ordinary health care plan.

4.5. Health care in the International Space Station

Health care procedure for ISS crew members should be established for longer periods (up to three to six months) than for Shuttle mission crew members. Pre- and in-flight health care and post-flight rehabilitation will be more detailed, and the health care team will be composed of international personnel.



Some people may question how space medical research contributes to medicine on the ground. Unlike the terrestrial medicine with which doctors diagnose and treat patients, space medicine deals with specially selected healthy persons and overcoming the adverse effects anticipated in space. However, there are many spinoffs arising from space medical research, some of which are highlighted here. You will find them directly beneficial to our daily medical use.

5.1. Blood Analyzer

A common medical instrument is the blood analyzer. In the 1970s, existing mechanical analysis blood systems were far too large for spacecraft use and would not have functioned properly in microgravity. For the Skylab manned orbital laboratory, a toaster-sized centrifugal analyzing device was developed with funding provided by NASA (see right). It is an epoch-making system which can perform 80 to 100 chemical blood tests using a single drop of whole blood.

5.2. Vision therapy

Recently, vision therapy centers have sprouted up here and there around town. These centers use the Accommotrac System, a device to help sufferers from myopia (near-sightedness) and hyperopia (far-sightedness) who cannot properly focus their eyes to use the ciliary body, a muscle to control the thickness of the eye lens, without wearing glasses. This device is a spinoff stemming from research in space medicine. The investigator in NASA said that he himself suffered from myopia but could considerably improve eyesight with this device.

5.3. Food Service System

Hospitalized patients look forward to the daily meals during their monotonous stay in a hospital. A hot meal is an important factor affecting their appetites. The Food Service System, which is now widely used in hospitals, is originated in space technology developed by NASA in 1966-67 for meal service aboard the Apollo lunar spacecraft (see right).

5.4. Other devices

There are other spinoffs too many to count but include:
Coronary arterialization by applying the low temperature laser, which was originally developed for measuring air gas; a cutting-edge pacemaker which can change the heart rate in response to body activity; a temperature capsule for measuring internal body temperatures (see right) with the application of battery technologies; a vision screening device for children's eyesight and so forth. There are also space medicine technologies that have potential for practical use in preventing and curing osteoporosis, curing muscle atrophy diseases, rehabilitating program for patients of cerebral infarction and cardiac insufficiency, and so forth.
JAXA is conducting a Bed Rest Study with the cooperation of healthy volunteers. Bed rest with six degrees head down tilt causes a fluid shift toward the head and unloading of bone and muscle and is thus supposed to simulate microgravity. Using bed rest studies, we can investigate effects of microgravity and develop health care procedures for astronauts. Many other research projects are conducted in JAXA's Tsukuba Space Center to promote astronauts' health and well-being.




An unprecedentedly huge structure will soon be constructed in space. Japan is also entering a new era of long-term spaceflight. Space medicine that originated from aerospace medicine in the 1940s is now rapidly developing to meet the requirements when common citizens as well as astronauts expand their habitats to space. We are attempting to use an international laboratory, investing in tomorrow, in search of greater scientific knowledge which may contribute to maintaining the beautiful environment on Earth so that the next generation can live safely. It is our hope that the importance of manned space development will be fully understood by more and more people.


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Last Updated : December 5, 2013

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