Managing Astronauts' Health for Long-Duration Stays in Space Maintaining and Promoting Astronauts' Physical and Mental Health

On long-duration space flights, bones loose calcium and muscles become weaker. This is a November 1998 photograph of Astronauts Mukai and Glenn undergoing medical examinations aboard Space Shuttle Discovery.

People in space are also exposed to radiation which is somehow different from Earth. At present, little is known about how this radiation affects an astronaut's health in life time span.

In addition, Canadian, European, Japanese, Russian, and US astronauts will live together within the relatively limited confines of the International Space Station (ISS). We can expect that people of different cultural backgrounds living together in such a closed environment will be subject to considerable physical and mental stresses.

Considering these physical and mental stresses, potential astronaut candidates are subjected to many medical and psychological examinations during the selection process, and only those most physically and mentally fit are selected as ISS astronaut candidates.

During an astronaut's anticipated 10-year plus active career, we can expect that some astronauts will become sick or be injured in unexpected accidents. We must therefore prepare for these situations. In particular, we must thoroughly study how to properly respond when an astronaut is injured or becomes sick while aboard ISS. In some sense, ISS can be considered an extremely remote outpost since doctors will not always be present and medical equipment and facilities are limited.

For the above reasons, we must carefully consider mental and physical condition when selecting ISS astronaut candidates. We also need to consider astronauts during training, on orbit, and rehabilitation after return to Earth. Finally, we need to plan for astronauts' return to space and eventual retirement. In other words, we must manage an astronaut's total physical and mental health from the time he or she is selected as an astronaut candidate until after he or she retires. This total health management is what we mean by managing astronauts' health. The ultimate purpose of this health management is to suitably preserve the astronaut's health so they can maximize their abilities, perform their duties safely, and execute their responsibilities.

Specialist from Many Fields Support Astronaut Health Management

If each country's space agency establishes its own methods of astronaut health management and treats astronauts individually in an international cooperative project such as ISS, it is inefficient and there will be confusion. For this reason, an international team composed of senior medical personnel of each agency is continuing to discuss astronauts' health management standards.

In JAXA, the Medical Research and Operations Office is responsible for implementing astronaut health care management. Within this Office, a team composed of nurses, specialists in psychology, physical training specialists, specialists in space radiation, and others is formed around an aerospace medicine group called the Flight Surgeon. The Flight Surgeon, supported by the team of specialists, is responsible for planning and implementing Japanese astronaut health management.

The medical fields necessary for astronaut health management cover a wide area. Therefore, the astronaut health management system is developed through the continuing support of specialists in each field.

Health Education for Astronauts and Support of their Families are Important

In practical terms, astronaut health management includes the following activities. First, as previously explained, astronauts are subjected to both medical and psychological screening during the selection process. Furthermore, after astronauts are selected, it is necessary to determine if their physical condition will allow them to perform their duties as astronauts through regular health check-ups. Should they become sick, it is necessary to diagnose and treat the illness as quickly as possible to ensure their long-term service as astronauts.

From another viewpoint, if the astronaut himself or herself does not fully understand the importance of health care, it will not be possible to keep and promote astronaut health, no matter how hard the medical staff works. For this reason, health care education in basic astronaut training is very important.

To this end, astronauts are scheduled to receive physical training using methods specially suited for them individually and receive lectures on nutrition, sleeping, stress relief, and first aid for injuries.

Furthermore, it is necessary to ensure that the astronaut and the astronaut's family can receive counseling whenever they have some concern about health problems. It is only natural that the team will have to respond to some astronaut sickness or injury in every-day life. It is important to maintain the astronaut's mental health onboard ISS, by making their families free from worrying about their working on ISS.

Space Medicines is one of the Basic elements of Manned Space Activities

The various medical fields related to astronaut health care are making advances on the Earth. Based on advances in technology, new medical equipment is being developed. This technology can be applied to astronaut health care aboard the ISS. Most suitable medical standards are continuing to evolve day-by-day. It is necessary to apply the newly gained knowledge and technology to astronaut health care management.

For this purpose, the Medical Research and Operations Study Development Office promotes space medical research to better maintain astronaut health. For example, the Office conducts simulations of long-duration space stays in cooperation with foreign space agencies, and analyzes the medical data of Japanese astronauts who have flown aboard the space shuttle. In this way, the Office continually seeks to improve the astronaut health care management system.

Eye examination. Based on current astronaut medical standards, astronauts must pass not only distant vision, but also color perception, field of view, movement perception, depth perception, and near vision examinations.

ENT examination. During basic training, astronauts undergo altitude and diving training and may suffer tym panitis. To prevent this, it is important to examine the astronaut's ear drum.