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«NASA/TM–2007–214755 The Apollo Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions ...»

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The Apollo Medical Operations Project:

Recommendations to Improve Crew Health and

Performance for Future Exploration Missions

and Lunar Surface Operations

Richard A. Scheuring, DO, MS, NASA

Jeffrey A. Jones, MD, MS, NASA

James. D. Polk, DO, MS, NASA

David B. Gillis, MD, Ph.D., UTMB/NASA

Josef Schmid, MD, MPH, NASA

James M. Duncan, MD, NASA

Jeffrey R. Davis, MD, NASA

Johnson Space Center, Houston, Texas

Joseph D. Novak, MEng

University of Chicago Pritzker School of Medicine, Chicago, Illinois National Aeronautics and Space Administration Lyndon B. Johnson Space Center Houston, Texas 77058 September 2007


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The Apollo Medical Operations Project:

Recommendations to Improve Crew Health and Performance for Future Exploration Missions and Lunar Surface Operations Richard A. Scheuring, DO, MS, NASA Jeffrey A. Jones, MD, MS, NASA James. D. Polk, DO, MS, NASA David B. Gillis, MD, Ph.D., UTMB/NASA Josef Schmid, MD, MPH, NASA James M. Duncan, MD, NASA Jeffrey R. Davis, MD, NASA Johnson Space Center, Houston, Texas Joseph D. Novak, MEng University of Chicago Pritzker School of Medicine, Chicago, Illinois National Aeronautics and Space Administration

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The Apollo Medical Operations Project was a team effort. Members of this team included the core Summit group at Wyle Labs: Kae Parker, Phyllis McCulley, Mary McFarther, Luisa Rivera, Christopher Stokes, Marilyn Sylvester, Karen Mathis and Sandy Ballesteros. The facility hosting the Summit, Space Center Houston, provided excellent accommodations and service led by Sheri Armstrong. The JSC Center Director, Michael Coats, provided opening remarks to the group and set the tone for the meeting. A tremendous thank you is offered to Dr. Joe Kerwin who provided insight and encouragement throughout the development process and for the face-to-face meeting.

Of course, thank you to all the NASA-JSC flight surgeons and astronaut physicians: Ellen Baker, Lee Morin, Scott Parazynski, Michael Barratt, Thomas Marshburn, Bob Satcher, David Wolfe and Anna Fischer offered their time in preparing for the meeting which could not have happened without them. Other individuals contributed to the writing of the manuscript and deserve heartfelt thanks: Barbara Tomaro, Donna Baumer, Jennifer Fogarty, Nancy House, Carol (Mimi) Kao and Malinda Moller. Lastly, the future generation of lunar explorers will benefit greatly from the servant spirit offered during the few days in June 2006 by the Apollo astronauts and flight surgeons. Their effort will improve the new vehicles and protect crew health and performance for years to come.

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This report is also available in electronic form at http://ston.jsc.nasa.gov/collections/TRS/

Table of Contents


1.0 Methods


2.1 Background Research

2.2 Data Collection

2.3 Panel Questions

2.4 Face-to-Face Summit

2.5 Post-Summit Review and Validation



3.1 Data

Operational and Research Recommendations by Category


4.1 EMU/EVA Suit

4.2 Lunar Surface Operations

4.3 In-flight Illnesses

4.4 Medication/Medical Kits (Appendix D)

4.5 Environmental Impacts

4.6 Radiation

4.7 Performance/Human Factors

4.8 Crew Schedule

4.9 Exercise

4.10 Food/Nutrition

4.11 Launch/Landing/Recovery Operations

4.12 Flight Surgeon-Crew Interaction


5.0 Conclusion

6.0 References

7.0 Appendix A Non Attributable Access Data Records

Appendix B Non-Attributable Panel Discussion & Post-Panel Responses................. 308 Appendix C Apollo Medical Operations Project Summary of recommendations Excel Spreadsheet

Appendix D Apollo Medical Kits from Biomedical Results of Apollo5

Appendix E Correspondence

Appendix F Meeting Agenda

Appendix G Personal Communications

i Figures Figure 1. Sample Access Data Record From the Apollo Medical Operations Project...... 5 Figure 2. EMU/EVA Issues

Figure 3. Lunar Surface Operations

Figure 4. In-Flight Illness

Figure 5. Medication/medical kits

Figure 6. Environmental Impacts

Figure 7. Radiation

Figure 8. Performance/Human Factors

Figure 9. Crew Schedule

Figure 10. Exercise

Figure 11. Food/Nutrition

Figure 12. Launch, Landing, and Recovery Operations

Figure 13. Flight Surgeon-Crew Interaction

Figure 14. Overall Status of the Apollo Suggestions

Tables Table 1. Astronaut Attendance and Participation at the Apollo Summit

Table 2. Post-Summit Questions, Answers and Recommendations.

Table 3: EMU/EVA Issues Recommendation Implementation

Table 4: Lunar Surface Operations Recommendation Implementation

Table 5: In-Flight Illness Recommendation Implementation

Table 7: Environmental Impacts Recommendation Implementation

Table 8: Radiation Recommendation Implementation

Table 9: Performance/Human Factors Recommendation Implementation

Table 10: Crew Schedule Recommendation Implementation

Table 11: Exercise Recommendation Implementation

Table 12: Food/Nutrition Recommendation Implementation

Table 13: Launch, Landing, and Recovery Operations Recommendation Implementation

Table 14: Flight Surgeon-Crew Interaction Recommendation Implementation.............. 52 Table 15. Disposition of Recommendations

ii Acronyms ARDIG Advanced Requirement Development Integration Group BM Bowel Movement CA#### CARD Requirement number CAD Coronary Artery Disease CARD Constellation Architecture Requirements Document CDR Commander CEV Crew Exploration Vehicle CM Command Module CMP Command Module Pilot CSM Command Service Module CxCB Constellation Control Board EARD Exploration Architecture Requirements Document ECP Exercise Countermeasures Program EMU EVA Mobility Unit EPSP EVA Physiology Systems and Performance ESP EVA Systems Project EVA Extravehicular Activity ExMC Exploration Medical Capability GI Gastro-Intestinal HRP Human Research Program HS#### HSIR Requirement number IR Infrared ISS International Space Station JSC Johnson Space Center LAT2 Lunar Architecture Team 2 LADTAG Lunar Airborne Dust Toxicity Analysis Group LBP Low Back Pain LEVA Lunar EVA LM Lunar Module LMP Lunar Module Pilot LSAM Lunar Surface Access Module MAG Maximum Absorbant Garment MCC Mission Control Center MORD Missions Operations Requirements Document PMC Private Medical Conference POGO Partial Gravity Simulator PRD Personal Radiation Dosimeter PVC Premature Ventricular Contractions R&R Rest and Relaxation RFID Radio-Frequency Identification SRD Systems Requirements Document STS Space Transportation System TEC Trans Earth Coast TLC Trans Lunar Coast UCD Urine Collection Device WBC White Blood Count iii


Introduction. Medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), advanced Extravehicular Activity (EVA) suits and Lunar habitat are currently being developed. Crews returning to the lunar surface will construct the lunar habitat and conduct scientific research. Inherent in aggressive surface activities is the potential risk of injury to crewmembers. Physiological responses to and the operational environment of short forays during the Apollo lunar missions were studied and documented. Little is known about the operational environment in which crews will live and work and the hardware that will be used for long-duration lunar surface operations. Additional information is needed regarding productivity and the events that affect crew function, such as a compressed timeline. The Space Medicine Division at the NASA Johnson Space Center (JSC) requested a study in December 2005 to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The operationally oriented goals of this project were to develop or modify medical requirements for new exploration vehicles and habitats, create a centralized database for future access, and share relevant Apollo information with the multiple entities at NASA and abroad participating in the exploration effort.

Methods. A review of medical operations during Apollo missions 7 through 17 was conducted. Eleven categories of hardware, systems, or crew factors were identified during preliminary data review generating 581 data records, which were captured in an Access database. The preliminary review resulted in 285 questions which were posed to surviving Apollo crewmembers using mail, face-to-face meetings, phone communications, or online interactions. Crewmember responses to these questions formed the basis for recommendations to items in each of the categories.

Results. Fourteen of 22 surviving Apollo astronauts (64%) participated in the project.

Approximately 236 pages of responses to the questions were generated based on the Apollo experiences, with 107 recommendations garnered for future vehicles, habitats, EVA suits, and lunar surface operations.

Discussion. The Apollo medical operations recommendations are being incorporated into the exploration mission architecture at various levels: 21 recommendations either validated, revised or created new requirements, 4 are currently in practice, 34 are being evaluated, and 54 are being considered. A centralized database has been developed, and the recommendations have been presented to the different organizations involved with building the new vehicles, habitats, suits, or systems that may impact crew health and performance.

Conclusions. The Apollo crewmembers’ input has proved to be an invaluable resource to a multitude of departments beyond space medicine. We will continue soliciting input from this group as we evolve and refine requirements for future exploration missions.

1.0 INTRODUCTION The Apollo program, which began in January of 1966, was comprised of 18 missions: 12 crewed missions (including the Apollo 204 mission with Virgil “Gus” Grissom, Ed White, and Roger Chaffee) and six crewless missions which tested the capabilities of the Saturn rocket components6. The Apollo 7 mission heralded the first successful crewed mission, and in July of 1969, Apollo 11 fulfilled John F. Kennedy’s mandate to send a man to the moon and return him safely home7. Twenty-six men flew Apollo missions, including four repeat flyers. Of the manned missions, six flights conducted between July 1969 and December 1972 successfully landed 12 humans on the lunar surface and returned them to the Earth.

In January 2004, President George W. Bush committed the United States to the further exploration of space8. This new vision for space exploration has the benefit of the cumulative knowledge and experience gained from the Apollo program. The exploration effort will require the development of new vehicles to transport crews from Earth to the lunar surface and for transportation while on the moon. In addition, crew will need (EVA) suits and extended duration habitation elements for the lunar surface operations10.

The Crew Exploration Vehicle (CEV) and Lunar Surface Access Module (LSAM) though slightly larger, will bear many similarities to the Apollo Command Module (CM) and Lunar Module (LM). The EVA suits may serve the dual function of a launch and entry suit as well as the lunar surface suit. Lunar habitation is a new frontier, enabling humans to live on the moon for extended periods in order to conduct science experiments and use the lunar environment for in-situ resource utilization.

During previous studies, Apollo astronauts provided input into the engineering and mechanical aspects of EVA suit system designs 2. However, no study has specifically addressed the impact of the Apollo vehicles, hardware, and systems on crew health or performance throughout all mission phases, including lunar surface operations and the influence of that impact on the new exploration vehicles and mission architectures.

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