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Inspiration Mars Crew Health and Safety Concerns
Inspiration Mars
Crew Health and Safety Concerns

Taber MacCallum Graham Scott, Ph.D. Ann R. Kennedy, D.Sc.

Jonathan Clark M.D., M.P.H.

Humans 2 Mars Summit May 6-8, 2013 - George Washington University

Ph.D. Ann R. Kennedy, D.Sc. Jonathan Clark M.D., M.P.H. Humans 2 Mars Summit May 6-8, 2013

Approach to Crew Health and Safety

The prowess of American academic medicine and life

sciences will be harnessed to address the Inspiration Mars crew health

Primary Approach: Pre-mission phase (crew selection, prevention, health screening, prelaunch crew optimization)

Secondary Approach: In-flight countermeasures to

reduce or delay the degrading effect of the mission or

environment

Tertiary Approach: In-flight Diagnosis and Treatment of

a condition that has developed

the mission or environment • Tertiary Approach: In-flight Diagnosis and Treatment of a condition that has

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Key Inspiration Mars Approach

“Abort to Earth” is not feasible

Advanced medical care systems should focus on mission performance, less on post mission health, which can be managed back on Earth

Pre-mission health optimization will be used to the

maximum extent possible

Personalized Medicine Program (using genomics/

proteomics) will be used to individualize therapeutic

and preventive measures based on environmental and genetic risk factors

will be used to individualize therapeutic and preventive measures based on environmental and genetic risk factors

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Astro-Omics

Astro-Omics • Personalized Genomic Medicine for astronauts to better safeguard long duration exploration missions

Personalized Genomic Medicine for astronauts to better safeguard long duration exploration missions utilizing a systems biology approach

Personalized genomic medicine is a 21st century strategy for risk mitigation during long duration deep space missions

To fly to Mars and return safely to Earth we need to employ

the full power of 21st century Earth based medicine

Countermeasure Applications

o

Pharmaco-astro-genomics

o

Omics based interventions to mitigate radiation effects Astronauts

exhibit “personal” responses to space radiation

o

Optimizing sleep and circadian rhythms for astronauts

o

Develop disease susceptibility assay(s) & personalized mitigation approaches

rhythms for astronauts o Develop disease susceptibility assay(s) & personalized mitigation approaches 4

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Personalized Medicine For Astronauts

Personalized Medicine For Astronauts Radiation Effects Can we use – omics technologies to monitor the effects

Radiation Effects

Can we use omics technologies to monitor the effects of space radiation on the molecular physiology of individual astronauts?

Cucinotta F.A., et al., “Physical and Biological Organ Dosimetry Analysis for International Space Station Astronauts”, 2008, Radiation Research, 170(1):127-138.

Mader, Thomas H. et al, “Optic Disc Edema, Globe Flattening, Choroidal Folds, and Hyperopic Shifts Observed in Astronauts after Long-duration Space Flight”, Opthamology, (2011), 118(10),2058-69

Space Flight”, Opthamology, (2011), 118(10),2058-69 Pharmacogenomics Can we select efficacious drugs with
Space Flight”, Opthamology, (2011), 118(10),2058-69 Pharmacogenomics Can we select efficacious drugs with

Pharmacogenomics

Can we select efficacious drugs with minimal adverse effects for individual astronauts?

with minimal adverse effects for individual astronauts? Visual Impairment – Intracranial Pressure Why do some
with minimal adverse effects for individual astronauts? Visual Impairment – Intracranial Pressure Why do some

Visual Impairment Intracranial Pressure

Why do some astronauts experience visual impairment and others not?

some astronauts experience visual impairment and others not? Neurobehavioral Factors Can we personalize sleep

Neurobehavioral Factors

Can we personalize sleep countermeasures for individual astronauts?

Basner, M., et al “Mars 520-d mission simulation reveals protracted crew hypokinesis and alterations of sleep duration and timing”, PNAS, (2013), Feb 12, 110(7), 2635-40

protracted crew hypokinesis and alterations of sleep duration and timing” , PNAS, ( 2013), Feb 12,

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Personalized Medicine Strategy For Inspiration Mars

Candidate Selection

Medicine Strategy For Inspiration Mars Candidate Selection Candidate Training Flight Post-Mission • Accelerate
Medicine Strategy For Inspiration Mars Candidate Selection Candidate Training Flight Post-Mission • Accelerate
Medicine Strategy For Inspiration Mars Candidate Selection Candidate Training Flight Post-Mission • Accelerate

Candidate Training

For Inspiration Mars Candidate Selection Candidate Training Flight Post-Mission • Accelerate existing astro-omics

Flight

Mars Candidate Selection Candidate Training Flight Post-Mission • Accelerate existing astro-omics based

Post-Mission

Accelerate existing astro-omics

based research

Undertake comprehensive omics analysis of candidates

 

Implement targeted omics based analysis of candidates

• Design mission specific -omics based

Design mission specific -omics based

countermeasures

Test mission specific omics based countermeasures

 

Operationally deploy personalized medicine based countermeasures

• Develop personalized based countermeasures for unanticipated medical contingencies “on -the- fly” using data

Develop personalized based countermeasures for unanticipated medical contingencies “on-the-fly” using data already collected

Monitor astronauts following return to Earth using omics based medicine

• Detect cancer/ other diseases early

Detect cancer/ other diseases early

astronauts following return to Earth using – omics based medicine • Detect cancer/ other diseases early

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Space Radiation Types

High dose-rate Solar Particle Events

o

medium to high-energy protons

o

occur during maximum solar activity

o

cause acute radiation sickness

Low dose-rate Galactic Cosmic Radiation,

solar wind

o

Protons, Gamma rays, high energy heavy particles (HZE) and secondary radiation

o

Neurologic and cardiovascular deficits, cancer

o

Combined with microgravity effects

o

Largest doses occur during minimum solar activity in an 11-year solar cycle

Combined with microgravity effects o Largest doses occur during minimum solar activity in an 11-year solar

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Radiation Risk Reduction Strategies

Vehicle shielding design requirements

Active and passive personnel dosimetry

Real time space weather monitoring

o

Monitoring Heliosphere for impending SPE

o

SPE forecasting methods

Crew training for contingency procedures that minimize

radiation risk during SPE

Rapidly deployable polyurethane shielding crew radiation shelter during SPEs

The use of novel radioprotectants and treatment strategies to

reduce performance effects that can follow an exposure to

large SPE doses.

Dietary neutraceuatical agents to reduce reactive oxygen species

that can follow an exposure to large SPE doses. • Dietary neutraceuatical agents to reduce reactive

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Radiation Environment Risk Assessment

Mission occurs during solar minimum Expert consensus: risk is manageable

Risk of Exposure-Induced Death 500-d Mars Flyby (GCR + SPEprob)

of Exposure-Induced Death 500-d Mars Flyby (GCR + SPEprob) • Multiple dose mitigation strategies can be

Multiple dose mitigation

strategies can be used to

reduce the risk

o

Upper stage & propellant residuals

o

Water storage placement

o

Crew selection

o

Dietary/pharmaceuticals

& propellant residuals o Water storage placement o Crew selection o Dietary/pharmaceuticals 10

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Psychological and Behavioral Health

Psychological and Behavioral Health 11

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Inspiration Mars Medical Team

Interdisciplinary Team including Academic,

Industry, and Government representation

Specific Focus on Radiation, Microgravity and Behavioral Health Threats utilizing

Personalized Medicine Astro-omics

Approach

Tiered Approach involving candidate

selection, crew training, as well as mission

and post mission support utilizing the highest level of advanced health care delivery

crew training, as well as mission and post mission support utilizing the highest level of advanced

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