Civilian doctors need to start boning up on the medical implications of time spent in microgravity in readiness; for the advent of commercial spaceflight; researchers warn. Until now, they say, all astronauts have rigorously healthy and fit people who have to match the high standards imposed by NASA; other state-owned space agencies around the world. This, they note, is all about to change.
“The emergence of privatized commercial spaceflight is affording to pay customers; including those with pre-existing health conditions, the opportunity to fly in space. And this means that many GPs in the coming years will be faced by patients who want to know if they have what it takes to blast off. Doctors, therefore, will need to be familiar with the potential hazards and risks of space travel and to assess each patient’s ability to withstand them.

Immense stress on the body

Crucially, Stepanik and colleagues point out; GPs will not require to formally approve anyone’s wish to head for the stars, but, even so, any information they provide may have legal ramifications. Obvious challenges would space tourists (or asteroid miners) include the immense stress on the body occasioned by rocket take-off and the anxiety and discomfort that can triggered by the noise and motion involved.

Beyond that, however, health matters can become complicated; in ways with which neither patients nor community doctors may aware. Even comparatively minor issues can arise during spaceflight; ranging from facial puffiness, due to shifting internal fluids; to back pain arising from slight spinal lengthening in microgravity. Many astronauts have reported the inability to pee for the first few days.

Usually, self-resolves and “rarely requires a temporary period of self-catheterization”. However, with admirable understatement, “for the lay participant; such experiences may greatly reduce the enjoyment of the flight “Furthermore, self-catheterization adds additional risks such as microtrauma and the introduction of infection; altering the mission risk profile and introducing a potential need for more comprehensive medical evaluation or care.”

The astronaut’s career

The authors take care to stress that a shift away from career astronauts to members of the public on board spacecraft will also entail a shift in legal parameters. The US Federal Aviation Administration (FAA); has already taken steps in this area; decreeing that ultimately it is the responsibility of individual passengers to decide if they are fit enough to withstand the stresses and strains of a space journey.
However, such an idea is predicated on the principle of informed consent, and, the researchers say; “it is difficult to legally show that participants fully understand their risks and the legality of their own consent; raising concern about potential liability despite the consent process”. To try to get on top of the myriad challenges looming for the medical community as the age of private space fight dawns, Stepanik, Blue; Parazynski urge “a strong collaboration among practicing clinicians; space medicine specialists; the aerospace community” in order to protect the interests of all parties involved.