Since the first human spaceflight by Yuri Alekseyevich Gagarin in 1961, more than 560 persons have flown in space. The vast majority of highly trained and rigorously selected astronauts in excellent physical condition and health. Currently, astronauts and other participants in spaceflights to the International Space Station must adhere to medical certification; standards set by the National Aeronautics and Space Administration (NASA) and its international partners.
The emergence of privatized commercial spaceflight is expected to afford paying customers; including those with preexisting health conditions, the opportunity to fly in space. So prospective spaceflight companies and their medical departments will
provide guidance for their suborbital participants and will also increasingly depend on health documentation from clinicians who may not familiar with the specific challenges of various activities and mission profiles related to spaceflight.
Prospective spaceflight participants
Current U.S. law, enforced by the Department of Transportation’s Federal Aviation Administration (FAA); Office of Commercial Space Transportation; mandates that prospective spaceflight participants provide written informed consent after having a clear understanding of the inherent risks of the flight.4-7; Although pilots flying various privatized commercial space vehicles to hold a second-class FAA medical certificate; with its attendant medical requirements,8,9 there are currently no medically binding criteria for determining a participant’s; suitability for prospective commercial spaceflight; beyond guidelines from several aerospace specialty organizations.
Space medicine is a broad clinical discipline that encompasses the many challenges facing humans engaged in spaceflight and other aerospace activities. But threats in the space environment vary according to the duration of the flight and range from physiological and adaptive alterations of the human body; to the psychological challenges of isolation and distance from Earth. The responsibility for understanding the ramifications of participants’ preexisting medical conditions; for ensuring the safety of participants in the expanding spaceflight industry will fall to many clinicians in collaboration with dedicated space medicine specialists and the aerospace community in general.
The Training and flights
Data and experience gleaned from training and flights will, over time, help determine the need for additional medical recommendations for persons with certain medical conditions. But there are numerous emergency or off-nominal situations in spaceflight. An example is the loss of integrity of a pressurization system (vehicle or space suits); which can result in severe hypoxia or decompression illnesses.
This review, however, focuses on the nominal and expected challenges of spaceflight and aims to provide; the practicing clinician with an appreciation of the unique medical and environmental challenges; in light of the expected increase in civilian spaceflight. In conclusion, the field of space medicine is poised for a substantial transition from primary government. guidance for persons with certain medical conditions. Strong collaboration among practicing clinicians, space medicine specialists; the aerospace community will ensure the safety of the participants in the expanding spaceflight industry