This year’s Aerospace Medicine Group Autumn Lecture was given by Dr Volker Damann, Head of Space Medicine at the European Space Agency’s European Astronaut Centre in Cologne.
Dr Damann drew on his extensive experience in aspects of space medicine to give a comprehensive overview of the aerospace medical issues needing to be addressed in the selection, preparation and in-flight management of astronauts.
Dr Damann covered the numerous technological risks an astronaut faces, ranging from those relating to a habitable atmosphere (including provision of an appropriate diet and potable water), exposure to toxic hazards, noise and cosmic radiation through to microbiological risks.
The microgravity environment provokes a number of short, medium and long term medical changes. Dr Damann succinctly described these changes, especially those relating to the musculoskeletal, cardiovascular and neurological systems. He also highlighted the less obvious medical challenges that the space environment poses, ranging from ophthalmological issues (such as foreign bodies entering the eye in the microgravity environment) to dermatological conditions and psychiatric/psychological problems.
The limited medical resources on board a spacecraft mean that the response to medical incidents is limited. As manned missions become longer so the risk of an incident requiring medical attentions rises, with a possible need for medical evacuation occurring once in 5.5 years. Neither treatment option, be it ‘stand and fight’ or ‘stabilize and evacuate’ is ideal. There is, therefore, a need for intensive risk mitigation actions before and during the space flight. Dr Damann confirmed the conclusion made by Dr Kevin Fong in last year’s autumn lecture - if a medical condition/accident in space is survivable in the first place, the challenges posed in both resuscitation and return to earth are such that successful medical evacuation may not be realistic.
In his final section Dr Damann took a forward look, particularly the need for autonomy when planning manned space flights to other planets. Life support systems and medical care would need to be addressed, as would the significant supply/resupply requirements. Technology, including the use of robotics and remote diagnostics, will play a role but Dr Damann concluded that such missions may well require a crew physician.
Dr Damann’s lecture was well attended and the extensive questions from the audience at the end of the presentation were testament to the level of interest in this topic.
This report was written by Air Cdre. Richard Broadbridge, Head of Strategy and Integration, Defence Primary Healthcare Command and Chairman, Aerospace Medicine Group, Royal Aeronautical Society.