Operatiotial Medicine 



crews. To supplement NASA Operational Medicine flight surgeons, a board of 

 specialists will need to be assembled as on-call consultants who represent varying 

 areas of expertise and have been additionally trained by NASA in problems 

 unique to space medicine (7). Operational Medicine is responsible for ensuring 

 that all ground-based medical personnel in support of missions are adequately 

 trained. 



In the future, the responsibilities of Operational Medicine personnel will be to 

 support simultaneous missions, which may include missions in low-Earth orbit, 

 geostationary orbit, lunar, or Mars flights, all with heterogeneous crews. 



Applied Research of Operational Significance 



Operational Medicine conducts research primarily through the Detailed 

 Supplementary Objective (DSO) program of the JSC Space Biomedical Research 

 Institute. This program accepts research proposals having direct relevance to 

 significant operational problems from either intramural or extramural sources, but 

 it does not solicit proposals. All DSO's undergo peer review conducted by the 

 Universities Space Research Association (USRA). Biomedical problems with 

 operational significance studied to date include space motion sickness, 

 cardiovascular deconditioning, pharmacodynamics, and anti-orthostatic 

 countermeasures. 



Operational Medicine is involved in a longitudinal study of all astronauts. As part 

 of this effort, the program is conducting yearly physical examinations of present 

 and past astronauts at JSC in an attempt to identify the long-term medical effects 

 of repeated exposures to the space environment (8). 



Specific Medical Concerns 



Advances in the practice of medicine are dependent upon progress in biomedical 

 research; this principle also applies to space operational medicine. Therefore, 

 much of the material reviewed here concerning prevention, diagnosis, and 

 treatment has been addressed in other reports, such as A Strategy for Space Biology 

 and Medical Science for the 1980s and 1990s (NAS, 1987), as well as in the summary 

 of biomedical research given in this report (9). Operational Medicine must 

 maintain close ties with the biomedical research community in order to foster and 

 encourage investigations in critical operational areas. 



Prevention. Preventive medical measures are utilized before as well as during a 

 flight. Current crew selection and subsequent retention criteria have proven 

 effective in preventing a number of potential medical problems. This is evidenced 

 by the fact that no U.S. space mission has been curtailed or canceled as a result of 

 inflight medical problems. Consideration should be given now to any special 

 modifications of the crew selection and retention criteria needed to ensure the 

 success of longer missions in the future, such as a Mars mission. The 

 psychological implications of extended missions with longer isolation times will 

 become increasingly important, as will a better understanding of factors 

 influencing group dynamics (10,11). 



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