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Mission phaseIn-flight
39 articles tagged · 5 topic · 13 clinical · 1 equipment · 20 research
Behavioral Health & Performance in Isolation and Confinement
Psychological, sleep and team-dynamics effects of long periods in small, isolated and confined crews.
Isolation & ConfinementDistance from EarthBehavioral Health & Sleep
SMF-T-0009 · draftSpaceflight Bone Loss
Unloading in microgravity drives loss of bone mineral, particularly at weight-bearing sites, with incomplete recovery after return.
Gravity FieldsMusculoskeletalRenal & GU
SMF-T-0006 · draftSpaceflight-Associated Neuro-ocular Syndrome (SANS)
Optic disc edema, globe flattening, choroidal folds and hyperopic shifts observed in long-duration astronauts.
Gravity FieldsHostile/Closed EnvironmentNeuro-ophthalmicNeurological & Cognitive
SMF-T-0002 · draftSpace Radiation Environment & Biological Effects
Beyond low Earth orbit, crews are exposed to galactic cosmic rays and solar particle events that are difficult to shield and raise long-term health concerns.
RadiationOncologyNeurological & Cognitive
SMF-T-0007 · draftSpace Motion Sickness & Space Adaptation Syndrome
Nausea, malaise and vomiting in the first days of weightlessness as the vestibular system adapts.
Gravity FieldsVestibular & SensorimotorGI & Nutrition
Clinical articles (13)
Behavioral health monitoring
What psychological problems have occurred in spaceflight, how agencies select, train, monitor and support crews, what isolation analogs teach us, and how to help with reintegration after return.
◆◆◇◇ Low · F A E
SMF-C-0005 · countermeasure · draftBone loss countermeasures
How much bone astronauts lose, what prevents it (resistance exercise, nutrition, and in research, bisphosphonates), how NASA monitors BMD with DXA, T-scores and FRAX, and what a primary care clinician should do after a long flight.
◆◆◆◇ Moderate · F A E
SMF-C-0014 · protocol · draftDCS & EVA
Why spacewalks carry decompression risk, how prebreathe protocols prevent it, how DCS is recognized and treated without a hyperbaric chamber, and other EVA hazards (CO2, water in the helmet, hand injuries) — with links to dive and altitude medicine.
◆◆◆◇ Moderate · E A F
SMF-C-0006 · countermeasure · draftExercise countermeasures
What spaceflight does to aerobic capacity and muscle, NASA's fitness standards in plain numbers, how in-flight exercise works, and how to prescribe reconditioning after return.
◆◆◆◇ Moderate · F A E
SMF-C-0010 · topic · draftEmergencies & evacuation
What medical care is actually available on a spacecraft, who provides it, how evacuation works from orbit, and why the model changes completely for lunar and Mars missions.
◆◆◆◇ Moderate · F E C
SMF-C-0013 · topic · draftKidney stones
Why spaceflight raises stone-forming risk (bone calcium loss, low urine volume), what prevents it, how a stone would be recognized in flight, and what to watch for in the year after return.
◆◆◆◇ Moderate · F C E
SMF-C-0009 · topic · draftSpace pharmacy & drug stability
What astronauts actually take, whether drugs still work in space, what happens to medications stored for months to years, and how to plan a formulary for missions far from resupply.
◆◆◇◇ Low · F E M
SMF-C-0001 · standard · draftMedical standards overview
What NASA's crew health standard actually requires, how astronauts are medically selected and recertified, and what that means for a clinician who sees space travelers.
◆◆◆◆ High · E F
SMF-C-0011 · topic · draftPOCUS in space
How ultrasound became the main imaging tool in space — remote-guided FAST, echo, eye and kidney scans, and routine screening of the jugular veins for thrombosis — and what that means for clinicians on the ground.
◆◆◆◇ Moderate · F E
SMF-C-0000 · guide · draftClinician quick-start
A one-page orientation for GPs, emergency physicians, nurses and flight/aviation doctors: what to ask, what to check, the red flags, and where to find the details — before and after spaceflight.
◆◆◆◇ Moderate · E F
SMF-C-0003 · countermeasure · draftRadiation limits & monitoring
NASA's radiation limits in plain clinical terms, how crew dose is monitored, what shielding can and cannot do, and what it means for a patient's lifetime cancer screening.
◆◆◆◇ Moderate · E C F M
SMF-C-0004 · protocol · draftSANS management
How space agencies screen for and manage optic disc edema, globe flattening, choroidal folds and hyperopic shift in long-duration flyers — and how to evaluate a returning astronaut's eyes.
◆◆◆◇ Moderate · F A E
SMF-C-0007 · protocol · draftSpace motion sickness
Who gets space motion sickness, how it is graded, why promethazine is NASA's treatment of choice, what else is used, and how to manage the same symptoms after landing.
◆◆◆◇ Moderate · F E
Equipment guides (1)
Research pages (20)
Radiation & cancer
Space radiation may raise an astronaut's lifetime chance of cancer. There are no human data for this kind of radiation, so the risk is modeled, with wide uncertainty.
◆◆◇◇ Low · M C E
RSK-02 · NASA risk · draftBehavioral health & cognition
Long missions can strain mental health and thinking. Problems in flight have so far stayed below diagnostic levels, but analog data suggest risk grows with mission length and isolation.
◆◆◇◇ Low · F A E
RSK-03 · NASA risk · draftTeam performance
Small crews must cooperate under stress and, far from Earth, with long communication delays. Conflict and coordination problems are well documented in flight and in analogs.
◆◆◇◇ Low · F A E
RSK-04 · NASA risk · draftSleep, circadian rhythm & workload
Astronauts sleep about six hours a night in flight, and schedules shift their body clocks. Ground studies tie this to worse performance and mood and to long-term disease risk.
◆◆◆◇ Moderate · F A E
RSK-05 · NASA risk · draftMedical conditions in flight
Illness and injury will happen on long missions. Far from Earth, the crew must handle them with limited supplies and no quick evacuation.
◆◆◇◇ Low · F C E
RSK-06 · NASA risk · draftMedications
Medicines must work and stay safe for years without resupply. Shelf life in space, and how the body handles drugs there, are not fully known.
◆◆◇◇ Low · F E
RSK-07 · NASA risk · draftFood & nutrition
Nutrition needs in flight are fairly well understood. What isn't solved is a safe, appetizing food supply that keeps its nutrients for five years.
◆◆◆◇ Moderate · F E
RSK-08 · NASA risk · draftEarth-independent operations
Far from Earth, a small crew must handle problems without real-time help from Mission Control. Vehicle, software, training and task design have to support that.
◆◆◇◇ Low · F E
RSK-09 · NASA risk · draftSANS (eye & brain changes)
About 70% of long-duration crew show at least one eye sign of SANS. The cause is unknown and no countermeasure is proven yet.
◆◆◆◇ Moderate · F A E
RSK-10 · NASA risk · draftCardiovascular adaptations
Weightlessness shifts fluids toward the head and deconditions the heart and vessels, causing light-headedness on landing. Whether space radiation adds long-term heart disease risk is unresolved.
◆◆◇◇ Low · F A M E
RSK-11 · NASA risk · draftBone loss & fracture
Bones lose density without gravity's load. Exercise and drugs reduce the loss, but recovery after flight can be incomplete.
◆◆◆◇ Moderate · F E
STU-01 · landmark study · draftNASA Twins Study
One identical twin spent a year on the ISS while his brother stayed on Earth as a genetic control. Most changes reversed within six months, but some did not.
◆◆◇◇ Low · F
RSK-12 · NASA risk · draftMuscle & aerobic fitness
Even with about 10 hours of exercise a week, astronauts lose fitness in flight, and some don't meet NASA's standards. Exploration spacecraft will have less room for exercise equipment.
◆◆◆◇ Moderate · F E
STU-02 · landmark study · draftInspiration4 & SOMA
The 2024 Nature package on the first all-civilian orbital crew. It found that most changes from a 3-day flight reversed, and it launched an open atlas of astronaut biology.
◆◆◇◇ Low · F E
RSK-13 · NASA risk · draftSensorimotor & balance
The brain re-tunes balance and orientation for weightlessness. That causes motion sickness and clumsiness around gravity changes, just when landing and early surface work demand the most.
◆◆◆◇ Moderate · F E
STU-03 · landmark study · draftISS long-duration cohorts
Most of what clinicians know about 6-month spaceflight comes from cohorts of 4 to 46 ISS astronauts. Key studies, what they found, and their limits.
◆◆◆◇ Moderate · F
RSK-14 · NASA risk · draftKidney stones
Bone loss and low urine volume raise kidney stone risk in flight. Prevention is well defined, but there's no way yet to treat a stone on a deep-space mission.
◆◆◆◇ Moderate · F A E
RSK-16 · NASA risk · draftMicrobes & infection
Spacecraft carry microbes, including opportunistic pathogens, and spaceflight can change both microbes and the immune system. Current measures limit most of the harm.
◆◆◇◇ Low · F M E
RSK-17 · NASA risk · draftImmune changes
The immune system becomes dysregulated in flight, which can reactivate dormant viruses and cause rashes. These changes persist through 6-month missions.
◆◆◆◇ Moderate · F M E
RSK-19 · NASA risk · draftHypoxia (exploration atmosphere)
To make frequent spacewalks practical, future habitats may run a lower-pressure, mildly hypoxic atmosphere, roughly like living at 4,000–8,300 ft. Effects over long periods are being studied.
◆◆◇◇ Low · F E