William Tarver, MD, MPHChief, Clinical Services

NASA Johnson Space Center

Your Health is Our Mission

https://ntrs.nasa.gov/search.jsp?R=20100020255 2020-05-14T21:58:14+00:00Z

• Medical- Whatrisks you bring tothe table(cholesterol,hypertension, etc)

• Occupational-What risks youcome away with aresult of theoccupation

Your Health is Our Mission

Your Health is Our Mission

--_T^1 --_ 1y fir+ _ _ _ _

• OSHA and NIOSH donot dictate controls orreporting for spacework

• Hazards are controlledby the individualprograms

• Ethical and moralobligation to performsurveillance, but nolegal obligationcurrently

Your Health is Our Mission

From Scientific American

• Radiation of theSpace Variety

• Bone loss

• Lasers

• Cadmium

• Hydrazine

• Nitrogen Tetroxide

• Ammonia

_. •Noise

• WeightlessnessYour Health is Our Mission

x

• Benchmarked off ofsimilar programsDoD and theDepartment ofEnergy

• Allows insight intolongterm sequelaefrom exposures inthe workplace

in

Your Health is Our Mission

• Phase 1• Phase 2

• Workforce controlsfor comparison

• Low StatisticalPower

• No Consent

1. Must serve two sometimesconflicting goals of research9 9 ,.and occupational surveillance...

2. No comparison group can meetevery goal or need, it should beindividualized...

3. Increase the quality andquantity of preventive care toincrease the data...

4. NASA should assumeresponsibility for the lifelonghealth care of its active andformer astronauts.

• Preventive • OccupationalMedicine HealthProtocols Surveillanceâ Age Based (40, Protocols

45, 50, 60, etc) w;., â Radiationâ Ultrasound ''! â Boneâ Mammography w .^ â Eyeâ MRI , â Cadmiumâ Colonoscopy .^ ,:^, â HydrazineYâ Stress Test â Leadâ Complete

fâ etc, etc.Physicals

k

â De rm Surveysâ D EXA T:

â Etc, etc.

• Query the data and •compare to 3 NASAworkers for eachastronaut....

• No consent obtained, just •implied.

• Poor statistical power. •

• No flight dataincorporated!!!

•

Before

After

Query the database andfind the best comparisongroup to answer thequestion being askedMuch more statisticallypowerful.Consent for directstudies, no consentneeded for generic occhealth trends.Flight data incorporated.

Your Health is Our Mission

• Meets Ethical and Moralobligation

• Increases data availableto research

• Identifies and preventsexposure related disease

• Allows feedback intospacecraft design

• Allows NASA to followlong term health impacts

Your Health is Our Mission