Medical guidelines for suborbital commercial human spaceflight: A review

摘要

Introduction: Commercial human spaceflight is an emerging sector, and medical guidelines regarding 'fitness to fly' for spaceflight participants (SFPs) continue to evolve. This work is the culmination of the Association of Spaceflight Professionals' Life Sciences Working Group, representing a review of US medical guidelines for commercial spaceflight participants. The review examines available data and publications, and makes recommendations going forward with respect to pre and in-flight mitigation of medical risk, covering medical screening & evaluation, in-flight medical capabilities, training recommendations and opportunities for refining the guidelines as more data becomes available.Methods: A Google & PubMed search using relevant search terms was used to identify publications of interest.Results: Medical guidelines for SFPs must be guided by risk mitigation, further study of blind spots in our current knowledge, the development of more accurate models with larger sample sizes and inclusion of data regarding physiological responses in participants with comorbidities during the transition from high-G to microgravity and back. A plan to medically monitor all SFPs and create a universal database to log in-flight events will inform future medical recommendations for suborbital flight. Standardizing a medical evaluation process to stratify risk as well as an immediate pre-flight screening will increase safety and delineate a role for aerospace medicine specialists. Flight vehicles should house basic medical equipment, first aid and medication kits, along with crew safety and first aid training, akin to commercial air travel. Finally, the suborbital environment should make an effort to eventually become more accessible to SFPs significant medical equipment, mobility limitations, deformities or disabilities.Discussion: As the frontiers of commercial suborbital spaceflight expand, there is a need for a simultaneous push to evolve medical recommendations/guidelines to maximize safety, while protecting flight providers from the risk of litigation. The challenge in issuing medical recommendations for suborbital spaceflight lies in adequately protecting SFPs while protecting their autonomy, and not smothering a fledgling industry with over-regulation. High-risk spaceflight participants should be mitigated as much as possible before flight, and all SFPs should be informed of the evidence and uncertainty that exists around medical guidelines during the informed consent process.