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Episode 11: Space Health

By Brinley Macnamara
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With the democratization of space travel underway, how will we balance the health risks of space with our species’ existential need to explore what lies beyond our little blue planet?

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Brinley Macnamara (host) (00:02):

10 years from now, how will space tourism be different than how it is today?

Dr. Valerie Gawron (00:07):

It’s getting to the point where it’s no longer a $20 million price tag. It’ll eventually be something in a $20,000 thing. And if you’re going to do once in a lifetime trip, that might be just what you want to do. Maybe that’s how you celebrate your 25th wedding anniversary, or your 50th birthday, or a graduation.

Brinley Macnamara (host) (00:34):

Hello and welcome to MITRE’s Tech Futures Podcast. I’m your host, Brinley Macnamara. At MITRE, we offer unique vantage point and objective insights that we share in the public interest. And in this podcast series, we showcase emerging technology that will affect the government and our nation in the future. Today, we’re talking about Dr. Valerie Gawron’s MITRE investigation into what the future of human health will look like in of all places, outer space. But before we begin, I want to say a huge thank you to Dr. Kris Rosfjord, the Tech Futures Innovation Area Leader in MITRE’s Research and Development Program. This episode would not have happened without her support. Now, without further ado, I bring you MITRE’s Tech Futures Podcast episode number 11.

Brinley Macnamara (host) (01:35):

Dr. Valerie Gawron, a Senior Principal Human Factors engineer in MITRE Labs, spent most of her career working with many household names in space from Sally Ride to Buzz Aldrin to study the effects of space travel on the human body. But in her most recent space health project, Dr. Gawron turned her focus to studying the effects of space travel on the health of civilians. I.e., people who don’t fall into the category of an elite professional astronaut, who made it through NASA’s notoriously intense, albeit closely guarded medical selection process. People like you and me. Why? Because in the coming decades, people like you and me might very well have the chance to go to space. I asked Dr. Gawron about what options a civilian would have if they wanted to travel to space. And as a quick disclaimer, I should note that Dr. Gawron’s interview was recorded late last year in 2021. So when she refers to “this year” in her answer, she means 2021.

Dr. Valerie Gawron (02:37):

So right now, they have three. And in the future, they’ll have six. So you can go in the rocket, such as Blue Origin. Remember their first flight was July 20th of this year. And SpaceX plans to use a rocket to take passengers to the moon as early as 2023. You can also have space planes, so Virgin Galactic’s first flight was July 11th of this year. And also available are high altitude balloons, such as World View, it’s already taking payloads. And a Spanish company, Zero 2 Infinity, they’ve had unmanned flights and are preparing for manned ones. In the future, we are told there are going to be space hotels, Axiom Space and Bigelow space operations, both plan to build hotels, are building hotels that will attach to the International Space Station.

Dr. Valerie Gawron (03:35):

Orion space is a five person hotel. Gateway Foundation, this one is pretty ambitious, 352 person hotel. And of course, the reef that Blue Origin is developing with a number of partners is being planned. And it would be for tourists as well as researchers and workers. And lastly, Elon Musk is really pushing to have point to point earth travel. So you can get to from New York to Tokyo in one hour. And you would include in that to actually get up into space.

Brinley Macnamara (host) (04:21):

Now, I should note that the seeming explosion of space tourism is all happening in the context of the rapid expansion of an even bigger industry, commercial space. As of today, it is cheaper than ever to launch a payload into space. For context, the cost of sending a kilogram of cargo to Earth’s orbit on the US Space Shuttle was around $65,000 dollars. By 2018, SpaceX had brought that cost down by a factor of 60, to $1,500 per kilogram. And SpaceX’s CEO and chief engineer, Elon Musk thinks this cost go down even further in the coming years to $100 per kilogram. This means that everything from launching satellites to conducting experiments on the ISS is only getting cheaper with many companies even looking beyond the Earth orbit to opportunities like precious mineral mining on asteroids to setting up a permanent base on the moon. I asked Linda Fischetti, the Director of MITRE’s Health Innovation Center about what this could all mean for the future of work in space.

Linda Fischetti (05:22):

That’s actually our motivation for working in this space. So when you do think about manufacturing jobs, when you think about mining jobs, when you think about the hotels that will be circling the planet, we know that there will be people in service roles in the hotels. There will be miners on the dark side of the moon. And these jobs will most likely be filled by people who come from traditionally underserved populations here in the world. This is the motivation for us to make sure we fully understand the effects of space travel for commercial space flight participants, because we want to be able to work in service for and inform populations and individuals who are doing these jobs in space.

Brinley Macnamara (host) (06:15):

And while we may be a little ways away from a day when the last leg of our morning commutes takes us an extra 60 miles above planet Earth, into outer space, in just 2021 alone, we saw a wave of civilian astronauts break several glass ceilings. A pediatric cancer survivor took a three day trip around Earth’s orbit on SpaceX’s Dragon. Three billionaires were launched into space. And at 90 years old, William Shatner, yes, that William Shatner, hitched a ride to suborbital space becoming the oldest astronaut in human history. I asked Dr. Kris Rosfjord, the Tech Futures Innovation Area Leader about the implications of the expanding diversity of space flight participants on the community’s research needs.

Dr. Kris Rosfjord (06:56):

Space tourism is tightly coupled with the space health efforts that we’ve undertaken, specifically looking at as we go from space being a government dominated venture to a commercial venture of private citizens, purchasing greater diversity of the type of participants that are involved with space. Specifically, if you look at our government astronauts, they are the equivalent of professional athletes. One of my favorites was Sally Ride, and she was the equivalent of a professional tennis player. She was a tennis player at a very high level. Whereas we look now, the age of the participants is much broader than when it was just government participants, as well as perhaps the medications and the conditions of those traveling to space is much broader than what it was when it was just our elite core of astronauts.

Dr. Kris Rosfjord (07:52):

And understanding both the response and the precautions needed in space for the diversity of ages and perhaps what happens to those medications and conditions and their responses to hyper gravity is really the potential impact we saw for space health. And then you talked about, hey, over the next 10 to 20 years, the diversity is going to be growing. And our sample size, our number of participants is going to rapidly grow as well.

Brinley Macnamara (host) (08:21):

So that brings me to the key question we’re going to answer in this podcast. Just how hard is space travel on the human body? To answer this question, I have to take you back to NASA’s very beginning.

Brinley Macnamara (host) (08:34):

While it doesn’t take a rocket scientist to figure out that space is downright dangerous, in the earliest days of America’s space program, it did take a bunch of rocket scientists to figure out if space was even survivable. In fact, the first living things in space were animals, sent up by NASA in the 1950s to see if a living organism could really survive a trip to space. And luckily some of those pioneering dogs, cats, and guinea pigs. Yes, guinea pigs were really some of the first space health guinea pigs, did survive their journeys to space, paving the way for human space flight a decade later. And while there are still many open questions around space health, notably the effects space travel will have in a wider range of participants in its 60 plus years of sending humans to space, NASA has been able to identify some common side effects of space.

Brinley Macnamara (host) (09:21):

And while there are many, we’re going to cover three in this episode. Number one is space motion sickness. If you’ve ever been car sick, sea sick, or roller coaster sick, you may have a muted sense of what this feels like. Dizziness, nausea, perhaps even vomiting into a paper bag. Now add g-forces from a rocket launch, microgravity, a space suit, and very little room to move around, and you get space motion sickness. And according to Dr. Gawron’s research, space motion sickness is as human as our insatiable drive to explore the great beyond. Around 42% of astronauts in the Space Shuttle Program experience space motion sickness. There’s even a Guinness World Record tied to this notorious effect of space flight. For the first person, a Russian cosmonaut, to vomit in space. The second side effect of space is bone demineralization. While bone density loss occurs naturally as we age, space can dramatically accelerate this process in its astronauts.

Dr. Valerie Gawron (10:18):

So when we lose gravity, there’s no pull. And so that’s how it affects both the bone strength and also the muscle strength, right? We have nothing fighting against us.

Brinley Macnamara (host) (10:35):

But the good news, for all of you aspiring space travelers, is that NASA has largely resolved the seemingly unavoidable effect of microgravity. How? They put a gym in space. And if you’re now wondering how the heck a workout is possible on the International Space Station, NASA astronaut Jack Fischer was kind enough to record one of his workout sessions, rapid fire style.

Jack Fischer (10:56):

We have a special treadmill. First off, we got to find it. Where is it? It’s on the wall. How cool! We first get a heart rate monitor. Next, we get our super duper harness. Next off, we connect in to the T2 itself. These are very important because they simulate load that we would have on Earth and they pull us to the treadmill. Otherwise, we’d just float off. We make sure that it’s calibrated, and we start. A light jog. A little higher pace. And then the coolest part of the whole thing is at the end of your workout, it gives you the miles traveled, not just the miles ran. So using the speed of the space station, 17,500 miles an hour, you can go like, I don’t know, 9,000 miles. That’s a pretty good run.

Brinley Macnamara (host) (11:37):

And the mileage is certainly paying off. Over the years, NASA has reported a significant decrease in the severity of bone loss experienced by their astronauts during their time in space. And the third and final side effect of space that we’ll cover today is quite an interesting one. Why? Well, it was discovered when the astronaut and doctor, Michael Barrett asked for a spinal tap as soon as he got back to Earth after a long trip to the ISS. The reason? While he was in space, he noticed a sharp decline in his vision. And subsequent scans showed that the shape of his eyeballs had changed.

Brinley Macnamara (host) (12:12):

Over the years, NASA has noticed this change in about 70% of its astronauts to varying degrees of severity. And as of today, scientists have yet to narrow in a culprit with a 100% certainty, but many in the community believe this common issue has something to do with the increased intracranial pressure that astronauts experience while in space. As two liters of fluid, yes, you heard me correctly, two liters of fluid, redistribute from their lower extremities to their heads while in space. I asked Dr. Gawron about how the space health community is keeping track of all these observations being made about the astronauts’ health in space.

Dr. Valerie Gawron (12:47):

So for the United States crew medical data are available, they kept in a database that’s called Lifetime Surveillance of Astronaut Health.

Brinley Macnamara (host) (12:57):

And while this database is open source, it has one key problem. It was never designed for epidemiological research purposes. In other words, it wasn’t designed to support researchers who seek to develop a high level of confidence in the frequency with which common side effects of space occur in the space faring population. This means that as of today, we really only have rough estimates. Thus, Dr. Gawron believes that there is a critical need for an epidemiological research study to be conducted on the health effects of space. And with the space faring population only set to become more diverse in the coming years, we are at an inflection point.

Brinley Macnamara (host) (13:33):

Luckily, the entire community of stakeholders, everyone from MITRE’s in-house space health experts to the commercial space flight companies and flight surgeons agree that we, i.e., humanity would stand to benefit from more hard data on the health effects of space. And this agreement culminated in a two day workshop co-hosted by the Commercial Spaceflight Federation and MITRE in May of 2021 with the aim of laying down a foundation of what this research effort might look like. I asked Dr. Gawron about whether the workshop had a successful outcome.

Dr. Valerie Gawron (14:06):

Everyone met as equals. During the two day workshop and all of the preparation meetings before that, everyone was treated honestly, openly and respectfully, even though there’s natural tension obviously in competition among the commercial space companies and also that tension between an industry and its regulators, but every one worked extremely well with each other and very goal oriented on what research is needed and what order does that research need to be performed.

Brinley Macnamara (host) (14:55):

As I was doing the background research for this podcast, I couldn’t help but wonder, are there any health benefits of space? And to my surprise at the tail end of our discussion on all the inherent health hazards of space, Dr. Sybil Russell, MITRE’s Health Innovation Area Leader mentioned the one and perhaps the only health benefit of space that amidst everything going on in our world, I felt was worth mentioning in this podcast.

Dr. Sybil Russell (15:21):

My understanding of the Overview Effect is that it’s a phenomenon that happens to people when they come back from space. Specifically, they come back with a new level of compassion. They’re more likely to grasp how interconnected our common fate really is in humanity. And I’ve read that they have a wonder of and a better understanding that we’re all really in this together.

Brinley Macnamara (host) (15:55):

All right, Kris, last question of the day. If you had the chance to go to space, would you go? Why or why not?

Dr. Kris Rosfjord (16:03):

When do we leave, I guess is my only question. Space travel that’s being done through space tourism, I would love to be a part of it at some point. It sounds like an excellent adventure. And I think of the old Sally Ride quote when she took that first flight, she announced it was an E-ticket. I guess, back at Disneyland, they used to charge different amounts and have different types of tickets for different rides. And the most exciting and the best rides took E-tickets. And I would love to take the ultimate E ticket ride.

Sally Ride (16:38):

Have you ever been to Disneyland?

Mission Control (16:38):

Affirmative.

Sally Ride (16:38):

That was definitely an E-ticket.

Mission Control (16:38):

Roger that, Sally.

Brinley Macnamara (host) (16:59):

The show was written by me. It was produced and edited by myself and my co-host, Eliza Mace, Dr. Kris Rosfjord, and Dr. Heath Farris. Our guests were Dr. Valerie Gawron, Dr. Kris Rosfjord, Linda Fischetti and Dr. Sybil Russell. The music in this episode was brought to you by Arthur Benson, Ooyy, Wendy Marcini, Sarah the Instrumentalist, and Truvio. We’d like to give a special thanks to Dr. Kris Rosfjord, the Technology Futures Innovation Area Leader for all her support. Copyright 2022, MITRE PRS # 22-0477, February 8th, 2022.

Brinley Macnamara (host) (17:41):

MITRE: solving problems for a safer world.

Meet the Guests

Dr. Valerie Gawron

Valerie Gawron has a BA in psychology from the State University College at Buffalo, a MA also in psychology from the State University College at Geneseo, a PhD in Engineering Psychology from the University of Illinois, and a MS in Industrial Engineering and MBA both from the State University of New York at Buffalo.  She completed postdoctoral work in environmental effects on performance at the New Mexico State University in Las Cruces and began work for Calspan directly following.  She remained at Calspan for 26 years until it was eventually acquired by General Dynamics and she was made a technology fellow.  She is presently a human factors engineer at the MITRE Corporation.  Dr. Gawron has provided technical leadership in Research, Development, Test, and Evaluation of small prototype systems through large mass produced systems, managed million dollar system development programs, led the design of information systems to support war fighters and intelligence personnel, fielded computer aided engineering tools to government agencies and industry, tested state-of-the-art displays including Helmet Mounted Displays, Night Vision Goggles, and Synthetic Vision Displays in military and commercial aircraft, evaluated security systems for airports and United States Embassies, conducted research in both system and human performance optimization, applied the full range of evaluation tools from digital models through human-in-the-loop simulation to field operational tests for military, intelligence, and commercial systems, directed accident reenactments, consulted on driver distraction, accident investigation, and drug effects on operator performance, and written over 425 publications including the Human Performance, Workload, and Situation Awareness Measures Handbook (third edition) and 2001 Hearts: The Jane Gawron Story.  Both are being used internationally in graduate classes, the former in human factors and the latter in patient safety.

Dr. Gawron has served on Air Force Scientific Advisory Board, the Army Science Board, Naval Research Advisory Committee, and National Research Council.  She gives workshops on a wide range of topics to very diverse audiences from parachute testing given as part of the Sally Ride Science Festival for girls ages 8 to 14 to training applications of simulation to managers and engineers.  She has worked programs for the United States Air Force, Army, Navy, Marines, NASA, the Departments of State and Justice, the Federal Aviation Administration, the Transportation Security Administration, the National Transportation Safety Board, the National Traffic Safety Administration, as well as for commercial customers.  Some of this work has been international and Dr. Gawron has been to 195 countries.  Dr. Gawron is an associate fellow of the American Institute of Aeronautics and Astronautics, a fellow of the Human Factors and Ergonomics Society, and a fellow of the International Ergonomics Association.

Linda Fischetti

Linda Fischetti is the director of MITRE’s Health Innovation Center, which applies the talents of hundreds of professionals across the healthcare ecosystem to solve some of the nation’s largest problems in health policy, technology, reimbursement, and other pressing challenges.

Fischetti has held previous healthcare management roles in payer, provider, government, and private sector environments, including as vice president of Care Delivery within the Accountable Care Solutions division of Aetna. Prior to that, she was the chief health informatics officer for the Veterans Health Administration at the U.S. Department of Veterans Affairs. In this role, she was instrumental in reaching across many federal executive branch departments to create alignment during the formative years of the government’s activities in health information technology and informatics.

A current board member of HIMSS Americas, Fischetti previously served as a board member of Health Level 7 and the National eHealth Collaborative. She also served a two-year term on a U.S. federal advisory committee, the Health Information Technology Standards Committee. She is an adjunct associate professor at Georgetown University in the Health Systems Administration program.

Fischetti holds a Bachelor of Science in nursing and Master of Science from the University of Maryland-Baltimore.

Dr. Kris Rosfjord

Dr. Kris Rosfjord is a senior principal member of the technical staff at the MITRE Corporation. At MITRE, she directs emerging technology research including prototype development across many fields such as Artificial Intelligence and Analytics, Sensing and Imaging, and Advanced Materials and Manufacturing. Prior to joining MITRE, she was the Clare Boothe Luce Assistant Professor in the Electrical and Computer Engineering Department at the University of Maryland, College Park, where she led a research group in nanostructures and materials development.  Previously she was a postdoctoral fellow in the Quantum Nanostructure and Nanofabrication Group at MIT and a member of the technical staff at MIT-Lincoln Laboratory. Kris earned a B.E. in Electrical Engineering from the Georgia Institute of Technology and a M.S. and Ph.D. in Electrical Engineering and Computer Science from the University of California, Berkeley.

Dr. Sybil Russell

Dr. Sybil Russell is a Chief Scientist in the Health Innovation Lab and the Health Innovation Area Lead of the MITRE Innovation Program where she focuses on funding research projects in health, public health, and health policy. She is a researcher, board certified practicing physician, public health expert, and teacher. Prior to joining MITRE, she worked at the Johns Hopkins University School of Medicine as a Medical Director and Pediatric Hospitalist. She continues to practice at Johns Hopkins as a Pediatric Hospitalist and has taught at several medical schools over the past 15 years. She has earned a B.A. in political science and a B.S. in cell and molecular biology from Tulane University, an M.D. from Emory University School of Medicine, and an M.P.H. from Johns Hopkins Bloomberg School of Public Health.