Less than 600 people traveled to space by today. What do we know about space health so far, and why does it matter for the broader population?

For one thing, it’s possible space travel will be a new normal in the not so far future. Already, Virgin Galactic announced commercial space flights, and so has Blue Origin, the space effort by Amazon.com founder Jeff Bezos. The cost is predicted to be between 250.000 to a few million USD. In 2023, Space X is predicted to fly a Japanese billionaire and a coterie of artists to the moon.

Mind the gravity, molecules!

Apart from engineering skills, astronauts need to be well prepared for the psychological pressures of space missions. Long-lasting confinement in the space ship can quickly put people under severe anxiety or depression, team dynamic is different compared to the usual work or home setting, where you can always leave, go for a walk, or take time in a remote place to think and relieve the pressure of work and relationships. In the physiological sense, gravity influences various body systems - from cardiovascular, brain, musculoskeletal system. “It has been observed that in space, where gravity decreases the need to use muscles, the brain region in charge of movement of our body, actually increases in size,” mentions Ilaria Cinelli - a biomedical engineer with a structured PhD in neural engineering. While she’s not an astronaut, she is very passionate about space and has completed the Space Studies Program of the International Space University at TU Delft (The Netherlands). She is an Associate Fellow of the Aerospace Medical Association, President-Elect of the Aerospace Human Factors Association, and Member-at-Large of the Life Sciences and Biomedical Engineering Branch.  

Findings on the effects of lack of gravity on the human body could potentially help cure diseases on Earth and in essence open up a whole new way of treating conditions in new, gravity free designed environments, mentions Ilaria Cinelli.

This year, NASA published a study of two twin brothers - one traveled to space, and the other stayed on Earth. Researchers monitored both and compared what changes happened to the twin who traveled to space, to observe what physiological, molecular, and cognitive changes could happen to a human from exposure to spaceflight hazards. 

Among other things, the astronaut on the space mission experienced a change in telomere length dynamics during spaceflight and within days of landing (Telomere lengths tend to get shorter as we age; however, lifestyle factors, stresses and environmental exposures can also affect the rate at which this shortening occurs). Genes were affected. Cognition seemed to stay unaffected. All these findings are important for future research, also for healthcare problems on Earth. As written by Nasa, “findings from the Twins Study may be used to develop new treatments and preventative measures for stress-related health risks on Earth. For example, telomere research may improve efforts to mitigate the effects of aging and disease. The proteomic research could have implications for research on traumatic brain injury. Research in astronauts could give new insights into how changes in the body are related to risk factors for diseases. These are just a few of many ways spaceflight research can help humankind.”

Space on Earth

Not all space health research is done in space. So-called analog missioned take place in extreme environments on Earth such as Antarctica or deserts. These missions involve people that aren’t necessarily astronauts but serious enthusiasts or researchers of space. Analog missions aim at discovering various effects extreme environments can have on human physical performance and team dynamics. 

Ilaria was involved in several analog missions, many of them in the leadership position. The shortest one lasted four days and the longest one for three weeks. Analog missions can last even longer. As she describes, there is no guarantee of what the mission will be like, as space and people are unpredictable. “In the end, the mindset is individual’s most crucial strength on a mission to be able to focus on the goal of the mission. First priority is safety of the crew, then the mission objectives,” says Ilaria Cinelli.

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Some questions addressed: 

• What are the most apparent differences in medicine in space - how does the body differ in terms of reactions?

• What kind of digital health technologies are used in space missions already?

• A big question for space medicine development is testing. One option ara analog missions. Ilaria, can you tell us more about those, what they are, what can be tested, and how is research done?

• In April this year, Nasa revealed results of a so-called twins study - The landmark Twins Study brought ten research teams from around the country together to observe what physiological, molecular, and cognitive changes could happen to a human from exposure to spaceflight hazards. This was accomplished by comparing retired astronaut Scott Kelly while he was in space, to his identical twin brother, retired astronaut Mark Kelly, who remained on Earth.

• Ilaria, space medicine is a very niche area of research. Less than 600 people have been to space, and while commercial space flights. Virgin Galactic announced commercial space flights, and so has Blue Origin, the space effort by Amazon.com founder Jeff Bezos. The cost is predicted to be between 250.000 to a few million USD. What are the implications of space medicine for the broader society?