Taxi to the ISS - Medical Guidelines for Space Tourists
With Respect to Cardiovascular and Neurological Diseases
Dr. Anis Karim
Master of Science in Space Studies 2004-2005
International Space University
Strasbourg, France
Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
ABSTRACT
Introduction: The objective of this study is to give an insight into the medical
guidelines to be followed for the selection of space tourists for taxi flights, with
respect to the cardiovascular and neurological diseases, and the inflight
countermeasures, monitoring and treatment that can be provided. Methods: For every
disease, the possible countermeasures, monitoring and treatment that could be
provided onboard the International Space Station were studied. Results: The
information obtained was then analyzed for a compare-and-contrast study of the
cardiovascular and neurological diseases. It was inferred that simple countermeasures
could be effectively provided on the ISS for space tourists with cardiovascular and
neurological diseases, without extra onboard hardware. In the case of monitoring,
cardiovascular diseases can be easily monitored onboard the ISS, while neurological
diseases require a trained astronaut for the same. Although treatment is diseasespecific, since many diseases have common symptoms, a general symptomatic line of
management can be undertaken. A practical guideline was also proposed for
passenger selection. Conclusions: This study shows that diseases are not obstacles in
the path of people who want to enjoy the excitement of space travel. Most of the
cardiovascular and neurological diseases can have practical countermeasures,
monitoring and treatment equipment onboard the ISS.
Keywords: space tourists, taxi flight, selection guidelines, fitness to fly.
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
TABLE OF CONTENTS
ABSTRACT…………………………………………………………………...2
INDEX OF FIGURES………………………………………………………...4
INDEX OF TABLES………………………………………………………….4
1
2
INTRODUCTION………………………………………………….…..5
1.1
THE NEED……………………………………………………………5
1.2
THE OBJECTIVE……………………………….……………….…..5
METHODS……………………………………………………………..6
2.1
TERMINOLOGY……………………………………………………..6
2.2
METHOD OF STUDY……………………………………………….6
3
RESULTS……………………………………………………………...7
4
DISCUSSION…………………………………………………….…..10
4.1
COUNTERMEASURES……………………………………….…..10
4.2
MONITORING………………………………………………………10
4.3
TREATMENT………………………………………………....11
4.4
PROPOSED SELECTION GUIDELINE…………………………11
5
CONCLUSIONS & RECOMMENDATIONS………….…………..13
6
REFERENCES………………………………………………………15
7
APPENDIX A………………………………………………………...16
8
APPENDIX B……………………………………………………...…20
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
INDEX OF FIGURES
Figure 4-1: Flowchart showing the proposed guideline for passenger
selection……………………………………………………....12
INDEX OF TABLES
Table 3-1: Results for cardiovascular diseases…………………………7
Table 3-2a: Results for neurological diseases……………………………8
Table 3-2b: Results for neurological diseases……………………………9
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
1
INTRODUCTION
The age of Space Tourism has dawned with the flights to the International Space
Station, of Dennis Tito and Mark Shuttleworth. The so-called ‘Taxi Flight’ is a
round-trip to the ISS, on the Russian Soyuz spacecraft, with stays of 6 to 8 days on
the ISS. The crew goes up on a new Soyuz with the provisions to the ISS; and returns
in the old Soyuz that had been attached to the ISS during the previous mission. With
more and more individuals ready to pay for the third seat on the Soyuz for an
unforgettable journey of their lifetime, there is an inherent demand for widening the
selection criteria for space travelers, so as to allow the ‘not-so-perfectly-healthy’
aspirants also to feel the excitement of space travel. The lack of established
guidelines for space tourists poses a great difficulty for passenger selection.
1.1 THE NEED
In 2001, when the financially-constrained Russian Aviation and Space Agency
decided to launch US millionaire, Dennis Tito, on a Soyuz taxi mission to the ISS for
USD 20 million, NASA immediately opposed the plan, citing a number of reasons.
One reason was that the station partners had not yet agreed upon a guideline policy
for selecting visiting crewmembers to the ISS. Despite the objections, the Russians
went forward with the launch, and thus Dennis Tito became the first paying space
tourist (April 2001). However, the station partners made headway on selection
criteria for ‘spaceflight participants’, and came up with a nine-page document entitled
‘Principles Regarding Processes and Criteria for Selection, Assignment, Training and
Certification of ISS (Expedition and Visiting) Crewmembers’ (Halvorson 2002).
Surprisingly, the criteria lacked detail on medical and training requirements, and were
focused more on behavior and conduct. This leaves room for the involved space
agencies to define their own medical criteria. To this end, new selection criteria for
spaceflight participants is the need of the hour.
1.2 THE OBJECTIVE
The objective of this study is to give an insight into the medical guidelines to be
followed for the selection of space tourists for taxi flights, with respect to the
cardiovascular and neurological diseases, and the inflight countermeasures,
monitoring and treatment that can be provided.
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
2
METHODS
The primary data for disease disqualification/exception was obtained from the
Aerospace Medical Association Task Force on Space Travel report (2001). The
exception cases were further evaluated to propose possible inflight countermeasures,
monitoring and treatment.
2.1 TERMINOLOGY
For the purpose of this study, the following terminology was used:

A cause for disqualification is defined as ‘any medical condition or treatment
regimen which could endanger the health of the passenger, fellow passengers, or
crew; compromise safety inflight or on the ground; or pose a threat to completion
of the flight’ (Aerospace Medical Association Task Force on Space Travel 2001).

An exception means ‘further evaluation has to be done, depending on the
condition of the passenger and the circumstances of the flight.’

Countermeasures means ‘the possible measures that could be undertaken inflight,
to prevent the worsening or recurrence of the disease or its complications.’
Monitoring refers to ‘the possible means to monitor the passenger inflight, for any
symptoms related to the disease.’

Treatment is defined as ‘the possible inflight treatment measures to control the
symptoms, if they occur, and thus control the disease, until the passenger returns
to ground for normal treatment procedures.’
2.2 METHOD OF STUDY
First, for a particular disease or condition, the possible countermeasures that could be
provided on the ISS were probed. Then, the onboard facilities for periodic or
continuous monitoring were looked into. Then, the onboard treatment measures that
could be provided, if the disease worsens in spite of all the undertaken
countermeasures, were explored.
As the Soyuz spacecraft used for taxi flights has only limited workspace and minimal
onboard medical equipment (to measure pulse, blood pressure, etc.), the
countermeasures, monitoring and treatment procedures proposed here are more
applicable to the ISS, although some may fit to Soyuz also (Zak 2005). As such, the
medical risks related to the Soyuz phase of the flight (2 days to go to ISS and 3 hours
to come back) have not been evaluated.
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
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RESULTS
The results of the study are given in the tables 3-1, 3-2a and 3-2b.
Disease /
Condition
Cardiovascular
Counter
measures
Onboard
Monitoring
Onboard
Treatment
Low-fat diet,
exercise, control
blood pressure,
stress
management
ECG
Medication (beta(Electrocardiogram), blockers, Calciumechocardiogram, blood channel blockers,
pressure, pulse,
ACE inhibitors,
respiratory rate
etc.), low-fat diet
Arrythmias /
Conduction
Defects
(Nonhemodynamically
significant)
e.g.: Atrial
fibrillation
A well-balanced,
low-fat diet,
regular exercise
ECG, echocardiogram,
blood pressure,
respiratory rate, heart
rate and rhythm
(pulse)
Pericarditis /
Myocarditis
(6 months postrecovery)
Medication,
exercise, relieve
stressful and
riskful activities,
salt restriction
ECG, echocardiogram,
blood pressure, pulse,
respiratory rate,
temperature
Hypertension
(Well controlled)
Medication,
exercise, relieve
stressful and
riskful activities,
low-salt diet
Blood pressure, pulse
Structural /
Valvular Defects
(Asymptomatic)
e.g.: Mitral valve
prolapse
Antibiotics to
prevent infection
ECG, echocardiogram,
doppler examination,
blood pressure,
respiratory rate, heart
rate and rhythm
(pulse)
Cardiomyopathy
(Asymptomatic)
Exercise, salt
restriction
ECG, echocardiogram
Coronary Artery
Disease
(Asymptomatic)
Anti-arrhythmic
medication
Corticosteroids,
aspirin, salt
restriction,
diuretics, ACE
inhibitors
Emergency:
sodium
nitroprusside,
labetalol.
Continue
medication
Antibiotics, antiarrhythmics,
vasodilators,
digitalis, diuretics,
propranolol,
anticoagulants
Digoxin, diuretics,
vasodilators, ACE
inhibitors, beta
blockers,
cordarone
Table 3-1: Results for cardiovascular diseases
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Disease /
Condition
Neurological
Multiple
Sclerosis
(Certified fit after
evaluation)
Parkinson’s
Disease
(Certified fit after
evaluation)
Counter
measures
Onboard
Monitoring
Onboard
Treatment
Exercise, wellbalanced diet,
avoid fatigue and
stress, reduce
factors that may
trigger an MS
attack
Abnormal reflexes,
decreased movement,
speech and vision
changes, nystagmus,
tremor, weakness
Interferon,
glatiramer acetate,
corticosteroids
(prednisone),
benzodiazepines,
amantadine.
Exercise, adequate
rest and relaxation
Exercise, wellbalanced diet,
avoid stress,
Regular rest
periods
Tremor, Rigidity,
Depression, Emotional
changes (Anxiety,
stress, and tension),
Difficulty in
swallowing and
chewing, Speech
changes, Urinary
problems or
constipation, Excessive
sweating, Sleep
problems, Dyskinesias,
Muscle aches and pains
(myalgia)
Medication
(levodopa +
carbidopa,
amantadine,
Deprenyl,
Anticholinergics,
Selegiline,
Bromocriptine,
pergolide,
pramipexole and
ropinirole)
Weakness, or paralysis,
speaking, swallowing,
or vision, breathing,
consciousness level.
Carotid Doppler, Echo,
ECG (EKG), Holter
monitor, Heart rate &
Rhythm
Tissue
Plasminogen
Activator, early
use of Heparin and
Aspirin. Oxygen
may be
administered when
necessary.
Analgesics & antihypertensives.
Nutrients and
fluids
Cerebral
Vascular Disease
(Stroke)
(Certified fit after
evaluation)
Control blood
pressure,
cholesterol,
diabetes and any
heart disease.
Continue
medication, lowfat diet. Exercise
regularly.
Seizure disorder
(Epilepsy)
(A reasonable
seizure-free
period)
Adequate diet
and sleep,
NA
medication,
(Electroencephalogram
prevent triggering
[EEG] in research
factors. Avoid
phase)
risk of head
injury.
Oral anticonvulsants
(Phenobarbital)
Table 3-2a: Results for neurological diseases
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Disease /
Condition
Neurological
Counter
measures
Dementia
(Certified fit after
evaluation)
e.g.: Alzheimer's
disease
Control high
blood pressure
and diabetes. Eat
a low-fat diet.
Regular exercise.
Intracerebral
Neoplasm (Brain
Tumor)
(Certified fit after
evaluation)
Continue
medication,
reduce fluid
intake to decrease
the chance for
edema
Fixed
Neurological
Deficit Due to
Any Cause
(Certified fit after
evaluation)
Continue
medication
Onboard
Monitoring
Onboard
Treatment
Medication (Antipsychotics,
Serotonin-affecting
drugs (trazodone,
buspirone),
Dopamine blockers
(haloperidol,
Risperidal,
olanzapine,
clozapine))
Corticosteroids
Changes in
(dexamethasone),
personality or
osmotic diuretics
memory, speech,
(urea or mannitol),
vision, weakness,
anticonvulsants
seizures, headaches,
(phenytoin),
alertness, muscle
analgesics, antacids
strength,
or histamine
coordination, reflexes,
blockers to control
and response to pain
stress ulcers
Impairment of
attention, orientation,
memory, judgment,
language, aaltered
sleep patterns,
personality changes,
motor and spatial
skills, and function
Changes in function
of the part affected
Specific
medication for the
cause
Table 3-2b: Results for neurological diseases
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
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DISCUSSION
The cardiovascular and neurological diseases were compared and contrasted to get a
clear picture.
4.1 COUNTERMEASURES
With regard to the cardiovascular diseases studied, it was found that there are
common onboard countermeasures that could be provided to all the diseases. These
include exercise, continuing medication, controlling blood pressure and having a wellbalanced low-fat diet. This may be attributed to the dynamic nature of the
cardiovascular system. Diseases like hypertension, cardiomyopathy and coronary
artery disease require reduced salt intake and stress. Structural and valvular defects
are unique, as they require prophylactic antibiotic therapy.
The neurological diseases require mostly unique countermeasures, which can be
attributed to their unique symptoms. As such, a set of common countermeasures can
hardly be put forward. For example, stroke requires controlling blood pressure,
cholesterol and diabetes, whereas epilepsy requires adequate diet, sleep, medication
and preventing triggering factors. But, some diseases were found to have common
countermeasures. For example, multiple sclerosis and Parkinson’s disease patients
should be prevented from anxiety, stress, fatigue, etc. Of course, regular medication
is an absolute requirement for all the neurological diseases.
From this study, it is inferred that simple countermeasures can be effectively provided
on the ISS for space tourists with diseases, without extra onboard hardware. At the
same time, it is interesting to see that the types of countermeasures to be provided are
different, within and among the various body systems.
4.2 MONITORING
The onboard monitoring for all the cardiovascular diseases is by using the same
parameters and hence the same equipment. The pulse and blood pressure can be
easily monitored.
Facilities for ECG (electrocardiogram), doppler and
echocardiogram are also available onboard. As stated earlier, the dynamic nature of
the cardiovascular system helps us to monitor all the diseases by measuring few
parameters. The need for bulky instruments is avoided by the use of integrated
multiple-parameter measuring instruments. For example, sensors placed at the
fingertip can measure pulse and partial pressure of oxygen in the blood. At the same
time, diseases like pericarditis and myocarditis require additional monitoring of
respiratory rate and temperature.
In the case of neurological diseases, monitoring is mostly disease-specific or specific
to a group of diseases. Impairment of the sensory system has quite different
monitoring requirements than that of the motor system. Moreover, most diseases
have associated emotional and behavioral changes also. As a result, efficient
monitoring can be provided only by a trained astronaut specialized in neurological
diagnosis. This could be a constraint for the qualification of the passenger. In the
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
case of lesser-trained astronauts, medical guidance from the ground can be of great
help in the monitoring process. Telemedicine facilities with real-time or near-realtime two-way communication between the space station and the ground control
station are highly desired.
So, while there are onboard instruments to monitor the cardiovascular parameters,
there are no regularly used instruments for monitoring neurological parameters. It is
inferred that cardiovascular diseases can be easily monitored onboard the ISS, while
neurological diseases require a trained astronaut for the same.
4.3 TREATMENT
As treatment is disease-specific, a generalization cannot be applied. Every disease
has to be controlled by its specific oral, intravenous or intramuscular therapy. But, as
many diseases have common symptoms, a general symptomatic line of management
can be undertaken. The positive factor is that, with the current medical facilities on
the ISS, efficient therapy can be initiated to control the symptoms, well before the
passenger is moved to a hospital upon returning to Earth. The negative factor lies in
the fact that the multi-million dollar mission will most probably not be shortened just
to save the life of the passenger. This brings into light the undeniable reality that the
passenger should accept the personal risks associated with space travel.
4.4 PROPOSED SELECTION GUIDELINE
Fig. 4-1 shows the flowchart describing the proposed guideline for passenger
selection.
When the status of the passenger falls in the ‘exception’ category, and after further
evaluation, he is certified fit for the flight, the next step would be looking into the
countermeasures that could be provided onboard the ISS.
If the required
countermeasures cannot be provided onboard, the passenger becomes disqualified
even if he is medically fit. If the required countermeasures can be provided, the next
step is evaluating the required onboard monitoring measures. As in the case of
countermeasures, qualification for flight depends on the availability of onboard
monitoring measures. Likewise, the required onboard treatment measures are also
evaluated. Only when all these requirements are met, can the passenger be certified
‘Medically Qualified for Flight.’
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Fig. 4-1: Flowchart showing the proposed guideline for passenger selection
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
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CONCLUSIONS & RECOMMENDATIONS
This study shows that certain diseases need not be obstacles in the path of people who
want to enjoy the excitement of space travel. Most of the cardiovascular and
neurological diseases can have practical countermeasures, monitoring and treatment
equipment onboard the ISS. However, the implementation of the following
recommendations would help more aspirants to realize their dreams.
(1) Improvements in the countermeasures, monitoring and treatment measures
onboard the ISS to include most, if not all, of the diseases. These diseasespecific measures will help to accommodate every aspiring space tourist. For
example, use of EEG (Electroencephalogram) to monitor tourists with a controlled
history of Epilepsy. Another option could be a customizable onboard medical
system capable of being adaptable to different passenger needs.
(2) Measures to manage medical emergencies should be greatly enhanced, so as
to cope with any situation that may endanger the life of the tourist. It will in
turn help to control the complications, in the case of an unprecedented delay in
moving him to a hospital on Earth. For example, use of defibrillator to manage
ventricular fibrillation.
(3) Development of new and compact automated diagnostic and monitoring
systems should be accelerated. For example, ‘Heartache’ is an automated chest
pain diagnostic system for distant space travel, being designed at San Jose State
University, USA (Wesley 2002).
(4) Miniaturization of equipment is highly desired. The current advances in microtechnology and nano-technology should be able to make this happen sooner rather
than later. Nanobots and molecular robots are in the horizon. Results of research
in these fields should be readily incorporated into the medical sector.
(5) Another option could be modification of existing medical equipment to
measure multiple parameters. For example, Blood Glucose Monitors can be
upgraded to measure cholesterol, ketone bodies, etc. ECG (Electrocardiogram)
equipment can be upgraded to measure EEG (Electroencephalogram). This in
turn saves space and time, which are limited in spaceflight. Moreover, this
provides easy use and management of the equipment.
(6) One option for easy drug delivery is to use new methods like skin patches and
implants. This makes the onboard life easier for the tourists, since they don’t
have to worry about periodic medicine intake and dosage. For example, use of
Lidocaine skin patch to treat local pain.
(7) The tourists should be allowed to take along with them small instruments and
medicines that are not available on the ISS. For example, Blood Glucose
Monitors.
(8) Regulations regarding space qualification of instruments and technology
should be liberalized. The current regulations impose unwanted restrictions to
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
the space qualification of new technologies. As such, new and very efficient
medical equipment are not allowed to be flown. The opposite would have made
the onboard medical management dramatically better. For example, wireless
diagnostic and monitoring equipment, wireless electrodes, etc.
(9) The proposed guideline for passenger selection can be used effectively for taxi
flights, with modifications, if necessary, in the future. As the linear method of
selection is simple and efficient, it can be applied to all diseases. The guideline,
along with the existing astronaut selection criteria, could be developed into new
space tourist selection criteria.
The results of this study are in agreement with and complement the report of the
Aerospace Medical Association Task Force on Space Travel (2001). However,
further study and research are needed to establish efficient space tourist selection
criteria. In the coming years, technological advancements would help more and more
people to go to space, and ultimately, medical problems may not be a constraint for
space travel.
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REFERENCES
Aerospace and High Technology Database (Database) 2005, [Online] Available at:
http://www.csa.com
Aerospace Medical Association Task Force on Space Travel 2001, ‘Medical
Guidelines for Space Passengers’, Aviation, Space, and Environmental
Medicine, vol. 72, no. 10, pp. 948-950.
MedicineNet.com (Medical Dictionary) 2005, [Online] Available at:
http://www.medterms.com
Medline Plus (Medical Encyclopedia) 2005, [Online] Available at:
http://www.nlm.nih.gov/medlineplus/encyclopedia.html
Space Passenger Task Force 2002, ‘Medical Guidelines for Space Passengers-II’,
Aviation, Space, and Environmental Medicine, vol. 73, no. 11, pp. 1132-1134.
Wesley, L. P. 2002, ‘An Automated Chest Pain Diagnostic System for Distant Space
Travel’, 2002 IEEE Aerospace Conference proceedings, vol. 7, pp. 7-3311 –
7-3315.
Halvorson, T. 2002, ‘Partners Set Standards for Station Tourists; Miscreants
Need Not Apply’, space.com, [Online]
Available at: http://www.space.com/missionlaunches/iss_guests_020131.html
‘Planned Launch for ISS Expedition 7 Crew and an EVA for Expedition 6’ 2003,
starryskies.com, [Online] Available at:
http://starryskies.com/articles/2003/04/expedition7.html
HeartCenterOnline 2005, [Online] Available at:
http://www.heartcenteronline.com/myheartdr/home/index.cfm
Zak, A. 2005, ‘SPACECRAFT: Manned: Soyuz’, RussianSpaceWeb.com,
[Online] Available at: http://www.russianspaceweb.com/soyuz.html
EEG Research 2005, [Online] Available at:
http://www.eegresearch.com/index.htm
‘More Products’ 2005, National Nanotechnology Initiative, [Online] Available at:
http://www.nano.gov/html/facts/MoreProds.htm
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APPENDIX A
Medical Guidelines for Space Tourists
(Adapted from: Aerospace Medical Association Task Force on Space Travel
2001, ‘Medical Guidelines for Space Passengers’, Aviation, Space, and
Environmental Medicine, vol. 72, no. 10, pp. 948-950)
Disease / Condition
Cardiovascular
Disqualify
Exception

(Symptomatic)

(Hemodynamically
significant)

(Asymptomatic)

(Non-hemodynamically
significant)
Pericarditis / Myocarditis

Heart Transplant /
Replacement


(6 months post-recovery)
Coronary Artery Disease
Arrythmias / Conduction
Defects
Pacemaker / Implantable
Defribillators
Hypertension
Structural / Valvular Defects
Cardiomyopathy


(Severe or poorly
controlled)

(Symptomatic)

(Symptomatic)
Neurological
Multiple Sclerosis

(Active)
Parkinson’s and Other
Movement Disorders

Cerebral Vascular Disease /
Malformations / Aneurysms

Seizure disorder

Dementia

International Space University, MSS ‘05

(Well controlled: Qualified
with possible exceptions)

(Asymptomatic)

(Asymptomatic: Evaluate
for qualification)

(Evaluate condition and
neurological deficit)

(Evaluate degree and
extent of impairment)

(Evaluate for neurological
dysfunction and
musculoskeletal disability)

(A reasonable seizure-free
period)

(Evaluate cognitive
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Headaches
Syncope or Other
Disturbance of
Consciousness

(Frequent, severe or
incapacitating,
particularly migraine)

(Recent or Unexplained)
Intracerebral Neoplasm

Fixed Neurological Deficit
Due to Any Cause

Ophthalmological
Visual Acuity
Narrow Angle Glaucoma
Any Acute Condition
Ear / Nose / Throat
Any Acute Disease
Meniere’s and Other
Vertiginous Conditions
Orthopedic
Musculoskeletal Integrity
(Amputations,
Malformations, Arthritides,
Use of Appliances)
Osteoporosis
Cervical or Lower Spinal
Cord Disease
Diathesis for Pathological
Fractures
Acute Injury or Pain
Genito-Urinary
Calculi
International Space University, MSS ‘05
impairment related to
organic disease)

(Evaluate for exception)

(Evaluate for exception)

(Legally blind)


(Pain, Discomfort or
Interference with ability
to see)

(Pain or Discomfort)


(Treated and there is
reasonable vertiginous-free
period)

(Structural and functional
integrity preclude
capability of emergency
ground egress and use of
life support systems)

(Severe)

(Significant)


(Until Asymptomatic)

(Evaluate for exception)

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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
(Symptomatic)
Chronic Renal Failure /
Renal Insufficiency

Pregnancy (including loss or
termination of known
pregnancy for any reason)

Dysmenorrhea
Acute Infection or Urinary
Tract Obstruction
Dermatology
Any severe Skin Disease
(Psoriasis, Chronic Pruritis,
Skin Tumors)

(Significant functional
impairment)
Bipolar Disease
Suicide Attempt / Gesture
Claustrophobia
Substance Abuse /
Dependence
Miscellaneous Conditions
(Phobias, Anxiety, Panic
Attacks, Depression)
Oncology
Cancer
Gastro-Intestinal
Peptic Ulcer Disease
Inflammatory Bowel
Disease
International Space University, MSS ‘05

(6 weeks post-partum)


(Interferes with use of
life support equipment)
Psychiatry
Any Psychotic Episode

(Evaluate level of
insufficiency)


(Reversible Cause)


(Evaluate for exception)


(If there are no
immediate means of
relieving apprehension
from confinement)

(Ongoing)

(History)

(Evaluate history of
stability)

(Any active or treated
cancer which interferes
with function of any
system or has the
potential for
incapacitation)

(Evaluate for exception)

(Symptomatic)

(Symptomatic)

(Asymptomatic)

(Asymptomatic)
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Irritable Bowel Syndrome
Acute Pancreatitis
Gall Bladder Disease
Active Abdominal Pain,
Nausea/Vomiting, Diarrhea
of Any Etiology
Hepatitis
Cirrhosis
Ostomies
Abdominal Surgery

(Symptomatic)


(Symptomatic)
Asthma
Pneumothorax
Pulmonary Function
Miscellaneous
Diabetes mellitus
Infectious / Contagious
Disease
Anemia
Medication
Dental
International Space University, MSS ‘05

(Asymptomatic)


(Acute)


(Until complete
recovery)
Pulmonary
COPD (Chronic Obstructive
Pulmonary Disease)

(Asymptomatic)



(Current or Recurrent)

(Significantly decreased
due to any cause)

(Unstable, Brittle or
Poorly Controlled)

(Active)

(Severe / Symptomatic)

(Significant Side-Effects
like Somnolence, Nausea
/ Vomiting or
Exacerbation of Illness, if
dosages are missed or
poorly absorbed)
 (Significant Discomfort)

(Evaluate for exception)

(Evaluate for qualification)

(Evaluate for exception)

(Evaluate for exception)

(Evaluate all others)

(Evaluate all Type I
Diabetics)

(Blood-borne diseases like
Hepatitis B & HIV/AIDS:
Evaluate for qualification
based upon risk of
transmission)
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
8
APPENDIX B
Aspects of Space Tourist Safety
Cardiovascular
Neurological
Medical
Orthopedic
Gastro-Intestinal
Psychological
Training
Genito-Urinary
Pulmonary
Psychiatry
Technical
Space
Tourist
Safety
Economic
Ophthalmological
Ear/Nose/Throat
Dermatological
Legal
Oncology
Miscellaneous
Mission Design
Risks
International Space University, MSS ‘05
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Taxi to the ISS – Medical Guidelines for Space Tourists With Respect to Cardiovascular and Neurological Diseases
Taxi to the ISS - Medical Guidelines for Space Tourists
With Respect to Cardiovascular and Neurological Diseases
Dr. Anis Karim
Master of Science in Space Studies 2004-2005
International Space University
Strasbourg, France
International Space University, MSS ‘05
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