An Overview of Occupational Surveillance for the Astronaut Corps: The Lifetime Surveillance of Astronaut Health (LSAH) Program

Astronauts have arguably the most unique occupational exposure profile of any profession. While many risks to humans in space have been identified, there may still be others left to discover. In order to understand these risks and properly address them, the National Aeronautics and Space Administration (NASA) created the Lifetime Surveillance of Astronaut Health (LSAH). The LSAH program was designed to address a variety of needs regarding astronaut health, including comprehensive medical care, operational and health care analysis, and occupational surveillance. The primary objective of the occupational surveillance aspect of the program is to identify and implement appropriate medical monitoring and preventive measures to address the occupational exposures encountered by the individual astronaut. Medical testing protocols address the primary identified risks to astronauts, including the effects of microgravity, noise, radiation, heavy metals, and lasers. Active and retired astronauts are provided with a standardized annual preventive medical exam (AE), while active astronauts have additional pre- and post-mission testing. Additional tests are added to the AE as appropriate based on age, exposure history, and other clinical indications, in accordance with US Preventive Services Task Force (USPSTF) guidelines and NASA Space Medicine Clinical Practice Guidelines. Individual exposure profiles are generated and updated at the AE, and Clinical Exposure Protocols are generated to inform hazard-related medical monitoring. This presentation outlines the protocols and procedures of the LSAH occupational surveillance program, and discusses ways that data are used for risk assessment and occupational surveillance.