At time of writing three countries in the world have the capabilities to launch individuals into space, the longest heritage belonging to the Russian and Americans. The space environment is incredibly harsh on the human body. The International Space Station (ISS) is somewhat protected by its position in Low Earth Orbit (LEO), astronauts travelling to Earth’s Moon, to Mars or on extended Exploration Class Space Missions (ECSM) will be exposed to a range of risks and hazards.
Risks and hazards are a metric that need to be included in all space flight planning. Risks need to be defined, both their likelihood and their severity (impact on humans). Without a definition and refinement of risk, the hazard cannot be defined, and the hazard cannot be controlled for.
Space Medicine provides a knowledge base, and knowledge has increased dramatically since the first human space flight, but it has gaps and limitations. The gaps and limitations need to be identified, and where possible, hazards identified and prepared for.
Operational space medicine is the area of space medicine where doctors predict and prepare for diseases, conditions, and are hopefully able to implement treatment parameters for astronaut patients. Our knowledge of human habitation outside of LEO, for deep space voyeurs, or colonisation on planets inside and perhaps one day outside our solar system, is limited. Human voyagers to the Moon have been brief affairs, and male gendered. No woman, no grandparent, no child has been recorded, reviewed and medically monitored in the off-Earth environment on an extended mission, with extended exposure to the space radiation or microgravity.
Which is the best definition of risk?
Definitions: A measure of the extent to which an entity is threatened by a potential circumstance or event, and typically a function of: (i) the adverse impacts that would arise if the circumstance or event occurs; and (ii) the likelihood of occurrence.
Risk is the possibility or probability that a future event with an uncertain outcome will occur, resulting in a negative consequence or adverse impact on something of value. It is a function of both the potential impact of an event and the likelihood of it happening, and can be understood as the intersection of a hazard (a source of potential harm) and a vulnerable system or asset.
Some important terms related to risk assessments include:
Hazard – a potential source of injury, adverse health effect, or damage to people, structures, equipment, or the environment. A common way to classify hazards is to categorize them as biological, chemical, ergonomic, physical, psycho-social, and safety hazards.
Hazard identification – the process of finding, listing, and characterizing hazards.
Risk – the combination of probability and severity that a person will be harmed or experience an adverse health effect if exposed to a hazard. Risk can also be applied to situations with property or equipment damage, or harmful effects on the environment.
Probability – the extent to which an event is likely to occur. The probability of harm may also be referenced as the likelihood of harm.
Severity – the seriousness of an incident, injury, or illness. Severity, or consequence, describes the highest level of damage possible from a hazard and is often described in terms such as catastrophic, critical, moderate, minor, or negligible.
In general, risk can be expressed as: Risk = probability x severity
https://www.ccohs.ca/oshanswers/hsprograms/hazard/risk_assessment.pdf
Hazard control – control measure(s) and action(s) taken to reduce the risk of a hazard based on the risk assessment. Hazard control should also include monitoring, re-evaluation, and compliance with decisions.
Why is risk assessment important?
Risk assessments are very important as they form an integral part of an occupational health and safety management plan.
They help to:
- Create awareness of hazards and risks.
- Identify who may be at risk (e.g., workers, cleaners, visitors, contractors, the public, etc.).
- Determine whether a control program is required for a particular hazard.
- Determine if existing control measures are adequate or if more should be done.
- Prevent injuries or illnesses, especially when done at the design or planning stage.
- Prioritize hazards and control measures.
- Meet legal requirements where applicable.
https://www.ccohs.ca/oshanswers/hsprograms/hazard/risk_assessment.pdf
Risk is characterized by three basic components:
- The scenario(s) leading to degraded performance with respect to one or more performance measures (e.g., scenarios leading to injury, fatality, destruction of key assets; scenarios leading to exceedance of mass limits; scenarios leading to cost overruns; scenarios leading to schedule slippage);
- The likelihood(s) (qualitative or quantitative) of those scenario(s); and
- The consequence(s) (qualitative or quantitative severity of the performance degradation) that would result if the scenario(s) was (were) to occur.
Scenarios begin with a set of initiating events that cause the activity to depart from its intended state. For each initiating event, other events that are relevant to the evolution of the scenario may (or may not) occur and may have either a mitigating or exacerbating effect on the scenario progression. The frequencies of scenarios with undesired consequences are determined. Finally, the multitude of such scenarios is put together, with an understanding of the uncertainties, to create the risk profile of the system.
In occupational medicine, scenarios are referred to as root causes or risk factors.
www.nasa.gov/reference/6-4-technical-risk-management/
The collective challenge for the space medicine community it to identify risk, hazards, and create a professional collective, to learn the techniques used in all forms and deliveries of medicine. This knowledge will be used to train our AI doctor, to help, assist our colleagues who will travel into space as part of mission crews.
We may not all have the opportunity to go to space, but those of our colleagues that do, will have our collective knowledge to lean on. What could be better than that?