the apollo-soyuz test project medical report

8/8/2019 The Apollo-Soyuz Test Project Medical Report

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NASA SP-411

TheApollo-So~zTest ProjectMedical

Report

National Aeronauticsand Space Adm inistration


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THE APOLLO-SOYUZ TEST PROJECT MEDICAL REPORT


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NASA SP-411

TheApollo-So~zTest ProjectMedicalReport

Compiled byA rnail Id E.N icogossian,M.D.

l977Scientific and Technical Information OfficeNational Aeronautics and Space AdministrationWashing on,D.C


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For sa le by th e N at iona l Technica l In forma tion Serv iceSpringfield, Virginia 22 16 1Price - $6.00

Library of Congress Cataloging in Publication DataAp o l lo S OYUZest Project.The Apollo-Soyuz Tes t Pro jec t m edica l report .(NASA SP ; 411)Bibliography: p.Includes index.1. Space medicine. 2. Apollo-So yuz Test Project. 3. Space flight-Physiological effe ct. I. N icogossian,Arnauld E. 11. L y n d o n B. Joh nso n Space Cente r. 111. Title . IV. Series: U nited States . N ationa l Aero-naut icsand Space Adminis t ra t ion . NASA SP ; 4 1 1 .RC1135.A66 616 .980214 11-2 310


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FOREWORD

Th e Apol lo-Soyuz Test Projec t (ASTP) was bo th an end and a beginning.It was the final f l ight of the highly successful Apo llo program. It was the lastt ime tha t three U.S. ast ronauts , t ight ly packed in to a comm and module , wouldlaunch f rom an expendable booster , e lbow the ir way through space , and thenretur n gracefully to a salty splashdown .But i t was the first t ime th at an international purpose t o manned fl ight wasdemonstra ted . Jo in t docking and the shar ing of quar te rs , exper iments , and pro-visions have all symbo lized the feasibility and t he w ill of co operative sp ace explora-t ion .As we summ arize the Life Sciences findings of this mission, we look forwardto th e future. We are confident tha t international manned missions will continu ein ever increasing freq uen cy and dura tion. We are also con fiden t tha t we will beable to s upp ort these missions and to insure the health and well-being o f al l spacetravelers.

Janua ry 1977DAVID . WINTER,M.D.

N A S A Director fo r Life Sciences

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PREFACEThe A pollo-Soyuz mission was the f irst space f light to be condu cted jointly by t he t w oleading nations in space exploration , the United States and the U.S.S.R. The primary purposeof this mission was to test system s for rendezvous and d ocking o f manned spacecraft as mightocc ur in standard interna tional space rescue missions and ,con sequ ently , t o dem onstrate theabili ty to effect crew transfer between spacecraft . The seco ndary purpose of th e mission was

to con duc t a program of science experim ents an d technology applications. Excep t for minormodif ication, the A pollo and S oyuz spacecraft were identical with those f lown o n previousmissions. A specially con struc ted dock ing module was used in flight for crew transfer andalso served as the structural base for the dockin g mechanism tha t interfaced with a similarmechanism on th e Soy uz spacecraft.This mission, off icially kn own as the A pollo-Soyuz Test Project (ASTP), brought theApo llo Program to a successful conclusion. While marking the end of an era, i t also heraldedthe beginning of increased international coop eration in th e space age. The rescue of man inspace as a feasible ope ration on an internatio nal basis, should the need ar ise, was demo nstrated.research studies that were performed on the astronauts. Because of the com promised post-flight crew health sta tus , no t all postflight research proce dure s could be accom plished. Thiscomp romise was the result of the anom alous entrance of toxic gas into t he spacecraft cabinduring the Earth landing sequence. Despite the exposure, the medical data collected are ofsuff icient interest to warrant inclusion in this off icial ASTP M edical Re port.Microbial Exchange and Zone-Forming Fungi. The medical microbiological analysis of theU.S. crewm embers is reported in chapter 13 of this repo rt. T h e Microbial Exchange experi-ment, w hich includes the data fro m the U .S.S.R. cosmona uts, and th e ot he r six (U.S.)science experime nts - Qua ntitative Observation of Light F lash Sensation, Biostack 111,Zone-Forming Fu ngi, Cellular Immu ne R esponse, Th e Effects of Space Flight o n Polym or-phon uclear L eukoc yte Response, and Killif ish Hatching and Orien tation - re reportedelsewhere (see Bibliography).A m ost impel ling por tion of this report is concerned with the en try phase of th e mission,when the crew was exposed t o toxic n itrogen tetroxide gas, and with the ir subsequent clinicalcourse and uneventful convalescence. Th e problem was managed expe ditiously and expertlyby the crews flight surgeons and team of medical consultants, bot h o nbo ard ship and at theTripler Army Medical Center , H onolulu , Hawaii.Th e Apollo era has end ed with the AS TP flight. Thu s, a remarka ble series of space mis-sions - prelunar and lunar Apollo, Skylab, and ASTP - has been co ncluded . These venturesare now history, and th e Space Shut tle era will fur ther the understand ing of man in the spaceenvironment he has come to know and respect .

This repo rt details th e results of the clinical aspects as well as th e preflight and postflight

Only t w o join t U S-U .S.S.R . l ife scienceskx perimen ts were included in this mission:

L AW R E NC E. DIETLEINN A S A Lyndon B, Johnson Space Center

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Chapter

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CONTENTS

PageSECTION I . BACKGROUND

U.S. and U.S.S.R. Medical Nego tiations and Agre em ents. . . . . . . 3Arnauld E. Nicogossian and Willard R. H awkinsSECT ION 11. CREW HEALT H AND FLIG HT MON ITORIN G

General Biomedical Evaluation . . . . . . . . . . . . . .Arnauld E. Nicogossian, Eduard C. Burchard, andJerry R . Hordinsky

Crew Heal th . . . . . . . . . . . . . . . . . . . . . .Arnauld E. Nicogossian, Charles K. L apin ta, Edu ard C. Burchard,G. W yckliffe Ho f le r, and Peter J . BartelloniResul ts of Pulmonary Funct ion Tests . . . . . . . . . . . .Arnauld E. Nicogossian, Charles F. Sa win, andPeter J. Bartelloni

J. Vern on BaileyMalcolm C. Smith and Rita M. R a p pRichard L. SauerJames K. Ferguson

In-Flight Radiation Detection . . . . . . . . . . . . . . .Fo od and Nut r it ion . . . . . . . . . . . . . . . . . . .Potable W ater . . . . . . . . . . . . . . . . . . . . .Flight Crew H ealth Stabilization Program . . . . . . . . . .

SECT ION 111. PREF LIGHT , IN-FLIGH T, ANDPOSTFLIGHT M EDICAL TESTING

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Achilles Te nd on Reflex . . . . . . . . . . . . . . . . . . .Eduard C. Burchard and Arnauld E. .VicogossianEarl V . LaFevers, Arna uld E. Nicogossian,William N . Hursta, and Joseph T. BakerG. W yckliffe Ho fl er , Arnauld E. Nicogossian,Stuart A . Bergman, Jr., and Ro bert L. Johnson

Electrom yograph ic Analysis of Skeletal Muscle . . . . . . . . . .

59ardiovascular Evalua tions . . . . . . . . . . . . . . . . . .

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Chapter Page12 In-Flight Lower Limb Volum e Measurement . . . . . . . . . . . 6 3G. Wy ckliffe Hoffler, Stuart A . Bergm an, Jr.,and Arnauld E, Nicogossian

Gerald R. TaylorCarolyn S. LeachStephen L. Kimzey and Phillip C. ohnsonJeri W. Brown

13 Med ical Microbiological Analysis of U.S. Crewmember s . . . . . . . 69874 Biochemis try and Endocr inology Resul ts . . . . . . . . . . . .

15 Hematological and Immunological S tudies . . . . . . . . . . . . 1 0 116 Crew Height Measurement . . . . . . . . . . . . . . . . . . 119

Bibliography . . . . . . . . . . . . . . . . . . . . . . . 1 23I n d e x . . . . . . . . . . . . . . . . . . . . . . . . . . 125Acknowledgments . . . . . . . . . . . . . . . . . . . . . . 1 2 9

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SECTION I

BACKGROUND


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1. U.S . AN D U .S.S .R. MEDICAL NEGOTIATIONS AN D AGREEMENTS

Arnauld E. Nicogossiana and Willard R. Hawkinsa

This discussion of m edical negotiations and agreements between representat ives of t heUnited S tat es and th e U.S.S.R. is presented chronologically.1972

Jo in t U.S. and U.S.S.R. negotiations f o r th e Apollo-Soyuz Tes t Project (ASTP) werecon ducte d a t regular intervals by th e U.S. a nd U.S.S.R. specialists a t the NA SA Lynd on B.Joh nso n Sp ace Cen ter (JSC) in the U nited Sta tes and, under th e auspices of the U.S.S.R.Ac adem y of Sciences, in th e U.S.S.R. Preliminary discussions were held Oc tob er 9 to 19 ,19 72 , in Moscow, U.S.S.R. During this meeting, medical special ists of W orking Grou p I11discussed in-flight crew sa fety , crew transfers, an d an in-flight m edical sup po rt system.In add it ion, t he y exchanged several prel iminary l ife sciences docum ents relat ing to theproposed joint venture.

1973Th e heavy schedules imposed by the Skylab orbi tal m issions limited medical negotia-t i ons i n 1 973 to the tw o joi nt l i fe sciences experiments, Microbial Exchange and Zone-Forming Fungi .

1 9 7 4 a n d 1 9 75Af ter com plet ion o f th e Skylab space fl ights in 19 74 , negotiations relating to th emedical requirem ents were renewed, and a joint session was held a t JSC from January 14t o Februa ry 1, 1974. Ap poin ted representat ives of the tw o countries exchanged generalinforma tion ab ou t the prefl ight , in-fl ight , and postflight m edical evaluat ions; schedules;and a f l ight crew health stabi lizat ion program. The negotiat ions and th e inten t to followup w ith appropriate docu me ntat ion and p reparation of a U.S.-U.S.S.R. working grou preference docum ent fo r medical requirements are recorded in the official minutes o f themeet ing by Working Group I . The nex t meeting, Apri l 8 t o M ay 3, 19 74 , was held again

at JSC. Before this meeting, bo th cou ntries exchanged do cum ents regarding the ir respec-tive medical requiremen ts. A t this meeting, discussion included flight crew health stabiliza-t ion program s (21 day s before f l ight fo r the United S tates and 10 days f or the U.S.S.R.) ,in-flight bioinstr um entatio n, possible drug kit exchange, dru g testing, schedules, andproto cols f or in-flight crew transfers. Since th e internal life sciences AS TP med ical re-quirem ents do cum ent was not c omp leted, only preliminary plans for the preflight andpostflight medical exam ination tim e lines were discussed at the time o f this meeting. T heprefl ight an d postfl ight medical requirem ents for bot h cou ntries were f inalized during the

aNASA Lyndon B. Johnson Space Center.

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THE APOLLO-SOYUZ TEST PRO JECT MEDICAL REPORTsucceeding meeting, held in M oscow, between August 26 and September 13, 1974. The in-fl ight medical requirem ents were com pleted an d add ed t o th e overal l medical requiremen tsdocu m ents during a meeting held Janua ry 30 t o Februa ry 13 , 1975 , a t JSC.independen tly tai lored by each cou ntry . Th oug h the main objectives of both programs areidentical (i.e., the stud y of mans physiology in space and o pti m um in-flight crew healthmaintenance), the m ethod s of accomplishing these ob jectives are dissimilar and generallyreflect each countrys respective medical philosophies. At th e star t of the ASTP medicalnegotiations, experim ental procedures for only tw o types of medical protoco l ( i .e . , lowerbo dy negative pressure and blood biochemical evaluat ions) had been agreed to u nder theauspices of the U.S.-U.S.S.R. Joi nt Working Gr ou p on Space Biology and Medicine. Th us,the major port ion of the medical evaluat ions and t he respective t ime l ines had to be dis-cussed and unified during the available t ime app ort ioned for the meetings of ASTP workinggroups. Th e small num ber of m edical representat ives part icipat ing at any t ime in thenegotiations and the increased secretarial and trans lator supp ort th at was needed accou ntedfor a delay in com plet ion of t he joint phase of the biom edical program.medical requiremen ts docum ent will be published separately at a later da te.conta ct between medical personnel of the tw o countries had been established for the ASTPin-fl ight port ion of the mission. I t was decided that , in case of need , commu nicat ionsbetween medical staffs would be routed through th e Joint F l ight Directors Loop . Also,the final med ical findings fro m this m ission w ould be presented durin g a regular session ofthe jo int U.S.-U.S.S.R.Working Gro up on Space Biology and Medicine.

Before ASTP, l ife sciences programs t o be implem ented in ma nned space fl ights were

For historical purposes, th e final English language version o f the AST P U.S.-U.S.S.R.Because each co untry was allowed to p roceed with i ts respective program, n o official

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SECTION I1CREW HEALTH AN D FLIGHT MONITORING


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2. GEN ERA L BIOMEDICAL EVALU ATION

Arnauld E. Nicogossian,a Eduard C.Burchard,a and Jerry R.Hordinsk ya

Fo ur areas of importance in heal th preventive maintenance became app arent from pre-1. Th e fl ight medicine sup port system and drug testing2. The work/rest cycle3. In-flight exercise and bioinstrumentation4. Foo d and nut r i t ion.Comprehensive prefl ight physical examinations were con ducte d 30, 15, an d 5 days

vious Ap ollo and S kylab space missions. These four areas are:

before launch. Addit ional abbreviated physical examinations were condu cted d ai ly start-in g 3 days before launch. Th e individual tolerance drug test ing was done 3 mon ths beforethe space fl ight , and no significant problems were encountered in ei ther prime o r backupcrewmen.tetroxid e and subsequen tly hospital ized a t the T ripler Army Medical Center, Hon olulu,Hawaii. Con sequ ently, m ost preplanned postflight medical activities no t directly relatedto crew health were canceled.which prov ided f or in-flight diagnosis and treatm ent of a possible illness, was con sideredpract ical for a short , 9-day flight. Tw o cardiovascular drugs, quinidine sulfate and dipyrid-amole, were added to the IMSS medication l ist in deference t o the past medical history ofone crewmem ber. Th e short durat ion of the mission and inade quate medical t raining of th ecrew precluded the ad dit ion of such diagnost ic equipment as a stethoscope o r a blood pres-sure measuring system into the IMSS. Th e overall m edical IMSS training, limited t o a 2-hou r general discussion with the comm and module pi lot , covered indicat ions for usage ofthe available drugs. In addit ion t o the IMSS, data from th e operat ional bioinstrumentat ionsystem wou ld also be used, as indica ted, as a diagnostic aid t o assist in the reco m me ndatio nfor t rea tment .t raining, would con sult with the crew surgeon and/or M ission Operat ions Co ntrol R oom(MOCR) surgeon over the open loo p of the air- to-ground comm unicat ion system, shouldthe need arise. Th e private medical com mu nicatio n loo p wou ld be reserved for use o n thecrews requ est o nly and with t he flight directors approval.

I t sho uld be m entioned that in the very early phase of prefl ight preparat ions, eachU.S.S.R. prime and back up crewman received a briefing regarding drugs conta ined in theU.S. medical kit. Fur th er a t tem pts to formal ly t ransla te U.S. drugs and modes of utiliza-tion in to w ritten Russian were not successful. By the s tart of the mission, a list of th eSoy uz drugs was available. It was translated into English by the efforts of U.S.S.R. med-ical personnel, and it included som e indication of drug u tilization, m od e, and dosages.Althoug h crud e, this list served as a reference for the MOCR m edical personnel.

In the en t ry phase of the m ission, the crew was exposed t o the toxic fum es of nitrogen

For mission completion, a modified Apollo in-flight medical support system (IMSS),

It was agreed before the actual f l ight that the crewm embers, because of their limited


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THE APOLLOSOYUZ TEST PROJECT MEDICAL REPORTDuring the 21-day prefl ight crew health stabi l izat ion program, the crew was maintainedon a nominal work/rest schedule. This schedule permit ted t he crew mem bers t o have a dai lyexercise pe riod and at least 7 hou rs of good night rest . I t a lso included scheduled work an dsome time for recreation each week.During the flight perio d, changes to the f l ight plan occasionally interrupted the periodsof planned crew sleep. The est imate of sleep durat io n m ade by grou nd person nel was ingeneral agreem ent with the su bjective evaluation of the crew. Th e difference in the launchand zone times of bo th countries and the scheduled t ime l ines for in-flight join t act ivi t iesinevitably led t o opera tional circadian shifts for bo th crews. Th e resulting in-flight circadianshifts for th e U.S. crewmen are depicted in Figures 2-1 and 2-2, where F - 2 is 2 days beforelift-off, F - 1 is 1 day before lift-off, and R + 0 is recovery day. The d urat ion o f sleep, sleepinterruptions, and the magnitude of circadian shifts required for the successful comp let ionof in-flight jo int activities are show n in th e figures. In sum m ary , a total of thre e major sleep/wake cycle shifts occurred during this sh ort-durat ion mission; the mos t significant shift of

approximately 4.5 hours occurred on mission day 2.

MD-2MD-3

tD-4MD-5m0I Houston 1-I

I MD-2 COCape Kennedy I+ Mission day (MD) 1 1*

MD-3 1MD-4 1

MD-5 1- -I MD-6 1II MD-8 1-tMD-6MD-7 1MD-8 - MD-7-- +MD-9 I MD-9 IR + O I R + O 1c- 1 1 1 1 1 1 1 1 1 1 1 1 1 ~ l t I I I I I I12 2 4 6 8 10 12 2 4 6 8 10 12pmam

Time of day

]I[ Sleep interruptions __ Shift i n sleep start timeleep timeFigure 2-1. Apollo-Soyuz Test Project Sleep Tim e and Circadian S hift (U.S. Crew)


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F - 1

MD-1MD-2MD-3MD-4Pm MD-5MD-6MD-7MD-8MD-9R + O-3 2 1

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H o u s t o n s t a nd a r d_ _ ---- leeping time

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I I I I ]1 2 3 4 5Var iat ion, h

Figure 2-2. Apollo-Soyuz Test Project Circadian Shift (US. rew)

The sporadic increase in the com man d m odule amb ient temperature ( t o as high as299.8 k (26.6' C) (80' F) ) during the lat ter part of the mission did not significantly affectthe overall in-flight work/rest cycle.Fl ight m enus were designed t o meet individual energy requ irements und er nor ma lgravity condit ions. The to tal daily caloric intake requirement was comp uted before thefl ight from lean bo dy mass measurements. This top ic is discussed in detai l in Ch apter 6.

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3. CREW HEALTH

Arnauld E. Nicogossian,a Charles K . LaPinta,a Ed uard C. Burchard,aG.Wyckliffe Hoffler? and Peter J . Bate l lon ib

SUMMARY OF CLINICAL FINDING S

Preflight Crew Health StatusMedical examina tions were performed on t he three crew mem bers at specif ic intervalsduring the 30-day preflight period. In anticipation of a long and busy laun ch day, eachcrewman at te mp ted to es tabl ish a m ore operat ional ly des irable s leep/work cycle 2 daysbefore lift-off (F - 2) and 1 day before lift-off (F - 1 ) by going to s leep a t approximately03:OO G.m.t. (1 1 :OO p.m. e.d.t .) and waking up at 13:OO G.m.t. ( 9 :OO a.m. e.d.t.); nohypn ot ic m edicat ions were used du r ing this per iod. O n day F - 4, al l crewmem bers wereon a low-residue diet. To furth er reduce the fecal con tent in his bowels, each crewmanused a Travad en em a and t w o Pericolace table ts on F - 1. During the preflight physicalexaminat ions , no s ignificant medical problems were detected in th e p r ime and ba ckupcrewmem bers. There were no changes in their health status , and the ir health remainedgood throu ghou t th e prefl ight phase of the mission. The Apo llo com man der (ACD R) wasno t sub jected t o studies involving radiation p rocedures because of a past history o f expo-sure t o high radiation levels.

In-Flight Crew Health StatusThe physical s ta tus of the AC DR, the com mand module p i lot (CMP) , and the d ock-ing module pilot (DMP) was mon itored d uring f light. Th e results are presented in th efollowing paragraphs.

Biomed ical instru me ntat ion and physiological data.-All physiological meas ureme nts re-mained w ithin the expected limits . Electrocardiographic and respiratory rate data wereobtained thro ugh the bioins trumentat ion d ata sys tem dur ing launch and on miss ion days2, 7, and 8 in conjunct ion with the exercise per iods ; addi tional data w ere obtained dur ingthe en try phase o f the mission. Table 3-1 is a summ ary of the physiological data obtainedf rom the biomedical ins trumentat ion.tion elec trodes resulted in poo r quality data n ot suitable for analysis . Because of ground-su pp ort techn ical difficulties on mission day 6, no biomedical data were received in theMission Co ntro l Ce nter (MCC). Altho ugh 5 minutes of ins trumented per iods of res t , ex-ercise, and postexercise data were formally requested before f light, the lack of know ledgein real t ime of the exercise star t and end times prevented correlation of the biom edicaldata with the actual activity periods.

On m ission day 2, interference of th e DMPs exercise harness with his bioins trumenta-

aNASA Lyndon B. Johnson Space Center.bTripler Army Medical Center, Honolulu, Hawaii.

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THE A POLLO -SOWZ TEST PROJECT MEDICAL REPORT

TABLE 3-I.-PHYSIOLOGICAL DATA S U M M R Y

Heart rate, beats/min Respiration rate, breaths/minACDR DMP CMPMission phase ACDR DMP CMPAv Peak Av Peak Av Peak

~~~ ~

Launch 105 130 95 123 82 117 14 14 9aOrbital flight

Mission day 2 74 90 (b) (b) 66 91 10 (b) 21Mission day 6 - - - - - - - - -Mission day 7 70 117 - - 94 137 22 - 26

- - - 16 -ission day 8 - - 74 , 140Entry 96 150 67 91 76 124 24 16 13

a b lu e s obtained during exercise.bPoor data.No biome dical data received.

No medically significant arrhy thm ias were de tec ted durin g this mission. Isolated pre-ma ture heartbeats were observed in all three crewmembers. Th e fact tha t the freque ncy andcharacter of these prematurities remained con sistent with data ob taine d previously duringground-based studies indicated tha t th ey were not related to space f light.Ad aptation to weightlessness.-All three crew mem bers experienced th e now classical fullness-of- the-head sensation immedia tely af ter Earth-orbital insertion. This sym pto m was mild anddid no t interfere with the crews per formance. The crewm embers comm ented t ha t they didn o t experience sensations of nasal s tuff iness or sinus congestion. Head m ovem ents and mov-ing around th e spacecraft did no t intensify th e fullness-of- the-head feeling an d did no t provok esym ptom s of mo tion sickness. There were no instances of nausea, vomiting, disorientation,or loss of appet i te .Crew transfers.-No significant prob lem s with th e in-flight dock ing mod ule (DM) com pressionand decom pression profiles were enco unte red during the mission. Th e DM con trol and lifesup port system performa nces were normal. During transfers, the DM pressure was raised withni t rogen f rom 3.32 t o 6.56 N/cm2. Dur ing t ransfers 1 , 2 , and 4, he So yuz crewmen reques tedthat ni t rogen be added t o the a tmosphere in the DM to decrease the percentage of oxygen(0,) seeping into th e Soyuz spacecraf t ; thus the DM-Soyuz combined volume tota l pressurewas increased b y 0.27, 0.40, and 0.13 N/ cm 2, respectively. No corrective actions were required

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CREW HEALTHdur ing manu al or auto ma tic crew transfer operations . Dur ing the t ransfer operat ions , 8.57kg of oxygen w ere used compared to 7.60 kg _redicted, and 6.21 kg of nitrogen were usedcompared to 6.38 kg predicted.At 52 hour s 1 1 minutes ground elapsed t ime (GET) , af ter reopening h atch 1, whichhad been c losed for docking, the crew repor ted a s t rong acetone-l ike od or in th e DM b utcould no t f ind the source . The crew per formed s tandard procedures to veri fy the accept-abi l i ty of th e DM atmosphere , then ini t ia ted mixing of the two atmospheres to allow re-moval of the o do r by the environmental control system in the comm and m odule (CM).Af ter extens ive ground-based s tudies , i t was pos tula ted that the od or was probably causedby m ethyl e thy l ke tone , me thyl isobuty l ke tone , o r bo th . These compound s a r e compo-nents in the glue used fo r l ining the DM wit h Velcro material. There was no evidence ofadverse ef fects to crew heal th f rom ex posure to the com poun ds o r fur ther repor ts of thisodor .Medication.-Table 3-11 is a list o f the m edications taken by each crewman during f light.

TAB LE 3-11.-MEDICATIONS TAKEN DURING FLIGHTMedication ACDR DMP CMP

Actifed (decongestant) 2Lomotil (an tiperistalsis) 7Scopolam ine-dext roamphe amine 0Aspirin a2

sulfate (anti-motion-sickness drug)

aNumber not definitely established.

On mission day 3, the ACDR not i f ied MCC that he to ok three Lo moti l table ts prophylacticallyin an a t te mp t to decrease the f requency of in-flight bowel movemen ts. He too k anoth er tw otablets on mission day 4 because of a loose bowel movement an d again took tw o Lom oti l table tsprophylactically on mission day 8 before DM jettison. Th e DMP and the CMP too k tw o Lomo tiltablets each, prophylactically, on mission day 3. The CMP took one scopolamine-dextroamphet-amine sulfate tablet prophylactically imm ediately af te r orbital insertion and repeated the samedose approximately 5 hours la ter .table ts prophylactically to prevent possible ear blockage during the en try phase. Since n osignif icant medical problem s requir ing specif ic treatmen t occu rred during f light, the medica-t ions used by each crewmemb er were minimal when com pared to those used on the major i tyof previous space f lights. No med ications for sleep were tak en at an y time during the in-f lightperiod.

On entry d ay, approximately 1 hou r af ter the s leep per iod, the ACDR too k tw o Act i fed

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THE APOLLO-SOWZ TEST PROJECT MEDICAL REPORTPostflight Crew Hea lth Status

The following discussion of crew hea lth sta tus af ter f l ight includes an analysis of t heef fects of spacecraf t a tmosphere c ontam inat ion.Recovery.-The U.S. crew was exposed t o toxic gases (most ly nit rogen te t rox ide (N 2O 4) )from inadvertent reaction con trol system (RCS) f ir ings during the d escent phase, 30 secondsaf ter drogue deploym ent and a t approximately 21: 15:07 G.m.t. (1 1: 15:07 a .m. Hawaii t ime)on July 24, 197 5. Th e N ,0 4 ente red the CM thro ugh the cabin pressure relief valve, whichwas opened during the landing sequence.During th e postlanding medical debrief ing, the ACDR re port ed, T here was a yellowish-brow n colored smoke which smelled like RCS. Th e smoke was so thick that I had a hardtime seeing the oth er crewme mbe rs o r the dials in front o f me. T he smo ke cleared very fast.Nei ther the DMP nor the CMP repor ted observing the yel low-brown smok e.

Once the crew disabled the RCS, and following initial peak expo sure, unco ntam inate dair was drawn in to the cabin unt i l landing occur red. Simultaneously, the l i thium hydrox ide(LiOH) scrubbers cont inued t o absorb the ni trogen oxide mixture .( inver ted) pos i tion, the ACDR unstrapped and fe ll down into the CM tunnel , hur t ing hisr ight shoulder and e lbow. He uns towed the oxygen masks and proceeded t o provide oxygento th e crewmembers . Not u nt i l the spacecraf t assumed s table I (upr ight) pos i t ion, approxi-mately 3 minutes 30 second s af ter landing, did th e ACDR notice t ha t th e CMPs mask washanging on th e side of his face and that he was unconscious. Fro m th e available history ,i t appears that the CMP was unconscious for approximately 50 seconds. In re t rospect , i t i sthoug ht tha t the exposure t o toxic fumes possibly com bined w ith ef fects of th e feet beingpositioned lower than the head while in stable I1 position cou ld have contr ib uted t o thisfainting episode. The CMP recovered pro mp tly wh en his face mask was positioned properlyand t he oxy gen f low was increased.was pos i tioned, and the CM hatch was opened. This act ion contr ibuted t o fur ther improve-ment of the ventilation and remov al of the n oxiou s gases from th e cabin.Approximately 40 minutes 50 seconds la ter (2 1 :5 8: 44 G.ni . t .) , the spacecraft washoisted ab oard th e recovery vessel U.S.S. New Orleans, and the crew exi ted the CM at 22:05:04 G.m.t. When the hatch was opened, a humid and moldy smell emanated f rom the CM;there was n o detectable odo r of the i r r i tant gas . All the crewmem bers appeared s tea dy,slightly pale, and profusely diaphoretic. Th e f irst indicatio n of exposure t o the gas camelater dur ing the hangar -deck ceremony when the A CDR reques ted oxygen for smo ke inhala-tion ; the exp osure event was detailed during the postf light debrief ing sessions also. Thesefacts were furth er ascertained by playback of onbo ard voice and data tapes.

At 2 1 18:24 G.m.t., the spa cecraft lande d. While the spacecraft was still in stable I1

Once in stable I position , the postlanding ventilation was activated, the f lotatio n gear

Spacecraft__---tmosphere toxicology.-Total t ime of crew exposure to the oxidizer vapors was4 minutes 40 seconds, from t h c a o su re of th e RCS isola t ion valves unt i l the crew donne doxyg en masks af ter landing. The p eak cabin conc entra tion af ter the RCS was electr icallydisabled was estimated t o be app roxim ately 7 00 parts per million (p/m) of N O4 at a pres-sure of 101.3 kPa (1 a tm) (F igure 3-1). The average oxidizer concentra t ion f rom the out-s ide inle t to the cabin pressure rel ief valve was 2000 p/m , o r 4100 mg/m 3. The peak cabinconce ntration resulted in an estimated average crew exposu re of approx imately 5 1 0 m g / m 3 ,

14


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CREW HEALTH

1400

12m.

,E [email protected]'E86 600.

800.+c

V

400.

200.

0

l6O0 R C S disabled (55:08 GET)r '\..

I I I I I I I224:54:00 55:OO %:MI 57:W 58:00 59:OO 225:WOO

Average exposure250 p lm or 510 mglm3,for 4 min40 s

Suit compressor masks on

Figure 3-1. Cabin Ox idizer Concen tration Expressed as Parts per Million ofNitrogen Tetrox ide at a Pressure of 10 1.3 kPa (1 atm )

which is equivalent t o app roximately 250 p/m of N, 0, at 1 01.3 kPa (1 a tm) . These toxi-cological estima tes were no t available at the tim e of exposure. Th e f inal estimate s of theactual to xic levels of N,O, were based on the analyses of the spacecraft LiOH canistersand th e visual comparison o f different color shades of N,O, and air mixtures (Figure 3-2).Initial recovery day physical findings.-Once in the Mobile Laborato ries (MOLAB) abo ardthe p rimary recovery ship (PRS), the medical team proceeded with th e medical debriefing.Oxygen was administered to all three crewmen for approxim ately 10 minutes . Th e vi ta ls igns that were recorded f rom the three crewmembers in supine posi t ion a t ap proximately22:40 G.m.t . ( 1 2:4 0 p.m. H awaii t ime) are as follows.

Heart rate,Crewmember beats/min

ACDRDMPCMP

906056

Blood pressure, Respiration rate,systolic/diastolic, breaths/minmm Hg1 18/70125170130180

162014

1 5


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THE APOLLO-SOYUZ TEST PRO JECT MEDICAL REPORT

me,Pfb

m5fYX

16


28/140

C R E W HEALTHBecause of t ime constraints, while the history of exposure to toxic fumes was beingrecon structed , the medical team proceeded w ith the routine recovery day ( R + 0) protocols.

l n e ALUK ,--,-.WIW llau v l l ! Jn 7 ,,chnr+. lv lc hlnnrl_ __mwing_ _ and n o radioisotope studies, underw ent thefull lower bo dy negative pressure (LBNP) protocol , w hich was terminated 3 m inutes early inthe minus 50 m m Hg period because of a dr op in his systol ic blood pressure.was completed and, after a prel iminary conference with the MCC surgeons at the NASALyndon B. John son Space Cen ter (JSC), i t was decided t o sto p all of the preplanned m edicalexper iments wi th th e except ion of the clinical exam inations as dictated b y the circumstances.Table 3-111 conta ins detai ls of the modified recovery d ay schedules.In general , the chief com plaints consisted of burning of the eyes with p rofuse tearing,burning sensat ion and i tching of the exposed skin surfaces which subsided shortly after theentr y in to th e M OLAB, t ightness of th e chest , retrosternal burning sensat ion, and inabili tyto inhale deeply which led to a nonprodu ctive and nonspasmodic cough. Th e review of sys-tems was noncon tributory . The three astronauts were in no acu te distress and all were ori-ented to t im e, persons, and place. Th e examination of the skin and mucosa was withinnorm al limits. Slight planta r hyp erker atosis and fissuring were present. Exam ination of theeyes revealed th e pupils to be roun d, regular, and equal in size; their react ion to l ight waswithin norm al l imits. Extraocular mo vements were inta ct , ful l, and equ al . Visual fields andfund i were well within norm al limits. Exam ination of th e ears, nasal muc osa, and ph arynxwas unremarkable. The tracheas were m idline and mobile. The shape and size of the thyroidglands were within normal limits. N o cervical vein engorg emen t was no ted ; carotid arterialpulsat ions were equal , with out b rui t , and within normal l imits. Th e chests were sym metricalwith good expansion. Deep inspirat ion produced coughing. Th e lungs were clear to percus-sion and auscultat ion. Exam ination of the cardiovascular system revealed normal sinus rhythm .Th ere were n o m urmu rs, thrills, clicks, or evidence of cardiomegaly. There was no abdom inaltenderness or organomegaly, and the bowel sounds were within norm al l imits. Abd ominaland lum bar paravertebral auscultat ion fai led t o reveal abnormal brui ts o r murmurs. Genital iaand rectal examin ations were unrem arkable. Detailed neurological examination show ed onlyslight fine tre m or o f the fingers. Slight hyperreflexia of the deep ten don reflexes was noted .Physical exam ination of th e endoc rine system was normal. The peripheral vascular systemwas intact . N o peripheral lymph adenopathies were detected . General ly, the musculoskeletalsystem was within normal limits.The examinat ion of the ACDR's right shoulde r and elb ow show ed slight tenderness o npalpat ion; there were n o ecchymoses or limitations to motion. The DM P exhibi ted a slightrestrict ion of m obil i ty of the lum bar spine and straightening of th e lordosis. This condit ionwas caused by a strain sustained while exercising during flight. He also had m inor bruisesover the right temp ora l region and the right patella. T he recorded postlight vital signs,weights, heights,' and o ral tem peratu res are shown in Table 3-IV.During the physical exam ination , following 5 minu tes in the standing posi t ion, i t wasnoticed that the CMP's systolic blood pressure dropped to 50 mm Hg with no audible read-ou ts for the diastolic pressure. He was pale and complained of generalized weakness. T heCMP was imm ediately returned t o a supine posit ion, and recovery from the orth ostat icepisode was uneventful. After 3 min utes in the supine position with elevation of the legs,his vital signs were: blood p ressure, 12 2/6 8 mm Hg; heart rate , 60 beats/min; and respirat ionrate, 15 breaths/min.

-.

At app roximate ly 23:2 0 G.m.t . ( 1 :20 p.m. Hawaii t ime), the ful l history of ex posure

'Importance of crew height measurements are detailed in Chapter 16 .

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THE APOLLO-SOWZ TEST PROJECT MEDICAL REPORTTABLE 3-III.-MODIFIED MEDICA L SCHEDULES ON RECO VE RY DA Y

Time, h:min EventG.m.t. Hawaii ACDR DMP CMP22:2422:35

22:4022:4522:55

23 :0223:lO23 :15

'23:2023:252 3 ~ 3 023:3223:4024:OO

0o:w00: 400:35

00:50

02:20

02:5008:OO

12:24 p.m.12:35 p.m.

12:40 p.m.12:45 p.m.12:55 p.m.

1 :0 2 p m .

MOLAB + 0,Microbiology sam ples,exposure history,and vital signsobtainedBlood drawing ini-tiatedLe g measurementsHeight and weightmeasurement

obtainedI nt o C V

MOLAB + 0,Exposure historyand vital signsobtained

MOLAB + 0,Exposure history,vital signs, andmicrobiologysamples obtained

-icrobiology samplesstarted

Blood drawinginitiated Blood drawinginitiated-

Leg measurements--

PFT-

Le g volume and EKCbl o p . m .: I5 p m .:2 0 p.m.:25 p.m.:3 0 p.m.:3 2 p.m.

Leg measurements-

P F T ~Resting echocar-diographyL B N FEarly dump hypoten-sion SO /? mm Hg,no subjectivesymptoms reportedEMG'Release from C VShower

1 :40'p.m.2:OO p m .

-Shower

-Shower

2:09 p.m.2:24 p m .2:35 p.m. Chest X-rays, physi-cal exam , and EKGinitiated

-Chest X-rays, physicalexam, EKG, andPFT initiated-

2:50 p m .

4:20 p.m. Chest X-rays, physicalexam, and EKGinitiatedRest in crew quarters

and supperTo PRS ickbay forsleep and observa-tion

Rest in crew quartersTo PRS sickbay forand suppersleep and observa-tion

4:50 p.m.1O:OO p m .

Rest in crew quartersTo PRS sickbay forand suppersleep and observa-tion

= cardiovascular laboratory.bEKG = electrocardiogram.

d~~ = pulmonary function test.eTerminated 3 minutes early.

'JSC confer ence with MCC surgeons regarding history o f fEMG = electromyograph.exposure to N O4 and mon ometh yl hydrazine. Decisionmade to stop & postflight med ical protocols.18


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CREW HEALTHTABLE 3-IV.-POSTFLIGHT PHYSIOLOGICAL PARAMETERS

Blood piesyiie,Heart rate, Respiration rate, Weight, Height, Temperature,beats/min breaths/min kg cm "C ( O F )systolic/diastolic,mm Hg

SupineSittingStandingSupineSittingStandingSupineSittingStanding

88100100606066608088

112/70111/72102/68112/701 101701 lO/SO

122168108/78100/78

ACDR 141416

DMP --20

CMP 161616

-77.7

-72.8

-77.6

-182.6

-180.5

-180.5

-35.7 (96.4)

-

-35.4 ( 9 5 . 8 )

--

36.0 (96.8)

Chest roentgenogram s do ne o n all three crewmem bers failed to reveal an y signs o fpulmonary involvement (F igure 3-3). Electrocardiographic tracings were w ithin no rmallimits and identical with baseline da ta.Subsequent Course of Events

For t he rem ainder of the evening of July 24 , 1975 , the crewmembers did no t exhibi tany signif icant change in general sym ptom atolog y. Th e feeling of chest t ightness, retrosternalburnin g sensation, and coug h on deep inspiration persisted with ou t worsening. Followingshowers an d sup per , the as t ron auts were t ransferred, a t 080 0G .m.t . July 25, 1975 (10.00 p.m.Hawaii t ime July 24, 1975 ) to th e s ickbay of the ship for res t and fur ther observat ion.Although they spent a re lat ively quiet n ight , s leep was inter rupted by occas ional episodesof coughing. None o f the crewmemb ers complained of shortness of breath.On Ju ly 25 , 1975 (day R + l ) , a t 16:10 G.m.t. (6: 10 a.m. Hawaii t ime) , the as t ronautswere awa kened for furthe r clinical evaluation, consisting of blood draws and chest roentgen-ograms. T h e general physical exam inations were unremarkable. When question ed abo utsym pto ms, all crewm emb ers complained of slight t ightness of the chest and m ore pronou ncedinabili ty to breathe deeply w ithout coughing. In fact , they were unable t o breath-hold andperform forced exp iratory maneuvers required for repeat pulm onary function tests . Th e fol-lowing table represe nts the vital signs as obtained in th e sup ine position.Followup chest roentgenograms were obtained at 1 8 : OO G.m.t. ( 8 : O O a.m. Hawaii time).Sho rtly af te r the chest X-rays were taken and while brushing his teeth, th e DM P experiencedslight shortness of brea th, developed giddiness, and fainted. He was unconscio us for ab ou t1 minute. There was slight twitching of the eyelids wit hou t evidence of seizure activity, andhe recovered quic kly when placed in the supine position. This episode was attr ibu ted toor thos ta t ic intolerance.

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TH E APOLLO-SOWZ TEST PROJECT MEDICAL REPORT

Figure 3-3. Chest Roentgenogram Showing N o Pulmonary Involvement

20


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CREW HEALTHBlood pressure,

mm HgHeart rate, Respiration rate,beats/min breathslminrewmember systolic/diastolic,

ACDRDMPCMP

906468

108170122/581 18/72

162020

The repe at ch est roentgenograms on all three crewmemb ers revealed the presence ofdiffuse, nodu lar- type inf il trates thro ugh out b oth lung f ields. A rosette- type pa ttern w ithoccasional confluen ce of the inf il trates was present. Both costod iaphragm atic angles wereclear with n o evidence of pleural effusion, Kerley B l ines, o r increased pu lmon ary vasculature.There was n o prominence of the pulmonary ar tery and n o s igns indicat ive of the lef t or r ighthea rt involve men t. These finding s were suggestive of alveolar exu dati ve fillings, characteristicof a diffuse chemical pneu mon itis; an exam ple is shown in Figure 3-4 of the same astronautdetailed in Figure 3-3.At 18:30 G.m.t. (8 :30 a.m. Hawaii t ime), each astrona ut was given 1 6 mg of dexametha-sone intravenously and t he n transferred to Tripler Army Medical Center in Hono lulu, Hawaii,for furth er medical care.Ad ditional bedside chest X-rays, obtained at 20:4 5 G.m.t. (10 :45 a.m. Hawaii t ime j,confirmed th e diagnosis made a board the recovery vessel. Arterial blood gases were sampledat room air a t 21 :00 G.m.t. ( 1 1 :00 a.m. Hawaii t ime). Th e results are tabulated as follows,for par t ia l pressure of oxygen (p 0 2 ) , partial pressure o f carbon dioxide (pCO,) , and hydrogen-ion conce ntra t ion (pH).

Measuremen, ACDR DMP CMPp 0 2 , mm Hg 76 90 7 0PCO,, mm Hg 37 28 43PH 7.41 7.48 7.43

Repeated ches t X-rays obtained a t 01:OO G.m.t. July 26, 1975 ( 3 : O O p.m. Haw aii t imeJuly 25, 1975) showed an increase of the inf il t ra tes, more pronou nced on the DMP's X-ray.Follow up room-air ar ter ial blood gas studies performed at 01:30 G.m.t. ( 3 : 3 0 p.m. Hawaiitime) are tabu lated as follows. The blood gas f indings were indicative of mild respiratoryalkalosis with hyp erventilation and hyp oxem ia.It was decided to switch t o oral s teroid therapy, consisting of daily doses of 80 mg ofPrednisone. Because of the lack of symptomatology and the absence of cyanosis and/o rsigns of severe anox ia, oxygen w as not administered. Vital s igns remained stable, and therewas no evidence of cardiac rhythm dis turbances .

21


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THE APOLLO-SOYUZ TEST PROJECT MEDICAL REPO RTn,

d

Figure 3-4. Chest Roentgenogram Suggestive of Alveolar Exudative Fillings

2 2


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CREW HEALTH

Measurement ACDR DMP CMPPO,, mm Hg 84 86 84PCO,, mm Hg 29 33 35PH 7.43 7.51 7.44

Hospital Course and Follow upThe as tron auts were afebrile on admission and remained so throughout their hospitaliza-t ion per iod. Vital signs remained generally within normal limits. N o significant changes inpostflight weights were observed (Table 3-V).

TABLE 3-V.-PREFLIGHTAND POSTFLIGHT WEIGHT VARIATIONBody weight, kg

ACDR DMP CMPDay

F - 3 0F - 15F - 5F - 1F - 0R t OR t 1R + 2R + 3R t 4R t 5R t 13-x f SDa

78.278.877.078.276.977.679.578.977.377.376.879.5

75.376.076.775.774.872.876.476.578.580.076.478.2

77.8 2 0.83 75.7 f 0.71

81.080.479.880.180.277.681O80.674.876.978.682.2

80.3 f 0.45aMean plus or minus tandard deviation.

2 3


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TH E APOLLOSOWZ TEST PROJECT MEDICAL REPORTThe crewmembers cont inued to have mild discomfort with dee p inspiration. Th ediscomfort gradual ly lessened. They becam e asym ptoma t ic on Ju ly 27 , 1975 (day R + 3).The chest X-rays re turned t o normal on J uly 2 9, 197 5 (day R + 5) . The cor t icoste roids

were gradually tapered an d finally discontinue d on Aug ust 2, 19 75 (day R + 9 ) .The crewmem bers were discharged from the hos pital on Ju ly 30, 1975 (day R + 6).A period of rest , recondit ion ing, and ob servation in Hawaii followe d. Daily med ical evalu-ations remained within norm al l imits. All the crewm emb ers part icipated in mild exercise,such as jogging, und er medical supervision; the y ex hibited a gradual im provem ent in physicalendurance . The crew memb ers le f t Hawai i on August 7 , 197 5, and were re turned to theirregular duties.sure to N, 0, vapors. I t was established tha t there were no obvious residual aftereffectsf rom the exposure t o toxic fumes.

Followup detailed m edical evaluations were performed 4 weeks af te r the in it ial expo-

Clinical Laboratory DataExtensive laboratory studies were conducted to de term ine the presence of N, 0, and /or mon om ethyl hydrazine exposure. Th e laboratory findings are discussed in Cha pters 1 4and 15. Because the nature of these toxic fum es was no t com pletely know n, i t was decidedto p erform several specific tests to isolate the com pou nds men tioned. These tests includedthe search for Heinz bodies and for elevation of serum triglycerides, cholesterol , methem o-globin, and hy drazine levels.

com pared to the prefl ight levels. By day R + 1, the methemoglobin level had dropped t o am ean value of 2.0 percent, n ot significantly different f rom prefl ight values. This finding iscompat ib le wi th , but no t pa thognomonic of , exposure to N,O, . There was no increase inthe serum cholesterol and triglyceride levels or th e presence of h ydrazine o r Heinz bodieswhich would be indicative of m ono me thyl hydrazine inhalation.

There was an init ial elevation in t he methem oglobin level (m ean = 4.2 percent) a t R + 0

2 4


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4. RESULTS OF PULMONARY FUNCTION TESTSArnauld E. Nicogossian? Charles F. Sawin,a and Peter J. Bate l lon ib

Preflight pulmona ry fun ction tests were performed in conju nction w ith othe r medicalevaluat ions 45, 30 , and 15 days before lif t-off (F - 45,F - 30, and F - 15 , respectively).Because o f hardware malfunction on day F - 45, ata were no t amenable t o analysis andonly t w o sets of dat a were used for baseline purposes. Following exposure to nitrogentetroxide and 10 minu tes prebreathing of 100-percent oxygen, pulmonary function screen-ing tests were obtaine d on all three crewmembers on recovery day aboard the p rime recoveryvessel. Th e qua lity of recovery day (R + 0) data was satisfactory, and n o significant changeswere observed wh en com pared to the preflight means. Follow up evaluations were performed1 , 2, and 13day s af ter recovery (R + 1 , R + 2, and R + 13, respectively) at T ripler ArmyMedical Center and repeated on da y R + 2 9 at the NASA Lyndo n B. Johnson Space Centerciated with d eep inspira t ion and breath holding on days R + 1 and R + 2 , n o sat is factorydata co uld be ob taine d. In general, because of different typ es of hardware and techniquesemp loyed in these pulm onary function measurements, the ob taine d data were variable andinterp retatio n was diff icult . A slight decrease of t imed exp iratory f lows was observed 1 dayfollowing recovery (day R + 1). Besides th e already m entione d mild hypo xia and respirato ryalkalosis (Ch apte r 3), the on ly significant finding was a decrease in the single-breath carbo nmon oxide diffusing capacity (DLCO, >. These f indings were in agreement with t he observedroentgenological abnormalities. The Jecrease in the diffusion capacity was more p ronou ncedin the Apollo comm ander: less than 50 percent of the predicted value based on his age,weight, and height. This decrease in DLCOsB persisted u ntil test day R + 13. The R + 29data obta ined f rom the three crewmembers showed that the measured pulmonary funct ionparam eters, including DLCOs*Band repeat bloo d gas determin ations (breath ing room air and100-percent oxyg en), were within norma l l imits . These data are summarized in Tables 4-1,4-11, and 4-111.

and at Saint Lukes Episcopal Hospital in H ouston , Texas. Because of the disco mfort asso-

aNASA Lyndon B. Johnson Space Center.bTripler Army Medical Center, Honolulu, Hawaii.

2 5


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THE APOLLO-SOW2 TEST PROJECT MEDICAL REPORTTABLE 4-I.-APOLLO COMMANDER PULMONARY FUNCTIONS

Parameter Preflight- sp R + O R + l R + 2 R + 5 R t 1 3 R t 2 9RV (liters)CV (liters)VC (liters)TLC (liters)FVC (liters)FEV-1 (liters)FEV-1 %FVCFVC %vcMEFR (l/sec)MMFR (l/sec)E%vccc-%TLCDLCO,, (mlCO/min/mm Hg)

2.53 f 0.120.59 f 0.245.38 f 0.107.90 ? 0.175.39 f 0.043.83 ? 0.08

71.1 f 1.07100.2 k2.16

5.93 f 0.252.83 f 0.12

10.8 ? 4.2639.3 f 2.61

2.0 (b)0.645.45 3.727.505.13 3.673.72 2.78

72.40 75101.60 98

5.70 5.412.90 2.36

11.70 (b)35.20 (b)

(b )

2.10

5.107.224.803.70

7672

5.9 13.407.5

33

5.554.1 7

75

8.413.63

8.3Sb 14.58

2.14

5.607.825.564.26

7699

9.503.66

14.48

2.230.935.357.555.203.75

7297.3

5.33.0

17.441.93 1.33

aMean plus or minus s tandard devia t ion.bCr ewman unab l e t o pe r f o r m maneuve r.R V = res idual volum eC V = clos ing volum eVC = vital capacityT L C = to ta l lung capaci tyF V C = forced vi ta l capaci tyFEV- 1 = f o r ced exp i r a t o r y vo l ume in one s econdM E F R = maxi mum exp i r a t o r y f l ow ra t eMMFR = maxi mum mi dexp i r a to r y flow ra teCC = clos ing capaci tyDLCOsB = s ingle breath carbon m ono xide di f fus ing capaci ty

26


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RESULTS OF PULMONARY FUNCTION TESTSTABLE 4-II.-COMMAND MODULE PILOT PULMONAR Y FUNCTIONS

Parameter Preflightx f SDa R t. 0 R + l R + 2 R + 5 R t 1 3 ~ + 2 9RV (liters)CV (liters)VC (liters)TLC (liters)FVC (liters)FEV-1 (liters)FEV-1 %-VCE %vcMEFR (l/sec)MMFR (l/sec)cv- %vcK %TLCDLCOs, (mlCO/min/mm Hg)

2.1 1 f 0.340.53 +- 0.055.1 1 ? 0.107.23 f 0.354.98 f 0.043.91 f 0.31

78.5 f6.1697.8 k3.50

7.10 f 1.143.93 f 0.38

10.33 f 0.7636.43 f 3.17

2.87 (b)0.935.06 3.707.905.23 2.823.69 2.10

70.40 75103.4 76

5.70 4.254.20 1.61

18.4048.10

2.28

5.027.304.573.41

7491

6.8 12.81

133815.09

5.284.1 278

8.334.21

24.87

2.07

5.207.235.164.09

7999

9.234.43

29.55

1.980.855.287.264.863.95

81.292.8

7.83.7

16.13941.13

aMean plus or min us standard deviation .bCrewman unable to perform maneuver.

27


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THE APOLLOSOWZ TEST PROJECT MEDICAL REPORTTABLE 4-III.-DOCKlNG MODULE PILOT PULMONARY FUNCTIONS

Parameter R + O R + 1 R + 2 R t 5 R + 1 3 R + 2 9reflightx f SDaRV (liters)CV (liters)VC (liters)TLC (liters)FVC (liters)FEV-1 (liters)FEV-1 %FVCE %vcMEFR (llsec)MMFR (I/sec)cv- %vccc- 0TLCDLCO,, (mlCO/min/mm Hg)

2.47 f 0.420.78 f 0.335.51 f 0.027.97 f 0.45.41 f 0.054.01 f 0.02

74.1 f 1.0198.2 f 1.35

8.33 * 0.383.07 _+ 0.06

14.1 f 5.8640.7 f 3.78

2.57 2.46.96 (b) 2.350.39 0.555.50 5.11 5.25 5.83 5.588.50 7.87 8.41 8.045.42 4.56 5.25 5.69 5.83 5.643.92 3.58 3.32 4.48 4.40 4.15

72.20 78 63 79 75 7398.70 89 100 100 100

8.00 9.13 8.51 11.45 7.63 8.72.80 3.21 1.51 4.03 3.51 3.07 OO 9 9.9

39.60 34 37.416.37 20.15 28.22 29.23

aMean plus or minus standard deviation.bCrewman unable t o perform maneuver.

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5 . IN-FLIGHT RADIATION DETECTION

J. Vernon BaileyaRADIATION DOSIMETRY

O ne personal radiation d osim eter (PRD ) and one passive dosime ter (PD) each wereassigned to and were worn a t launch by the Apollo comman der (ACDR ), command mo dulepi lot (CMP), and docking modu le pi lot (DMP). During the m ission, the PDs assigned t othe ACDR and th e DMP were worn in the lef t leg pocke t of th e in-flight coveralls, and thePD assigned to th e CMP was worn in the lef t thigh poc ket. All fl ight dosim eters were re-covered and r e turned t o the NASA L yndon B. Johnson Space Center (JSC) for evaluation.PASSIVEDOSIMETERS

The f l ight PD s were disassembled, and the comp onent d etectors were forwarded to thecognizant analysts . The therm olum inescent dosimeters were analyzed in the LockheedRadia tion La bora tory , and th e results are reported following this paragraph. The nuclearemulsions were forwarded to Dr. H. J. Schaefer at the Naval Aerospace R esearch L aboratory ,and preliminary results are reported following the next paragraph. The ne utron resonancefoils and t he Lexan t rack de tectors were forwarded t o Dr . J. S. Clark, JSC, and Dr. E. V.Bento n, University of San Francisco, respectively. T he con trol PD confirmed th at no extra-neous prelaunch radiation occurred. No evidence of con taminat ion o r comp onent damagewas observed during disassembly of the dosimeter. Th e PD results from t he thermo lumi-nescent d osimeters are as follows.

Serial no.1077107810791087

AssignmentACDRCMPDMPControl

Mission dose,mradllOt 1 1108+ 1100f 10< I

~~


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THE A POL LOS OW Z TEST PROJECT MEDICAL REPORTA preliminary analysis of the nu clear emulsions based o n pho tod en sito me ter measure-me nts and ra t ios of those measurements to prot on doses determined f rom t he previousApollo Earth-orbit mission agreed well with the therm olum ines cen t dosim eter data. These

results are as follows.Emulsion Proton dose (estimated),pack no. Assignment mraderial no.

1077 1B ACDR1078 2B CMP1079 3B DMP

1029990

The t rack and grain cou nt analyses are being cont inued to provide a more accu ratemeasurement of the Apollo-Soyuz Test Project (ASTP) crew dose from the trapp ed radia-t ion environment .PERSONAL RADIATION DOSIMETERS

Personal radiation dosim eter (PRD ) postmission response testing was performed atJSC. The PRD ba tter y voltages were measured before th is testing was begun. Batteryvoltages on all three PRDs exceeded 10.70 V dc ; 9.0 V dc was the required m inimum forsatisfactory operation. Premission and postmission responses were com pare d and areessentially identica l. A t a dose level of 0.93 mrad/h, personal radia t ion dos imeter 10 22H REand 1037 HR E responses were minus 6 percent , and PRD 102 5H RE response was minu s 12percent. At all da ta poi nts above 2.0 mra dlh , the response deviations for all three instru-me nts were zero percent. There fore, the following mission doses reported are splashdownvalues with no response corrections. Th e tolerance show n represents th e one-register-count(0.01 rad) uncertainty inherent to digital readouts.

Mission dose,raderial no.rewmanACDR 1022HRE 0.15 ? 0.01CMP 1025HRE 5.58DMP 10 37HRE .12 ? .01

The in-f light malfunction observed o n PRD 102 5H RE was no t reproduced dur ing thepostmission testing. One register cou nt (0.01 rad ) was accumulated during the 4.5 daysbetw een splashdown and initiation of postmission testing. However, this deviation is normal


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IN-FLIGHT RADIATIO N DETECTIONand within design specifications. Th e 30 to 40 ounts pe r day accum ula ted during themission in dicated eith er a gate-to-drain leakage of the e lectrometer (MOSFE T) o r loosecznducthe partic.!es in the ion chamber . However, nei ther condi t ion would accoun t fo rthe 144 co un ts registered between the last in-f light reading a nd t he splashdown reading.An intermittently open circuit could, during entry buffeting, register counts at a veryhigh rate an d might also acco unt for the day-to-day coun ting observed. Since this PRDoperated n orm ally during the Apollo 10, Apollo 15, and Skylab 3 missions, th e con ditionresult ing in th e ASTP malfunct ion probably occur red jus t before , o r during, launch. Tw odents in t he a lumin um housing (on one co rner and on e edge), no t present dur ing preins ta l l-ation a cceptan ce testing, were observed when the dosime ter was retu rne d to JSC. T hedents indicated th at the ins trument had been dropped and /or s t ruck.

SUMMARY

T h e t h re e P D s an d t w o of the PRDs operated satisfactorily throu gh ou t the mission.Because n o fu ture mission su pp ort is anticipated for these PRDs, failure analysis of thePR D ma lfunction ing during the zero-g portion of this mission is no t planned currently.The 10 to 1 5 mra d/da y crew exposures reported fo r the ASTP PRDs and PDs are amongthe lowest rep orted for any Apollo mission and approach th e minim um response sensitivityof the PRDs. Th e tota l space radiation exposure of the ASTP crew men is insignif icantf rom a medical s tandpoint .

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6. FOOD AND NU TRITIONMalcolm C. Smitha and Rita M. Rappa

IWT RIEN T ENERGY REQUIREMENTS DETERMINATION

As a result o f Ap ollo and Sky lab exper imentat ion, data now exis t showing re la t ion-ships betw een ground-based an d in-flight energy requirements. I t is recognized t ha t thebest estim ates of ground-based energy requirements are made o n th e basis of lean bod ymass (LBM ); i .e., muscle mass. Ac curate determ ination of LBM may b e obtain ed from atota l body coun t of gamma radia t ion emit ted by the bodys natural burde n of potassium-40 (4 0 K) .the pota ssium c ont ent o f LBM is nearly constant an d th at bo dy fat is essentially free ofpotassium. In this con text , the body is considered to be composed of two comp ar tmen ts ,the fa t com par tme nt and th e fa t- f ree LBM comp ar tmen t .Since 0.01 19 percen t of all naturally occurr ing K is the radioactive isotope 40K, ameasure of this isotope is an indirect m easure of the to ta l K. Th e whole -body coun te rmeasures 40K. Tota l K is calculated and LBM is determ ined by use of appro priate con -s tants .I t was anticip ated th at th e average daily in-flight energy inta ke in th e Apo llo-SoyuzTest Project (ASTP) would fa l l shor t of Sk ylab intakes and would more c losely appro xima tethe averages observed during Apollo f lights ( i .e. , appro xima tely 2 9 kcal/kg /day) b ecause ofthe brevity of the m ission and the failure to achieve metabolic stabilization. Fo r this reason,cer ta in nutr ients , in par t icular sodium (N a) and K, were conc entra ted in those foods forwhich the crew displayed the highes t preference and w hich were deemed most l ikely t o becons um ed. As much as possible of the minimum nu tr ient requirements w ere included in abasic diet of appro xim ately 180 0-2 00 0 kilocalories (kcal) . Despite these measures, an aware-ness of the t rue energy demands should be kept in mind for und ers tanding the degree ofmetabolic deficiency that was incurred.ground radia t ion coun t ing facil i ty a t th e NASA Lynd on B. Jo hnso n Space Center af terapp rop riate calibratio n with similar coun ting facili ties at U.S. Air Force School of A viat ionMedicine and at B attelle N.W. Laboratories. Additional calibration in the techniqu e wasaccomp lished using 42K. Potassium-42 has a 12.36-hour half-life and em its beta rays havinga maximum energy of 3 .52 MeV and a gamm a ray having an en ergy of 1.525 MeV. Th egamma ray energy is c lose enough t o th at of 4 0 K ( 1.46 MeV) to enable direct compar isonof the pho topeak areas for calibration purposes. Fo r cal ibration, the same amou nt of 42Kingested b y th e voluntee r is placed in a 500-ml bo ttle, and the b ott le is f i lled with water .A weighed qua nt i ty of potass ium ni t ra te (KNO,) is placed in the same size bo ttle a nd dis-solved in water , and the solut ion is di luted t o the same volume as the 42K solut ion. Count ing

The whole-body cou nter m ethod of determining LBM is based o n the assum ption that

Lean bod y mass was determined b y m easurement of tota l body 4 0 K in the low-back-


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FOOD AN D NUTRITIONgiven in Ta ble 6-I .172 Lean bod y m ass measurements, derived from da ta on total exchange-able K, have been used as a basis for expressing caloric expenditure in S kyla b crewm embers.1ne resuits of these ~~ix i ip~ t i i t i~ i i sirc shewn in Table 6-11. !t c m be reen, t h ~ r ~ f n r e ,hatthe Skylab crewm embers had a ca loric in take a t a leve l of 4 5.68 f 4.5 0 kcal /kg/day. Basedon in-fl ight changes in total b ody weight , m uscle mass, and b ody volume, it appears tha t anaverage daily energy intake of 49.0 f 3.5 kcal/kg/day would have resulted in negligible bodyweight loss in Skylab crewm embers.the energy required t o maintain LBM during th e ASTP mission was predicted. Th e resultsof this predict ion are show n in the following table together w ith est imated energy based onsubjective evaluation by th e individual of his menus. (Changes in crew bo dy weights arealso included.)

rm

On the basis of S kylab energy consu mp t ion data and ASTP tota l bo dy K measurements,

Predicted energy consumptionbased on - Average in-flightSubject energy intake,Body mass 40K, Menu test, kcalldaykcallday kcalldayACDRCMPDMP

2822 2790 29003241 2913 30002975 3245 2867

In-flight bod ywt change,kg

-0.45-2.52-2.90

IN-FLIGHT FOODFlight menus were designed t o m eet com parable individual energy requirements und erno rm al gravity conditions, specified nutrie nt levels, and crew-selected preferred foods.Energy requirem ents calculated for each crewman were 28 1 5, 2760, and 255 4 kca l/day forthe A CD R, the CMP, and th e DMP, respectively. Based on crew men u acceptance, evalua-t ions, and com patibi l i ty tests, an average dai ly caloric intake o f 2 82 0 kcal was provided forthe ACD R and the CMP, and 3 16 5 kcal was provided fo r the DMP. Estim ates of in-flightfood consum pt ion based on daily repo rts indicate tha t averages of 29 00 , 3000, and 2867kcallday w ere consumed by the A CDR , the CMP, and the DMP, respectively.

ei th er calcium lactate o r potassium gluconate. Calcium (Ca) fort i f ied beverages were l imitedto tw o per m an per d ay , whereas only on e K-fort if ied beverage was required f or each 4-daymenu cycle.

To meet the specified daily nutrient levels, some of the beverages were fortified with

'Carolyn S. Leach and Paul C. Rambaut: Biochem ical Responses of the Skylab Crewmen: An Overview. Ch. 23 of'Philip c. Johnson, Theda B. Discon, and A drian D. LeBlanc: Blood Volume Changes. Ch. 26 of BiomedicalResults

Biomedical Results from Skylab, NASA SP-377, in press.from SYla b. NASA SP-377, in press.

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TABLE 6-L-TOTAL EXCHANGEABLE POTASSIUM I NSKYLAB CREWMEMBERS

Subject3208 ?r 1143870 f 1053782 f 13 33245 f 13 33045f 234565 f 1143195k 563569 f 1653517 f 200

a Mean plus or minus standard deviation.

TABLE 6-II.-SKYLAB IN-FLIGHT ENERGY INTAKE

Energy intakeLBM,kg kcallday kcall kgldayubject

57.O66.971.458.253.673.457.362.262.5

26162746260626362581354329592850303 1

45.8941.0536.5045.2948.1 548.3051.6445.8248.50

a45.68 f 4.50a Mean plus or minus tandard deviation.

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FOOD AND NUTRITION

The crew selected a 4 d a y menu cycle as used prev iously on Apol lo missions ra therthar. th e 6-day cycle used during Skylab missions. The average dai ly nutr ie nt intake s forthe propo sed and est imated in-fl ight food consu mp tion fo r each crewrrii ii iare shown ir.Table 6-111.TABLE 6-III.-A VERAGE DAILY NUTRITIONAL INTAK E

Energy, Protein, Calcium, Phosphorus, Sodiu m, Potassium, Magnesium,Crewman kcal g mg mg mg mg mgProposed intake

ACDR 2820 99.7 1076 1832 4983 2942 313CMP 282 0 98.1 1458 1996 4724 2984 288DMP 3165 112.2 1375 21 13 6402 3745 355

Estimated actual intakeaACDR 2900 98.0 1295 1830 4970 2983 299CMP 3000 101.9 1661 207 1 5318 2975 290DMP 2867 107.7 1422 1964 6079 3748 322

a Average of 7 nominal days; incomplete days have been omitted.

In addit ion to the scheduled meals, a pan try containing beverages and snack food swas suppl ied . These foods cou ld be used t o subst i tu te o r supplement the normal meali tems.irradiated breakfast rol ls; thermostabilized/irradiated tu rkey , corned beef , and charcoalbroi led steak ; thermostabil ized cranbe rry sauce; tuna a nd salmon in cans which required acan ope ner ; comm ercial cookies and graham crackers; deh ydra ted beef p at ty , pears, andpo tat o pa t ty ; interme diate m oisture almo nds and cheese sl ices; and dried beef jerky.In general , the crew was sat isfied with th e quality and qu ant i ty of f l ight fo od pro-vided. N o gastrointest inal problem s were encountered during the mission. App eti tes duringfl ight were reported t o be the same as during the prefl ight period. Th eCMP reportedchanges in the tas te o f fo ods dur ing f light and ind icated th at sa l ty food s tasted bes t to h im.As on prev ious Apol lo missions , the crew repor ted gas in the ho t w ater supply which in ter -fered with complete rehydrat ion of the food. Throu ghou t the mission, high-priority act iv-i t ies and w ork schedules frequen tly precluded ade quate t ime for meal preparat ion and foodconsumpt ion .

New fo od for this mission included d ehyd rated comp ressed pea bars and spinach bars;

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7. POTABLE WATERRichard L. Sauera

Postfl ight com men ts f rom the crew indicated th at th e potable w ater was of goodqual i ty . N o out-of-specification conditions were noted in the m icrobiological and chem-ical analyses conducted .measured 2 hou rs later was suff icient for microbial con trol.problems were experienced. As in previous flights, som e gas was prese nt, particularly inthe ho t wa ter .Postf light analyses indicated a lack of residual chlorine in t he p otab le water . Thisdeficiency remains unexplained since the records indicate th at the last in-f light chlorinationwas accomplished 17 hou rs before landing. Chemical analyses of postf light samples showedall levels wi thin sp ecification limits. Microbiological results were positive for Flavobacteriumspecies at levels of 10 microorganisms/ml.

Preflight chlorina tion was accomplished 19 hours before launch . Th e level of chlorineIn-flight chlorination s were accomplished approximately o n schedule, and n o in-flight

NASA Lyndon B. Johnson Space Center.

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8. FLIGHT CREW HEALTH STABILIZATION PROGRAM

james K . Ferguson2The Flight Crew H ealth Stabil izat ion Program (FCHSP) was activated for theApo llo Soyuz Test Project (ASTP) as outl ined in the program d ocum ent. Prime and back-u p crewm en were he ld u nder condi t ions of semi-isolation fro m 2 1 days before f l ight unti llaunch. Living quarters were established onsi te at the N ASA Lynd on B. Johnson SpaceCenter (JSC) for both the pr ime and backup crewmen. The exis ting crew quar te rs a t theN A SA J o h n F. Ken nedy Space Cente r (KSC) were used while the crewmen were at tha tfacility.

lance Office 90 days before lift-off. All physical exam ination s for persons o n this list werecom pleted on schedule. Surveil lance of the hea l th s ta tus of primary contacts began onJune 2 , 197 5, and cont inued through July 24, 1975, for a to ta l of 53 days. The totalnum ber of primary conta cts under surveillance reached 38 1. The num ber and loca tion ofthe primary conta cts are as fol lows.

An identif icat ion l ist o f prim ary con tacts was made available to th e M edical Surveil-

JSC KSC Other Total313 32 36 381

Active surveil lance was provided at the primary w ork areas during the t imes whencrewm en were present in the areas. Th roa t exam inations and tem perature checks weremade on ce daily on each primary con tact entering the prim ary work area. Th e results ofthis act ive surveillance are sh own in Table 8-1.

TABLE 8-I.-ACTIVE SUR VEILLANCE OF PRIMARY CONTACTS

Category JSC KSCContacts examined (tota l) 1169 203Examining days 16 12Average daily examinations 73 16.9Contacts referred to clinic 5 1


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THE APOL LO SOW Z TEST PROJECT MEDICAL REPORT

The primary conta cts reported their i l lnesses and exposure to i llnesses to the M edicalSurveil lance Office. All report ing was made o n a voluntary basis. Th e num ber and locat ionof th e primary con tact reports were as follows.

Reports JSC KSC Other TotalIllness 28 8 0 36Contacts to illness 7 1 0 8

The rate of i llnesses reported by the prim ary co ntacts was 12.4 i llnesses per 1000persons per week. The ra te of contacts t o i llness repor ted was 3 per 10 00 persons per week.The types of i llness and exp osures to i l lness repo rted b y the prim ary c ontac ts are shown inTables 8-11 and 8-111, respectively.TABLE 8-II.-TYPES OFILLNESSES REPOR TED BY PRIMARY CONTACT

Sym pto m complex a JSC KSC Percent totalUpper respiratory infect ion (URI)BronchitisPneumoniaUpper enteric illnessLower enteric illnessFever presentHeadache presentSkin infection presentOther infectious illness

2330102401

8180306

1136

a One illness may contain more than one symptom complex.

The FCHSP was successfully completed with the recovery of the crewm en at the closeof th e mission. N o infect ious i llness occurred in any of the crewm en during the period oftime they were covered by the program.It was necessary fo r the crewm en t o enter a no nprimary work area during th e prefl ightperiod for the purp ose of obtaining addit ional suit-fi t checks, for tests, and fo r the use ofmedical test eq uipm ent. In each case, however, the co ntingency plans were fol lowed and noproblems were encountered.

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FLIGHT CREW HEALTH STABILIZATION PROGRAM

TABLE 8-III.-EXPOSURES TO ILLNESS REPORTED BY PRIMAR Y CONTAClX

Illness contacted JSC KSC Percent totalURIChicken poxMumpsImpetigo

1 01 02 00 I

13132513

Typhoid fever 1 0 13Infectious hepatitis 2 0 2s

The ra te of pr imary contac t repor t ing of i llnesses appeared t o be improved over pastmissions. Fo r exam ple, the ASTP sum mer mission had a greater num ber of i l lness repo rts(1 2.4 per 1000 per week) than was observed in th e fall and win ter missions of the Skyla bProgram (average 8 .2 per 1000 per week) . However , the repor t ing of the contacts toillness remained appro xim ately th e same as o n past missions; the u pp er respirato ry illnesswas predominant and represented 81 percen t of the to tal i l lnesses reported.

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SECTION I11

PREFLIGHT, IN-FLIGHT, AN D POSTFLIGHT MEDICAL TESTING


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9. ACHILLES TENDON REFLEXEduard C. Burcharda and Arnauld E. Nicogossiana

Generalized hyp erref lexia was reported following long-duration S kylab orbital mis-s ions . Because i t was expected th at changes in the neuromuscular funct ion would occureven af ter a short-du ration space f light, a decision was made to m easure the Achillesten do n ref lex durat ion in conju nction with th e Apollo-Soyuz Test Project (ASTP) mission.

METHOD AND MATERIAL

The measurement of th e Achi lles tendon reflex t ime was per formed dur ing the phys-ical examinat io n o n a ll three pr ime as trona uts 30 days before lif t-off (F - 30), 15 daysbefore lif t-off ( F - 1 9 , and on re cove ry da y ( R + 0) using a Burdick FM-1 photomotograph .A techn ique using a pho toelectr ic cell is emp loyed t o time th e Achilles tend on reflex bymeasur ing th e displacement of the foo t. A lamp and condensing lens in on e side of theU-shaped housing directs a beam of l ight on to a pho tovoltaic cell on the opp osite side ofthe hou sing (Figure 9-1(a)) . With the subject kneeling com fortably o n a specially designedchair , the u nit is positioned so that the light beam is partially intercepted by the metatarsalregion of th e fo ot (Figure 9-1(b)) .

F igure 9- l (a) . Photomotograph. Sketch of the DeviceaNASA Lyndon B. Johnson Space Center.

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THE AP OLLO -SOWZ TEST PROJECT MEDICAL REPORT

Figure 9-l( b). Photom otograph . Posit ioning of the Device

A tap on the Achi lles tendon wi th a percussion hammer causes the foot to move inthe l ight beam and thereb y t o generate a change in photocell voltage. T he change in volt-age is recorded o n electrocardiograph paper t o give a t ime-posit ion plo t of reflex action .For each test , an average num ber of 10 complexes on a strip ch art is analyzed using aphotom otogram scale (Figure 9-2). To determine the duration of the reflex response,measurements a re made f rom the beginning of the hamm er tap t o one-ha lf the re laxa tionperiod.RESULTS

Table 9-1 and Figures 9-3 and 9-4 contain th e Achil les tend on reflex data for theApol lo commander (ACDR) and the docking mo dule pilot (DMP) from tests perform edon days F - 30, F - 1 5 , and R + 0. Fo ur prefl ight baseline sets of data were obta ined onthe comm and m odule pilot (CMP) because he had had previous tests o n July 24 andOctober 10 , 1973 , while performing as backu p crewman for Skylab missions 3 and 4(Figure 9-5).

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ACHILLES TENDON RE FLEX

Peak contractionrHammer tap--.

_c_Hammer tap to 112 relaxation

Figure 9-2. Photom otogram Tracing. Th e Horizontal Distancefrom Ham mer T ap t o One-Half Relaxation is Measuredin Milliseconds

TABLE 9-1 .-ACHILLES TENDON REFLEX DA TA

Reflex tim e, msSkylab ASTP

Crewmember July 24, 1973 Oct. 10, 1973 F - 3 0 F - 1 5 R + OACDR - - 298 304 280DMP - - 399 354 312CMP 317 340 303 291 299

The Achilles tendon reflex was measured within 2 hours after recovery and afte r theASTP astron auts had entered the op erat ional Mobile Lab orator y (Figure 9-6). The ACDRand th e DMP exhibi ted a shortening in the reflex durat ion t im e (Table 9-1), whereas theCMP showed an increased reflex t ime when his datum was compa red w ith his last prefl ightresults. In add it ion t o the noted changes in reflex t ime, all three crewm emb ers showedsignificant f ine tremo r, as docum ented by tracings (Figure 9 - 9 , which could reflect theeffects of the inhaled vapor of ni trogen tetroxide. This t remor which was recorded onthe basel ine tracings of th e Achilles tend on reflex was also clinically observed in th e fingersfor a shor t t ime o n R + 0.

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I I(a)

Figure 9-3. Achilles Tendo n Reflex Tim e, Apo llo Commander(a) Preflight, F - 3 0(b) Postflight, R + 0

Figure 9-4. Achilles Tendon Reflex T ime, D ocking Module Pilot(a) Preflight, F - 3 0(b ) Postfl ight, R + 0

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CONCLUSION

The data show th e predicted postfl ight change in th e Achil les ten do n reflex t ime;also, for the f irst t ime since the ten do n reflex measurem ent was introdu ced, postfl ighttrem or was documen ted. Fu rthe r cl inical studies will be required t o determ ine whetherthe occurrence of such t remors i s re lated to exposure t o tox ic mater ia l .

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10. ELECTROMYOGRAPHIC ANALYSIS O F SKELET AL MUSCLE

Earl V. LaFevers,a Arnauld E. Nicogossian,William N. Hu rsta) and Jos ep h T. Bakerb

The f i rs t oppo rtuni ty to s tudy the effects of long-durat ion weightlessness o n hum anskeletal muscle function occurred du ring the Skylab missions. T he results of the Skylabassessments provided ample evidence that normal muscle func tion is altered by periods ofweightlessness of 59 days or more. This conclusion is sup porte d by a num ber of physio-logical a nd biochemical changes that occurred during Skylab missions (ref. 10-1). T heresults of ground-based studies have shown th at these changes are related t o abno rmalmuscle functio n (refs. 10-2 to 10-7). Fo r example, in the S kylab crewme n, tension capa-bility was decreased afte r flight. Th e electrom yogra m (EMG) spectral characteristicsshowed states of muscle superexcitabil i ty and increased fatigabil i ty with g radual returnto baseline states (ref. 10-8).The purpose of this s tu dy was t o investigate changes in skeletal muscle electricalactivity t h at occur after ex posure to short-term weightlessness; i .e., less than 10 days.The following changes were hypothesized .pow er into higher frequencies1. Heightened ex citabil i ty as evidenced b y a significant shift ing of t he spectral2. Re duc ed muscle electrical efficiency3 . Increased muscle fatigabil i ty when t h e muscles are subjected t o a m oderatefatigue-indu cing stress.

METHOD A ND MATERIALS

InstrumentationA skeletal muscle stress apparatu s was designed and buil t t o enable controlled iso-metric muscle testing and measurements. A two-channel EMG detector was buil t to recordthe EMG. All data were recorded at a rate of 9.52 cm /s (3 . 75 in/s ) on magnet ic tape bya four-channel recorder. A four-channel strip-chart recorder was used t o m onito r the data

playback from the m agnetic tape during the experiment .Protocol

Data were obtained on 3 prefl ight days: 45, 30, and 15 day s before l ift-off. Surfaceelectrodes were placed o n th e lower leg muscles (gastrocnemius an d soleus) and on the armmuscles (biceps brachii and brachioradialis). Seated in th e m uscle stress apparatus, t hecrewman was ins t ructed t o exert a ser ies of graded effo rts as follows.aNASA Lyndon B. Johnson Sp ace Center.bTechn ology Incorporated, Houston, Texas.

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THE A POLLO-SOWZ TEST PROJECT MEDICAL REPORT

1. 10 seconds at 10-percent max imum voluntary contra ct ion (MVC), 20 seconds rest2. 10seconds a t 20-percent MVC, 2 0 seconds res t3. 10seconds at 30-percent MVC, 20 seconds rest4. 60 seconds at 50-percent MVC (leg) and 40 -percent MVC (arm).Leg measurements and arm measurements were collected sequential ly. Postfl ight only(recovery day) da ta on one ast ronaut were obta ined.Data Processing

A com puter program, EMGAN , was wri t ten t o process the force and EMG data. 'Force data were cal ibrated into po und s and averaged over 1-second intervals. Th e EMGsignals were analyzed in 4-second segmen ts. T he da ta were calibrated int o microv olts, andthe integrated value for each segment was foun d. T he discrete Fou rier t ransform w as usedto calculate the m agnitude of the pow er spectral densi ty.Muscle Excitability

Skeletal muscle disuse attributable to 9 da ys of space-flight weightlessness resulted inincreased excitabil i ty of the instrum ented m uscles of this study . Stressed at 30 percent ofMVC, the gastrocnemius and biceps brachii muscles showed a postflight increase in theirpredominant f requency of 30 H z (25 percent) and 2 0 H z (40 perce nt), respectively. Beforethe flight, the soleus muscle showed an increase in predomina nt frequency am oun ting to30 H z (25 percent) . Th e brachioradial is muscle showed the least exci tabi l ity effect fromweightlessness.Muscle Electrical Efficien cy

The ra tios of in tegrated e lec t romyogram (IEMG) t o force for both the gast rocnemiusand brachioradialis muscles showed a decreased level of electrical efficiency as a result o fth e 9 days in weightlessness; the data for the biceps and brachioradial is muscles show atendency for increased electrical efficiency. All of the m uscles, with t he ex ception o f thegastrocnem ius, show ed a decrease in th e level of the IEM G a fter flight, and all of the musclesshow ed a progressive inc rease in electrical activity with increasing contrac tion force bo thbefore and after f l ight . Th e IEMG-to-force rat ios for the 1 minu te fat igue-inducing stressshow ed the tendenc y for all the muscles t o decrease in efficiency as the stress was maintained.Th e soleus muscle show ed th e greatest change in efficiency as a result of the 9 days in weight-lessness.Muscle Fatigabi ty

Analyses of variance were con ducted on the p owe r spectral data o f the fou r musclesused in this stu dy . Th ree main effects were considered in the analyses.

W. . Hursta: EMC AN: A Computer Program for Time and Frequ ency Dom ain Reduction of Electromyographic Data.Special report, Technology lnc., Sept. 1975.

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ELECTROMYOGRAPHIC ANALY SIS OF SKEL ETAL MUSCLE

1. Conditions, pref light compared to postf light2. Tim e increme nts; i .e., the fo ur equally spaced time intervals within th e 1-minutecon t inu ous isometr ic hold fo r which the EMG was spectrally an alyzed3. Freque ncy band s used for th e data analysisa. Leg muscles, 1 0 t o 60 Hz in 10-Hz increm entsb. Arm muscles , 10 t o 30 Hz in IO-Hz incrementsSignificant shif ting of the p ower spectra int o lower frequencies was considered evidenceof muscle fatigabili ty. In th e leg muscle, there was a signif icant difference between preflightand po stf light sp ectral power levels; the p ostf light data show ed a significantly greater pro-gressive po we r shif t into the lower frequencies as a result of th e 1-minute isometr ic stress.Th e arm muscles did no t exhib it s ignif icant differences between c onditions.

CONCLUSIONS

Th e present investigation o f skeletal muscle function involving bo th leg extensor and armflexor muscles in a shorter period of exposu re t o weightlessness (9 days) has show n tha t th emuscle d ysfunc tion character istics pro min ent af ter 59 day s of expo sure in weightlessness ( t heSkylab 2 mission) are also evident af ter only 9 days of exposure in weightlessness.th at skeletal muscles are susceptible to functio nal changes associated with th e reduced muscleactivity in weightlessness. Since all changes showed increased sensitivity, th e probab le site forthis effect is the m uscle f ibers, for the following reason: Previous clinical s tudies have show nth at rand om loss or reduced activity in muscle f ibers, as in m yo pa thy , result in higher f ir ingfrequencies of th e m uscle, whereas dysfunctio ns of neural loci result in lower f iring frequencies(refs. 10-9 t o 10-13).Several studies have provided evidence that the electrical activity of muscles increasesas a function of tension (refs. 10-14 to 10-18). Also, previous studies have sho wn th at , af tera period of immobil ization, or , as in m yop athy , the EMG ampli tudes are depressed when com-pared with unaffected muscles (refs. 10-13 and 10-19). Th e results of this stud y are in agree-ment with those f indings.The greater EMG amp litudes of th e gastrocnemius in response to disuse are no t readilyund erstood . However, Liberson et al. ( ref . 10-20) have provided indirect evi

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