Pulmonary challenges of prolonged journeys to space: taking your lungs to the moon

Prisk, G Kim

doi:10.5694/mja2.50312

ARTICLE
AUTHORS
REFERENCES

Topics

Anatomy and physiology

Health occupations

Respiratory tract diseases

Summary

Space flight presents a set of physiological challenges to the space explorer which result from the absence of gravity (or in the case of planetary exploration, partial gravity), radiation exposure, isolation and a prolonged period in a confined environment, distance from Earth, the need to venture outside in the hostile environment of the destination, and numerous other factors.
Gravity affects regional lung function, and the human lung shows considerable alteration in function in low gravity; however, this alteration does not result in deleterious changes that compromise lung function upon return to Earth.
The decompression stress associated with extravehicular activity, or spacewalk, does not appear to compromise lung function, and future habitat (living quarter) designs can be engineered to minimise this stress.
Dust exposure is a significant health hazard in occupational settings such as mining, and exposure to extraterrestrial dust is an almost inevitable consequence of planetary exploration. The combination of altered pulmonary deposition of extraterrestrial dust and the potential for the dust to be highly toxic likely makes dust exposure the greatest threat to the lung in planetary exploration.

University of California, San Diego, La Jolla, CA, USA

Correspondence: kprisk@ucsd.edu

Acknowledgements:

Many of the studies were funded by the National Aeronautics and Space Administration (NASA) and the National Space Biomedical Research Institute under various contracts and grants. G Kim Prisk is currently funded by the National Institutes of Health under R01 HL119263.

Competing interests:

No relevant disclosures.

1. Chancellor JC, Blue RS, Cengel KA, et al. Limitations in predicting the space radiation health risk for exploration astronauts. NPJ Microgravity 2018; 4: 8.
2. Yi B, Matzel S, Feuerecker M, et al. The impact of chronic stress burden of 520‐d isolation and confinement on the physiological response to subsequent acute stress challenge. Behav Brain Res 2015; 281: 111–115.
3. Perhonen MA, Franco F, Lane LD, et al. Cardiac atrophy after bed rest and spaceflight. J Appl Physiol 2001; 91: 645–653.
4. Lang T, Van Loon JJWA, Bloomfield S, et al. Towards human exploration of space: the THESEUS review series on muscle and bone research priorities. NPJ Microgravity 2017; 3: 8.
5. Widrick JJ, Knuth ST, Norenberg KM, et al. Effect of a 17 day spaceflight on contractile properties of human soleus muscle fibres. J Physiol 1999; 516: 915–930.
6. Glazier JB, Hughes JM, Maloney JE, West JB. Vertical gradient of alveolar size in lungs of dogs frozen intact. J Appl Physiol 1967; 23: 694–705.
7. Bryan AC, Milic‐Emili J, Pengelly D. Effect of gravity on the distribution of pulmonary ventilation. J Appl Physiol 1966; 21: 778–784.
8. West JB, Dollery CT, Naimark A. Distribution of blood flow in isolated lung: relation to vascular and alveolar pressures. J Appl Physiol 1964; 19: 713–724.
9. West JB. Pulmonary gas flow and gas exchange. In: West JB, editor. Respiratory physiology: people and ideas. New York: Oxford Press, 1966: 140–196.
10. Christofidou‐Solomidou M, Pietrofesa RA, Arguiri E, et al. Space radiation‐associated lung injury in a murine model. Am J Physiol Lung Cell Mol Physiol 2015; 308: L416–L428.
11. Sawin CF, Nicogossian AE, Rummel JA, Michel EL. Pulmonary function evaluation during the Skylab and Apollo‐Soyuz missions. Aviat Space Environ Med 1976; 47: 168–172.
12. Robertson WG, McRae GL. Study of man during a 56‐day exposure to an oxygen‐helium atmosphere at 258 mm Hg total Pressure. VII. Respiratory function. Aerosp Med 1966; 37: 453–456.
13. Elliott AR, Prisk GK, Guy HJ, West JB. Lung volumes during sustained microgravity on spacelab SLS‐1. J Appl Physiol 1994; 77: 2005–2014.
14. Guy HJ, Prisk GK, Elliott AR, West JB. Maximum expiratory flow‐volume curves during short periods of microgravity. J Appl Physiol 1991; 70: 2587–2596.
15. Elliott AR, Prisk GK, Guy HJ, et al. Forced expirations and maximum expiratory flow‐volume curves during sustained microgravity on SLS‐1. J Appl Physiol 1996; 81: 33–43.
16. Prisk GK, Guy HJ, Elliott AR, et al. Pulmonary diffusing capacity, capillary blood volume, and cardiac output during sustained microgravity. J Appl Physiol 1993; 75: 15–26.
17. Prisk GK, Fine JM, Elliott AR, West JB. Effect of 6 degrees head‐down tilt on cardiopulmonary function: comparison with microgravity. Aviat Space Environ Med 2002; 73: 8–16.
18. Guy HJ, Prisk GK, Elliott AR, et al. Inhomogeneity of pulmonary ventilation during sustained microgravity as determined by single‐breath washouts. J Appl Physiol 1994; 76: 1719–1729.
19. Prisk GK, Guy HJB, Elliott AR, et al. Ventilatory inhomogeneity determined from multiple‐breath washouts during sustained microgravity on Spacelab SLS‐1. J Appl Physiol 1995; 78: 597–607.
20. Verbanck S, Linnarsson D, Prisk GK, Paiva M. Specific ventilation distribution in microgravity. J Appl Physiol 1996; 80: 1458–1465.
21. Prisk GK, Elliott AR, Guy HJ, et al. Multiple‐breath washin of helium and sulfur hexafluoride in sustained microgravity. J Appl Physiol 1998; 84: 244–252.
22. Dutrieue B, Verbanck S, Darquenne C, Prisk GK. Airway closure in microgravity. Respir Physiol Neurobiol 2005; 148: 97–111.
23. Prisk GK, Lauzon AM, Verbanck S, et al. Anomalous behavior of helium and sulfur hexafluoride during single‐breath tests in sustained microgravity. J Appl Physiol 1996; 80: 1126–1132.
24. Lauzon AM, Prisk GK, Elliott AR, et al. Paradoxical helium and sulfur hexafluoride single‐breath washouts in short‐term vs. sustained microgravity. J Appl Physiol 1997; 82: 859–865.
25. Dutrieue B, Lauzon AM, Verbanck S, et al. Helium and sulfur hexafluoride bolus washin in short‐term microgravity. J Appl Physiol 1999; 86: 1594–1602.
26. Dutrieue B, Paiva M, Verbanck S, et al. Tidal volume single breath washin of SF6 and CH4 in transient microgravity. J Appl Physiol 2003; 94: 75–82.
27. Prisk GK, Guy HJB, Elliott AR, West JB. Inhomogeneity of pulmonary perfusion during sustained microgravity on SLS‐1. J Appl Physiol 1994; 76: 1730–1738.
28. Prisk GK, Elliott AR, Guy HJ, et al. Pulmonary gas exchange and its determinants during sustained microgravity on Spacelabs SLS‐1 and SLS‐2. J Appl Physiol 1995; 79: 1290–1298.
29. Lauzon AM, Elliott AR, Paiva M, et al. Cardiogenic oscillation phase relationships during single‐breath tests performed in microgravity. J Appl Physiol 1998; 84: 661–668.
30. Elliott AR, Prisk GK, Schöllman C, Hoffman U. Hypercapnic ventilatory response in humans before, during, and after 23 days of low level CO2 exposure. Aviat Space Environ Med 1998; 69: 391–396.
31. Prisk GK, Elliott AR, West JB. Sustained microgravity reduces the human ventilatory response to hypoxia but not hypercapnia. J Appl Physiol 2000; 88: 1421–1430.
32. Dijk DJ, Neri DF, Wyatt JK, et al. Sleep, performance, circadian rhythms, and light‐dark cycles during two space shuttle flights. Am J Physiol Regul Integr Comp Physiol 2001; 281: R1647–R1664.
33. Sá RC, Prisk GK, Paiva M. Microgravity alters respiratory abdominal and rib cage motion during sleep. J Appl Physiol 2009; 107: 1406–1412.
34. Migeotte PF, Prisk GK, Paiva M. Microgravity alters respiratory sinus arrhythmia and short‐term heart rate variability in humans. Am J Physiol Heart Circ Physiol 2003; 284: H1195–H2006.
35. Wantier M, Estenne M, Verbanck S, et al. Chest wall mechanics in sustained microgravity. J Appl Physiol 1998; 84: 2060–2065.
36. Prisk GK, Fine JM, Cooper TK, West JB. Pulmonary gas exchange is not impaired 24‐hours following extra‐vehicular activity. J Appl Physiol 2005; 99: 2233–2238.
37. Prisk GK, Fine JM, Cooper TK, West JB. Vital capacity, respiratory muscle strength, and pulmonary gas exchange during long‐duration exposure to microgravity. J Appl Physiol 2006; 101: 439–447.
38. Prisk G, Fine J, Cooper T, West J. Lung function is unchanged in the 1 G environment following 6‐months exposure to microgravity. Eur J Appl Physiol 2008; 103: 617–623.
39. Prisk GK. Microgravity and the respiratory system. Eur Respir J 2014; 43: 1459–1471.
40. Weibel ER. Morphometry of the human lung. New York: Academic Press, 1963.
41. Haase H, Baranov VM, Asyamolova NM, et al. First results of Po2 examinations in the capillary blood of cosmonauts during a long‐term flight in the space station “Mir”. International Astronautical Congress and International Astronautical Federation; 1990. Proceedings of the 41st Congress of the International Astronautical Federation; Dresden (Germany), 6–12 October 1990. Paris, France: International Astronautical Federation; pp. 1–4.
42. West JB, Dollery CT. Distribution of blood flow and ventilation‐perfusion ratio in the lung, measured with radioactive CO2. J Appl Physiol 1960; 15: 405–410.
43. Permutt S. Pulmonary circulation and the distribution of blood and gas in the lungs. Physiology in the space environment. Washington: National Academy of Science, National Research Council 1485B; 1967. pp. 38–56.
44. Verbanck S, Larsson H, Linnarsson D, et al. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity. J Appl Physiol 1997; 83: 810–816.
45. Van Muylem A, Antoine M, Yernault JC, et al. Inert gas single‐breath washout after heart‐lung transplantation. Am J Respir Crit Care Med 1995; 152: 947–952.
46. Conkin J, Klein JS, Acock KE. Description of 103 cases of hypobaric sickness from NASA‐sponsored research (1982–1999). Houston, TX: Johnson Space Center; 2003. Report No. NASA/TM‐2003‐212052. https://ston.jsc.nasa.gov/collections/TRS/_techrep/TM-2003-212052.pdf (viewed July 2019).
47. Waligora JM, Horrigan D, Conkin J, Hadley AT. Verification of an altitude decompression sickness prevention protocol for shuttle operations utilizing a 10.2‐psi pressure stage. NASA Technical Memorandum 58259. Houston, TX: NASA, 1984; pp. 1–44. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19840020323.pdf (viewed July 2019).
48. Cotes JE. Lung function assessment and application in medicine; 5th ed. Boston: Oxford Blackwell Scientific Publications, 1993: 251–262.
49. Prisk GK, Fine JM, Cooper TK, West JB. Pulmonary gas exchange is not impaired 24 h after extravehicular activity. J Appl Physiol 2005; 99: 2233–2238.
50. NASA Exploration Atmospheres Working Group. Recommendations for exploration spacecraft internal atmospheres: the final report of the NASA Exploration Atmospheres Working Group. NASA; 2010. Contract No. NASA/TP‐2010‐216134. https://ston.jsc.nasa.gov/collections/trs/_techrep/TP-2010-216134.pdf (viewed July 2019).
51. Graf JC. Lunar soils grain size catalog. Report No. NASA‐RP‐1265. NASA, 1993. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19930012474.pdf (viewed July 2019).
52. Linnarsson D, Carpenter J, Fubini B, et al. Toxicity of lunar dust. Planet Space Sci 2012; 74: 57–71.
53. Karmali F, Shelhamer M. The dynamics of parabolic flight: flight characteristics and passenger percepts. Acta Astronaut 2008; 63: 594–602.
54. Hoffman RA, Billingham J. Effect of altered G levels on deposition of particulates in the human respiratory tract. J Appl Physiol 1975; 38: 955–960.
55. Darquenne C, West JB, Prisk GK. Deposition and dispersion of 1‐μm aerosol boluses in the human lung: effect of micro‐ and hypergravity. J Appl Physiol 1998; 85: 1252–1259.
56. Darquenne C, Paiva M, West JB. Prisk GK. Effect of microgravity and hypergravity on deposition of 0.5‐ to 3‐μm‐diameter aerosol in the human lung. J Appl Physiol 1997; 83: 2029–2036.
57. Butler JP, Tsuda A. Effect of convective stretching and folding on aerosol mixing deep in the lung, assessed by approximate entropy. J Appl Physiol 1998; 83: 800–809.
58. Darquenne C, Prisk GK. Effect of small flow reversals on aerosol mixing in the alveolar region of the human lung. J Appl Physiol 2004; 97: 2083–2089.
59. Bennett WD, Chapman WF, Lay JC, Gerrity TR. Pulmonary clearance of inhaled particles 24 to 48 hours post deposition: effect of beta‐adrenergic stimulation. J Aerosol Med 1993; 6: 53–62.
60. Moller W, Häussinger K, Winkler‐Heil R, et al. Mucociliary and long‐term particle clearance in the airways of healthy nonsmoker subjects. J Appl Physiol. 2004; 97: 2200–2206.
61. Darquenne C, Prisk G. Deposition of inhaled particles in the human lung is more peripheral in lunar than in normal gravity. Eur J Appl Physiol 2008; 103: 687–695.
62. Darquenne C, Borja MG, Oakes JM, et al. Increase in relative deposition of fine particles in the rat lung periphery in the absence of gravity. J Appl Physiol 2014; 117: 880–886.
63. Lam CW, Scully RR, Zhang Y, et al. Toxicity of lunar dust assessed in inhalation‐exposed rats. Inhal Toxicol 2013; 25: 661–78.
64. Levine JS, Winterhalter D, Kerschmann RL. Dust in the atmosphere of mars and its impact on human exploration. Cambridge: Cambridge Scholars Publishing, 2018.

Online responses are no longer available. Please refer to our instructions for authors page for more information.

Pulmonary challenges of prolonged journeys to space: taking your lungs to the moon

Topics

Summary

Author

Comment

Do you have any competing interests to declare? *