Assessment of Strategies for Managing Cancer Risks Associated with Radiation Exposure During Crewed Space Missions

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Astronauts face unique health-related risks during crewed space missions, and longer-duration missions that extend to greater distances in our solar system (including to the Moon and Mars) will likely increase those risks. Cancer risks due to ionizing radiation exposure are one of these health-related risks. Assessing, managing, and communicating radiation-induced cancer risks associated with spaceflight are challenging because of incomplete knowledge of the radiation environment in space, limited data on radiation-induced cellular damage mechanisms, lack of direct observations from epidemiological studies, and the complexities of understanding radiation risk.

At the request of the National Aeronautics and Space Administration (NASA), an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine convened to provide advice on NASA's proposed updates to their space radiation health standard, which sets the allowable limit of space radiation exposure throughout the course of an astronaut's career. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks provides the committee's recommendations and conclusions regarding the updated space radiation health standard, NASA's radiation risk communication strategies, and a process for developing an ethics-informed waiver protocol for long-duration spaceflight missions.

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Report Recommendations and Conclusions

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144 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-47966-5
ISBN Ebook: 0-309-47975-4
DOI: https://doi.org/10.17226/26155

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National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press.

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Hedvig Hricak

Hedvig Hricak, M.D., Ph.D., Drhc (Chair), is Chair, Department of Radiology, Memorial Sloan Kettering Cancer Center, a member of the Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, and Professor, Gerstner Sloan Kettering Graduate School of Biomedical Sciences, New York, NY. The hallmark of her research career has been the development, validation and dissemination of new diagnostic imaging techniques, particularly for oncology; she is actively engaged in developing evidence-based imaging guidelines and introducing applications of machine learning and AI for oncology. For her research accomplishments and her efforts to promote national and international education and collaboration in oncologic imaging, she has won numerous awards, including David Rall Medal, for Distinguished Leadership, National Academy of Medicine, five gold medals, honorary memberships or fellowships in twenty-two international radiological societies. She holds an honorary doctorate from the Ludwig Maximilian University, Munich and the University of Toulouse III, Paul Sabatier; Toulouse, France. Hricak is a member of the National Academy of Medicine (formerly the Institute of Medicine) and a “foreign” member of both the Russian Academy of Sciences and the Croatian Academy of Sciences and Arts. She has served on a number of national advisory boards and councils, including the National Institutes of Health Board of Scientific Counselors, the Scientific Advisory Board of the National Cancer Institute, the Advisory Council of the National Institute of Biomedical Imaging and Bioengineering and the Nuclear and Radiation Studies Board, National Academy of Sciences. She has also served as chair, co-chair or member on a number of Institute of Medicine/National Academy of Medicine and the National Academy of Sciences studies.

R. Julian Preston

R. Julian Preston, Ph.D. (Vice-Chair), is currently a Special Government Employee (Expert) with the Radiation Protection Division of the U.S. Environmental Protection Agency (EPA). He was previously the Associate Director for Health for the National Health and Environmental Effects Research Laboratory of EPA. He also served as Director of the Environmental Carcinogenesis Division at EPA and as senior science adviser at the Chemical Industry Institute of Toxicology. He has been employed at the Biology Division of the Oak Ridge National Laboratory and has served as Associate Director for the Oak Ridge–University of Tennessee Graduate School for Biomedical Sciences. Preston's research and current activities have focused on the mechanisms of radiation and chemical carcinogenesis and the approaches for incorporating these types of data into cancer risk assessments. Preston currently serves on two National Council on Radiation Protection and Measurements committees and is a member of the National Academy of Sciences Nuclear and Radiation Studies Board and was recently a member of an Office of Science and Technology Policy Committee on Low Dose Radiation Research. Preston was chair of Committee 1 of the International Commission on Radiological Protection (ICRP), a member of the ICRP Main Commission, and the Representative and a member of the U.S. delegation to the United Nations Scientific Committee on the Effects of Atomic Radiation. He served as Chair for the National Research Council's Committee to Assess the Scientific Information for the Radiation Exposure Screening and Education Program and on the Task Group on the Biological Effects of Space Radiation. He is an associate editor of Environmental and Molecular Mutagenesis and Chemico-Biological Interactions. Preston has had more than 200 peer-reviewed papers and chapters published. He received his B.A. and M.A. from Peterhouse, Cambridge University, England, in genetics and his Ph.D. from Reading University, England, in radiation genetics.

Amy Berrington de Gonzalez

Amy Berrington de Gonzalez, D.Phil., is the Branch Chief and senior investigator in the Radiation Epidemiology Branch at the National Cancer Institute. She is an internationally recognized cancer epidemiologist who has made important contributions to the understanding of cancer risks from medical radiation exposures. Berrington is the PI of the U.S. Pediatric Proton Therapy Cohort, the Kaiser Breast Cancer Survivors Study and co-PI of the UK Pediatric CT scans cohort, which was the first epidemiological study to support a direct link between CT scans and subsequent cancer risk. Berrington is currently a member of the National Academy of Sciences Nuclear and Radiation Studies Board and has participated in numerous national and international radiation and cancer advisory committees. She is an elected member of the American Epidemiological Society and served on the editorial board for the American Journal of Epidemiology. Before joining the National Cancer Institute, she held faculty positions at Oxford and Johns Hopkins University. Berrington is also the Senior Advisor for Strategic Activities in the Division of Cancer Epidemiology & Genetics. In this role, she provides advice to the Director on the division research portfolio and works with the Deputy Director to oversee strategic planning.

Ann Bostrom

Ann Bostrom, Ph.D., is the Weyerhaeuser endowed Professor of Environmental Policy at the Daniel J. Evans School of Public Policy and Governance, University of Washington. From 1999-2001, she was the program director at the National Science Foundation for the Decision, Risk and Management Science program. She researches risk perception, risk communication, and decision-making under uncertainty, with a focus on mental models of hazardous processes. Her current research projects include interview, survey and experimental research on perceptions, communication and decision making about climate change, earthquake early warning, and extreme weather forecasts and warnings. Bostrom earned her Ph.D. in Policy Analysis from Carnegie Mellon University, her M.B.A. from Western Washington University, and her B.A. in English from the University of Washington.

Casey Canfield

Casey Canfield, Ph.D., is an Assistant Professor in Engineering Management & Systems Engineering at Missouri S&T. Her research is focused on quantifying the human part of complex systems to improve decision-making, particularly in the context of energy, governance, and healthcare. She has a Ph.D. in Engineering & Public Policy from Carnegie Mellon University, where she published research on behavioral interventions and risk management in the context of energy and cybersecurity. After completing her Ph.D., she spent a year and a half as a Science and Technology Policy Fellow in the U.S. Department of Energy’s Solar Energy Technologies Office.

Harry Cullings

Harry M. Cullings, Ph.D., was Chief of the Statistics Department at the Radiation Effects Research Foundation (RERF) in Hiroshima and Nagasaki, Japan, until 2018 and is now a consultant to RERF. He has been conducting research at RERF since 1999. RERF is a public interest foundation funded by the Japanese Ministry of Health, Labour and Welfare and the U.S. Department of Energy (DOE). Cullings holds a B.S. in Fundamental Sciences from Lehigh University, and an M.S. in Medical Physics and Ph.D. in Analytical Health Sciences (Biometrics) from the University of Colorado Health Sciences Center in Denver, Colorado. He completed a postdoctoral fellowship in Radiation Sciences, funded by the DOE at the University of Pittsburgh. The emphasis of Cullings’ research is on radiation dosimetry and other aspects of radiation epidemiology, including dosimetric uncertainty and applications of spatial statistics. Cullings has published numerous reports, papers in scientific journals, and book chapters on subjects related to radiation dosimetry and radiation health effects research. He served as a member of the Joint U.S.-Japan Working Group on the Reassessment of Atomic-bomb Dosimetry, which created the Dosimetry System 2002 that is currently in use at RERF. Cullings’ research has been funded strictly through the Radiation Effects Research Foundation, in part through a DOE award to the National Academy of Sciences. Cullings has received no external research funding from government agencies, private companies, or foundations.

Lawrence T. Dauer

Lawrence T. Dauer, Ph.D., DABHP, FHPS, is an Associate Attending Physicist in the Departments of Medical Physics and Radiology at Memorial Sloan Kettering Cancer Center, and is their Corporate Radiation Safety Officer. He has spent more than 35 years in the field of radiation protection and health physics, including programs for the nuclear energy and industrial sectors as well as operations and research in medical health physics. His research focuses on low dose radiation epidemiology and dosimetry, improving radiation protection practices and communication avenues to reduce the risk of exposure to ionizing radiation and to facilitate beneficial clinical applications. He is currently a Council and Board member of the National Council on Radiation Protection and Measurements (NCRP). He is currently serving NCRP as the Scientific Coordinator for the Million Person Study of Low-Level and Low-Dose-Rate Effects. He served 7 years on the International Commission on Radiological Protection Committee 3, Radiation Protection in Medicine, and has served on several committees for the Health Physics Society (HPS), Greater New York Chapter of the HPS, Radiological and Medical Physics Society, American Association of Physicists in Medicine, American College of Radiology, Society for Interventional Radiology, and Radiation Research societies. He has received the Elda E. Anderson and the Fellow Awards from the HPS.

Bernard A. Harris, Jr.

Bernard A. Harris, Jr., M.D., M.B.A, F.A.C.P., is currently Chief Executive Officer and Managing Partner of Vesalius Ventures, Inc., a venture capital firm that supports and invests in early to mid-stage Healthcare technologies and companies. Harris also serves as Chief Executive Officer of the National Math & Science Initiative, and leads the organization’s efforts to improve teacher effectiveness and student achievement in communities across the country. He has been involved in math and science education for over 25 years through his philanthropy efforts through the Harris Institute & Foundation. Harris was at the National Aeronautics and Space Administration (NASA) for ten years, where he conducted research in musculoskeletal physiology and disuse osteoporosis. Harris earned a Bachelor of Science in Biology from the University of Houston, a Master of Medical Science from the University of Texas Medical Branch at Galveston, a Master of Business Administration from the University of Houston and a Doctorate of Medicine from Texas Tech University School of Medicine. He completed a Residency in Internal Medicine at the Mayo Clinic, a National Research Council Fellowship in Endocrinology at the NASA Ames Research Center and trained as a Flight Surgeon at the Aerospace School of Medicine, Brooks Air Force Base. He is also a licensed private pilot and certified scuba diver. He is the recipient of numerous awards, including honorary doctorates from Stony Brook University, Morehouse School of Medicine, New Jersey Institute of Technology and University of Hartford, NASA Space Flight Medal, NASA Award of Merit, a fellow of the American College of Physicians, and was the recipient of the 2000 Horatio Alger Award.

Alejandra Hurtado de Mendoza

Alejandra Hurtado de Mendoza, Ph.D., is an Assistant Professor at the Cancer Prevention and Control Program at Georgetown Lombardi Comprehensive Cancer Center. She is a bilingual Social Psychologist with an interdisciplinary training in Anthropology and Communication, Culture, and Technology. She aims to combine interdisciplinary approaches in social psychology, behavioral science, and communication to develop and evaluate interventions that address stark disparities in the uptake of genetic risk assessment in high-risk underserved groups. Her research focuses on translational genomics with underserved populations. She is PI of a 5-year multisite grant to test the impact of a culturally targeted narrative video on genetic counseling and testing uptake in Latina women at-risk of hereditary breast and ovarian cancer. She is also co-leading an NINR R21 grant to adapt an Intelligent Tutoring System intervention (BRCA-Gist) to enhance the use of genetic counseling services in at-risk Latina and African American women. In her Career Award (KL2) she adapted an evidence-based telephone counseling intervention to broaden the reach and accessibility to genetic counseling for at-risk Latina women.

Jeffrey Kahn

Jeffrey Kahn, Ph.D., M.P.H., is the Andreas C. Dracopoulos Director of the Johns Hopkins Berman Institute of Bioethics, a position he assumed in July 2016. From 2011, he has been the inaugural Robert Henry Levi and Ryda Hecht Levi Professor of Bioethics and Public Policy. He is also Professor in the Department of Health Policy and Management of the Johns Hopkins Bloomberg School of Public Health. He works in a variety of areas of bioethics, exploring the intersection of ethics and health/science policy, including human and animal research ethics, public health, and ethical issues in emerging biomedical technologies. Kahn has served on numerous governmental and international advisory panels, including most recently on the International Commission on the Clinical Use of Heritable Human Genome Editing. He is currently chair of National Academies of Sciences, Engineering, and Medicine’s (NASEM’s) Board on Health Sciences Policy, chair of the NASEM’s Committee on Aerospace Medicine and Medicine of Extreme Environments and has previously chaired its committee on the Use of Chimpanzees in Biomedical and Behavioral Research (2011); the committee on Ethics Principles and Guidelines for Health Standards for Long Duration and Exploration Spaceflights (2014); and a committee on the Ethical, Social, and Policy Considerations of Mitochondrial Replacement Techniques (2016). He is current a member of the National Academy of Medicine Council.

Guillermina Lozano

Guillermina Lozano, Ph.D., is a geneticist recognized for her studies of the p53 tumor suppressor pathway, from characterizing p53 as a transcriptional activator to characterizing the physiological importance of Mdm2 and Mdm4 proteins as inhibitors of p53, and the consequences of p53 mutations on tumor development. Lozano completed undergraduate studies in Biology and Mathematics at Pan American University (now known as the University of Texas Rio Grande Valley). She completed graduate studies at Rutgers University and the University of Medicine and Dentistry of New Jersey, and a post doctoral fellowship at Princeton University. She was hired as an Instructor at The University of Texas MD Anderson Cancer Center in 1987 and is now chair of the department of Genetics. She was elected a Fellow of the American Association for the Advancement of Science. She received the Minorities in Cancer Research Jane Cooke Wright Lectureship, and Women in Cancer Research Charlotte Friend Lectureship awards both from the American Association for Cancer Research. Lozano is also the recipient of distinguished alumni awards from both her undergraduate and graduate alma maters. She is a member of the National Academy of Sciences and the National Academy of Medicine.

Giovanni Parmigiani

Giovanni Parmigiani, Ph.D., is a professor in the Department of Data Sciences at the Dana-Farber Cancer Institute and of Biostatistics at Harvard T.H. Chan School of Public Health as well as Associate Director for Population Sciences at the Dana-Farber/Harvard Cancer Center. He received his undergraduate degree in economics and social sciences at Università L. Bocconi, and a Masters and Ph.D. in statistics from Carnegie Mellon University. He has held faculty positions at Carnegie Mellon, Duke and Johns Hopkins. His work creates statistical tools for understanding cancer data, with particular focus on cancer risk in genetic epidemiology and genomics contexts. He pioneered the use of machine learning in the assessment of risk from inherited suscpetibility to cancer, developing risk assessment tools that have been in use for over two decades. He also played a key role in early studies of somatic mutations in cancer. He is the recipient of several awards including mentoring awards at Johns Hopkins, Harvard, and Dana Farber.

Robert L. Satcher

Robert L. Satcher, Ph.D., M.D., is an Associate Professor in the Department of Orthopaedic Oncology at The University of Texas MD Anderson Cancer Center (MDACC) in Houston, Texas. He specializes in the treatment of skeletal metastatic disease, soft tissue sarcoma, technology applications for improving surgical outcomes, teleoncology, and intra operative navigation. Satcher is a former Astronaut, having served as a mission specialist who visited the International Space Station. Satcher is leading institutional efforts to establish the clinical enterprise for virtual care at MDACC. Additionally, his work with MD Anderson’s Global Oncology enterprise is focused on building relationships with international healthcare partners that will lead to the construction of a Cancer Center in sub-Saharan Africa. Satcher co-founded the eHealth Research Institute, a collaborative endeavor between Rice University, the National Space Biomedical Research Institute, and MDACC, to bring together physicians with academic and industry researchers to improve access to specialized health care using the latest in research and technology. Satcher is a member of numerous professional organizations including the American Academy of Orthopaedic Surgery, Musculoskeletal Tumor Society, National Comprehensive Cancer Network, American Telemedicine Association, American Association of Cancer Research, Doctors United in Medical Missions, and the Orthopaedic Research Society.

Carol E. Scott-Conner

Carol Scott-Conner, M.D., Ph.D., M.B.A., is Professor Emeritus of Surgery at the University of Iowa Carver College of Medicine. She received her B.S. in Electrical Engineering from the Massachusetts Institute of Technology in 1969, and her M.D. from New York University School of Medicine in 1976. She remained at New York University to complete a five year general surgical residency in 1981. She was appointed Head of the Department of Surgery at the University of Iowa in 1995. She is the author or coauthor of nine major surgical texts and a book of short stories. Her other works have included numerous papers, chapters and presentations on a wide range of surgical topics.

Igor Shuryak

Igor Shuryak, M.D., Ph.D., is an assistant professor in the Center for Radiological Research, Department of Radiation Oncology at Columbia University Medical Center. His research interests focus on mechanistic mathematical modeling of the effects of ionizing radiation on living organisms. They include modeling of radiation-induced carcinogenesis at both low and high doses (e.g., second cancers induced by radiotherapy for primary malignancies), cancer therapy (e.g., tumor control and normal tissue complications), nontargeted (“bystander”) effects of radiation (e.g., for densely-ionizing radiation exposures such as those occurring on manned space missions), and mechanisms of resistance to ionizing radiation in human and nonhuman cells. Shuryak is currently a co-investigator on two competitively awarded NASA-funded grants related to space radiation carcinogenesis. Shuryak’s training and experience have been interdisciplinary, starting with biology (B.A. from Columbia University) and medicine (M.D. from State University of New York Downstate College of Medicine). He received a Ph.D. degree with distinction from the Department of Environmental Health Sciences (Columbia University, Mailman School of Public Health) for work on combining both short- and long-term time scales in mechanistic modeling of radiation-induced carcinogenesis.

Gregory R. Wagner

Gregory R. Wagner, M.D., is an Adjunct Professor of Environmental Health at the Harvard T.H. Chan School of Public Health. At Harvard, he teaches about the science behind occupational and environmental policies and regulations and the process of improving health protections at work. He also chairs the Policy Working Group for the Harvard Center for Work, Health, and Wellbeing. Wagner previously served as Senior Advisor to the Director of the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention. From 2009 to early 2012, he served as Deputy Assistant Secretary of Labor for Mine Safety and Health, leading efforts to develop and enforce regulations protecting the health and safety of U.S. miners. He has worked closely with both the World Health Organization and International Labor Organization to stimulate and support international efforts to better recognize and prevent diseases from work and improve screening and surveillance practices. Board certified in internal medicine and public (occupational) health, Wagner has practiced rural primary care medicine and taught both medicine and public health.

Gayle E. Woloschak

Gayle Woloschak, Ph.D., is currently a professor of Radiation Oncology at Northwestern University in Chicago and an adjunct professor of Religion and Science at Lutheran School of Theology Chicago, and at Pittsburgh Theological Seminary. She holds a Ph.D. in Biomedical Sciences from the University of Toledo (Medical College of Ohio), and a D.Min. in Eastern Christian Studies from Pittsburgh Theological Seminary. Her laboratory interests include molecular biology, radiation biology and nano-biotechnology, and her science-religion fields include biological evolution, stem cell research, and ecology.

Lydia Zablotska

Lydia Zablotska, M.D., Ph.D., M.P.A., is a Professor in the Department of Epidemiology and Biostatistics in the School of Medicine at the University of California, San Francisco (UCSF), where she serves as the Leader of the Occupational and Environmental Epidemiology Area of Concentration. Zablotska is a physician and epidemiologist with extensive training and publications in radiation epidemiology, biostatistics, and risk modeling. Her research activities have focused primarily on the examination of risks of radiation exposures in various occupational and environmental settings. Zablotska’s work has clarified our understanding of the effects of occupational radiation exposures on health risks of nuclear power industry workers and workers of the uranium fuel production cycle in various occupational cohorts from the U.S. and Canada. Zablotska serves as a Director of Epidemiology, Biostatistics and Population Health education in the medical school curriculum at UCSF and has received multiple institutional and national teaching and mentoring awards. She is the inaugural Councilor for Epidemiology at the Executive Council of the Radiation Research Society. She is also currently a member of the National Council on Radiation Protection and Measurements (NCRP) Committee on the “Evaluation of Sex-Specific Differences in Lung Cancer Radiation Risks and Recommendations for Use in Transfer and Projection Models.” Recently, she was a member of the NCRP Committee on “Meeting the Needs of the Nation for Radiation Protection” and served as a leader of the section on Radiation Epidemiology.

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Assessment of Strategies for Managing Cancer Risks Associated with Radiation Exposure During Crewed Space Missions Public Session

January 25 - 26, 2021

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The National Academies of Sciences, Engineering, and Medicine Committee on the Assessment of Strategies for Managing Cancer Risks Associated with Radiation Exposure During Crewed Space Missions will be hosting a virtual public session on January 25-26, 2021 from 11:00 AM to 3:00 PM ET.

This committee has been tasked by NASA to review and assess NASA's processes for long-term risk assessment and management for currently anticipated crewed missions with respect to cancer (excluding current and post mission effects of radiation) due to exposure to space radiation.

Through the course of the study, the committee will meet several times. The public session is one of the many processes that the committee will use to gather information and assemble evidence that members will examine and discuss in the course of making the committee’s findings, conclusions, and recommendations. The focus of this public session is for the committee to clarify the scope of the charge with the study sponsor and initiate the process of gathering relevant information related to the study.

Registration is now open for this virtual public session. The agenda will be forthcoming.

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It is essential to the National Academies mission of providing evidence-based advice that participants in any of our meetings or events avoid political or partisan statements or commentary and maintain a culture of mutual respect. The statements and presentations during our meetings or events are solely those of the individual participants and do not necessarily represent the views of other participants or the National Academy of Sciences, which is a non-partisan, tax exempt organization that includes under its Charter the National Academy of Engineering and National Academy of Medicine, and that operates the National Research Council.

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Assessment of Strategies for Managing Cancer Risks Associated with Radiation Exposure During Crewed Space Missions

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Assessment of Strategies for Managing Cancer Risks Associated with Radiation Exposure During Crewed Space Missions

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Featured publication

Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks

Description

Collaborators

Committee

Sponsors

Staff

Parent projects

Board on Health Sciences Policy

Standing Committee on Aerospace Medicine and the Medicine of Extreme Environments

Major units and sub-units

Contact

Provide feedback

Request materials

More like this

Standing Committee on Aerospace Medicine and the Medicine of Extreme Environments

Transportation Research Board Executive Office

National Cooperative Highway Research Program

Modernizing Mathematics Education for Grades 9-14

Health Care Financing to Improve Availability of Affordable Contraception: Identifying Promising Practices

Review of Methods in the Report on Carcinogens Handbook

Exploring Relevant Policy Domains — Housing Policy and Population Health: A Workshop