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Space exploration programmes, currently under discussion in the US and in Europe, foresee human missions to Mars to happen within the first half of this century. In this context, the European Space Agency (ESA) has conducted a study on the human responses, limits and needs for such exploratory missions, the so-called HUMEX study (ESA SP-1264). Based on a critical assessment of the limiting factors for human health and performance and the definition of the life science and life support requirements performed in the frame of the HUMEX study, the following major critical items have been identified: (i) radiation health risks, mainly occurring during the interplanetary transfer phases and severely augmented in case of an eruption of a solar particle event; (ii) health risks caused by extended periods in microgravity with an unacceptable risk of bone fracture as a consequence of bone demineralisation; (iii) psychological risks as a consequence of long-term isolation and confinement in an environment so far not experienced by humans; (iv) the requirement of bioregenerative life support systems complementary to physico-chemical systems, and of in situ resource utilisation to reach a closure of the life support system to the highest degree possible. Considering these constraints, it has been concluded that substantial research and development activities are required in order to provide the basic information for appropriate integrated risk managements, including efficient countermeasures and tailored life support. Methodological approaches should include research on the ISS, on robotic precursors missions to Mars, in ground-based simulation facilities as well as in analogue natural environments on Earth.

The European Space Agency has recently initiated a study of the human responses, limits and needs with regard to the stress environments of interplanetary and planetary missions. Emphasis has been laid on human health and performance care as well as advanced life support developments including bioregenerative life support systems and environmental monitoring. The overall study goals were as follows: (i) to define reference scenarios for a European participation in human exploration and to estimate their influence on the life sciences and life support requirements; (ii) for selected mission scenarios, to critically assess the limiting factors for human health, wellbeing, and performance and to recommend relevant countermeasures; (iii) for selected mission scenarios, to critically assess the potential of advanced life support developments and to propose a European strategy including terrestrial applications; (iv) to critically assess the feasibility of existing facilities and technologies on ground and in space as testbeds in preparation for human exploratory missions and to develop a test plan for ground and space campaigns; (v) to develop a roadmap for a future European strategy towards human exploratory missions, including preparatory activities and terrestrial applications and benefits. This paper covers the part of the HUMEX study dealing with lunar missions. A lunar base at the south pole where long-time sunlight and potential water ice deposits could be assumed was selected as the Moon reference scenario. The impact on human health, performance and well being has been investigated from the view point of the effects of microgravity (during space travel), reduced gravity (on the Moon) and abrupt gravity changes (during launch and landing), of the effects of cosmic radiation including solar particle events, of psychological issues as well as general health care. Countermeasures as well as necessary research using ground-based test beds and/or the International Space Station have been defined. Likewise advanced life support systems with a high degree of autonomy and regenerative capacity and synergy effects were considered where bioregenerative life support systems and biodiagnostic systems become essential. Finally, a European strategy leading to a potential European participation in future human exploratory missions has been recommended.

This chapter introduces the main topics of research that have benefited so far from the space environment (reduced gravity, ambient radiation, vacuum, etc.), and provides an outlook for future research development. By convention, it is split into two fields: physical sciences/engineering and life sciences.

costly. The key is therefore to establish an accurate assessment of the victim’s state and this is currently tributary to the presence onboard of a medical doctor and equipment. We propose in this contribution a network trac model for the deployment of an inight, satellite based telemedicine service. The purpose of the terminal is to support accurate remote assessment using a cabin crew member as operator. This contribution also includes an estimation of the network resources required for running the service.

The general health issues considered in two scenarios of human long-term exploratory missions, which include a mission to a lunar base and a mission to Mars, have been analysed. Based on statistical data from occupational and normal population groups of Western countries, the following safety objectives have been chosen: individual risk of death by illness (=natural death) during the mission shall be −3 /year, that by injury (=accidental death) −4 /year, and that from all causes, including spacecraft failure (taken from most exposed professions) −2 /year. Using the classical reliability requirements for human space missions, reliability objectives have been set for each mission scenario, resulting in values compatible with the mission safety objectives. The main results are as follows: (i) based of the probability of occurrence of diseases and injuries and on the constraints imposed by exploratory mission scenarios, the crew shall have a full autonomy in terms of medical and surgical diagnostics and care means and competency; (ii) the control of the toxic and biological risks in a confined environment for a so long exposure shall be carefully analyzed and the technical solutions shall master these risks; (iii) the state of the art shows that bone loss during the long stay in weightlessness, especially during missions to Mars, remains an unacceptable risk. Solutions to control and to prevent this risk shall be developed; (iv) the control of human physical capacity impairment under weightlessness shall be optimised. A roadmap in the field of health care has been elaborated for a future European participation strategy towards human exploratory missions taking into account preparatory activities, such as analogue situations and ISS opportunities, and potential terrestrial applications and benefits.