NASA - Findings Of Astronaut Health Review

[Waspie_Dwarf]

Over the last 24 hours there has been much talk of NASA astronauts flying drunk. This has been generated by a review into the health of astronauts (particularly mental health) in the wake of the event involving Lisa Nowak (see HERE).

The results of that health review were announced at a press conference today. NASA has released these results as a series of pdf documents, which I have reproduced the links to below.

Some of these documents are quite long and it is impractical to reproduce them here, so I have reproduced the opening statements and the frequently asked questions. The FAQ provides a reasonable summary of the review.

Links:

• + Statement From Deputy Administrator Shana Dale (20 Kb PDF)
• + NASA Astronaut Health Care System Review Committee Report to the Administrator (81 Kb PDF)
• + Johnson Space Center Internal Review Findings (236 Kb PDF)
• + Public Medical Review Fact Sheet (32 Kb PDF)
• + Frequently Asked Questions

Edited July 27, 2007 by Waspie_Dwarf

[Waspie_Dwarf]

Opening Remarks
NASA Deputy Administrator Shana Dale
July 27, 2007

In the wake of former astronaut Lisa Nowak’s arrest in February 2007, the Astronaut Health Care System Review Committee was formed when NASA Administrator Mike Griffin directed the Agency’s Chief Health and Medical Officer, Dr. Richard Williams, to conduct a review of the medical and behavioral health services available to NASA astronauts at the Johnson Space Center. The Review Committee, chaired by Air Force Colonel Richard Bachmann, Commander of the US Air Force School of Aerospace Medicine, was comprised of eight representatives of other federal agencies. Let me take a moment to acknowledge the important work done on such short notice, with great dedication and time commitment, by members of the Astronaut Health Care System Review Committee. You’ll hear from Col. Bachmann after I speak.

The first major issue is our need to revisit how to most effectively deliver medical and behavioral health care for NASA’s astronauts. The Johnson Space Center (JSC) internal review, led by JSC Director Mike Coats, outlined and evaluated the Johnson Space Center’s extensive health care programs for our astronauts, which includes their behavioral health, and recommended improvements to those programs, which we are going to implement. A more extensive behavioral health assessment will be added to annual flight physical examinations for all astronauts. We also are emphasizing the importance of behavioral health support to Shuttle crewmembers, and offering time with behavioral health providers before, during, and after flight. And, we are committed to improving the quality and usefulness of our psychological testing and assessment during the astronaut selection.

These enhancements are aimed at improving the psychological care and testing procedures for astronauts, which was the key focus of JSC’s internal review. We thank Mike Coats and the team of experts who worked on this review, and we believe the resulting modifications will be good for the Astronaut Corps and for NASA.

NASA’s Medical Policy Board, consisting of senior government medical experts from inside and outside NASA, will further assess the medical and behavioral findings and recommendations in the JSC internal review as well as the report of the external Review Committee. The board will provide advice on policy changes that will improve the NASA health care system, and will provide oversight of the implementation of those policies.

The second major area of NASA’s focus is undertaken with the recognition that the members of our Astronaut Corps, civilian and military, represent a group of America’s most extraordinary and talented individuals, by any standard. We take the recommendation of developing an astronaut code of conduct very seriously. It actually has been under discussion at NASA prior to this report. For almost the entire history of the astronaut corps, our experience has been that NASA’s astronauts conduct themselves with integrity, professionalism, and a desire to bring honor to America and our Nation’s space program. A written code of conduct, one that is initiated by the astronauts themselves, can only strengthen this commitment. We are looking at how such a process will be collaboratively implemented.

Third, we will examine the structure of the Astronaut Office, as the Review Committee report recommends, with a renewed interest in establishing what are referred to as, “enduring supervisor relationships.” We plan to develop an anonymous survey to be completed by members of the Astronaut Corps and flight surgeons to initiate even more feedback on the findings and recommendations of the report in order to optimize supervisory relationships, health care delivery, and mission success. There may be other issues that astronauts are also interested in having resolved or clarified using this approach.

Fourth, we will act immediately on the more troubling aspects of the report, with respect to alcohol use and the anecdotal references to resistance of Agency leadership to accepting advice or criticisms about the fitness and readiness of individuals for space flight. The report does not provide specific information about alcohol-related incidents and the Review Committee has left it to NASA to determine the scope of these alleged incidents.

Let me bring you up to date on this fourth category, and share with you what has been done since the draft report was briefed to NASA senior management.

The Administrator and I have directed NASA’s Chief of NASA’s Office of Safety and Mission Assurance to undertake an internal safety review. He will gather information, conduct necessary analyses, and determine the facts of the reported alcohol-related incidents. If any incidents occurred, he will determine the causes and recommend corrective actions. He also will review all existing policies and procedures related to alcohol use and space flight crew medical fitness during the immediate preflight preparation period to ensure that any risks to flight safety are dealt with by appropriate medical authorities and flight crew management, and, if necessary, elevated through a transparent system of senior management review and accountability.

In the meantime, NASA’s existing T-38 aircraft alcohol use policy that historically has been applied to space flight has been explicitly extended as an interim policy to flight on any spacecraft. This interim policy prohibits alcohol use for 12 hours prior to flight and further states that astronauts will neither be under the influence nor the effects of alcohol at the time of launch. A comprehensive review of alcohol use policy prior to aircraft use or space flight in underway.

Mike Griffin and I will closely monitor progress on these issues. After the review is completed, it is our intention to share the findings with the public, to the maximum extent possible.

One final thought, much of the information contained in this report is, or comes from, anecdotal material. Whatever specific information the Astronaut Health Care System Review Committee obtained in the course of its study, if it is of a health nature, it is subject to rules of medical record privacy. Therefore the Review Committee has stated it cannot disclose this information. Having said that, we do intend to apply the lessons learned from this exercise, and to use this as an opportunity to move our culture closer to the optimum in responsiveness, care, professionalism, and performance integrity that we would all like to see.

Source: + Statement From Deputy Administrator Shana Dale (20 Kb PDF)

[Waspie_Dwarf]

Frequently Asked Questions About The Astronaut Health Care System Review Committee Report

07.27.07

BACKGROUND: On July 26, the NASA Astronaut Health Care System Review Committee delivered its final report to the NASA administrator. The report gave the findings of their review of the health services available to astronauts. The committee examined current healthcare systems, medical policies, medical standards and medical certifications for astronauts. The members reviewed documents and conducted interviews with astronauts, their families and NASA health care professionals.

1. Who is on the committee? What was their assignment?

The Astronaut Health Care System Review Committee was formed after NASA Administrator Michael Griffin directed the agency's Chief Health and Medical Officer Dr. Richard Williams in a Feb. 7, 2007, memo to conduct a review of the medical and behavioral health services available to NASA astronauts at the Johnson Space Center in Houston, Texas. Eight committee members were selected from a pool of nominees provided by the senior medical officers of other federal agencies. The committee was chaired by Air Force Col. Richard Bachmann, commander of the USAF School of Aerospace Medicine. It was one of two reviews, the other being an internal Johnson Space Center review, begun in the wake of former astronaut Lisa Nowak's arrest.

2. What will NASA do with the report?

NASA is carefully evaluating all of the recommendations in the report. Many recommendations already have been accepted, including:

• Look for ways to enhance use of behavioral health data in the astronaut selection process
• Take steps to ensure that flight surgeons, trainers, and astronauts are free to communicate concerns of flight safety to senior leadership and encourage such communication
• Adopt a formal code of conduct for the astronaut corps
• Provide regular training to flight surgeons regarding behavioral health assessments
• Promote better communication from flight surgeons to all astronauts on their personal status with regard to medical qualification for space flight assignments
• Work to enhance a program of external peer review of NASA's medical and behavioral health staff
• Establish one credentialing and privileging authority for both the flight medicine and behavioral health providers, with documented processes for accountability
• Institute behavioral health assessments in conjunction with annual astronaut flight physicals

Other health-related recommendations will be reviewed and considered by the NASA Medical Policy Board. The board, which consists of senior physician representatives from NASA and other federal agencies, recommends NASA medical policy and guidance for human space and atmospheric flight. Dr. Richard Williams is the chief health and medical officer at NASA and the chairperson of the board. Other recommendations concerning astronaut corps management and communications between the astronaut corps and the flight medicine teams will be reviewed and considered by the director of the Johnson Space Center. An overall implementation plan will be provided by Dr. Williams, the director of flight crew operations, the director of space life sciences, and the director of the Johnson Space Center to the NASA administrator and deputy administrator on or before January 1, 2008.

3. The report recommends NASA establish and enforce an astronaut code of conduct. What plans are there for a code of conduct?

JSC managers, including officials within the astronaut office, have been discussing an astronaut code of conduct prior to this report. NASA accepts the recommendation and is NASA is reviewing how such a process will be collaboratively implemented. We're not going to speculate on what such a code of conduct might include.

4. What are the current policies regarding alcohol use by astronauts? Are astronauts allowed to consume alcohol immediately prior to flight?

NASA has an alcohol use policy for agency aircraft flight that historically has been applied to space flight. As a result of the report, NASA has adopted an interim space flight policy based on the agency's T-38 aircraft policy. This interim policy states that astronauts are not qualified for flight if they consume alcohol within the 12 hours prior to flight and astronauts will neither be under the influence nor the effects of alcohol at the time of launch. All astronauts will be educated on the policy. A comprehensive review of alcohol use policies relating to aircraft flight and space flight is underway.

5. Two instances were noted in the report where astronauts were intoxicated prior to flight, prompting flight surgeons and/or fellow astronauts to raise concerns to leadership. Who were the astronauts who, according to the report, abused alcohol before a flight? Will there be an investigation?

The committee received allegations regarding alcohol use that it did not attempt to confirm or verify. The committee included the comments in its report to NASA, but the committee has not provided NASA the names of individuals or flights involved in the alleged incidents.

NASA is unaware of any astronauts who were intoxicated prior to flight. However, the administrator and deputy administrator have directed an internal review, which will be conducted by the Office of Safety and Mission Assurance. Until we have more information, NASA cannot determine the veracity of these claims.

6. The report found that leadership disregarded input from flight surgeons on fitness for duty and from crew members on substandard astronaut performance. How will you fix this problem?

The NASA administrator and deputy administrator have directed an internal review of the allegations of alcohol misuse contained in the report. NASA senior leaders work to promote an environment that encourages all employees to bring safety issues up the chain of command without fear of retaliation. Such an environment helps ensure those safety issues will be given serious consideration.

7. If NASA implements the recommendations in this report, could future incidents similar to the Nowak incident be prevented?

NASA's goal is to provide the best possible health care for our astronauts. We asked the committee to review our procedures so we can improve them. The report notes that "Initial screening and recurrent psychological evaluation are not intended to, nor can they, predict a disorder of conduct or 'act of passion.' However, they can identify persons at increased risk, allowing proactive interventions which may mitigate the risk." NASA shares this view.

8. Did the medical review team examine Lisa Nowak's records?

No.

9. Why is there no psychological evaluation of space shuttle astronauts after initial selection? Will astronauts now undergo regular behavioral health assessments?

NASA traditionally has followed aeromedical guidelines for atmospheric flight in the provision of medical care for short-duration missions. In most of these models, periodic formal behavioral health testing has not been conducted. Flight surgeons are relied upon to recognize behavioral health problems and seek appropriate consultation. NASA medical and behavioral health experts have recommended that behavioral health assessments now be conducted for all astronauts in conjunction with annual flight physicals. We are prepared to implement annual behavioral health assessments of all astronauts as part of our astronaut health care program.

10. How will changes that NASA makes as a result of this report affect international astronauts?

NASA's international partner agencies that have active astronauts will be informed of any changes in NASA policies or procedures that may affect them.

Source: + Frequently Asked Questions

[Waspie_Dwarf]

NASA Releases Results of O'Connor Safety Review

The media advisory is reproduced below:

Aug 28, 2007

David Mould/Michael Cabbage
Headquarters, Washington
202-358-1898
david.r.mould@nasa.gov, mcabbage@nasa.gov

MEDIA ADVISORY: M07-111

NASA Releases Results of O'Connor Safety Review


WASHINGTON - On Wednesday, Aug. 29, NASA will announce the results of a review conducted by NASA Chief of Safety and Mission Assurance Bryan O'Connor to evaluate allegations of improper alcohol use by astronauts.

NASA will hold a news conference at 1:30 p.m. EDT, in the James E. Webb Memorial Auditorium at NASA Headquarters, located at 300 E St., S.W., Washington. NASA Administrator Michael Griffin and O'Connor will participate in the news conference.

O'Connor began reviewing all existing policies and procedures related to alcohol use and astronaut medical fitness prior to spaceflight after the NASA Astronaut Heath Care System Review Committee released its findings in July. His report will be available online at 11 a.m. on Wednesday at:

http://www.nasa.gov/audience/formedia/features/astronautreport.html

Media representatives may ask questions from participating NASA field centers. Reporters should call their local center to confirm its participation in the event.

The news conference will be carried live on NASA Television and online. To watch online and for NASA TV downlink, schedule and web video streaming information, visit:

http://www.nasa.gov/ntv

- end -

Source: NASA Media Advisory M07-111

[Waspie_Dwarf]

NASA Safety Review Finds No Evidence of Improper Alcohol Use by Astronauts Before Space Flight

The press release is reproduced below:

David Mould/Michael Cabbage
Headquarters, Washington
202-358-1600
david.r.mould@nasa.gov, mcabbage@nasa.gov

Aug 29, 2007

RELEASE: 07-184

NASA Safety Review Finds No Evidence of Improper Alcohol Use by Astronauts Before Space Flight

WASHINGTON -- A NASA safety review released Wednesday found no evidence to support claims that astronauts were impaired by alcohol when they flew in space. NASA chief of Safety and Mission Assurance Bryan O'Connor conducted the monthlong review to evaluate allegations included in the Astronaut Health Care System Review Committee's report, which was released in late July.

"I have said many times during the past weeks that NASA takes these allegations very seriously -- just as we would any issues that could impact the safety of our missions," NASA Administrator Michael Griffin told a news conference at NASA Headquarters. "But at the same time, I also have said that the stories cited in the report seem improbable to those of us familiar with the astronauts' rigorous and very public activities during the hours leading up to a space flight."

O'Connor's review covered the past 20 years of space flight and includes:

• approximately 90 interviews with participants and witnesses to the last few days before shuttle and Soyuz launches, including current and former astronauts, flight surgeons, research and operations support nurses, shuttle suite technicians, closeout crew technicians and the managers and staff of crew quarters, including managers familiar with the crew quarters in Kazakhstan;
• a review of more than 40,000 records dating back to 1984, including mishap and close call reports, anonymous safety reports, safety hotline reports and disciplinary actions involving alcohol and drugs. These records cover 94 shuttle missions and 10 Soyuz missions;
• a review of relevant policies, procedures and near-launch timelines and staffing; and
• an inspection of crew quarters at Johnson Space Center in Houston and the Kennedy Space Center in Florida.

O'Connor interviewed almost 80 percent of active astronauts and all current operational flight surgeons. None of them corroborated allegations of preflight alcohol use or claims that management disregarded flight surgeon concerns about alcohol impairment and astronauts' fitness to fly.

"My review represents a good deal more investigation than normally would be done in response to an anonymous safety concern," O'Connor said. "As a result, I am confident there are enough safeguards in place to prevent an impaired crewmember from being strapped into a spacecraft."

NASA is moving forward with a wide range of improvements based on other recommendations from the Astronaut Health Care System Review Committee's report.

Working with members of the astronaut corps, NASA is developing a formal astronaut code of conduct, or "Expected Astronaut Principles of Behavior," which will be a document that outlines expectations. The agency's medical managers also are studying how changes and initiatives advocated by the committee would fit into NASA health care procedures in a way that improves their effectiveness.

And NASA has accepted recommendations concerning the analysis and use of behavioral health data to improve astronaut selection criteria.

NASA will convene expert working groups to advise the agency on possible changes to its psychological testing. Additional training for flight surgeons in behavioral health assessments is planned, and evaluations will be added to annual flight physicals for all astronauts. Continuity of care in NASA clinics will be evaluated. The agency will ensure better clinical communication through regular meetings between behavioral health providers and flight surgeons.

In addition, NASA plans to improve procedures and instructions used in the administration of health care services for its behavioral health clinic. Briefings by flight surgeons to crewmembers are being re-emphasized to ensure astronauts fully understand the nature and purpose of all health-related testing and data collection. Senior NASA leaders also are holding meetings with flight surgeons and astronauts to ensure they understand the multiple pathways to communicate safety and health concerns.

To view O'Connor's report, along with a transcript and video of Wednesday's news conference, visit:

http://www.nasa.gov/audience/formedia/features/astronautreport.html

- end -

--------------------------------------------------------------------------------

Source: NASA Press Release 07-184

[ROGER]

All the rules , time and money put to this project are not going to change "Simple HUMAN nature". Though I supose it should be done to protect NASA from liability. I dont hold any one to a Higher Moral Standard ,even Astronauts. It leads to disapiontment.

[MID]

NASA Safety Review Finds No Evidence of Improper Alcohol Use by Astronauts Before Space Flight

[

Pretty much what I figured.

NASA is a hell of an organization these days. All this effort and investigation, and professional response to unfounded rumors....

Dr. Griffin has a hell of a staff, and I commend him for that, and for alot more, because that guy is likely the best Administrator NASA has had in decades.

I also believe I know what he thinks about this matter, and what he thought about it from the very start (which is why he has such a professional staff).

The idea was untenable, and in fact, impossible.

But NASA moved professionally and thoroughly. I hope this dies where it is...resolved.

I do like the emphasis on crew behavioral and psychological health, however.

[Picturesque Orion]

I don't know why NASA even bothers. It's just a rumor started by a pack of fools, why waste money on that?

[Waspie_Dwarf]

I don't know why NASA even bothers. It's just a rumor started by a pack of fools, why waste money on that?

Actually it was a rumour started by the official enquiry into astronauts health. NASA really couldn't just ignore it.

The allegations put NASA in a no win position:

• If they didn't investigate then the media would claim NASA had something to hide.
• If they did find that astronauts were drunk on duty then the media would have a field day.
• As it is, with nothing being found it's only a matter of time before there are claims of a cover up.

[MID]

I don't know why NASA even bothers. It's just a rumor started by a pack of fools, why waste money on that?

Waspie has a point.

It's was really a must investigate situation. But at the same time, it's rather a damned if you do, damned if you don't sort of thing. Dr. Griffin knew full well that the allegations came from unsubstantiated sources, and that they described essentially impossible circumstances.

However, he did what any good administrator would (and he is a good one, perhaps the best we've ever had). He ordered a complete investigation, being fully aware of the media, as he is, and fully aware that a lack of response in the wake of the Lisa Nowak situation would lead to a real media problem. Additionally, this was all incorporated into the astronaut health inquiry that's been ongoing since Lisa Nowak's incident--also a prudent measure.

The allegations were, in my opinion, ridiculous from the start, but Dr. Griffin pressed into it fully, despite realizing this fact (if you watched the STS-118 post-flight mission management press conference, you could clearly see his opinion of the idea, worded in an exceedingly diplomatic manner, and also the lengths to which this investigation had progressed (10 years of examination in both the Russian and U.S. flight programs and hundreds of interviews at that time).

It was indeed a waste of people's time, but it was prudent, and wise to do so.

Further, I think Waspie's postulation about a cover-up is a distinct possibility, since they found no evidence of the impossible in this matter.

If that rears it's ugly head in the media, I think we might just see Dr. Griffin express himself a little more fully.

That...would be fun (I like the guy, and I'd love to see him come out and say what's on his mind...without any political correctness!)