Werneth Charles M, Patel Zarana S, Thompson Moriah S, Blattnig Steve R, Huff Janice L
NASA Langley Research Center, Hampton, VA, USA.
Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA.
Commun Med (Lond). 2024 Jun 11;4(1):105. doi: 10.1038/s43856-023-00408-4.
Expanding human presence in space through long-duration exploration missions and commercial space operations warrants improvements in approaches for quantifying crew space radiation health risks. Currently, risk assessment models for radiogenic cancer and cardiovascular disease consider age, sex, and tobacco use, but do not incorporate other modifiable (e.g., body weight, physical activity, diet, environment) and non-modifiable individual risk factors (e.g., genetics, medical history, race/ethnicity, family history) that may greatly influence crew health both in-mission and long-term. For example, clonal hematopoiesis of indeterminate potential (CHIP) is a relatively common age-related condition that is an emerging risk factor for a variety of diseases including cardiovascular disease and cancer. CHIP carrier status may therefore exacerbate health risks associated with space radiation exposure.
In the present study, published CHIP hazard ratios were used to modify background hazard rates for coronary heart disease, stroke, and hematologic cancers in the National Aeronautics and Space Administration space radiation risk assessment model. The risk of radiation exposure-induced death for these endpoints was projected for a future Mars exploration mission scenario.
Here we show appreciable increases in the lifetime risk of exposure-induced death for hematologic malignancies, coronary heart disease, and stroke, which are observed as a function of age after radiation exposure for male and female crew members that are directly attributable to the elevated health risks for CHIP carriers.
We discuss the importance of evaluating individual risk factors such as CHIP as part of a comprehensive space radiation risk assessment strategy aimed at effective risk communication and disease surveillance for astronauts embarking on future exploration missions.
通过长期探索任务和商业太空运营来扩大人类在太空中的存在，这就需要改进量化航天员太空辐射健康风险的方法。目前，放射性癌症和心血管疾病的风险评估模型考虑了年龄、性别和烟草使用情况，但未纳入其他可改变的（如体重、身体活动、饮食、环境）和不可改变的个体风险因素（如遗传学、病史、种族/族裔、家族病史），而这些因素可能会对航天员执行任务期间和长期的健康产生重大影响。例如，不确定潜能的克隆性造血（CHIP）是一种相对常见的与年龄相关的状况，是包括心血管疾病和癌症在内的多种疾病的新兴风险因素。因此，CHIP携带者状态可能会加剧与太空辐射暴露相关的健康风险。
在本研究中，已发表的CHIP风险比被用于修正美国国家航空航天局太空辐射风险评估模型中冠心病、中风和血液系统癌症的背景风险率。针对未来火星探索任务场景，预测了这些终点的辐射暴露致死风险。
我们在此表明，血液系统恶性肿瘤、冠心病和中风的辐射暴露致死终生风险显著增加，这在男性和女性航天员辐射暴露后的年龄函数中可以观察到，这直接归因于CHIP携带者健康风险的升高。
我们讨论了评估诸如CHIP等个体风险因素的重要性，将其作为旨在对未来探索任务中的宇航员进行有效风险沟通和疾病监测的全面太空辐射风险评估策略的一部分。
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