Issues of health care under weightlessness.

This review will address issues of effects of space flights on the body. Cardiovascular deconditioning often induce symptoms like orthostatic intolerance after flight, and during flight there will be space motion sickness during the first few days with headache, malaise, nausea and eventually vomiting. These symptoms disappear and do not interfere with the performance of the astronauts after several days. During long-term flights, effects will be muscle atrophy and calcium loss from the skeleton. Radiation effects will be a significant issue, increasing with the length of the space flight. Also during long-term flights, psychological problems will become of increasing importance. Astronaut health care will be discussed related to Space Shuttle missions and Space Station missions. Furthermore, countermeasures for long-term space flights (up to 6 months) will be outlined. The NASA health care programme is reviewed, and the frequency of illnesses and injuries encountered in the NASA programme is discussed. There will be a need for setting up an international health care programme in view of the upcoming international cooperation in the Space Station era. It is emphasized that the Space Station is an international platform. Therefore, the health care team will be composed of international personnel, mainly from NASA with participation of Europe, Canada, Russia, and Japan. Specialized medical doctors will form the team and support the crew members from the ground. Some issues, such as medical licensing and responsibility, remain to be solved.