Memorandum 26
Submission from Dr Alyson Calder[39]
THE UNITED KINGDOM MUST NOT MISS THE OPPORTUNITY
TO BE LEADERS IN THE FIELD OF SPACE MEDICINE
1. EXECUTIVE
SUMMARY
2. The United Kingdom is currently one of
few countries with growing expertise in the field of Space Medicine.
Interest in this branch of modern medicine has never been so great.
I believe that the United Kingdom is well placed to be a leader
in this field. However, if government does not recognise that
the UK is at a pivotal point for the future of this branch of
research, we are at risk of losing current expertise and its many
benefits for good. It would be a great pity if this were to happen,
simply due to short-sightedness.
3. MY BACKGROUND
4. During the past decade, I have gained
expertise in the field of Space Medicine research. I have done
so through placements at international Space institutes, including
the Yuri Gagarin Cosmonaut Training Centre (Russia), NASA Johnson
Space Center (Texas), NASA Kennedy Space Center (Florida), Vanderbilt
Center for Space Physiology and Medicine (Tennessee) and the Microgravity
Laboratory, (Porto Alegre, Brazil). I have attended and presented
research at numerous space medicine conferences, high schools,
hospitals and university departments around the globe. These activities
have had to be self-funded. I have worked with and met hundreds
of doctors and health professionals from around the world who
also recognise the benefit of space medicine. It is a source of
disappointment to them and myself that the United Kingdom does
not at present seem to share this insight.
5. ANNUAL UK
SPACE MEDICINE
CONFERENCE
6. I established the 1st UK Space Medicine
Conference in 2004 to explore the level of interest existed in
this field within the UK. A lecture theatre was filled and a clear
interest amongst both health professionals and students was highlighted.
On the basis of this, the UK Space Biomedicine Group was formed
as a focus for national Space Medicine education and research.
Our efforts were commended by Sir Professor Graeme Catto, President
of the General Medical Council who recognised that medicine in
the UK must continue to push boundaries, and that doctors should
maintain the ability to think laterally.
7. This meeting has gained interest each
year, and the 3rd UK Space Medicine Conference was held on 30
September-1 October 2006 at the National Space Centre, Leicester.
Over 100 delegates attended this year's meeting to see two days
of lectures from 26 presenters, including representatives from
NASA, the National Space Biomedicine Research Institute and the
European Space Agency. Feedback was positive from all who attended,
and an air of excitement and education was clear. I do not know
of any branch of medicine which would inspire medical students
enough to spend their own money and time on an intensive weekend
medical conference in Leicester! It is difficult, however, when
this level of enthusiasm is raised and students enquire about
educational and research opportunities to advise them that they
must fund these projects themselves if they are to pursue their
passion.
8. EDUCATIONAL
ACTIVITES
9. Space medicine has clear educational
benefits from primary school through to postgraduate levels. It
provides a fresh way to study and learn about human physiology
and pathophysiology. It excites and inspires students and encompasses
many branches of science including physiology, physics, biology
and psychology. It is closely related to history and international
relations, amongst many other subjects. It is ideal holistic teaching
material. I have lectured on the subject of space medicine from
the Highlands of Scotland to China and have always received a
warm response from students fascinated to learn more. Questions
from students always run over time.
10. RESEARCH
ACTIVITIES
11. For every medical problem encountered
in microgravity, an analogous condition occurs on Earth. This
is one way in which space and hospital medicine are interconnected.
Examples include:
— Post-flight orthostatic intolerance
and othostatic intolerance experienced after bed rest and in conditions
such as multiple sclerosis, diabetes and autonomic dysfunction.
— Space motion sickness and inner
ear disturbances such as Menieres disease.
— Muscle atrophy experienced by
astronauts and disuse muscle wasting following bed rest and sarcopenia
of old age.
— Loss of bone mineral density
in astronauts and disuse osteoporosis in hospital patients on
bed rest or with immobolised limbs in plaster casts.
12. ORTHOSTATIC
INTOLERANCE
13. My particular area of interest is the
condition of post-flight orthostatic intolerance. This is the
difficulty astronauts have maintaining their blood pressure on
standing up on return from microgravity. It a common and disabling
condition for both astronauts and hospital patients. I worked
with Dr David Robertson from the Center for Space Physiology and
Medicine at Vanderbilt University during a medical elective. Dr
Robertson is the founder of the American Autonomic Society and
is a world expert in orthostatic intolerance. He recognizes the
merits of the unique model of microgravity to research the complex
mechanisms behind this condition. He conducted and designed an
experiment to perform microneurography in microgravity in order
to study the sympathetic nervous system in space. Such research
broadens our understanding of such pathophysiology back on Earth.
14. I helped to set up research at the NASA
Kennedy Space Center to study the use of ergotamine as a countermeasure
to post-flight orthostatic intolerance. Apart from having the
potential to treat post-flight OI in astronauts this drug may
have implications for treating resistant orthostatic intolerance
in hospital patients.
15. One of the main mechanisms of post-flight
OI is loss of plasma volume in astronauts. I am working with Dr
Yannis Pitsiladis and Mr Chris Easton at the University of Glasgow
to study the effect of a new hyperhydration strategy on plasma
volume and postural change. We hypothesise that hyperhydration
with creatine and glycerol may help both astronauts and hospital
patients with orthostatic intolerance by expanding plasma volume.
16. UNITED KINGDOM—BRAZIL
RESEARCH COOPERATION
17. I was delighted to be invited to work
at the Microgravity Laboratory in Brazil earlier this year
where I conducted unique research into cardiopulmonary resuscitation
in hypogravity (ie simulated Martian and Lunar gravitational environments).
Not only did this answer the interesting question of whether chest
compression would be effective in such environments, but it allows
us to reflect on hospital practice. A life support provider with
low body mass performing chest compressions on a patient with
low chest wall compliance may not be achieving adequate compression
depth. The equipment we designed to monitor chest compression
depth would be an ideal training tool for hospital life support
providers.
18. CONCLUSION
19. Space medicine helps us to study the
human body in microgravity. Of greater interest to me as a
hospital doctor is its ability to help us understand conditions
on Earth, inspire students and doctors and to keep our medical
minds fresh to new discovery. This, to me, is the very essence
of what medicine and education is all about.
October 2006
39 Chair of International Activities, Space Medicine
Association, constituent organization of the Aerospace Medical
Association, Founder and Organiser of Annual UK Space Medicine
Conference, and Co-Founder UK Space Biomedicine Group. Back
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