Apollo 7 to 11 Medical Concerns and Results

8/7/2019 Apollo 7 to 11 Medical Concerns and Results

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NASA TECHNICALASA TM X-58034MEMORANDUMovember 1969APOLLO 7 TO 11: '.MEDICAL CONCERNS AND RESULTS

Presented atthe XVIII International Congress of Aerospace MedicineAmsterdam, The Netherlands, September 18, 1969


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ABSTRACT

The goal of the Apollo Program is to land menon the moon and safely return them to earth. Themedical task thus outlined required confirmation ofthe Gemini findings and definition and solutic itof any, p roblems encountered in the four Apollo flights priorto the Apollo 11 lunar landing. The medical con-cedes included the following.

1. The effect of decreased red blood cell massand decreased exercise capacity and of cardiovascu-lar deconditioning on the ability of the crew to dolunar-surface activity2. The capability to work effectively in one-sixth g and the energy cost of such work3. The ability to get adequate rest and sleepin flight and on the 1,11mir surface4. The prevention of preflight, inflight, andpostflight illness by proper preventive medicine5. The possibie development of motion sick-ness of vestibular origin6. The conduct of a postfli p -lit quarantine ofcrew and lunar samples

The results of the Apollo 7 to 11 missions, demon-strating the ability of man to handle this difficulttask and the environment successfully, arc discussedin detail and are related to the future of mannedfliglit.


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CONTENTSSectionINTRODUCTICN . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .NATURAL AND SPACECRAFT ENVIRONMENT . . . . . . . . . . . . . . . . .

Cabin Atmosphere . . . . . . . . . . . . . . . .. . . . . . . . . . . .Cabin and Suit Temperatures . . . . . . . . . . . . . . . . . . . . . . . . .Noiseand Vibration . . . . . . .. . . . . . . . . . . . . . . . . . . . .

ACCELERATION AND IMPACT . . .. . . . . . . . . . . . . . . . . . . .Radiobiology.Toxicology.General Weightlessness . . . . . . . . . . . . . . . . . . . . . . . . . . . .Food ....................................Water Management . .Waste Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Work/Sleep Cycles . . . . . . . . . . . . . . . . . . . . . .. . . . .MedicalKit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Bioinstrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Preventive Medicine and Inflight Disease . . . . . . . . . . . . . . . . . . .

PHYSICAL EXAMINATIONS . . . . . . . . . .. . . . . . . . . . . . . . .Cardiovasc ular ResponseHematology-Biochemistry . . . . . . . . . . . . . . . . . . . .. . . .Immunology . . . . .. .. . . . . . . . . . . . . . . . . . . .Microbiology. . . . . . . . . . . . . . . . . .. . . . . . .. . Page1444555678910101212121414161717


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SectionageLunar-Surface Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9Quarantine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .0

CONCLUSION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2


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TABLES

TableI APOLLO MANNED MISSIONS . . . . . . . . . . . . . . . . . . . .II MAXIMUM ACCELERATION . . . . . . . . . . . . . . . . . . . .

III ONBOARD RADIATION INSTRUMENTATION . . . . . . . . . . .IV APOLLO MISSIONS: RADIATION DOSE . . . . . . . . . . . . . .V BODY WEIGHT CHANGES AND CALORIE INTAKE FOR

APOLLO 7 TO 11 MISSIONS . . . . . . . . . . . . . . . . . . .VI APOLLO 11: ESTIMATED SLEEP BEFORE LUNAR LANDINGVII APOLLO CM MEDICAL KIT CONTENTS . . . . . . . . . . . . . .

VIII APOLLO 7 TO 11 CLINICAL PROBLEMS, PREFLIGHT . . . . . .IX APOLLO 7 TO 11 CLINICAL PROBLEMS, INFLIGHT . . . . . . .X APOLLO 7 TO 11 CLINICAL PROBLEMS, POSTFLIGHT.

XI METHODS FOR EVALUATING ORTHOSTATIC TOLERANCE . . .XII SUMMARY OF HEART RATE RESPONSES FOR

APOLLO 7 TO 11 MISSIONS . . . . . . . . . . . . . . . . . . .XIII SUMMARY OF CALF CIRCUMFERENCE DATA FOR

APOLLO 7 TO 11 MISSIONS . . . . . . . . . . . . . . . . . . .XIV PULSE PRESSURE RESULTS FROM APOLLO 7 TO 11 MISSIONS.XV ROUTINE HEMATOLOGY . .. . . . . . . . . . . . . . . . . .XVIRADIOISOTOPE HEMATOLOGY . . . . . . . . . . . . . . . . . .XVIIHEMATOLOGY DATA SUMMARY . . . . . . . . . . . . . . . . . .XVIIIBIOCHEMISTRY DATA SUMMARY . . . . . . . . . . . . . . . . .XIXURINE (24 HR) CHEMISTRY SUMMARY . . . . . . . . . . . . . .

Page23232424

252627

29303132

33

34343536373839


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PageableXXII APOLLO EMU METABOLIC ASSESSMENT: APOLLO 11, COM-PARISON OF ESTIMATED METABOLIC PRODUCTION . . . . . . .

XXIII _APOLLO EMU METABOLIC ASSESSMENT: APOLLO 11 LMP,INTEGRATED BTU PRODUCTION . . . . . . . . . . . . . . . . . .

42

43


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FIGURES

Figure Page1 Cabin oxygen enrichment sequence during Apollo 7 10-day flight . . . .42 Representative Apollo CM cabin temperatures (Apollo 7 data) . . . . .43 Representative LM cabin temperatures (Apollo 9 earth-orbitaldata)................................. 454 Representative LM cabin temperatures (Apollo 11 lunar stay) . . . . .55 Launch accelerations (Apollo 7 data)...66 Apollo 10 entry acceleration ..67 Artificial electron belt .478 New foods and packaging for the Apollo Program . . . . . . . . . . . .89 Apollo CM potable water system.910 Apollo waste management equipment. _. . ..,_, , , ,, ._ ,,, , ,911 Crew rest cycles (Apollo 8 data).012 Apollo 11 crew sleep periods.0

13 Apollo medical kit.114 Apollo crewman heart rate and leg volume response to LBNP . . . . .115 Apollo crewman heart rate response t.^ 5-minute 90 0 stand tests. .216 Apollo crewman blood pressure response to LBNP . . . . . . . 5217 Apollo crewman blood pressure response to 5-minute

9 0tand test.318 Workload/heart rate.319 Apollo EMU metabolic assessment (Apollo 11 CDR, real-timedata,ccumulated Btu)..4


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i

Figureage22pollo EMU metabolic assessment (Apollo 11 LMP) . . . , . . . . . ,723pollo EMU metabolic assessment (Apollo 11 heart rates) . . . . . .8


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A P O L L O 7 T O 1 1 : M E D I C A L C O N C E R N S A N D R E S U L T SBy C harles A . Berry, M . D.M anned S pacecraft C enter

I N T R OD U C T I ONThe goal of the Apollo Program is to land m en on the m oon and safely return themto earth. This goal was achieved with the successful lunar landing of Apollo 11 onJuly 20, 1969. Future lunar-landing missions will be accomj: i shed under the moreadvanced lunar exploration phase of the Apollo Program. This paper summarizes themedical knowledge and experience gained during the Apollo 7 to 11 missions. TheApollo Program was designed as a series of steps beginning with an earth-orbital.checkout of the command and service module (CSM), progressing to lunar-orbitalcheckouts of the CSM and the lunar module (LM ), and finally achieving a lunar landing.The five manned Apollo missions are listed in table I. Thus far, space-flight experi-ence during the three U. S. space-fl ight program s is comprised of 54 m an-hours duringProject Mercury, 1939 man-hours during the Gem ini Program, and 3105 man-hoursduring the Ap ollo Program , which includes 2 hours 14 minu tes of lunar-surface exp lo-ration for the Apo llo 11 comm ander (CD R) and 1 hour 42 minutes of lunar-surface ex--loration for the Apollo 11 lunar module' pilot (LMP). " The duration of the longestMercury mission was 30 hours, and the durations of the longest Gemini and Apollomissions were 14 and 11 da ys, respectively. Space-flight experience to Sep tembe r 1969totaled 5098 m an-hours.The successful com pletion of the Apollo 11 lunar-landing mission required plan-ning that was based on the results of all previous manned space fl ights. The m edicalinformation obtained from the Gemini Program w as the basis on which the medical sup-port and investigation for the Apollo flight series were planned. The significant posi-t ive m edical results from the Ge mini Program have been previously reported (refs. 1to 8) and are sum marized as follows:1. M oderate loss of red blood cell mass2. M oderate cardiovascular deconditioning3. M oderate loss of exercise capacity4. M inimal loss of bone density5. Minima l loss of calcium and m uscle nitrogen


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The possible effects of the EVA difficulties, the cardiovascular deconditioning,the loss of red blood cell mass, and the loss of exercise capacity on crew man pe rform-ance during the proposed lunar-surface a ctivity were of particular concern. The Apollospacecraft was a new vehicle which provided, for the first time, sufficient cabin volumeto allow freedom of m ovement and exercise, thus reducing the marked confinement, ofthe earlier Mercury a nd Gem ini flights. Accordingly, the following m edical objectivesfor the Apollo Program w ere established:

1. The assurance of crew safety2. The assurance of m ission com pletion and completion of those activities con-tributing to m ission success3. The prevention of back contamination of the biosphere4. The continuance of the understanding of the biomedical changes incident tomanned space flight

To me et these objectives, it was necessary to de velop a medical requirements docu-ment w hich detailed a preflight and postflight medical evaluation program. This pro-gram w ould provide information that would assure a proper m edical-support capabilityfor the lunar landing. Developme nt of the medical program w as particularly importantbecause all inflight medical experiments had been rem oved from the Apollo Programafter the Apollo spacecraft fire in 196 7 in order to concentrate on the operational com-plexity of the missions. The concern about the lunar mission was sum marized in arecent article on lunar me dicine (ref. 9).

The confirmation of the Gem ini Program data in the larger Apollo spacecraftwas vital to the prediction of the physiologic state of the crewm en at the time of thelunar-surface activity. The acquisition of microbial base-line data for the lunar-quarantine operations and the further documentation of space-flight effects upon manwere also critical objectives. The medical procedures that were conducted were de-veloped by a m ultidisciplinary team in the Med ical Research and O perations Director-ate of the NAS A M anned Spacecraft Center at Houston, Texas. Evaluations includedphysical examinations, hematology, immunology, biochemistry, bone densitometry,cardiovascular response, exercise capacity, and microbiology. These evaluationswere supplemented by the observations made in flight from continual voice monitoring,the monitoring of electrocardiogram and respiration during command m odule (CM )operations, and the monitoring of voice and electrocardiogram during L M o perations.During the A pollo 7 and 8 C M o perations, it was possible to monitor the electrocardio-gram and respiration of only a single individual at any given time. During the A pollo 9,10, and it missions, simultaneous monitoring of all three CM crewmen was possible,and mon itoring of one crewm an at a time w as possible in the LM. Du ring the Apollo 11lunar-surface exploration, both crewm en were m onitored simultaneously.

The author would like to acknowledge, by area of responsibility, the following


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2. Miand George3. Mission Control Staff Support: Charles K. LaPinta, M. D.; Gilbert J. Sales,M. D.; Sam L. Pool, M. D.; Frank L. LeCocq, M. D.; Fredric F. Doppelt, M. D.;Emmett B. Ferguson, M. D.; Robert N. Hahn, Biomedical Engineer; Don W. Mangold,Biomedical Engineer; Russell J. Kelly, Biomedical Engineer; Dan H. Taylor, Bio-medical Engineer; and David Bradshaw, Biomedical Engineer4. Flight Medicine: Clarence A. Jernigan, M. D.; M. Keith Baird, M. D.;William R. Carpentier, M. D.; Gilbert J. Sales, M. D.; Allan C. Harter, M. D. ;John Teegen, M.D.; Jerry M. Joiner, M.D.; Clint L. Holt, M.D.; Dolores O'Hara,

R. N. , and William J. Frome, D. D. S.5. Exercise Capacity: John A. Rummel, Ph. D.6. Lower Body Negative Pressure: Robert L. Johnson, M. D.; George W.Hoffler, M.D. ; and Roger Wolthuis, Ph. D.7. Immuno-Hematology: Craig L. Fischer, M. D.; Philip Johnson, Jr., M. D.;and Stephen E. Ritzmann, M. D.8. Bone Densitometry: ;: Pauline Mack, Ph. D.9. Food: Malcolm C. Smith, D. V. M.; Paul C. Rambaut, Ph. D.; andRita M. Rapp10. Water and Waste: Richard L. Sauer11. Virology: James L. McQueen, D. P. H.; and Bernard J. Mieszkuc, M. S.12. Bacteriology: James K. Ferguson, Ph. D.; and Gerald R. Taylor, Ph. D.13: Endocrine: Carolyn Leach, Ph. D.14. Toxicology: Elliott S. Harris, Ph. D.15. Radiation: Charles M. Barnes, D. V. M.; Richard E. Benson, D. V. M .;J. Vernon Bailey; Robert English; and Edward D. Liles16. Preventive Medicine: W. W. Kemmerer, Jr., M.D.; W. Carter Alexander,Ph. D. ; and B. Wooley, Ph. D.17. Bioinstrumentation: George G. Armstrong, M. D.18. Quarantine Control Officers: Harold Eitzen, Ph. D.; Howard J. Schneider,


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19. Physiological Data Engineers: Edward L. Moseley, Ph. D.; andFrank A. M ichelli20. EVA Metabolic Management Team: G eorge F. Humbert, M. D.; Edward L.Moseley, Ph. D.; Frank A. Michelli; Lawrence J. Nelson; Russell J. Kelly;Law rence Kuznetz; and J. M. Waligora

N A T U R A L A N D S P A C E C R A F T E N V I R O N M E N TCabin Atmosphere

Following the Apollo spacecraft fire in 1967, it was decided that the cabin atmosphere at launch w ould contain less than 100 percent o xygen. Calculations and studiesshowed that if a 60-percent-oxygen/40-percent-nitrogen atmosphere were used atlaunch and if the crewmen were denitrog6nated for 3 hours prelaunch, problems ofhypoxia and dysbarism could be avoided w hen the spacecraft attained the nominal cabinpressure of 5 psia. The Apollo spacecraft have actually been launched with a64-percent-oxygen/36-percent-nitrogen atmosphe re. The cabin urine-dump valve wa sleft open at launch and for a n umber o f hours after launch to establish a given leak rateand to aid in the ox-i gen enrichment of the cabin. On the Apollo 7 flight, an oxygenanalyzer was carried on board, and readings of the oxygen percentage w ere taken dur-ing the mission. The oxygen enrichment profile is shown in figure 1. The oxygenpartial pressure was never less than that normally present at sea level. The crewmenalways removed helmets and gloves w ithin the first hour after launch and usually withinthe first half hour. The suits were removed at convenient times early in the mission,._and flight coveralls were w orn for the major portions of the flight. During the Ap ollo 7mission, the crew donned the suits at one time to c heck their capability to do so and tocheck their reentry configuration. The c rew also don ned the suits without the helmetsand gloves in order to u se the foot -restraints which w ere built into the suit loop for useduring reentry. On the flights since Apo llo 7, the suits have not been w orn during re-entry but have been redonned for critical mission phases such a s the separation anddocking of the LM and C M and the lunar-surface activity.

C ab i n and Su i t T em pe ra tu resDuring the Apollo 7 to it missions, the CM cabin temperature was m aintained atapproximately 70 F, varying from 62 0 to 80 F. This temperature was generallymaintained without the use of cabin fans. Occasionally, crewm en were c ool duringtranslunar coast, but adjustment of the environmental control system returned thecabin to comfort levels (fig. 2). The suit temperatures were measured at the suit in-let and were always maintained at a lower level than that of the cabin. The tempe ra-ture in the LM during earth orbit or lunar orbit was m aintained between 65 and 70 Fexcept during and immediately following depressurization (fig. 3). During the sleep


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With the Apollo lunar missions, man, for the first time, penetrates the protec-tive "magnetic um brella" and exposes him self to direct galactic radiation and to par-ticles from solar flares should such flares occur. It now appears from actualmeas uremen ts that, under norm al circumstances, true space is devoid of significantradiation, consisting principally of galactic radiation at levels approxim ating 10 m rad/day. Solar flares seem to occur at random intervals and, with short-duration missionsto the lunar surface, it is improbable that a solar flare producing a significant particleevent wou ld occur during the time of a lunar mission. Should a particle event occur,the radiation doses received by the crewm en are expected to be med ically insignificantbecause of protection afforded by the thickness of the spacecraft wall. As a typical ex-ample, the worst solar flare measured during the last solar cycle, November 12, 1960,would have given the CM crewmen a skin dose (0. 07-mm depth) of 237 rads and a depthdose (5 cm) o f only 15 rads. The effect of these doses on an average man w ould beminimal. It is possible to have multiple flares, but the probability of such an occur-rence during the time interval required for an A pollo mission is low.

Du ring later Apollo flights, there is a short period of time during crew occupancyof the LM and also during lunar-surface EV A w hen a large solar flare, should such aflare occur, could be of some medical significance. Under the wo rst conditions con-ceivable, skin doses to an astronaut could be as high as 691 rads, but because of theradiation spectrr .n, the depth doses would not exceed 2 5 rads. Although no p athologi-cal effects are predicted as a result of such a de pth dose, the skin dose possibly couldaffect crew performance moderately because of skin irritatio:, blepharitis, and soforth. In addition, a radiation dose of this magnitude approac hes the threshold of aradiation dose that could result in mo re serious latent sequelae such as epilation,_ fi-brosis, edema, and moist desquamation. Fortunately, certain operational constraintscan be used to limit radiation exposure. Iii addition, the probability of a solar flare ofthe magnitude described is quite sm all, probably no m ore than one in 5 000 missions.Radiation of the A pollo spacecraft is being measured by the instruments listed intable III, some of w hich we re also used in the Gem ini series of earth-orbital missions.

The results of the radiation measurements m ade by the dosimeters on the A pollo 7to it missions are reported in table IV. The doses, reported in rads, are the meanvalues of all measureme nts made. A final precise estimate of the Ap ollo 11 radiationdose has not been determined becau se certain instrumentation has been quarantined.The radiation doses accumulated by the astronauts are generally much less thanradiation doses to specific organs of the body during routine diagnostic procedures.C ertainly, the radiation risk from the A pollo 7 to 11 series of flights has been minim al.

T o x i c o l o g yThree approaches were taken to assure the safety of the Apollo CM and LMatmospheres.


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3. Analysis and evaluation of the atmospheres of the Ap ollo 7 CM, the Apollo 8CM, and the Apollo 9 LM during altitude chamber tests at the NA SA K ennedy SpaceCenter (KSC)

The objectives of these end-item tests were to examine the atmospheres forknown contaminants, to identify and quantitate known contaminants, and to establishthe fact that contam inants were below levels that w ould produce physiological effects.It was revealed through these verification tests that approximately 50 com pounds ex-isted in the spacecraft atmosphere, but conc entrations were too low to be of toxicologi-cal significance, even when group ed according to primary m odes of action. Off-gassingwas shown to increase with tim e and, significantly, was not reduced by curing out at ahard vacuum for a 7-hour period.From po stflight analyses of charcoal from the Ap ollo 7 to 10 missions, the pres-ence of over 50 com pounds in the spacecraft atmosphere was established; however, notall of these compoun ds were evident during preflight analysis. Of most significancewas the presence of relatively large amou nts of halocarbons such as meth anol, ethanol,propanol, isopropanol, methyl chloride, mesitylene, and N -octane.The following three prob lem areas still exist.1. Observed methem oglobinemia. A review of the contaminants of the space-craft shows no contam inant of sufficient concentration to produce a m ethemoglobinemia.2. Halocarbons.- Halocarbons can react w ith the lithium hydroxide (LiOH) of theenvironmental control system (ECS) canister to produce highly toxic products. Actionis being taken to reduce th is potential hazard.3. Odor. Odors have been detected in the A pollo 9 and 11 spacecraft and the

causes and effects are unk nown. Sam ple bottles are available for potential use in thedetermination of the p resence and possible sources of odors on future flights.Genera l Weight lessness

Flighterews have confirmed t he Gem ini observations of an initial feeling of full-ness in the head when weightless flight is attained. This sensation has lasted for vary-ing lengths of time during th e first day of flight. An aw areness of a lack of weight ofobjects and clothing has been noted b y crewmem bers, and the capability to impart m ini-mal velocities to objects in the weightless environment has b een used repeatedly forliving and working w ithin the spacecraft. Intravehicular activity has required minimaleffort to move ab out, and crewm en have been able to mo ve quite freely, frequently inan underwater swimming m anner, and have done acrobatic movements such as rolling,tumbling, and spinning w ithout difficulty. There has been no evidence of increasedworkload in intravehicular weightless movem ent; in fact, it appears that the workload


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this soreness to the frequently assumed fetal position in the weightless environment.However, the soreness has not created any real difficulty. In general, the crews haveadapted extremely well to the weightless environment, have found the environmentpleasant, and have used the environment to assist them in accomplishing inflight activi-ties. Specific comments relating to particular problem areas are noted in later por-tions of this discussion.

FoodFreeze-dehydrated, rehydratable, and bite-sized foods similar to those used inthe Gemini Program w ere used for the Apollo 7 and 8 missions. One exception was theintroduction of "w et-pack" turkey bites and gravy on the Apollo 8 m ission. Extensivechanges in the types of food and packaging were implem ented during the time periodencom passing the Apollo 9, 10, and 11 missions. These changes and the approach toinflight nutrition were necessary be cause of the following factors:1. Inflight food comsumption was inadequate to m aintain metabolic balance (lesscaloric intake than calories expende d and loss of tissue fluid and electrolytes).2. Meal preparation and consumption required too much time and effort.3. Water for reconstitution of dehydrated foods was off-flavor and containedlarge quantities of undissolved hydrogen and oxygen gas.4. Functional failures occurred in rehydratable food packages.5. Development of a system of foods and packaging that was more familiar inappearance, flavor, and m ethod of consum ption w as required.6. Anorexia occurred during flight.7. The probable reduced energy requirements for performance in weightlessnesswere considered.Ninety-six different foods were available before the first manned Apollo mission.Approximately 60 of these foods were developed during and carried over from theGem ini Program. Of the 42 different foods to be used on the A pollo 12 flight, only 24are from the original Apollo food list. New foods and packaging consist primarily of

high-moisture-content (60 to 70 percent) thermostabilized m eat portions (called w et-packs), freeze-dehydrated me at and vegetable com binations that contain larger piecesof meat than the w et packs and that are package-designed for utensil or spoon usage,some new flavors of powdered beverage, intermediate-moisture-content (10 to 30 per-cent) fruits and candylike items, and sandwich spreads with sliced "fresh" breads(fig. 8).The sandwich spreads are heat sterilized in hyperbaric chambers to reduce


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accom panying wa ter-servicing procedures and water-bactericide addition (chlorine inthe CM and iodine in the LM ) have delivered potable water throughout the Apollo flights.The addition of bactericides is necessary because of the cross connections be-tween the potable- and waste-w ater systems and the potential for migration of orga-nisms through the check valves (fig. 9). During the early Apollo CM flights, the crewexpressed adverse reactions to the taste of chlorine in the water. The revision ofchlorination procedures has eliminated this problem. O bjectionable am ounts of freegas in the Apollo 9 CM potable water were observed by the crew . On the Apollo 11flight, the use of a hydrophobic-hydrophilic water/gas separator satisfactorily elimi-nated most of this free gas. In addition to the water/gas separator, the use of a silver-palladium hydrogen separator in the Apollo 12 CM will further decrease the am ount offree gas in the potable water. Because of adverse iodine depletion rates in the LM -3(Apollo 9) and LM-4 (Apollo 10) water systems, it was necessary to employ a micro-bial filter upstream of the w ater-use port. Alteration of the LM -5 (Apollo 11) water-system preserv icing procedures resulted in the maintenance of a m icrobially effectiveiodine residual throughout the flight of LM -5 and eliminated the need for the microbialfilter. Continuation of this revised preservicing procedure will eliminate the need toincorporate the microbial filter in subsequent spacecraft.No other immediate changes in the Apollo CM and LM p uable-water systems,

procedures, and equipment are anticipated. With the extension of the L M lunar stay,however, revisions to the servicing procedure of the w ater system w ill be required toensure that an effective iodine residual will be maintained in the LM water system.W as te Management

Feces collection in both the LM and the C M is accomplished through the use ofthe Gemini fecal collection system. This system is a tape-on bag which is only mar-ginally adequate because an inordinate amou nt of time is required for its use and be-cause no provision is made to isolate odors that accompa ny defecation.

Urine collection in the CM is afforded by an updated G emini urine transfer as-sembly. This device incorporates a roll-on cuff and an intermediate urine storagebag. The A pollo 12 CM will be equipped with an experimental urine collection assem-bly which w ill eliminate a direct interface between the u ser and the urine co llectiondevice.Urine collection on board the L M is accomplished by an in-suit urine bag fittedwith a roll-on cuff. This device has performed satisfactorily, and no changes areplanned (fig. 10).

W ork/S leep Cyc les


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with adequa te sleep. The primary factors that contributed to the fact that inflight sleepwas less than that obtained on earth w ere (1) cyclic noise disturbances resulting fromsuch events as thruster firings, commun ications, or movem ent within the spacecraft;(2) staggered sleep periods; (3) significant displacements of the astronaut's normaldiurnal cycle; (4) the so-called command-pilot syndrome; (5) the u nfamiliar sleep en-vironment; and (6) excitement.During the Apollo Program, no new sleep problems have been encountered. Theold problems originally defined in G emini missions continue to be investigated. Themain difficulty has been in the application of medical knowledge and expertise to mis-sion planning. Apollo missions are necessarily tailored around an operational trajec-tory which, by nature, is highly inflexible and constraining. The astronaut must be

integrated into this fixed mission plan in the best possible way. That is, man is re-quired to accomm odate to the mission and not the converse. N o ideal solution to thisdilemma e xists, if the program ob jectives are to be met in a timely fashion.The Apollo 7 work/sleep cycles were characterized by irregular and drasticshifting of the staggered sleep periods around the n ominal bedtime of 11 p. m. e. s. t.The crew never adapted to this bizarre work/sleep sc hedule, and in postflight debrief-ing, they reported that they ex perienced unsatisfactory sleep periods during the first3 days of flight. One crewm ember also reported that he once fell asleep on his w atch

because of fatigue and exhaustion and that he took 5 m illigrams of Dexedrine on anotheroccasion to stay awake during his work period. The Apollo 7 CD R recom mended thatfuture flightcrews c arefully evaluate the work/sleep cycles.Based on experience during the Apollo 7 m ission and on the fact that staggeredsleep periods were to remain in effect as a crew option on the A pollo 8 mission asspacecraft systems confidence was gained, Seconal, in 50- and 100-m illigram doses,was added to the me dical kit. The A pollo 8 work/sleep cycles are shown in figure . 11.These cycles varied greatly from the K SC d iurnal cycle and had the added com plicationof a 20-hour loitering period in lunar orbit. Real-time changes to the flight plan wererequired because of crew fatigue, particularly prior to transearth injection. Crewperformance was slightly degraded, and minor procedural errors were committed.Only the LM P regularly took 50 milligrams of Seco nal at bedtime for sleep.Apollo 9 was the first Apollo mission during which all three astronauts sleptsimultaneously. A definite improvement over the previous two missions in both quan-tity and quality of sleep was no ted, and a lack of postflight fatigue w as evident duringthe recovery-day ph ysical examination.The A pollo 10 mission sleep periods were simultaneous and deviated little fromthe normal circadian pe riodicity of the crew , except during the lunar-orbital phase inwhich the CDR and the LM P checked out and exercised the LM. On the Apollo 11 lunar-landing mission, the work /sleep cycles w ere actually quite ideal before lunar orbit in-sertion (fig. 12). Table VI provides the qu antitative sleep estimates obtained fromstudy of the telemetered biomedical data compared w ith the subjective reports of the


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addition, the LM sleep accommodations were poor. The CD R estimated he had little,if any, sleep in the LM , while the LM P estimated he had approximately 2 hours sleep.On the return flight, the crew slept well during the three transearth sleep periods.Coordinated efforts of the me dical staff and the flight planners must be continued tomaintain a 12-hour inflight workday, an 8-hour allowance for sleep, and a 4-hourperiod for leisure and relaxation. Future programs will afford better tools, such asthe electroencephalogram, for an objective assessment of sleep quality.

Med ical Ki tThe Apollo medical kit is shown in figure 13. The LM medical kit containseight Lom atil tablets, four Dexed rine tablets, 12 aspirin tablets, two Se conal capsu les,one bottle of methylcellulose (1 percent) eye lotion, and two compression bandages.To date, no item from this medical kit has been used. The contents of the CM medicalkit, the number o f tablets or items stowed, and the num ber of items used on a particu-lar mission are given in table VII. Som e changes in the medical kit contents have b eenimplemented as a result of flight experience. Included on a one-mission basis wereitems such as Benadryl and Tylenol, both of w hich were carried because of the aspirinsensitivity of one crewman. Two new medications added to the Apollo 11 kit wereScopolamine and Dexedrine in a combination capsule for the treatment of motion sick-

ness and M ylicon tablets to reduce the size of the gastrointestinal gas bubbles. Allcrewme mbers are tested for both sensitivity and response to each of the medicationscarried in the medical kit. Particular interest has been centered on the ability ofcrewme n to perform e ffectively at periods of 1, 2, 3, and 4 hours following the inges-tion of Seconal, Crewmen have been given flight-related performance tests at each ofthese four time intervals, and all have exhibited most satisfactory performance.Bio inst rumentat ion

The difficulties encountered w ith bioinstrumentation on the Apollo 7 flighi havebeen d etailed in a previous report (ref. 10), as has the fact that no difficulties wereencountered following a red esign of the harness for Apollo 8. No bioinstrumentationfailures have occurred on the Apollo 9, 10, or 11 missions. The crews receive de-tailed preflight briefing concerning the application of sensors, the temperatures to beexpected on the do-to-dc converter, and signal conditions. On occasion, degradedelectrocardiographic data have been evident because of some drying of the electrodepaste; replacement of the sensor has invariably restored the signal quality and pro-vided excellent data for the remainder of the m ission.Prevent ive M edicine and I n f l ight D isease

Following the A pollo 7 preflight, inflight, and p ostflight expe rience, a preve ntivemedicine regimen was detailed in the medical requirements document. Since the


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necess ary to accomplish the miss ion. Great cooperation and dedication is required onthe part of the crews and all Apollo team mem bers who m us t have direct contact withthe crew. As flight durations in excess of a week are being considered, it is quite pos-sible for inflight diseas e to develop from preflight exposure w ithout any evidence of thedisease prior to launch. There is a tremendous impetus to launch lunar missions atthe scheduled time in order to utilize a particular lunar launch window. There is alsoan obvious des ire to accomplish the miss ion in the best manner poss ible without jeop-ardy to LM or lunar-surface activity by crew illness. In addition, because of theApollo 11 m iss ion 21-day pos tflight quarantine period, the preflight preventive medi-cine program assumed greater importance. Details of the preflight and inflight upperrespiratory diseas es of the Apollo 7 crew and the gas trointestinal disturbance of anApollo 8 crewman have been reported in reference 10. The preflight clinical problemsass ociated with the Apollo 7 toll miss ions are s umm arized in table VIII. Apollo crewshave experienced occasional mild dermatologic problems such as seborrhea, ringworm,and tinea. In addition, crewmembers have had a number of upper respiratory tract in-fections including rhinitis, pharyngitis, and influenza, as well as a few episodes ofgastroenteritis. The Apollo 9 m iss ion was delayed becaus e of the preflight develop-ment of the rhinitis and pharyngitis in one crewmemb er. None of these illness es havebeen severe, but the potential impact any illness may have on a miss ion emphasizesthe concern with which even comm on and mild viral infections su ch as gas troenteritisand upper res piratory infections mus t be v iewed in the prelaunch phase. The inflightclinical problems are detailed in table IX. The three cases of coryza occurred duringthe Apollo 7 miss ion. The single episode of nausea and v omiting of unknown originwas probably secondary to a v iral gastroenteritis and occurred during the A pollo 8mission. All the fiber-glass irritation occurred during the Apollo 10 mission.

Five of the six crewm en aboard the Apollo 8 and 9 spacecraft developed somesymptoms of motion sickness. The s ymptoms ranged from mild s tomach awarenessfollowing head and body motion in the weightless environment to frank nausea andvomiting in one individual. The sym ptoms lasted from 2 hours to 5 days. Followingthese time periods, the affected crewmen w ere able to make any m ovement w ithin thespacecraft without symptoms and, thus, had successfully adapted to the environment.

On the Apollo 10 miss ion, one crewman had stomach awarenes s for a 2-dayperiod before he too adapted to the environment. Prior to the Apollo 10 mis s ion, thecrew had been instructed in the use of programed head movem ents des igned to speedthe adaptive process. Thes e movem ents w ere tried by the affected Apollo 10 crewm anon the first and s econd days of flight, and he noted an increase in s tomach awarenesssymptoms after 1 minute of head movement. The movements were tried again on thesev enth day of the flight after the crewman had " adapted" and after the LM activity.Again, the crewm an noted the development of increasing s ymptoms of stomach aw are-ness after 5 minutes of head movement.

Before the Apollo 11 mis sion, the crew was briefed concerning the availabilityof head movements and medication and concerning the use of cautious m ovement in thespacecraft to facilitate adaptation. No m otion s ickness sym ptoms were reported by


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Gemini m issions. It was dem onstrated through these program s that such decondition-ing posed no serious problems for earth-orbital flights of a 14-day duration or less,nor did decond itioning pose a problem during ascent from the lunar surface in the erectposition at the proposed launch accelerations under lunar grav ity (one-sixth g). Indeed,the gravity vector and astronaut physical activity on the lunar surface were co nsideredsalutary factors which cou ld reduce the severity of postflight orthostatic intolerance.Therefor,a, preflight and postflight cardiovascular evaluations we re perform ed on allApollo 7 to 11 crewmembers and on control subjects to assess the effects of these newvariables on the orthostat.c intolerance phenomenon.The test me thods used in assessing the degree of cardiovascular dec onditioning

or orthostatic tolerance are presented in table XI. These m ethods included lower bodynegative pressure (LBNP) and the 90 0 passive stand test when the use of LB NP wasprecluded by quarantine constraints. The physiological measurements obtained duringeach test were heart rate, blood pressure, and calf circumference. Other data con-sidered in evaluating the test results included bod y weight, blood volum e, exerciseresponse, and vasoactive hormones. Representative data plots for LB NP and for the90' stand test are detailed in figures 14 and 15, respectively.W hatever m ay be the etiological factors involved in cardiovascular decondition-

ing; heart rate remains the most sensitive current index of orthostatic intolerance. Asummary of the heart-mte responses obtained during provocative testing of the crew-mem bers of the Apollo 7 to 11 missions is given in table XII. It should be stated thatonly 60 percent of the 15 Apollo astronauts exhibited significant,postflight elevations ofthe supine heart rate, whereas 77 percent of the astronauts stressed by LBNP and100 percent of the astronauts stressed by simply standing had significantly elevatedpulse rates. It is clear, therefore, that provocative or stress testing reveals alteredcardiovascular responses which otherwise w ould not be detected. Thus far, nearly allApollo crewm en have-, eturned to preflight response levels within 30 to 50 hours afterrecovery, the time required for return to preflight response levels agrees well withthat noted after the Gem ini missions.The nine crewm en of Apollo 7 to 9 missions underwent LBN P testing. Only twocrewmen exhibited significantly increased calf circumference during LBNP testing,whereas three subjects exhibited decreased calf size significant at the p < 0. 0 5 con -fidence level (table XIII). This finding suggests that the postflight heart-rate responseis disproportionately greater than the degree of blood pooling in the lower' extrem itiesduring LBNP testing.Theoretically, blood pressure should bear a close relationship to real or simu-lated gravitational stresses on the cardiovascular system. No quantitative consistencyin either systolic or diastolic blood pressure patterns has been exhibited w hen eitherthe LBNP or 90 0 stand test modes w ere used in Apo llo Program testing (figs. 16 and17). Pulse pressure readings also have not correlated well with other measurements,but, generally, the resting supine pulse pressure (table XIV) was decreased postflight


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A battery of additional hematologic determinations was performed on both plasmaand red blood cells. The results of these tests are qualitatively summarized intable XV II.The hem atologic studies conducted thus far in the Apollo Program revealed a sig-nificant loss of red blood cell mass following only the Apo llo 9 mission. The data thu sfar suggest that hype roxia as opposed to weight lessness is an importa nt factor in thered-blood-cell mass loss phenom enon and that perhaps even sm all quantities of diluentgas (nitrogen) may exert a protective or m oderating effect on oxygen toxicity as ex-pressed in the context of red blood cell-mass loss.

4A plethora of clinical biochem ical determinations has revealed a transient post-flight hyperglycem ia and decreased serum cholestrol and uric acid levels (table XV III).Postflight urinary excretion of hydro xyproline was increased ov er preflight base-linelevels, and there was a consistently diminished excretion of sodium, potassium, andchloride in the imm ediate postflight period (table XIX ).mmuno l o g y

Imm unologic studies during the Apollo Program have included a profile of ap p ro-priate serum protein fractions, lymp hocyte response, and RNA and DN A syntheses.Postflight increases in C-reactive protein levels were noted in two o f the A pollo 7crewmen, consistent with their inflight illness, as previously reported. Later Apolloflights revealed significant postflight increases of imm une globulin G, M, and A m aswell as in haptoglobin, ceruloplasmin and Aipha4 macroglobulin. Increases in theimm unoglobulius are related to th e episode of clinical illnesses previously alluded to ,and increases in haptoglobin and ceruloplasmin are probably related to a m oderategeneralized stress reaction. No significant changes were observed in the other deter-minations listed in table X X .

M i c r o b i o l o g yThe Apollo microbiology program includes the disciplines of bacteriology,my cology, virology, parasitology, and protozo6logy. The prim e objective of the pro-gram is the qualitative and quantitative definition of the "normal (preflight) andI space-flight adjusted" (postflight) microbiota of each crewmember. Swab samplesfrom eight body areas and specimens of urine, feces, and a throat-mouth gargle arecollected from each astrona ut at intervals of launch date m inus 30 days (F-30), F-14,F-0 (8 hours prior to lift-off), and immediately upon return. Results of comprehen-sive microbiological analyses of such specimens are used to (1) permit early recogni-tion and treatm ent of infectious diseases or potential problems during the preflightphase, (2) predict the possible qualitative contam ination of returned lunar samples andlessen the impact of such contaminantson procedures for bioassay and release of lunarsamples from quarantine, (3) determine the aggregate effects of spacecraft environ-


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Lunar-Surface Act iv ityIn planning and training for lunar-surface activity, NASA medical personnel wereaware that previous Apollo flights had shown there would be some effect on the crewbecause of 3 days of weightlessness. This effect would probably manifest itself in a

heart-rate change resulting from some cardiovascular deconditioning and decrease inexercise capacity. Fortunately the red blood cell mass loss had been removed fromconsideration. The crew men were sensored and m onitored during three preflight simu-lations, once in the water immersion facility, once in the altitude chamber, and onceduplicating the lunar-surface time line on a simulated lunar surface. None of theseproduced exactly the real-time lunar-surface cond itions relative to one-sixth g, motion,and so forth, but the mo nitored results were used to predict the energy co st of the lunaractivity. Table XXII indicates these predictions from each simulation for the C DR andLMP and the com parison with the actual mission estimate. The predictions and actualmission estima tes were quite close for the LMP and quite at variance for the CD R. Thethree me thods used for real-time metabolic mon itoring we re (1) heart rate com pared toa Btu calibration curve obtained by bicycle ergometry, (2) oxygen u sage from the port-able life-support system (PLSS), and (3) water inlet and outlet temperature of theliquid-cooled undergarme nt (LCG).

The data revealed that the oxygen usage and L CG methods resulted in energy costlevels 61 percent below those estimated by heart rate in the CDR and 81 percent abovethose estimated by heart rate in the LMP. The LCG and oxygen methods agree andmatch the evaluation by television m onitoring of the activity. The source s of heart-rateerror are many and include laboratory calibration, uncertain area of the regressioncurve at low heat rate, psychogenic effect,- deconditioning, and heat storage. Themetabolic estimates of the surface activity for each crewman by each method are show nin figures 19 and 20 with an integrated best estimate of the actual energy cost. Fig-ures 21 and 2 2 illustrate the premission predictions for each task in the time line com -pared with the best estimate based on real-time data. The latter compared favorablywith the premission estimate in both cases and appeared to be w ell within the calculatedmargins for the expendables (water and oxygen) in the PLSS.

The integrated Btu production for the LM P for each task in the time line is de-tailed in table XXIII. The energy cost of the entire 146 minutes of surface activity was2982 Btu.

The hea rt rates for each crew ma n during the lunar-surface activity are shown infigure 23. The highest rates noted were 140 to 160 bpm for the CD R during docum entedsample collection and transfer of the sample box to the LM.It can be concluded from these data that the energy expenditure for a given taskvaries with individual crewmen , but the average hourly-`otal Btu production was 900 to1200. The LCG method appears best suited for estimating crewm an Btu production foruse in calculating consumables. The heart-rate method is a valuable relative indi-cator of Btu production, but a poor absolute indicator. The Apollo 11 data indicate that


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to be favored by m icrobial shifts. The Apollo 11 lunar-surface activity was condu ctedwithin expected energy costs at an average of 1200 Btu/hr. The LCG temperaturemethod of energy-use estimation is best, and it appears that the lunar-surface activitytime can be safely extended. The Apollo it quarantine was a demanding operation andwas conducted very successfully. Further lunar exploration is anticipated with m uchmore confidence as a result of the knowledge gained from Apollo missions 7 to 11.

R E F E R E N C E S1. Berry, C. A.; and Catterson, A. D.: Pre-Gemini Medical Predictions VersusGem ini Flight Results. Gemini Summary C onference, NASA SP -138, 1967,pp. 197-218.2. Berry, C. A.: Space Medicine in Perspective; A Critical Review o f the MannedSpace Program. J. A.M.A., vol. 201, no. 4, July 24, 1967, pp. 232-241.3. Berry, C. A.: The Medical Legacy of Gemini. Life Sciences and Space Research,vol. VI, A. H. Brown and F. G. Favorite, ed., North-Hoiland Publishing Com-pany (Am sterdam), 1968, pp. 1-19.4. Fischer, C. L.; Johnson, P. C.; and Berry, C. A.: Red Blood Cell Mass andPlasma V olume C hanges in Manned S pace Flight. J. A. M. A., vol. 200, no. 7,May 15, 1967, pp. 579-583.5. Graybiel, A.; Miller, E. F.; Billingham, E. J.; Waite, R.; Dietlein, L.; andBerry, C. A.: Vestibular Experiments in Gemini Flights V and VII. AerospaceMed., vol. 38, no. 4, Apr. 1967, pp. 360-370.6. Anon.: A Review of Medical Results of Gemini VII and Related Flights. NASATM X -60589, 1966.7. Berry, C. A.; Coons, D. 0.; Catterson, A. D.; and Kelly, G. F.: Man's Re-sponse to Long-Duration Flight in the Gemini Spacecraft. Gemini MidprogranrConference, NASA SP-121, 1966, pp. 235-262.8. Kelly, G. F. ; and Coons, D. O.: Medical Aspects of Gemini Extravehicular Ac-tivity. Gemini Summ ary Conference, NASA SP-138, 1967, pp. 107-125.9. Berry, C. A..: Lunar Medicine. Sci. J., vol. 5, no. 5, May 1969, pp. 103-107.

10. Berry, C. A.: Preliminary Clinical Report of the Medical Aspects of Apollos VIIand VIII. Aerospace Med., vol. 40, no. 3, Mar. 1969, pp. 245-254.


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TABLE I . - APOLLO M ANNED MISSIONS

Mission Crew Launchdate Description Duration,hr: min: secApollo 7 Schirra Oct. 11 1 1968 Earth-orbital checkout of 260: 09: 45Eisele the CSMCunninghamApollo 8 Borman Dec. 21, 1968 First lunar-orbit flight 147:00:11Lovell for checkout of the

Anders CSM at lunar distanceApollo 9 McDivitt Mar. 3, 1969 First manned earth-orbital 241: 00: 54Scott checkout of the LM,Schweikart CSM/LM rendezvous,and EVAApollo 10 Stafford M ay 18, 1969 First lunar-orbit rendezvous 192: 03:23Young and low pass over lunarCernan surfaceApollo 11 Armstrong- July 16, 1969 First lunar landing and EVA 195:18:35Collins on the lunar surfaceAldrin

TABLE II . - MAXIMUM A CCELERATION

Mission Acceleration in g at Launch S-IVB reignition SPS burns _ReentryApollo 7 4.2 < 1 -- 3.4Apollo 8 3.97 -- a0. 68 6.84Apollo 9 3.9 -- b< 1 3.35Apollo 10 3.97 -- -- 6.78


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TABLE I I I. - ONBO ARD R ADIATION INSTRUMENTA TION

Instrument Measurement LocationNuclear particle Alpha-proton spectrometer (4 channels Service moduledetection system proton, 15 to 150 MeV; 3 channels(NPDS) alpha, 40 to 300 MeV); telemeteredVan A llen belt Skin and depth dose rates; telemetered C MdosimeterRadiation survey Portable, hand-held ratemeter; C Mmeter 4 linear ranges, 0 to 0. 1 to (portable)0 to 100 rad/hr; visual readoutPersonal radiation 1/crewman; accumulated radiation Suitdosimeter dose; 0.01 to 1000 rad; visualreadoutPassive radiation 4/crewman; emulsion/thermoluminescent - Constant-weardosimeter dosimeters; postflight analysis garment

TABLE IV. - APOLLO M ISSIONS: RAD IATION DOSE[Thermoluminescent dosimeters]

Mission Average dose,radApollo 7 0.16Apollo 8 .16Apollo 9 .20Apollo 10 .47Apollo 11 .18


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TABLE V. - BODY WEIGHT CHANGES AND CALORIE INTAKEFOR APOLLO 7 TO 11 MISSIONS

Body weight, lb Average dailyAverage preflight Launch day Recovery Recoveryrewman inflight calorie(F-28, F-24, F-5) (F-0) (R+0) +1 day (R+1) intake. kcal

Apollo 7CDR 195 194 188 19 1 1966CMP 153 157 14 7 15 1 2 144LMP 157 156 148 154 1 804

Apollo 8CDR 169 16 9 161 16 3 1477CMP 169 172 164 165 1 688LMP 146 142 138 13 9 1 339

Apollo 9CDR 16 1 159 154 156 1924CMP 18 1 178 173 181 1 715LMP 164 159 15 3 157 1 639

Apollo 10CDR 175 17 1 169 171 1407CMP 169 165 160 161 1 487LMP 175 173 163 165 1 311

Apollo 11CDR 173 172 164 170 2 040CMP 167 166 159 159 1645LMP 172 167 166 170 2 278

Total2 526 2 500 2 407 4 5 3 25 201

Average


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TABLE VII . - APOLLO CM MEDICAL KIT CONTENTS

Quantity per flightApollo 7 Apollo 8 Apollo 9 Apollo 10 Apollo 11te m

Stowed Used Stow-d Used Stowed Used Stowed Used Stowed UsedEye drops, 2 1 2 2 2 0 01%4 percentmet'hgleelluloseCompress; 2 0 2 0 2 0 2 0 2 0bandageBand-aids 1 2 2 1 2 0 1 2 0 1 2 0 1 2 0Antibiotic 1 1 1 0 1 0 1 0 1 0ointmentSkin cream 1 0 1 1 1 1 1 0 1 0Demerol injectors 3 0 3 0 3 0 3 0 3 0Marezine 3 0 3 0 3 0 3 0 3 0injectorsMarezine 24 3 24 1 24 4 1 2 0 0 0

tabletsDexedrine tablets 12 1 1 2 0 1 2 0 1 2 0 1 2 0Darvon compound 1 2 2 a 1 8 0 1 8 0 1 8 0 1 8 0capsulesActifed tablets 24 24 60 0 60 1 2 60 2 60 0Lomotil tablets 24 8 24 3 24 1 24 1 3 24 2Nasal emollient 1 1 2 1 3 3 1 . 0 3 0Aspirin tablets 72 , 48 72 8 72 2 72 116 72 (b)


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TABLE VII. - APOLLO CM MEDICAL KIT CONTENTS - Concluded

Quantity per flightItem Apollo 7 Apollo 8 Apollo 9 Apollo 10 Apollo 11

Stowed Used Stowed Used Stowed Used Stowed Used Stowed UsedAchromycin 24 0 24 0 24 0 1 5 0 15 0tabletsAmpicillin 60 0 60 0 45 0 45 0Seconal, 21 1 21 1 0 2 1 0 21 0100-mgcapsulesSeconal, 1 2 7 050-mg

capsulesNasal spray 3 0 3 1 3 0 3 0(Afrin)Benadryl, 50 mg , 8 0 0Tylenol, 325 mg 1 4 7 0Eye drops, 1 0 2 0 2 01 percentmethylcelluloseOptaalm c 1 0 0ointment(Bacitracin)Scopolamine- 12 6DexedrineMylieon tablets 20 0


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TABLE VIII. - APOLLO 7 TO 11 CLINICAL PROBLEMS, PREFLIGHT

Symptoms/findings Etiology No. of occurrencesMild uri Undetermined 3Rhinitis and pharyngitis Herpes simplex 2Gastroenteritis ? salmonellosis (walnut meats) 2Gastroenteritis Undetermined 3Facial rash Seborrhea 2Folliculitis (abdomen) Undetermined 1Ringworm (arm) Microsporum canis 1Tinea crura Undetermined 1Tinea pedis Undetermined 1Pulpitis, tooth no. 31 Previous restoration and 1cariesInfluenza syndrome Undetermined 2


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TABLE IX. - APOLLO 7 TO 11 CLINICAL PROBLEM S, INFLIGHT

Symptoms/findings Etiology No. of occurrencesCoryza Undetermined 3Stomatitis Apthous ulcers 1Nausea and vomiting Undetermined 1Nausea and vomiting Labyrinthine 1Stomach awareness Labyrinthine 5Recurrence of facial rash ? contact dermatitis 1Respiratory irritation Fiber glass 1Eye irritation Fiber glass 1Skin irritation Fiber glass 2


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TABLE X. - APOLLO 7 TO 11 CLINICAL PROBLEMS, POSTFLIGHT

Symptoms/findings Etiology No. of occurrencesGastroenteritis Possible food poisoning 1Mild uri Undetermined 1Rhinitis, pharyngitis Influenza B 1Influenza syndrome Influenza B 1Influenza syndrome Undetermined 1Influenza syndrome Influenza A 2 1Pulpitis, tooth no. 7 Caries and previous restoration 1Congestive prostatitis Undetermined 1Unilateral nasal discharge Undetermined 1Serous otitis media (very mild) Undetermined 1


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TABLE XI. - METHODS FOR EVALUATING ORTHOSTATIC TOLERANCE

Test Method MissionProvocative tests of the LBNP by incremental Apollo 7, Apollo 8,antigravity responses differential pressure and Apollo 9of the cardiovascularsystem (Preceded by 90 passive stand test Apollo 9, Apollo 10,5-minute supine con- and Apollo 11trol data.he LBNP

also has 5-minuterecovery data.)Preflight and postflight Heart rate (HR) --collection of timedphysiologic measure- Blood pressure (sys- -ments tolic blood pressure,diastolic blood pres-sure, pulse pres-

sure, mean bloodpressure)Change in leg volume --(OLV)Other related data -(weight, blood vol-ume, vasoactivehormones, exercisecapacity)


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TABLE XII. - SUMMARY OF HEART RATE RESPONSES FORAPOLLO 7 TO 11 MISSIONS

[Indicated postflight values versus inean of three preflight values]

Subjects Test day Test mode Total no.of subjectsNo. of subjects bycategory of significance Range,Obpm

^2 No significance


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TABLE XIII. - SUMMARY OF CALF CIRCUMFERENCE DATAFOR APOLLO 7 TO 11 MISSIONS

[ Postflight value versus mean of three preflight measurements]

Test mode No, of subjects Status SignificanceRest supine 15 of 15 Decreased10 of 15 Decreased p < 0. 05LBNP stressed 2o 9 Increased p < 0. 053 of 9 Decreased p < 0. 05

4 of 9 Variable N SaApollo 7, 8, and 9 only.b Not significant.

TABLE XIV. - PULSE PRESSURE RESULTS FROM A POLLO 7 TO 11 M ISSIONS[ Postflight values versus mean of three preflight values]

Test mode No. of subjects Status SignificanceRest supine 13 of 15 Decreased4 of 15 Decreased p < 0. 05LBNP a, b 9 of 9 Decreased5 of 9 Decreased p < 0. 0590 0 stand 7 of 9 Decreased3 of 9 Decreased p < 0. 05aApollo 7, 8, and 9 only.b Three subjects experienced presyncopal episodes during immediatepostflight LB NP .


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TABLE XV. - ROUTINE HEMATOLO GY

Parameter MissionApollo 7 A pollo 8 Apollo 9 A pollo 10 Apollo 11 AOAaRed blood cells 0 4 * t t 4 4 0 0Hematocrit 0 0 4 4 0 0Hemoglobin 0 0 0Reticulocytes 0 C 0 0White blood cells 0

Neutrophils 0Lymphocytes t t t t 0 t t t t tMonocytes 0 t t 0 0Eosnophs_Basophils 0

Platelets 0 0 0 0 0 0

a Apollo over all.Legend:

0 No occurrenceSignificant trend (positive)+2Q (u represents standard deviation)+3Qt Significant trend (negative)

f t -2 0t t t -3 QND Not done+ OccurrenceTF Data to follow


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TABLE XVI. - RADIOISOTOPE HEMATOLOGY

Parameter MissionApollo 7 Apollo 8 Apollo 9 Apollo 10

Plasma volume 0 t t NDRed blood cell mass 0 0 t NDFerrokinetics, t ND ND14 C-glycine survival 0 0 0 ND51 Crsurvival 0 0 t NDActive red blood cell Na-K flux ND ND t 0Passive red blood cell Na-K flux ND ND 0a 0a

aTechnically unsatisfactory.Legend:

(See table XV.)


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T ABL E XVI I. - HE MAT OL OGY DAT A S UMMARY

Parameter MissionApollo 7 Apollo 8 Apollo 9 Ap ollo 10 Ap ol lo 11Decrease in reticulocyte count 0 0 + 0 0Depressed ferrokinetics + + N D N D N DLoss of red blood cell mass 0 0 + N D N DDecrease in plasma vitamin E 0 + + TF N DDecrease in red blood cell vitamin E 0 0 0 TF N DDecrease in plasma vitamin A N D N D + TF N DDecrease in red blood cell membrane lipids 0 0 + TF N DDecrease in phosphofructokinase 0 + 0 N D N DIncrease in hexoskinase + 0 0 N D N DDecrease in phosphoclyceric kinase 0 0 + N D N DIncrease in phosphoglyceric kinase + 0 0 N D N DIncrease in glucose-3-phosphate dehydrogenase 0 0 + N D N DDecrease in glucose-3-phosphate dehydrogenase 0 + 0 N D N DIncrease in glutathion (reduced form) 0 0 + N D N DDecrease in glutathion (reduced form) + n 0 ND N DIncrease in Na-K flux N D N D 0a 0a N DDecrease in active Na-K flux N D N D + 0 N DIncrease in red blood cell adenosine triphosphate contact 0 + 0 N D N DIncreased H2 O 2 sensitivity + 0 + N D N DM ethemoglobin formation 0 + 0 N D TFRed blood cell morphologic changes (wet preparation) 0 0 + N D N DPostflight leukocytosis + + 0 + +

Absolute neutrophilia + + 0 + +Absolute lymphopenia + + 0 + +


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TABLE XVHI . - BIOCHEMISTRY DATA SUMMA RY

Parameter MissionApollo 7 Apollo 8 Apollo 9

1

A p ol lo 10 A p oll o 1 1 A O A aG l u c o s e 4 44 4 4 4 4Cholesterol + t .Serum glutamic-oxalacetic transaminaseBlood urea nitrogenUric acid t tAlkaline phosphatase

Ca

M g ii tiInorganic phosphateTotal bilirubinCreatinineCreatinine phosphokinaseLactic dehydrogenase'(LDH ) t t + + +`+

LDHlheart fractionLDH2^ 44 4 4 4 t t

EnglishDA 3nomenclature t t t t t tLDH4 t tLDH5 - liver fraction

N a 44 t tt44K t tC l t t tOsmolality t t t t 44 t t t tTotal protein 44 4 4 4Albumin 44 4Alpha 1 44 44Alpha 2 4 4 4 4 4 44Beta 4 4


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TABLE XIX. - URINE (24 HR) CHEMISTRY SUMM ARY

ParameterMission

Apollo 7 Apollo 8 Apollo 0 Apollo 10 Apollo 11 AOAaUrine volumeSpecific gravityHydroxyprolineUric acidCreatinineInorganic phosphate t tN a t t t tK t t tCa t t tM g t tCl t it t

'"Apollo over all.Legend:

(See table XV. )


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TABLE XXI, - APOLL,O EXERCISE RESPONSE TEST( Oxygen consumption immediately postflight]

Heart rate,bpm X , ,percent` u No,fsubjects120 68.6 1.5, 2 151 4 0 74,5 11,6 151 60 77, 8 10,8 151 80 77,0 8, 1 3

`:Over all 73,8 12, 7 48a 100 percent = mean of three preflight measurements,


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TABLE =I. - APOLLO EMU METABOLIC ASSESSMENT:APOLLO 11, COMPARISON OF ESTIMATED METABOLIC PRODUCTION

Location and comments CDR LMP yA, H, T, Btu 'Percent" A. H. T. Btu Percent 1)Water immersion facility 775 -- 800 --Altitude chamber; 1050 17 1300 8suited, one gBuilding 9; Wallcihrough 1850 10 6 1375 15Premission prediction' 1350 50 1275 6Estimation of actual mission 90 0 -- 1200 _ --

Average hourly total Btu,i ^Percentage variation from estimation of actual mission.


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Time

Interval,M i ll1 1 1 12r

5

1 4

6

1T :4If10I 1 91 2I14

I

2jotal, 146I11lep,d,,fe(1 BtU production

lbito.o t a t I 3 t uiraHill hror in te r va lc c u n n i l il t lo l l20020201 0 5 0fi3i8 320080631276280 0 1135C1 1 54 0 69502763 38757 7: 0 1 0200602701450905601650359,151 1 0 07992Tljcal. 298 2TABLE XXI11. APOLLO 1 MU METABOLIC ASSESSMENT: APOLLO 11 LMP, INTEGRATED Bill PRODUCTIONEVA events G 1 ! ;TIlr: minAssist and nlunilor CD R 1 0 9 : 1 3Porfornl in it ia l. EV A 1 0 9 : 3 91?nvlroummilt fanlillarizatioll 100:44(deploy TV cable)Deploy Solar Wind Composition i00: 56expeliulrntSupply flag mill listen t')Prosulontial x09IllessalicEvaluate EVA c:apimillty lenvirun p letli ` 1k1l,9Inspect GM 110:34Deploy EASLIP 110.53CoMect ( 1 0 C 1 1 1 1 1 C 1 1 W ( I 9 a i m p l e an(1 j11 :1Solar Wind Composition Expurilllellt rTorlllinal p-WA(ingress with salllple 111:23return container)Ass is t and sonne t C D R 1 l l?51Closefeedwatel11:30


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5.5PRESSU RE, 5 0

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CABIN PRESSURE

O X Y G E N C O N T E N TQ U A N T I T Y ,PERCENT 7 0X Y G E N R E A D IN G S W E R E M A D E B Y T H E

A P O L L O 7 C R E W F R O M T H E O N B O A R D60NALYZER5 0 00T I M E , D A Y S

Figure 1. - Cabin oxygen enrichment sequence during Apollo 7 10-day flight.

SECONDARY COOLANTL O O P T E S T

90D R Y B U L BABIN TEMPERATURET E M P E R A T U R E ,o ^yp `J' `

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40 7 - -F IR ST M A NN ING + SE CO ND M A NN ING +HIRD M ANNING-- I3 0. 1143 44 45 46 47 48 49 50 51 70 7172 7 3 7 4 75 76 77 U 89 90 9192 93 94 95 96 97 98 99GROUND ELAPSED T IME , HOUR SFigure 3. - Representative LM cabin temperatures (Apollo 9 earth-orbital Plata).

80

60DEPRESSTEMPERATURE, 'FEPRESS50 TOUCHDOWN LIFT -OFFA 0SC-CONSUMABLES

3 0102 104 106 108 110 112 114 116 118 120 12? 124 126

GR OU N D E L A P SE D T IM E , HOU R SFiguro 4,- Representativv LN1 Cabin tk^ III porahirrs


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9.0002:202:222:242:26

T I M E , M IN : S E CFigUre 5. - Launch accelerations (Alxulo 7 data).

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BEEF W;TI-! VEGETABLES

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C H L R J R I N EINJECTION PORTP O T A B L EWATERTANK36 L 6/H

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FOOD PREPARATIONPROBE

Fitiure 9. - Apollo CM potnble water system.

TEMS

1 URINE COLLECTION DEVICEIGEN11N1 TYPE

2 URINE COLLECTION TRANSFER ASSY3 UCD CLAMP4 DEFECATION COLLECTION DEVICE

(GEMINI TYPE)5 N15A 07 FQUI PMENT

(MODIFIED GEMINI TYPE6 URINE SAMPLE BAG


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Figure 13. - Apollo medical kit.

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Documents

Apollo 7 to 11 Medical Concerns and Results