Commercial suborbital space tourism-proposal on passenger's medical selection

Commercial human spaceflight has excellent economic and technical perspectives in the next decades. Passengers will be persons from a general population differing from culture, age, gender and health status. They all will have to withstand physical loads of spaceflight such as acceleration and deceleration forces, microgravity, vibration, noise and radiation. There is a necessity to mitigate all negative impacts on the passengers' health. Besides precautionary measures in construction and equipment, a diligent medical selection and pre-flight training is recommended. To ensure an easy and at the same time qualified selection procedure, it is necessary to define medical selection criteria and training methods. As experiences with suborbital spaceflight of private passengers are still few we recommend to implement in the beginning of this new era maximum safety standards. Having performed a satisfactory number of successful flights, some of the selection criteria and training sessions might be loosened or modified. This judicious approach is in the interest of the spaceflight participants as well as of the providing companies. As a guideline we propose a four step approach that allows a quick decision concerning the fitness of participants to fly as well as an intensive preparation of the passengers. For the first two steps positive experiences from medical screening and examination of professional pilots can be utilised. According to JAR-FCL 3 (Joint Aviation Requirements-Flight Crew Licensing, Chapter 3) a questionnaire with medical interview targeting the medical background of the respective person and including no-go criteria provides a first estimation for applicants and medical examiners whether there will be a chance to be accepted as a passenger. The second step of selection comprises the physical examination of the applicant adjusted to the professional pilot's examination procedure. As the physical challenges of the suborbital flight will exceed the impact of general aviation, the standardized diagnostic programme should be purposefully extended. The third part of the selection consists of an intensive training programme, preparing the passengers for the upcoming challenges. In detail this training should comprise lectures about aerospace physiology, countermeasures to g-forces and motion sickness, emergency practices (e.g. rapid decompression or hypoxia) and a centrifuge ride with g-forces adapted to the respective flight profile. An altitude chamber flight, hypoxia experience and participation in a Zero-G-Flight might also be included optionally. The fourth step of the evaluation is caused by a possible delay between medical examination and launch. In the interval, the health status might have changed and serious illnesses might have developed. So, a short re-evaluation should be performed 7–14 days before take-off. A brief check-out procedure for medical re-evaluation of passenger's health status is recommended. As launch of suborbital spaceflights will take place all over the world at so called “Spaceports”, the development of standards for medical examinations and the training programmes as well as a mutual acceptance of the participating medical test and training centres will be very helpful for development of this industry. Joint recommendations for the emergency equipment of commercial spaceships will also have to be developed.

► Medical screening and training of participants of suborbital spaceflight are essential.
► Well selected passengers will help to minimise medically caused incidents.
► We suggest a four-step approach: questionnaire, physical examination, training, and pre-flight evaluation.
► International standards and mutual recognition of medical selection and training are necessary.