A specialized NASA working group has concluded an extensive review of health risks associated with Artemis-era missions, focusing on decompression sickness (DCS), venous thromboembolism (VTE), and the implications of patent foramen ovale (PFO). The panel’s findings integrate data from recent assessments, including the 2024 PFO study and the 2026 VTE working group report, to refine safety standards for lunar and deep-space operations.
Regarding cardiovascular health, the panel determined that the presence of a PFO is not a primary risk factor for VTE. Consequently, the group advised against altering current astronaut selection criteria based on PFO status. While the panel acknowledged that small PFOs (Grades 1 or 2) do not present significant risks, they noted differing perspectives on the management of larger PFOs (Grade 3 or higher). Ultimately, the group opted against universal screening or exclusion for large PFOs, instead recommending that crew members be informed of their status and provided the option for closure procedures.
The review also addressed the complexities of bubble formation during extravehicular activities (EVAs). The experts concluded that the predictive value of bubble scores for DCS remains uncertain, particularly for lunar surface operations involving partial gravity and ambulation. Furthermore, the panel emphasized that ground-based research should not automatically exclude subjects based on the presence of left ventricular gas emboli (LVGE), provided that participants are fully informed of potential risks.
Finally, the working group highlighted a critical need for standardized clinical guidance regarding medication use before and after EVAs. The panel noted that common analgesics—such as ibuprofen, acetaminophen, naproxen, and celecoxib—as well as aspirin, require clear protocols to ensure they do not inadvertently mask symptoms of decompression sickness.
Source: NASA
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