1. Federal Aviation Administration Commercial Space Transportation Human Space Flight Occupant Safety Telecon Telecon 7 – Medical Guidance for Crew & Spaceflight Participants March 21, 2013 David A. Gerlach Dr. Melchor J. Antunano

2. Office of Commercial Space Transportation Federal Aviation Administration 2 Agenda Introduction Rules of Engagement Next Steps Last Month’s Topic Today’s Topic Wrap-up Today’s facilitators are David Gerlach & Dr. Melchor Antunano

3. Office of Commercial Space Transportation Federal Aviation Administration 3 Introduction The FAA may not propose regulations covering occupant safety until October 2015. We presently drafting guidance and best practices for the industry. We would like input from the aerospace industry to provide key insights which will improve our guidance documents. We are hosting a series of one-hour telecons, each with a narrow focus on a specific technical topic to be held about once a month. We are using our industry advisory committee, COMSTAC, to help us in this endevour. We are not soliciting any proposals for agency support on this topic at this time. This is background research.

4. Office of Commercial Space Transportation Federal Aviation Administration 4 Rules of Engagement 1. When speaking, please identify yourself so we can follow up with you if we have more questions. 2. We are recording this teleconference. We will publish minutes that summarize the discussion. 3. Please limit your time to 2-3 minutes of time to allow for greater participation. You are welcome to follow up with a phone call or email to Randy Repcheck at randy.repcheck@faa.gov or 202-267-8760. 4. Call-in information: Call-In Number: (605) 475-4000 Participant Access Code: 574039# Help Line (For Problems with Connection): 877-482-5838

5. Office of Commercial Space Transportation Federal Aviation Administration 5 Next Steps After today’s meeting, we will take some time to put together minutes and publish them on the AST website. The meeting minutes will contain a list of attendees, the topic(s) discussed, and a summary of what was discussed. We look forward to you participating in the next conference call on April 16, 2013 at 1 pm Eastern.

6. Office of Commercial Space Transportation Federal Aviation Administration 6 Fault Tolerance, Margin and Reliability We discussed with the industry participants the best practices of applying fault tolerance, margin and reliability from a guidance perspective. Last Month’s Topic (15 January 2013)

7. Office of Commercial Space Transportation Federal Aviation Administration 7 Today’s Meeting Objective To explore industry views on medical best practices in Human Space Flight for ensuring that safety critical operations personnel (ground controllers & flight crew members), and spaceflight participants are physically capable of performing the necessary tasks for safety of the occupants. Safety Critical Operations Personnel: operations personnel that make time sensitive decisions that are essential to ensuring occupant safety during pre-launch, launch, on-orbit, reentry, landing and post- flight operations

8. Office of Commercial Space Transportation Federal Aviation Administration 8 Background The FAA Center of Excellence for Commercial Space Transportation developed a Flight Crew Medical Standards and Spaceflight Participant Medical Acceptance Guidelines for Commercial Space Flight 30 June 2012. The report recommended: 1)Medical guidelines for sub-orbital spaceflight participants 2)Medical guidelines for orbital spaceflight participants 3)Guidelines for medical certification of sub-orbital pilots 4)Guidelines for medical certification of orbital pilots This COE Report is highly recommended reading for those involved in Human Space Flight. This report is available at: www.coe-cst.org/core/scripts/wysiwyg/kcfinder/upload/files/2012.08.06%20Task%20183- UTMB%20Final%20Report.pdf

9. Office of Commercial Space Transportation Federal Aviation Administration 9 Today’s Discussion Topic – 1 Medical Certification – Safety Critical Flight Crew Members For public safety purposes, safety critical flight crew members are currently required to have a FAA Class II Medical Certificate. Is a Class II adequate screening for safety critical flight crew? Should additional medical criteria be developed as recommended in the COE Medical Guide? Should medical screening be different for orbital vs suborbital as recommended in the COE Medical Guide?

10. Office of Commercial Space Transportation Federal Aviation Administration 10 Today’s Discussion Topic – 2 Medical Screening – Spaceflight Participants (SFP) In its (FAA) guidelines, should the FAA recommend medical screening for SFPs as recommended in the COE Medical Guide? Is medical screening necessary to:  Inform SFPs of their personal medical risk?  Limit SFPs with serious medical problems from flying? Should medical screening be different for orbital vs suborbital?

11. Office of Commercial Space Transportation Federal Aviation Administration 11 Today’s Discussion Topic – 3 On-Orbit Medical Illnesses It is unknown whether the industry will follow the same medical quarantine practices as NASA. Thus, preventable on-orbit medical illnesses may occur. Should the FAA recommend a preflight quarantine or social isolation period to prevent the occurrence and/or spread of acute infectious diseases among occupants during flight? Should there be medical criteria for early termination of an orbital flight due to unexpected serious illnesses among occupants?

12. Office of Commercial Space Transportation Federal Aviation Administration 12 Today’s Discussion Topic – 4 On-Orbit Medical Emergencies Should there be medical criteria for early termination of an orbital flight due to unexpected medical emergencies (including trauma) among occupants? Is an emergency deorbit capability necessary for commercial orbital space vehicles due to potential medical emergencies? If it takes 1-2 hours to deorbit, should an operator be prepared to provide inflight emergency medical care to occupants?

13. Office of Commercial Space Transportation Federal Aviation Administration 13 Today’s Discussion Topic – 5 On-Orbit Medical Kits The FAA recommends a medical kit be carried on- board: What type of medical equipment should be recommended – first aid, basic life support, and/or advanced life support? Should the FAA provide a list of recommended minimum medical equipment and supplies included in an emergency medical kit for inflight use?

14. Office of Commercial Space Transportation Federal Aviation Administration 14 Today’s Discussion Topic – 6 Training for On-Orbit Medical Care Who (flight crew and/or spaceflight participants) should be trained to use inflight medical kits and provide inflight medical care if needed? What kind of inflight medical care training should provided (first aid, basic life support, and/or advanced life support)? Should the FAA recommend minimum practical knowledge and skills for inflight medical care training?

15. Office of Commercial Space Transportation Federal Aviation Administration 15 Wrap-up Thanks to everyone for participating! You can post comments, questions, etc. to Docket FAA-2012- 0818. If anyone has any new topics or suggestions on improving this discussion process, contact: Randy.Repcheck@FAA.gov 202-267-8760 We look forward to you participating in the next conference call on April 16. The topic will be “ Communications and Commanding - Best Practices for Minimum Level of Safety ”.