Polar Qualification and Space Screenings

Disability, illness, and extreme environments

Image by Long Ma via Unsplash

There are a lot of parallels between Antarctica and outer space— they’re both remote, isolated, austere environments, hard to get to (and get back from), yet are scientifically rich fieldwork sites. Plus they’re just neat; I’d love to visit both.

Because of these parallels, we can use case studies from Antarctica to predict trouble we might run into in space. A recent example is this piece about researchers who do fieldwork in Antarctica and have concerns about the National Science Foundation’s medical clearance process. The NSF’s polar Physical Qualification (PQ) process is required for any scientist wanting to deploy to a U.S. base in Antarctica— or even non-scientists hired to staff these bases. According to the NSF, this process was created “to protect both the individuals deploying and the overall mission”, but two dozen scientists published an open letter to the NSF earlier this year arguing that the PQ program needs to be reassessed and reformed based on “accounts of unfair treatment and disproportionately higher rates of disqualification for underrepresented groups”. One scientist interviewed in the article linked above reported being disqualified for his well-managed Type 1 diabetes even after a successful appeal, while another was required to have his wisdom teeth removed and take medication to treat what the PQ program claimed was latent tuberculosis against his doctor’s advice.

NASA also requires a very thorough medical and psychological health screening for its astronaut candidates. As far as I’m aware, this process has not been accused of the kind of capricious and retaliatory disqualifications that the polar scientists report in the article about NSF clearance process. On the other hand, medical screenings, by definition, discriminate against disabled applicants. And given that race and/or socioeconomic status are correlated with disqualifying conditions like diabetes, medical screenings for astronauts likely indirectly contribute to racial and ethnic underrepresentation in the astronaut corps.

The polar scientists interviewed also reported issues with the mental health portion of the polar PQ program. One scientist was disqualified from winter deployment because she’d adjusted her psychiatric medication within the previous year, making her “wary of making any future changes to her medication.” And another was banned from future deployments after she mentioned to the on-call doctor that she regularly saw a therapist— despite having no diagnosed mental health conditions. The open letter to the NSF argued that “…field participants should feel confident coming forward about discomforts or medical/emotional problems in the field, without concern that their PQ status will be immediately questioned. We are concerned that applicants who have been proactive about their mental healthcare are frequently [disqualified] for inadequate reasons and often without consideration of their therapists’ assessments.” This reminds me of yet another NASA-adjacent example: aircraft pilots in the U.S. who may hesitate to seek diagnosis or treatment of mental health disorders like depression or ADHD out of fear of losing their FAA certification.

As private spaceflight is becoming more common, prospective space travelers who wouldn’t be able to pass a NASA medical screening have a new, alternative (though still very narrow) path to space: by buying a ticket with a spaceflight company with less strict health requirements. But I wonder whether this will last beyond the first serious medical emergency in space. If a spacecraft passenger suffers a heart attack or diabetic emergency in space, will there be a public outcry? A move to regulate standardized health screenings for all space travelers?

Of course, the farther out we go from Earth, the more likely it will be that humans will develop illnesses and disabilities in space, either as a result of age or accident. And if it turns out we can successfully reproduce in space, someday children with disabilities will be born there. So we won’t always be able to require that every space traveler qualifies as “able-bodied” according to some medical screening procedure. Taking this long view, it makes sense to start thinking about how to design space technology and habitats to be more accessible for space travelers with disabilities, and to learn how to treat life-threatening medical conditions in space on a long-term basis, rather than just stabilizing patients for evacuation back to Earth.