Spaceflight Participant Pre-flight Screening Checklist

1 · Medical history questionnaire — before every suborbital flight [1]

Reviewed by a physician trained or experienced in aerospace medicine. A physical exam and lab tests are not required by the guidance, but are not ruled out.

• Ear, sinus or chest problems (otitis, sinusitis, bronchitis, asthma, other respiratory disorders)
• Dizziness or vertigo
• Fainting or any other loss of consciousness
• Seizures
• Tuberculosis
• Surgery and other hospital admissions
• Visits to physicians in the last 3 years
• Recent significant trauma
• History of decompression sickness
• Anemia or other blood disorders
• Heart or circulatory disorders, including a pacemaker or implanted defibrillator
• Mental disorders
• Claustrophobia
• Attempted suicide
• Use of medications
• Alcohol or drug dependence or misuse
• Last menstrual period; current pregnancy; birth, miscarriage or termination within the last 6 weeks
• Diabetes
• Cancer
• Rejection for life or health insurance

1 · Comprehensive medical history [1]

• Ear, sinus or chest problems (otitis, sinusitis, bronchitis, asthma, other respiratory disorders)
• Dizziness or vertigo
• Fainting or any other loss of consciousness
• Tuberculosis
• Surgery and other hospital admissions
• Recent significant trauma
• History of decompression sickness
• Anemia or other blood disorders
• Heart or circulatory disorders, including a pacemaker or implanted defibrillator
• Mental disorders
• Attempted suicide
• Use of medications
• Alcohol or drug dependence or misuse
• Last menstrual period; current pregnancy; birth, miscarriage or termination within the last 6 weeks
• Diabetes
• Cancer
• Rejection for life or health insurance
• Seizures, convulsions or epilepsy
• Allergies, including severe hay fever
• Significant motion sickness needing medication
• Stroke, muscular weakness or paralysis (in addition to seizures)
• Hepatitis, HIV/AIDS or other chronic infection
• Uncontrolled high or low blood pressure
• Fear of flying, heights, closed or open spaces; depression; anxiety
• Radiation treatment or occupational radiation exposure
• Collapsed lung (pneumothorax)
• Kidney stones or blood in urine
• Gallstones or gallbladder disease
• Previous spaceflights

2 · Physical examination [1]

• Vital signs: heart rate, breathing rate, temperature, blood pressure
• Head, face, neck and scalp
• Nose, sinuses, mouth, throat and ears, including eardrum and Eustachian tube function
• Eyes, including pupil function and eye movements
• Lungs and chest
• Heart: rhythm, sounds, murmurs
• Peripheral vascular system
• Abdomen, including hernia
• Genitourinary system
• Arms, legs and spine
• Lymph nodes
• General neurological examination
• General psychiatric evaluation: appearance, behavior, mood, communication, memory
• Rectal, pelvic and breast examination only if the history suggests a need

3 · Tests [1]

• Routine blood count (hematology)
• Blood chemistry
• Urinalysis
• Resting electrocardiogram (ECG)
• Chest X-ray (front and side views)
• Corrected visual acuity
• Hearing: conversational voice at 6 feet
• Pregnancy test (optional; offer to people who could be pregnant)
• Tympanometry and/or tonometry, if clinically indicated
• Lung function testing, if clinically indicated

4 · Timing [1]

• History, exam and tests valid for 1 year
• 1–2 weeks before each flight: updated history and abbreviated exam (vital signs; eyes, ears, nose, throat, heart, lungs, gut, musculoskeletal and neurological systems; brief mental status). Offer a pregnancy test where relevant.

Conditions to evaluate case by case [1]

• Any regular medication, prescription or not
• Cancer
• Severe injury or invasive procedure with significant loss of function
• Severe infection or contagious disease
• Radiation exposure above the limit cited in the guidance (written as 5 mSv in 5 years)
• Pregnancy, or birth or pregnancy loss within 6 weeks
• A psychiatric or behavioral condition that could make the person a hazard to self or others
• Any condition that could worsen with flight stresses or impair function

Blood pressure medicines (added by SMF) [3][4]

• Diuretics: list them. They add to the roughly 15% fall in circulating volume that causes lightheadedness on standing after landing.
• Beta-blockers: list them. They were the drug class most strongly linked to orthostatic hypotension in randomized trials. Never stop one abruptly.
• Ask the operator's physician whether to change, hold or re-time them, well before flight; record lying and standing blood pressure and heart rate.

The guidance asks whether a condition could cause an in-flight emergency or death, endanger others, interfere with protective equipment or emergency evacuation, or be harmed by flight. Clearance can be given case by case by the operator's physician [1].

Regulations the operator must meet (14 CFR Part 460) [2]

• Written risk disclosure: known hazards, that unknown hazards exist, the safety record, and that the U.S. Government has not certified the vehicle as safe (§ 460.45)
• A chance to ask questions out loud, then signed and dated written consent (§ 460.45(f))
• Reciprocal waiver of claims with the FAA (§ 460.49)
• Emergency training: smoke, fire, loss of cabin pressure, emergency exit (§ 460.51)

Part 460 sets no medical standard for participants; the FAA screening guidance is advisory [2][1].