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NASA Medical Requirements

NASA Medical Requirements Integration Documents (MRID)

Introduction

NASA's Medical Requirements Integration Documents (MRIDs) define the standardized data collection requirements for crew health assessment across all phases of spaceflight. Maintained under the JSC28913 baseline by NASA's Medical Operations division at Johnson Space Center, the MRID system ensures consistent, traceable health monitoring from preflight certification through postflight reconditioning.

Each MRID specifies what data must be collected, who it applies to, when it is required, and how the data is archived. The documents are organized into major categories: the Medical Evaluation Documents Board (MEDB) series covers clinical assessments performed directly on crew members, while the Medical Requirements (MR) series covers environmental monitoring, equipment management, and operational medical support.

The original MRID documentation is maintained in NASA's Life Sciences Data Archive (LSDA). This Implementation Guide provides FHIR Questionnaire representations of each MRID to support structured data capture and interoperability.

We welcome feedback on how these questionnaires are modeled in FHIR. Please share suggestions via GitHub Discussions or file an issue.

MEDB 1 - Physical Examinations

Physical examination requirements establish baseline health data and monitor for conditions that could compromise crew safety during spaceflight. These assessments are part of the annual astronaut medical examination and are required for flight certification.

MRID Questionnaire Applies To Required For Schedule
MEDB 1.6 Resting ECG All crew Annual exam / flight certification Annual; preflight
MEDB 1.8 Audiometry All crew Annual exam / flight certification Annual; preflight
MEDB 1.9 Dental Examination All crew Annual exam / flight certification Annual; preflight
MEDB 1.10 Ophthalmologic Examination All crew Annual exam / flight certification Annual; preflight
MEDB 1.11 Body Composition/DEXA All crew Annual exam / flight certification Annual; preflight
MEDB 1.14 Body Mass Measurement All crew Annual exam / flight certification Annual; preflight

MEDB 2 - Laboratory

Laboratory requirements ensure crew members are screened for infectious diseases and have baseline clinical values documented before flight. Several of these requirements apply specifically to long-duration missions (30 days or more), where the closed spacecraft environment increases infection risk and limits medical intervention options.

MRID Questionnaire Applies To Required For Schedule
MEDB 2.1 Routine Laboratory Panel All crew (≥30 day flights) Flight readiness - preflight baseline L-9/6 months, L-60 to L-10 days; R+0 to R+3 days
MEDB 2.2 MRSA Screening All flight crew All flights - infection prevention L-60 to L-30 days; retest L-10 if positive
MEDB 2.3 Tuberculosis Testing All flight crew All flights - annual screening Annual examination
MEDB 2.4 H. pylori Screening Long-duration crew (≥30 days) Long-duration missions - GI health L-180 to L-90 days

MEDB 3 - Radiation

Radiation monitoring is a continuous occupational health requirement for all ISS crew members. NASA maintains crew radiation exposures "as low as reasonably achievable" (ALARA) and documents exposure for lifetime risk assessment. The Space Radiation Analysis Group (SRAG) manages radiation monitoring data through the AREAS (Astronaut Radiation Exposure Assessment System) archive.

MRID Questionnaire Applies To Required For Schedule
MEDB 3.1 Radiation Monitoring / Crew Personal Dosimetry ISS crew (primary and backup) Every ISS increment - occupational monitoring Training L-19 months; preflight hardware processing; in-flight continuous; R+0 postflight

MEDB 5 - Fitness

Exercise physiology requirements track cardiovascular and musculoskeletal fitness to monitor for spaceflight-related deconditioning. Preflight testing establishes baselines; postflight testing documents recovery. In-flight exercise prescriptions serve as the primary countermeasure against bone and muscle loss during long-duration missions.

MRID Questionnaire Applies To Required For Schedule
MEDB 5.1 Aerobic Fitness Assessment Long-duration crew (≥30 days) Flight readiness - cardiovascular baseline L-180 to L-60 days; R+5 to R+7, R+30 days
MEDB 5.2 Strength Assessment Long-duration crew (≥30 days) Flight readiness - musculoskeletal baseline L-180 to L-60 days; R+5 to R+7, R+30 days
MEDB 5.3 Exercise Prescription Long-duration crew In-flight countermeasure - fitness maintenance In-flight continuous; weekly adherence tracking

MEDB 6 - Extravehicular Activity (EVA)

EVA medical requirements ensure crew members are medically cleared to perform spacewalks. These assessments are mission-critical: EVA crew must be certified well in advance and cleared again immediately before each EVA. The prebreathe protocol prevents decompression sickness (DCS) during the transition from cabin pressure to suit pressure.

MRID Questionnaire Applies To Required For Schedule
MEDB 6.1 EVA Medical Requirements EVA crew members only EVA approval - certification and pre-EVA clearance Certification at L-12 months; pre-EVA clearance before each EVA

MEDB 7 - Behavioral Health

Behavioral health requirements assess psychological readiness for spaceflight, monitor crew dynamics during missions, and coordinate family support services. These assessments are managed by the Behavioral Health and Performance (BHP) group and are particularly important for long-duration missions where isolation and confinement stress accumulate over time.

MRID Questionnaire Applies To Required For Schedule
MEDB 7.1 Preflight Psychiatric/Psychological Status Check Long-duration crew (≥30 days) Flight readiness - behavioral clearance L-12 months / L-240 to L-180 days; L-90 to L-30 days
MEDB 7.4 Crew Dynamics Assessment All crew (≥30 days) Crew team assessment - continuous monitoring L-180 to L-90 days; in-flight monthly; R+30 to R+60 days
MEDB 7.5 Family Support Evaluation Long-duration crew Long-duration missions - family services L-180 to L-90 days; in-flight monthly; R+0 to R+90 days

MR - EVA Support

Medical Requirements supporting EVA operations include prebreathe protocols and radiation contingency procedures. These are event-driven requirements triggered by specific mission activities or emergency conditions.

MRID Questionnaire Applies To Required For Schedule
MR087S EVA Prebreathe Protocol EVA crew EVA approval - DCS prevention Pre-EVA (before each EVA)
MR092L Solar Particle Event Protocol All ISS crew during SPE events Emergency response - radiation protection Event-driven (in-flight only)
MR093L Radiation Contingency Crew affected by contingency Emergency response - incident documentation Event-driven (contingency)

MR - Environmental Health

Environmental health monitoring ensures the spacecraft atmosphere, water supply, and surfaces remain safe for crew habitation. These requirements run continuously throughout ISS operations and are managed by the Environmental Health System group.

MRID Questionnaire Applies To Required For Schedule
MR051L Water Quality Assessment ISS operations - all crew Environmental monitoring - water safety Weekly (microbial), monthly (chemical)
MR022S Air Quality Monitoring All spacecraft (ISS) Environmental monitoring - atmospheric safety Continuous (major constituents); weekly/monthly sampling
MR054L Microbial Monitoring ISS operations - all crew Environmental monitoring - infection prevention Air weekly; surfaces monthly

MR - Equipment and Operations

Operational medical requirements cover the logistics of maintaining medical capability aboard the ISS: equipment maintenance, pharmaceutical management, telemedicine infrastructure, and postflight crew reconditioning.

MRID Questionnaire Applies To Required For Schedule
MR036L Medical Kit Inventory ISS operations Resource management - supply tracking Regular in-flight inventory checks
MR026L Reconditioning Assessment All returning long-duration crew Postflight recovery - return to duty R+0 to R+3 initial; weekly progress; final varies
MR050L Pharmaceutical Management ISS operations - all crew Resource management - medication safety In-flight continuous
MR032L Telemedicine Setup All ISS crew Mission support - remote medical capability Preflight training; in-flight verification
MR008L Medical Hardware Maintenance All on-orbit and ground medical equipment Equipment management - calibration and maintenance Continuous maintenance scheduling

References