The group reviewed hundreds of pages of NASA policies and procedures, Ball said. A practiced eye was cast on the evidence, in the hope of helping NASA tailor a vision for health care as astronauts move outward on long-duration sojourns, he said.

To this end, two themes run throughout the report.

First, not enough is yet known about the risks to human health during space stints of over a year, nor how best to mitigate risks for those traveling and working in deep space. Secondly, everything reasonable should be done to gain the needed data before humans can be dispatched on long-haul space treks.

Research involving bed rest studies, or using analog environments on Earth, the panel noted, are limited in their value to predict certain effects of microgravity and isolation on humans.

There is no substitute for clinical research being done on the spot in space. In this regard, the International Space Station (ISS) represents "the single most important test bed for that research," the study group reported.

However, using the ISS in this role has a problem.

The committee points out that NASA is undergoing two transitions "to the unknown."

Experienced gained from more than a 100 short-duration shuttle hops is now being overtaken by the long-duration stays on the space station. Also, there is a transition occurring as the emphasis on the machinery of spaceflight makes a conceptual shift to the biology of spaceflight.

"The challenges afforded by these twin transitions offer NASA strategic opportunity to reexamine its processes and structure and to build on its successes," the panel reports.

But early on, there is a need for NASA to tell it like it is.

And that is, there are health risks of long-duration missions beyond Earth orbit. Not only should the public get the message, but so too should space flyers.

"The risks to human health of long duration missions beyond Earth orbit, if not solved, represent the greatest challenge to human exploration of deep space."
     - - from the Safe Passage: Astronaut Care for Exploration Missions report

"The successes of short-duration space missions may have led to misunderstanding of the true risks of space travel by the public. Public understanding is necessary both for support of long-duration missions and in the event of a catastrophe," pointed out the panel of experts.

The public must be prepared for the possibility that "all countermeasures may tragically fail, that a crew may not return from a prolonged mission, or that individuals may not be able to function physically or mentally upon their return," the study group warned.

Among a suite of recommendations, the committee urged NASA to:

• Develop a comprehensive health care system for astronauts;
• Create a strategic health care research plan, one designed to increase the knowledge base about the risks to astronaut health;
• Give priority to understanding the effects of living conditions and behavioral interactions on the well-being and performance of crews on long-duration missions;
• Accelerate the melding of engineering and health science cultures; and
• Establish an "organizational component" headed by a person with authority and accountability for astronaut health issues, an official who would oversee policy-making, day-to-day operations, and budgetary needs.

"None of the committee members is a practicing engineer, and none is a physicist. Thus, we do not believe that our conclusions and recommendations should replace those of others. We hope, instead, that this report will add to the richness of NASA's approach to solving some of the most vexing issues," Ball said.