Human Physiology During Exposure to the Cave Environment: A Systematic Review With Implications for Aerospace Medicine

Mental health and sleep routines: Uttarkashi, India tunnel collapse workers' experience

Among the mental health outcomes and disaster types (determined by damage to life, property, long-term consequences, displacement, and unpredictability), floods are associated with anxiety and sleep problems, mudslides with anxiety and mood disturbance, volcanic eruptions with acute stress reactions, and earthquakes with anxiety, depression, and physical complaints. Disasters such as tunnel collapse are unique as it involves the healthy, without loss of personal property or displacement; hence, they can have very different health-related outcomes. In this study, we explore mental health and sleep-related issues in workers rescued from an under-construction collapsed tunnel trapped for 17 days. After the initial triage and stabilization and a detailed evaluation of their physical and mental health status, the participants responded to self-administered scales for assessing anxiety [Generalized Anxiety Disorder-7], depression [Patient Health Questionnaire-9], and insomnia [Insomnia Severity Index] in the local language (Hindi). A separate research team conducted open-ended interviews to explore daily routines and concerns, circadian rhythm, orientation to time and day of tunnel collapse to day of rescue events, and sleep routine (and other nuances such as sleep quality and daytime napping) during the 17 days of entrapment. Thirty-three workers consented and hailed from the northern and eastern states of India. They report a mix of hope and worry in the initial days. On the assessment of anxiety, depression, and sleep, only 2-5 scored above the cut-off value, and scales correlated with each other, though clinically it had no bearing. One-third were disoriented to the passage of time, which was related to difficulty falling asleep and more napping. Daytime napping was associated with delayed waketime. Those depressed had more difficulty in the onset, maintinance, and termination of sleep, and reduced total sleep time. Victims of tunnel collapse experience a different set of mental health and sleep problems compared to those reported in other disasters. The findings can partly be attributed to the disruption of light-dark cycles. As only a fraction develops these problems, there is a need for triaging while providing mental health and sleep-related interventions in such circumstances. Lastly, there is a need to establish a light-dark cycle to prevent disorientation among victims.

Night work, season and alertness as occupational safety hazards in the Arctic: protocol for the Noralert observational crossover study among Norwegian process operators

INTRODUCTION

The objective of this study is to determine the effects of night work, Arctic seasonal factors and cold working environments on human functions relevant to safety. The study aims to quantify the contribution of (1) several consecutive night shifts, (2) seasonal variation on sleepiness, alertness and circadian rhythm and (3) whether a computational model of sleep, circadian rhythms and cognitive performance can accurately predict the observed sleepiness and alertness.

METHODS AND ANALYSIS

In an observational crossover study of outdoor and indoor workers (n=120) on a three-shift schedule from an industrial plant in Norway (70 °N), measurements will be conducted during the summer and winter. Sleep duration and quality will be measured daily by smartphone questionnaire, aided by actigraphy and heart rate measurements. Sleepiness and alertness will be assessed at regular intervals by the Karolinska Sleepiness Scale and the psychomotor vigilance test, respectively. Saliva samples will assess melatonin levels, and a blood sample will measure circadian time. Thermal exposures and responses will be measured by sensors and by thermography.

ETHICS AND DISSEMINATION

All participants will give written informed consent to participate in the study, which will be conducted in accordance with the Declaration of Helsinki. The Norwegian Regional Committee for Medical Research Ethics South-East D waivered the need for ethics approval (reference 495816). Dissemination plans include academic and lay publications, and partnerships with national and regional policymakers.

'White Mars' - nearly two decades of biomedical research at the Antarctic Concordia station

NEW FINDINGS

What is the topic of this review? Biomedical research at the Antarctic Concordia Station. What advances does it highlight? Overview of findings in psychology, neuroscience, sleep, cardiovascular physiology and immune system, relevant in isolated, confined and extreme environments and spaceflight.

ABSTRACT

Extended stays in isolated, confined and extreme (ICE) environments like Antarctica are associated with a whole set of psychological and physiological challenges for the crew. As such, winter-over stays at Antarctica provide an important opportunity to acquire knowledge into the physiological and psychological changes that ICE environments inevitably bring. The European Space Agency (ESA) is particularly interested in conducting research in such an environment, as it is a unique opportunity to translate these results to space crews experiencing very similar issues. In the past two decades, the ESA has supported a total of 36 biomedical research projects at the Concordia station in collaboration with the French and Italian polar institutes. More specifically, studies in the areas of psychology, neuroscience, sleep physiology, cardiovascular physiology and immunology were performed. The outcomes of these studies are directly relevant for people working in ICE environments, but also help to better understand the biomedical challenges of those environments. Consequently, they can help to better prepare for human space exploration and to identify countermeasures to minimize the adverse effects of space environments on astronaut health. The aim of this review is to provide an overview of the biomedical studies that have taken place in the past two decades at the Antarctic Concordia station and to summarize the results and their implication for human spaceflight.