NASA’s plans for space exploration include a return to the Moon to stay—boots back on the lunar surface with an orbital outpost. This station will be a launch point for voyages to destinations further away in our solar system, including journeys to the red planet Mars. To ensure success of these missions, health and performance risks associated with the unique hazards of spaceflight must be adequately controlled. These hazards—space radiation, altered gravity fields, isolation and confinement, closed environments, and distance from Earth—are linked with over 30 human health risks as documented by NASA’s Human Research Program. The programmatic goal is to develop the tools and technologies to adequately mitigate, control, or accept these risks. The risks ranked as “red” have the highest priority based on both the likelihood of occurrence and the severity of their impact on human health, performance in mission, and long-term quality of life. These include: (1) space radiation health effects of cancer, cardiovascular disease, and cognitive decrements (2) Spaceflight-Associated Neuro-ocular Syndrome (3) behavioral health and performance decrements, and (4) inadequate food and nutrition. Evaluation of the hazards and risks in terms of the space exposome—the total sum of spaceflight and lifetime exposures and how they relate to genetics and determine the whole-body outcome—will provide a comprehensive picture of risk profiles for individual astronauts. In this review, we provide a primer on these “red” risks for the research community. The aim is to inform the development of studies and projects with high potential for generating both new knowledge and technologies to assist with mitigating multisystem risks to crew health during exploratory missions.

美国宇航局的太空探索计划包括重返月球并在月球表面建立一个轨道前哨基地。该站将成为前往太阳系更远目的地的航行的出发点，包括前往红色行星火星的旅程。为了确保这些任务的成功，必须充分控制与航天独特危险相关的健康和性能风险。根据 NASA 人类研究计划的记录，这些危害——太空辐射、重力场改变、隔离和限制、封闭环境以及与地球的距离——与 30 多种人类健康风险有关。计划目标是开发工具和技术来充分减轻、控制或接受这些风险。根据发生的可能性及其对人类健康、任务表现和长期生活质量影响的严重程度，被列为“红色”的风险具有最高优先级。这些包括：(1) 空间辐射对癌症、心血管疾病和认知能力下降的健康影响 (2) 太空飞行相关的神经眼综合症 (3) 行为健康和表现下降，以及 (4) 食物和营养不足。从太空暴露方面评估危害和风险（太空飞行和一生暴露的总和以及它们与遗传学的关系并确定全身结果）将为个体宇航员提供全面的风险概况。在这篇综述中，我们为研究界提供了有关这些“红色”风险的入门知识。其目的是为具有高潜力产生新知识和技术的研究和项目的发展提供信息，以协助减轻探索任务期间机组人员健康的多系统风险。