Propellant Off-Gassing and Implications for Triage and Rescue.

INTRODUCTION: Hypergolic propellants can be released in large amounts during space launch contingencies. Whether propellant-contaminated suit fabric poses a significant risk to rescue crews, due to off-gassing, has not been explored in detail. In this study, we addressed this issue experimentally, exposing space suit fabric to propellants (dinitrogen tetroxide [N2O4] and monomethyl hydrazine [MMH]).METHODS: The NASA Space Shuttle Program Advanced Crew Escape System II (ACES II) is similar to the NASA Orion Crew Survival System (OCSS) and was utilized here. Suit fabric was placed and sealed into permeation cells. Fabric exterior surface was exposed to constant concentrated hypergolics, simulating permeation and leakage. Fabric was rinsed, and permeation and off-gassing kinetics were measured. Experimental parameters were selected, simulating suited flight crewmembers during an evacuation transport without cabin air flow.RESULTS: The fabric allows for immediate permeation of liquid or vaporized MMH and N2O4. NO2 off-gassing never exceeded the AEGL-1 8-h level (acute exposure guideline level). In contrast, MMH off-gassing levels culminated in peak levels, approaching AEGL-2 10-min levels, paralleling the drying process of the fabric layers. DISCUSSION: Our findings demonstrate that MMH off-gassing is promoted by the drying of suit material in a delayed fashion, resulting in MMH concentrations having the potential for adverse health effects for flight and rescue crews. This indicates that shorter decontamination times could be implemented, provided that suit material is either kept moist to prevent off-gassing or removed prior to medical evacuation. Additional studies using OCSS or commercial crew suits might be needed in the future.Schwertz H, Roth LA, Woodard D. Propellant off-gassing and implications for triage and rescue. Aerosp Med Hum Perform. 2020; 91(12):956961.

Measuring disease progression in giant axonal neuropathy: implications for clinical trial design.

As part of a natural history study of giant axonal neuropathy, we hypothesized that the Friedreich Ataxia Rating Scale and the Gross Motor Function Measure would show a significant change over 6 months, reflecting subjects' decline in motor function. The Friedreich Ataxia Rating Scale was performed on 11 subjects and the Gross Motor Function Measure was performed on 10 subjects twice with a six-month interval. A paired two-tailed t-test was used to assess the difference in each subject's score. Significant changes were found over six months of 11.7 ± 11.0 (P = 0.006) for the Friedreich Ataxia Rating Scale and -10.0 ± 13.5 (P = 0.043) for the Gross Motor Function Measure, reflecting subjects' decline in motor function on examination and by report. These standardized assessments of clinical function are the first to be validated in giant axonal neuropathy and will be used in an upcoming gene therapy clinical trial.

The absence of curly hair is associated with a milder phenotype in Giant Axonal Neuropathy.

Giant Axonal Neuropathy is a pediatric neurodegenerative disorder caused by autosomal recessive mutations in the GAN gene on chromosome 16q24.1. Mutations in the GAN gene lead to functional impairment of the cytoskeletal protein gigaxonin and a generalized disorder of intermediate filaments, including neurofilaments in axons. Tightly curled hair is a common but not universal feature of Giant Axonal Neuropathy. The pathogenesis of curly hair is unknown, although disruption of keratin architecture is thought to play a role. As part of a broader natural history study of Giant Axonal Neuropathy, we found that the absence of curly hair is correlated with superior motor function (p=0.013) when controlling for age, as measured by the Gross Motor Function Measure. Theoretically, higher levels of functional gigaxonin protein or compensatory mechanisms could produce fewer abnormalities of neurofilaments and keratin, accounting for this phenotype. We suggest that straight-haired patients with Giant Axonal Neuropathy are potentially underdiagnosed due to their divergence from the classic phenotype of the disease. Due to their non-specific features of an axonal neuropathy, these patients may be misdiagnosed with Charcot-Marie-Tooth Disease type 2. Genetic testing for Giant Axonal Neuropathy should be considered in relevant cases of Charcot-Marie-Tooth Disease type 2.