The Future of Space Tourism

The Future of Space Tourism

The Future of Space Tourism
August 28, 2020
Several private companies are developing plans to take paying customers to space on a regular
basis. Federal oversight of space tourism has been deliberately light, consistent with the
Alyssa K. King
Commercial Space Launch Amendments Act of 2004 (P.L. 108-492), in which Congress
Analyst in Transportation
mandated a “learning period” for companies to develop business models, establish safety
Policy
standards, and design spaceflight vehicles prior to establishment of federal regulations.

In that law, Congress directed the Federal Aviation Administration (FAA) to develop indicators

showing when the space tourism industry has matured to the point that it can accommodate a
stricter safety regulatory regime. In a 2019 report to Congress, FAA found that the sector was not yet ready for stricter
regulation. It is to provide another assessment of the industry in 2022. The “learning period” during which the agency must
forbear from regulation is currently set to expire in 2023.
At present, the U.S. government has no procedures for certifying the safety of launch vehicles for tourist passengers. Launch
providers must receive a license for their rockets from FAA, but this licensing process addresses propulsion and trajectory
aspects of spaceflight missions and public safety on the ground rather than passenger safety. For flights with passengers
aboard, FAA requires crew and pilots of commercial spaceflight vehicles to meet certain training and medical standards, but
it has no standards applicable to passengers.
Before boarding a rocket to space, or even just to the edge of space, passengers are required by FAA to sign a waiver
acknowledging known risks of spaceflight. However, aerospace medical experts recognize many health risks associated with
spaceflight are still not well understood, and very little research has been done on medical consequences of such flights on
the health of untrained participants. Known medical risks vary based on many factors, including spaceflight profile, vehicle
configuration, destination, and duration, as well as preexisting medical conditions in passengers. Participants enduring
microgravity, high speeds, and intense gravitational forces could experience vision loss, motion sickness, balance issues, loss
of consciousness, and cardiovascular complications. FAA and the National Aeronautics and Space Administration (NASA)
recommended medical screening standards for tourist spaceflight participants in 2012, but these guidelines are not binding on
companies that provide launch or accommodation for space travelers.
In the event of an accident involving a commercial spaceflight vehicle and passengers, FAA’s requirement for passengers to
sign waivers absolves the government and launch operator of any liability for loss of life. However, families of spaceflight
participants are not required to sign a waiver and could sue the launch operator after such an accident. To date, no such action
has been tested in court. Responsibility for official accident investigations involving commercial s pace vehicles is shared
between FAA and the National Transportation Safety Board (NTSB).
In 2018, the Department of Commerce proposed designating its Office of Commercial Space as an independent bureau with
responsibility for commercial space traffic management, in addition to other functions. Since then, several bills have been
introduced to create such a bureau and give it principal responsibility for regulating commercial spaceflight. None of those
bills has been enacted.
As the congressionally mandated learning period approaches its expiration date, Congress may consider whether the
development of the industry has progressed enough to impose a stricter governance regime for space touris m activities.
Legislators could hold hearings, direct studies, or examine expert and industry views on whether the law restricting FAA’s
authority to regulate the safety of commercial spacecraft for tourist use should be extended again or allowed to expire entirely
or in phases. Congress also has supported the development of voluntary safety standards by industry, interagency working
groups, and the aerospace medical community, and may want to consider whether the federal government should use such
standards to create a regulatory framework.
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Contents
Introduction ................................................................................................................... 1
History and Development of a Space Tourism Sector ............................................................ 1
New Entrants ....................................................................................................... 2
Accommodations in Orbit...................................................................................... 3
Regulating Space Tourism ................................................................................................ 4
Federal Aviation Administration Oversight Responsibilities ........................................ 5
Interagency Medical Standard Recommendations ...................................................... 7
Medical Concerns for Spaceflight Participants ............................................................... 7
“G” Forces .......................................................................................................... 7
Oxygen Deprivation and Effects of Fluid Redistribution ............................................. 8
Vestibular Complications ....................................................................................... 9
Training Guidelines ............................................................................................ 10
Insurance and Liability Issues.................................................................................... 10
Accident Investigation ................................................................................................... 11
Considerations for Congress ........................................................................................... 12

Contacts
Author Information ....................................................................................................... 13

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The Future of Space Tourism

Introduction
Companies in the United States are advancing plans to offer paying customers rides into space on
a regular basis. This development has been encouraged by Congress, which passed legislation in
2004 meant to enable commercial space transportation companies to develop business models
under relatively light regulation.1 While this approach has contributed to rapid growth in
commercial launches of private satel ites and of government cargoes, it has created uncertainty
with respect to passenger transportation, as a nascent industry awaits guidance about what
measures the government wil require to keep paying passengers safe not only in space but on the
way there and back to Earth.
A space tourism boom has been forecast for more than a decade,2 but the current regulatory
landscape is designed for a fledgling industry that is yet to fully emerge.3 Companies proposing to
offer space tourism, which have stayed afloat financial y with the help of investors who foresee
long-term opportunities, wil at least initial y be dependent on a limited pool of exceptional y
wealthy customers.4 When and to what extent it should be regulated by the government remain
undecided.
This report provides an overview of the commercial space tourism industry and examines current
federal safety standards for human spaceflight, opportunities for development of oversight
frameworks, industry recommendations, medical considerations for space travelers, and other
regulatory issues Congress may face as space transportation companies begin flying and
accommodating paying customers.
History and Development of a Space Tourism Sector
The concept of a space tourist is fairly new. In 1998, U.S. bil ionaire video game developer
Richard Garriott founded Space Adventures, the only private company to send paying customers
to orbital space so far.5 For about a decade, the company functioned as a sort of space travel
agency that brokered rides for paying customers aboard the Russian space program’s Soyuz
rockets when seats were available. In April 2001, its customer, 60-year-old Dennis Tito, became
the first tourist to visit space.6 The National Aeronautics and Space Administration (NASA)
objected to Tito’s flight, citing training deficiencies, and declined requests from the company to
offer seats to tourists aboard NASA’s shuttles. Space Adventures sent a total of seven paying
customers to space between 2001 and 2009, including Garriott, who spent 12 days in orbit in

1 CRS Report R45416, Commercial Space: Federal Regulation, Oversight, and Utilization , by Daniel Morgan.
2 T estimony of NASA Deputy Associate Administrator of Space Station Michael Hawes in U.S. Congress, House
Committee on Science, Space, and T echnology, Space Tourism , 107th Cong., 1st sess., June 26, 2001 (Washington, DC:
GPO, 2001).
3 U.S. Congress, House Committee on T ransportation and Infrastructure, Subcommittee on Aviation, Commercial
Space Transportation, 111th Cong., 1st sess., December 2, 2009 (Washington, DC: GPO, 2 009).
4 Northern Sky Research, “ Space T ourism Market About to T ake Off,” December 17, 2019, at https://www.nsr.com/
nsr-report -space-tourism-market-ready-to-take-off/.
5 T he first private astronaut to fly beyond the Karman Line, the widely recognized edge of space, was test pilot Mike
Melville in a SpaceShipOne built by aerospace engineering company Scaled Composites in 2004. Melville was not a
paying customer, and as such is classified as a private astronaut and not a tourist for purposes of this report.
6 Catherine Clifford, “What it’s Like to T ravel to Space, from a T ourist who spent $30 Million to Live there for 12
Days,” CNBC, October 18, 2019 at https://www.cnbc.com/2018/10/19/what-its-like-in-space-from-a-tourist-who-spent-
30-million-to-go.html.
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2008. Tourist visits to space came to a halt when NASA’s shuttle program ended in 2011.
Thereafter, American astronauts bound for the International Space Station (ISS) were al ocated
seats aboard Soyuz rockets pursuant to a U.S. diplomatic agreement with Russia, leaving no extra
seats to accommodate tourist passengers.
While it is not currently possible for commercial travelers to fly into orbit with Space Adventures,
they can come close. Space Adventures operates a modified Boeing aircraft that takes off from a
runway, reaches a certain altitude, and performs a maneuver in the shape of an arc that al ows
passengers aboard to feel intense pressure almost twice that of normal gravity on the way up
followed quickly by less than a minute of weightlessness near the top of the arc. The feeling of
weightlessness is similar to what astronauts feel in the microgravity environment of the ISS. The
aircraft performs this maneuver several times within airspace designated by the Federal Aviation
Administration (FAA). The experience costs about $5,400 per passenger.7
New Entrants
Several newer companies have begun sel ing tickets or advertising future dates for tourist flights
to space:
Virgin Galactic, a publicly traded company founded by British entrepreneur Richard Branson,
had reportedly received more than 8,000 reservation requests for travel aboard its rocket as of
February 2020.8 The company says it has received down payments from 600 of those customers.
Its planned flight profile consists of an aircraft and a second-stage vehicle that detaches once the
main craft reaches a certain altitude and uses a rocket to propel it to suborbital space, an altitude
at which passengers wil temporarily experience weightlessness without entering orbit. To date,
no paying customer has flown aboard a suborbital spacecraft.9 Prior to the COVID-19 pandemic,
the company had publicly announced plans to begin flying tourists by 2022 from its spaceport in
New Mexico, but its operations have been delayed by the virus, according to securities filings.10
Blue Origin, a privately held company controlled by Amazon.com chief executive Jeff Bezos, is
building a passenger rocket and capsule to send a crew of up to six tourists to space for several
minutes from a launch site in West Texas. The company has tested the rocket, New Shepherd, a
dozen times with a dummy onboard covered in sensors to determine how trips might affect future
human customers.11 Blue Origin has not released information about when tourists might be able
to fly on the rocket, what tourist training might be required, or the anticipated price of a flight.
Space Exploration Technologies (SpaceX), a private company controlled by Tesla Motors
founder Elon Musk that is known for launching satel ites aboard reusable rockets, announced in
March 2020 that it would fly three tourists on a 10-day trip to the International Space Station in
2021. The price of the single trip is reportedly $55 mil ion.12 SpaceX intends to fly these tourists
on its Crew Dragon spacecraft, the same craft that transported two NASA astronauts to the ISS in

7 Space Adventures, “G Force One Ready for T akeoff” at http://www.gozerog.com/.
8 Catherine T horbecke, “Virgin Galactic to Resume Selling T ickets to Space, Reports Skyrocketing Demand,” ABC
News, February 26, 2020.
9 Ken Davidian, “Space T ourism Industry Emergence: Description and Data,” New Space, vol. 8, issue 2 (June 2020).
10 Virgin Galactic Holdings, Inc., SEC Form 10-Q for the Quarterly Period Ended June 30, 2020, p. 44, August 3, 2020.
11 Jonathan O’Callaghan, “Blue Origin Launches its First T ourism Rocket in Seven Months – And Hopes to T ake
Humans to Space in 2020, Forbes, December 11, 2019.
12 Sean O’Kane, “SpaceX Will Send T hree T ourists to the International Space Station Next Year,” The Verge, March 5,
2020, at https://www.theverge.com/2020/3/5/21166657/spacex-tourists-iss-international-space-station-orbit-falcon-9-
dragon.
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May 2020 from American soil for the first time since the U.S. space shuttle program ended.
Unlike other spacecraft that are in design and production for tourist transport, the Crew Dragon
wil be rated and certified against NASA criteria that wil formal y deem it safe for human
flight.13 SpaceX is also working with Space Adventures to send up to four private citizens into
orbit around Earth with a projected date of late 2021. In 2018, a bil ionaire from Japan placed a
down payment with SpaceX for a privately chartered tourist flight around the moon in a smal
vehicle that would be launched by a SpaceX rocket.14 SpaceX has said it hopes to launch the
excursion in 2023.
Space Perspective, a private company created in June 2020, proposes to use high-altitude
bal oons to transport tourists to the edge of space.15 Space Perspective plans to launch a footbal -
field-sized bal oon with an attached pressurized capsule, initial y from a base in Florida, to float
passengers to altitudes of nearly 19 miles. During the bal oon flights, passengers wil not
experience weightlessness but can expect to view the curve of the Earth and blackness of outer
space from far above the altitudes at which commercial airplanes normal y fly.16 The company
envisions the bal oons wil descend to Earth after a several-hour journey by gradual y releasing
gas, like traditional hot air bal oons. The company has said it plans to launch its first uncrewed
test flight in 2021.17
Accommodations in Orbit
Prospective space tourists may have several destinations to choose from. The providers of
accommodations in space may not be the same entities that provide space transportation.
One early destination is likely to be the ISS, which is controlled by NASA. In June 2019, NASA
changed a long-standing policy when it announced plans to al ow private citizens to fly to the ISS
for short visits.18 It did not, however, offer to provide transportation. It is unclear whether NASA
wil insist that private astronauts and space tourists visiting the ISS meet the same medical and
training requirements as NASA astronauts aboard the ISS.
Axiom Space, a private company that has several agreements with NASA, wil provide training
to private astronauts and plans to send the first fully private human spaceflight mission to the ISS.
This mission is expected to include three astronauts launched aboard a SpaceX rocket in 2021.19
According to Axiom, private astronauts wil go through initial physical and medical checks, and
training modules wil include 15 weeks of “expert training” in robotics, suborbital spaceflights,

13 National Aeronautics and Space Administration, “NASA Astronauts Launch from America in Historic T est Flight of
SpaceX Crew Dragon,” press release, May 30, 2020.
14 Jackie Wattles, “SpaceX Will T ake a Japanese Billionaire on a T rip Around the Moon,” CNN Business, September
18, 2018.
15 Loren Grush, “New Company Space Perspective Wants to T ake You to the Stratosphere via High -Altitude Balloon,”
The Verge, June 18, 2020.
16 Valerie Stimac, “New T ourism Company Space Perspective Aims to Make Space Accessible to as Many People as
Possible,” Forbes, June 18, 2020.
17 Stefanie Waldek, “T his New Company Wants to Send You to the Edge of Space in a High -T ech Balloon,” Travel
and Leisure, July 7, 2020 at https://www.travelandleisure.com/trip-ideas/space-astronomy/new-spaceflight -company-
space-perspective-balloon-ship.
18 National Aeronautics and Space Administration, “NASA Opens International Space Station to New Commercial
Opportunities, Private Astronauts,” press release, June 7, 2019, at https://www.nasa.gov/press-release/nasa-opens-
international-space-station-to-new-commercial-opportunities-private.
19 William Harwood, “Axiom Plans First Private Flight to Space Station, with Crew Launching Aboard SpaceX
Capsule,” CBS News, March 5, 2020.
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preparation for extreme environments, and high performance jet flights.20 The crew scheduled to
launch in 2021 wil perform research in support of developing modules for a new, privately
funded space station Axiom plans to construct and deploy to replace the ISS after its expected
retirement in 2024.21 The new station is intended to be open to visitors from space agencies and
the paying public. Under an agreement with NASA, the company plans to build the craft in stages
as a modular attachment to the ISS that wil be released as a free-floating station in orbit once
complete.
Gateway Foundation, a California organization, announced design plans last year for a space
hotel that could accommodate hundreds of passengers. The Von Braun Station design plans look
like a giant wheel rotating in space that could provide Earth-like gravity to passengers on board.
Construction is yet to start, but the company says it expects to complete the orbiting hotel by
2027 with the support of space construction company Orbital Assembly. Gateway’s website states
that individuals can increase their chances of winning a free trip to its spaceport and wil have
priority right to purchase shares in an eventual public offering by becoming “crew members.”22
Orion Span has announced a plan to build a luxury hotel in orbit. The hotel, Aurora Station,
would be able to accommodate four passengers and two crew for 12-day stays.23 The company
has been plagued by financial difficulties but claimed in February 2019 to have a seven-month
waitlist.24
Regulating Space Tourism
The U.S. government currently has no procedures for certifying the safety of launch vehicles or
space travel for tourists. An exhaustive certification process exists for commercial spacecraft
transporting NASA astronauts, but the same standards have not been formal y required of space
vehicles for tourist use.25
Federal law defines a spaceflight participant as “an individual, who is not crew or a government
astronaut, carried within a launch vehicle or reentry vehicle.”26 The few existing regulations
pertaining to commercial spaceflight participant safety address the responsibility of a launch
provider to inform a spaceflight passenger of certain risks and of the vehicle’s safety track
record.27 There are currently no federal rules related to suborbital operations or to the operation of

20 Axiom Space, “Preparing for Your Journey,” at https://www.axiomspace.com/private-astronauts-missions. “Private
astronauts” are distinct from spaceflight “ participants” who are not trained to pilot a spacecraft. T he Federal Aviation
Administration (FAA) has not issued guidance for training of private astronauts or certified them. However, it will
award astronaut wings to private astronauts aboard FAA-licensed launches who meet FAA requirements for flight crew
qualifications and training under 14 C.F.R. Part 460 and who fly higher than 50 miles above Earth’s surface.
21 NASA, “NASA Selects First Commercial Destination Module for International Space Station,” press release,
January 27, 2020.
22 https://gatewayspaceport.com.
23 Orion Span, Aurora Station at https://www.orionspan.com/.
24 Jeff Foust, “Orion Span Falls Far Short of Funding Goal to Support its Commercial Space Station Ambitions,” Space
News, February 1, 2019, at https://spacenews.com/orion-span-falls-far-short-of-funding-goal-to-support-its-
commercial-space-station-ambitions/.
25 Daniel Oberhaus, “How NASA Certifies New Spacecraft Safe Enough for Humans,” Wired, May 13, 2020, at
https://www.wired.com/story/how-nasa-certifies-new-spacecraft -safe-enough-for-humans.
26 51 U.S.C. §50902(20).
27 Federal Aviation Administration, “Guidance on Informing Crew and Spaceflight Participants of Risk,” FAA Office of
Com m ercial Space Transportation, April 4, 2017, at https://www.faa.gov/space/licensing_process/regulations/media/
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privately owned space stations and private vehicles in space. Federal regulations related to space
vehicle reentry pertain principal y to the safety of people on the ground, not to the safety of
passengers or crew members aboard commercial spaceflights.
Federal Aviation Administration Oversight Responsibilities
The Commercial Space Launch Amendments Act of 2004 (CSLAA; P.L. 108-492) designated
FAA as the regulatory authority for oversight and licensing of commercial space launch activities.
FAA’s Office of Commercial Space Transportation issued rules in 2006 setting requirements for
crew and participants aboard commercial flights.28 Unless FAA has issued paying spaceflight
participants their own licenses to launch and operate a spacecraft, an FAA-licensed crew is
required on board any vehicle launched from the United States that is carrying passengers in
space.
Under the human spaceflight requirements, the crew aboard a commercial space vehicle must be
trained to carry out duties on the ground or onboard so the space vehicle does not harm the
public. This training includes abort scenarios and emergency operations. Additional y, the crew
must demonstrate an ability to withstand the stressors of spaceflight. Each crew member with a
safety-critical role must possess a current FAA second-class airman medical certificate.29
FAA requires that a space vehicle operator must inform any spaceflight participant in writing of
the risks associated with launch and reentry and provide the safety record of the launch vehicle
prior to accepting compensation or making an agreement to fly a paying customer.30
During the informed consent process, an operator must present the risks in a “manner that can be
readily understood” by spaceflight participants without specialized education or training. The
vehicle operator must obtain a consent letter from each flight participant accepting the risks after
the operator provides the following in writing:
 each known hazard that could result in serious injury or death;
 acknowledgement that there are unknown hazards;
 a disclaimer that participation in spaceflight may result in death, serious injury, or
total or partial loss of physical or mental function;
 a disclaimer that the U.S. government has not certified the launch vehicle as safe
for carrying crew or passengers; and
 a description of the vehicle’s safety record, to include any accidents or mishaps
and corrective actions.31
While the Office of Commercial Space Transportation is responsible for enforcing these informed
consent requirements, it is prohibited by CSLAA from imposing any further safety requirements
on launch companies flying commercial spaceflight participants.32 In particular, it is restricted
from imposing new regulations, such as issuing design requirements for seatbelts or escape

Guidance_on_Informing_Crew_and_Space_Flight_Participants_of_Risk.pdf .
28 Federal Aviation Administration, “Human Space Flight Requirements for Crew and Space Flight Participants,” 71
Federal Register 75615, December 15, 2006.
29 Ibid.
30 14 C.F.R. §460.45.
31 Ibid.
32 P.L. 114-90, §111(5).
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hatches, which could affect the ability of commercial entities to innovate freely in areas of
spacecraft design and development. This prohibition, which was original y set to expire in 2012,
was extended to 2015 under the FAA Modernization and Reform Act of 201233 and then to
October 2023 under the Commercial Space Launch Competitiveness Act of 2015.34 According to
2016 testimony by the Government Accountability Office, experts believed that determining
whether and when to regulate the safety of crew and spaceflight participants was one of FAA’s
most significant chal enges.35
This Commercial Space Launch Competitiveness Act required FAA to submit an initial report to
Congress in March 2018 and a follow-on report in 2022 on the commercial space industry’s
progress in developing voluntary safety standards for human spaceflight. These reports must be
prepared in coordination with an industry advisory group and include observable metrics that
would indicate readiness of the commercial space sector to transition to a more regulated safety
regime without undermining the growth of the industry. The reports are also to include a
framework for transitioning to a new regulatory regime.
FAA submitted its first report, “Evaluation of Commercial Human Space Flight Safety
Frameworks and Key Indicators,” to Congress in 2017. The report identified four types of metrics
FAA proposes to use in determining whether greater federal regulation is appropriate:36
 Indicators of changes in the purpose of commercial space travel, such as moving
beyond adventure travel to providing regular transportation to orbital space
stations.
 Indicators of the size and complexity of the commercial spaceflight industry,
such as the number of suppliers of orbital and suborbital commercial services and
the existence of multiple suppliers of similar vehicles.
 Indicators of the industry’s progress in developing voluntary safety standards,
such as consensus safety standards and voluntary reporting.
 Indicators of FAA’s readiness to provide expertise in human spaceflight safety
and legal authorities to develop and implement a regulatory safety framework.
In February 2019, the Secretary of Transportation submitted a report to Congress recommending
activities and regulatory action that would support establishment of a new safety framework and a
proposed transition plan for the industry. The report found that, based on the readiness indicators,
as of 2019, no commercial human spaceflight activities were ready to transition to a new safety
framework that would involve regulatory action. This finding was based on the fact that, since the
2017 report identifying indicators of readiness, there had only been three FAA-licensed
commercial launches carrying trained crew and no commercial launches with tourists aboard.37

33 P.L. 112-95, §827.
34 P.L. 114-90 §111(9).
35 U.S. Government Accountability Office, “Commercial Space: Industry Developments and FAA Challenges,”
T estimony before the Subcommittee on Aviation, Comm ittee on T ransportation and Infrastructure, House of
Representatives, June 22, 2016.
36 Federal Aviation Administration, Report to Congress: FAA Evaluation of Commercial Human Space Flight Safety
Fram eworks and Key Industry Indicators, October 2017, at https://www.faa.gov/about/plans_reports/congress/media/
CSLCA_Sec111_Report_to_Congress.pdf.
37 Department of T ransportation, “Report to Congress: U.S. Department of T ransportation Ev aluation of Commercial
Human Space Flight Activities Most Appropriate for a New Safety Framework,” February 26, 2019, at
https://www.faa.gov/about/office_org/headquarters_offices/ast/advisory_committee/meeting_news/media/2019/may/
Section_111_Report_Summary_v3.pdf.
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Interagency Medical Standard Recommendations
Though federal law requires commercial spaceflight companies to inform passengers and crew of
mission-related risks, certain medical conditions associated with spaceflight are still unknown or
poorly understood. In 2012, FAA’s Center of Excellence for Commercial Space Transportation
issued a recommended set of comprehensive guidelines for medically screening crew and
spaceflight participants ahead of tourist flights. The “Flight Crew Medical Standards and
Spaceflight Participant Medical Acceptance Guidelines for Commercial Space Flight” was an
attempt by FAA, NASA, and medical experts to provide a consolidated guide to medical
screening practices that could be employed voluntarily by commercial operators and FAA.38 The
guidelines include a consensus set of passenger acceptance recommendations that could also
serve as advice to commercial operators developing their own medical programs.
Recommended guidelines for suborbital flights included requiring commercial spaceflight
participants to fill out a comprehensive medical questionnaire and undergo a physical
examination by a physician with knowledge of the spaceflight environment. The guidelines
recommended that the aerospace physician and vehicle operator develop, when possible,
mitigation strategies and training regimens for any spaceflight participant who does not meet
medical standards.
For orbital spaceflight, the guidelines recommend an additional mental health screening, as
orbital spaceflight is associated with significant psychological stressors that underlying
psychiatric or behavioral problems may exacerbate. Additionally, for orbital flights, the
guidelines recommended chest X-rays, pregnancy tests, drug tests, pulmonary function testing,
and exercise cardiovascular testing. Finally, the guidelines recommended post-flight medical
evaluations and debriefings for spaceflight participants aboard orbital flights.39
Medical Concerns for Spaceflight Participants
Spaceflight participants will face myriad health risks beyond the obvious perils of the initial
rocket launch. Medical data on the effects of spaceflight on the human body have largely been
provided by professional astronauts. Little research exists into the medical consequences of
spaceflight on the health of untrained participants. Health risks of spaceflight will vary based on a
number of factors, including spaceflight profile, vehicle configuration, destination, and duration,
as well as preexisting medical conditions in passengers. Orbital and suborbital flights will pose
different risks, as will the duration of time a participant endures microgravity, high speeds, and
increased gravitational forces.
“G” Forces
To get to space, commercial space companies use two methods: vertical and horizontal launch. A
vertical launch is one in which a rocket blasts off from a launchpad and carries its occupants
directly to space using propulsion. NASA’s space shuttle program and the May 2020
NASA/SpaceX launch of astronauts to orbit used this method. A horizontal launch, usually used
for suborbital flight, entails a traditional airliner-like vehicle that takes off from a runway and

38 Federal Aviation Administration, Center of Excellence for Commercial Space T ransportation, “Flight Crew Medical
Standards and Spaceflight Participant Medical Acceptance Guidelines for Commercial Space Flight,” June 30, 2012, at
http://coe-cst.org/flight-crew-medical-standards-and-spaceflight -participant-medical-acceptance-guidelines-for-
commercial-space-flight.
39 Ibid.
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gradually builds elevation with a spaceflight vehicle attached. At a certain altitude, the spaceflight
vehicle detaches from the airplane and its engines generate additional thrust to propel it into
space. Virgin Galactic’s tourist spacecraft uses this method.40
During both a rapid ascent to space from a vertical launch and a parabolic flight profile flown by
suborbital flights, crew and participants will encounter forces several times that of normal gravity
to get through Earth’s atmosphere. These are commonly referred to as “G” forces. An untrained
flight participant can sometimes withstand about five times the force of normal gravity, or 5G,
but others may lose consciousness at 3G.41 During a launch and a reentry through Earth’s
atmosphere, spaceflight participants are likely to experience forces from 3G to 6G or higher. 42
Under high G forces, humans can experience tunnel vision, loss of vision, motion sickness, or
loss of consciousness, as the heart must pump harder to circulate blood to the brain.43 Individuals
who smoke have diminished tolerance of high-altitude travel and G forces. Dehydration, fatigue,
alcohol, a sedentary lifestyle, and illnesses such as cardiovascular disease can also reduce a
person’s tolerance of G forces.44
FAA offers physiological training programs for pilots and one-day classes for prospective
spaceflight participants that include altitude chambers and vertigo demonstrations to simulate
human physiological responses to high-altitude travel. Additionally, a centrifuge could be used to
test a spaceflight participant’s tolerance of increased gravitational pressure, or G forces, and
could assist in resistance training on Earth, but a commercial spaceflight operator would need to
make arrangements for participants to gain access to one.45
Oxygen Deprivation and Effects of Fluid Redistribution
At higher altitudes where oxygen is in short supply, such as those at the edge of space, spaceflight
participants could be at risk of experiencing altitude sickness or other complications if oxygen
supply is not carefully controlled within the spaceflight vehicle. During hypoxia, which occurs in
humans at high altitudes without requisite oxygen supply, the body’s tissues are deprived of
oxygen, causing numbness, confusion, nausea, hallucinations, breathing problems, irregular
heartbeat, and, if left untreated, heart failure, brain damage, and death.
Federal regulations applicable to any pressurized aircraft operating above 25,000 feet require
commercial space transportation vehicles to be equipped with oxygen supply systems, but
participants in suborbital and longer-duration spaceflight need to be aware of signs and symptoms

40 Adam F. Dissel, Ajay P. Kothari, and Mark J. Lewis, “Comparison of Horizontally and Vertically Launched
Airbreathing and Rocket Vehicles,” Journal of Spacecraft and Rockets, Vol. 43, No. 1, pp. 161-163, January-February
2006.
41 Federal Aviation Administration, “Acceleration in Aviation: G Force,” FAA Civil Aerospace Medical Institute.
42 Rebecca S. Blue, Jon M. Riccitello, Julia T izard, Richard J. Hamilton, and James M. Vanderploeg, “Commercial
Spaceflight Participant G-Force T olerance During Centrifuge Simulated Suborbital Flight,” Aviation Space and
Environm ental Medicine, October 2012, at https://pubmed.ncbi.nlm.nih.gov/23066613/.
43 Marck HT M Haerkens, Ries Simons, and Andre Kuipers, “Doctor, May I T ravel in Space? Aeromedical
Considerations Regarding Commercial Suborbital Space Flights,” National Institutes of Health, National Library of
Medicine, 2011.
44 Pierre Bienaime, “Here’s How U.S. Fighter Pilots Learn to Survive Under Inhuman Levels of G Force,” Business
Insider, November 3, 2014.
45 National Aeronautics and Space Administration, “Learning Launchers, a Spin on T hings: Centrifuge,” press release,
November 26, 2019, at https://www.nasa.gov/audience/foreducators/stem-on-station/learning_launchers_centrifuge. A
centrifuge used to prepare for spaceflight is a large chamber on the end of an arm that spins it at high speeds in a
secured room. T he faster it spins, the more pressure the human body experiences.
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of oxygen deprivation in order to request supplemental oxygen if needed.46 Oxygen starvation
first effects the brain; judgment is impaired, so a participant may not realize the dangerous
situation. Within five minutes of being deprived of oxygen, brain cells begin to die and
significant, life-threatening brain damage occurs.47
The human body is made up of more than 60% water; in microgravity where humans are
weightless, these fluids redistribute themselves throughout the body.48 Flow of blood through
vessels changes, and the position and shape of organs change absent the gravitational forces
pulling them toward Earth.49 For example, the heart and eyeballs both change shape in
microgravity; without gravity, the back of the eyeball flattens and has caused vision problems in
astronauts who have stayed in space for extended periods. The heart becomes rounder and
slightly less elongated than on Earth, as it does not have to work against gravity and blood no
longer pools in the lower extremities.50 Changes like these can cause cardiovascular
complications for healthy individuals as well as those with certain preexisting conditions.51
Vestibular Complications
The vestibular system is contained in the inner ear and enables the human body to sense and
respond to changes in internal and external environments. These functions are used to determine
the body’s orientation, sense body movement changes in velocity and direction, and maintain
balance. When there is no visual reference, as is often the case during gravitational conditions in
spaceflight or weightlessness aboard spacecraft in orbit, vestibular systems often have difficulty
determining spatial orientation, and even short-term weightlessness can cause complications such
as motion sickness, vomiting, vertigo, headaches, and lethargy.52 Disruptions to the vestibular
system in space often result in symptoms similar to seasickness on Earth, where the combination
of a boat’s forward motion, speed, and rocking caused by swells incapacitate the vestibular
system’s ability to determine orientation and balance.53
Spaceflight participants who spend several days in space could also experience health
complications upon return to Earth. Vestibular disturbances and balance issues can occur in
individuals transitioning from living and sleeping in a microgravity environment back to a G1
environment on Earth.54 Additionally, medical research indicates travelers may be more

46 14 C.F.R. §135.157 requires any pressurized aircraft operating above 25,000 feet be equipped with at least a 10-
minute supply of supplemental oxygen for each occupant .
47 Federal Aviation Administration, “Hypoxia: T he Higher You Fly, the Less Air in the Sky,” FAA Civil Aerospace
Medical Institute, April 29, 2020.
48 Department of the Interior, U.S. Geological Survey, “T he Water in You: Water and the Human Body,” at
https://www.usgs.gov/special-topic/water-science-school/science/water-you-water-and-human-body?qt-
science_center_objects=0#qt -science_center_objects.
49 Arnauld E. Nicogossian et al., “Chapter 13: Musculoskeletal Adaptations to Space Flight,” Space Physiology and
Medicine: From Evidence to Practice, 4th Edition (New York: Springer, 2016).
50 Seema Yasmin, “Preparing Bodies for Liftoff: NASA Doctors Studying T ravel that Can T ake T oll on Organs, Skin,
Bones,” Dallas Morning News, June 26, 2015, at http://interactives.dallasnews.com/2015/spacebody/.
51 Naomi Brooks, “Five T hings that Happen to Your Body in Space,” The Conversation, January 15, 2016, at
https://theconversation.com/five-things-that-happen-to-your-body-in-space-52940.
52 National Aeronautics and Space Administration, “Human Vestibular System in Space,” NASA Education in the
Spotlight, April 10, 2009.
53A.L. Elo, “Health and Stress of Seafarers,” Scandinavian Journal of Work, Environment, and Health , Vol. 11, No. 6,
pp. 427-432, December 1985.
54 Michael Johnson, “ New Ways to Assess Neurovestibular System Health in Space Also Benefits T hose on Earth,”
National Aeronautics and Space Administration, March 28, 2019.
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susceptible to infection and illness due to a suppressed immune system caused by changes in
cellular function during even short trips to space.55
Training Guidelines
Commercial crew and private astronaut pilots licensed by FAA to fly to space—or the edge of
it—must meet certain training and medical standards, but those standards do not currently extend
to spaceflight participants paying for a trip. Often, private astronauts that serve as pilots on space
launch vehicles such as those flown by Virgin Galactic have significant NASA or military test
pilot experience and thousands of flight hours. However, some private astronauts may need
additional specialized training for certain missions such as docking with the ISS or using specific
technologies. This year, NASA signed an agreement to partner with a private contracting firm to
train such private astronauts at federal facilities56 and provide aeromedical services prior to,
during, and after private astronaut spaceflight missions.57 While NASA works with private
contractors on many mission support activities, this is the first NASA-sponsored contract for
private astronaut training.
Insurance and Liability Issues
International governance regimes are in place to provide guidance about liability for space-related
accidents. The United Nations Convention on International Liability Caused by Space Objects
entered into force in 1972.58 This agreement, which elaborates on Article VII of the Treaty on
Principles Governing the Activities of States in the Exploration and Use of Outer Space,
Including the Moon and Other Celestial Bodies (the Outer Space Treaty), stipulates that a state
that launches an object to space shall be liable to pay compensation for damage caused by that
object on the surface of Earth or to aircraft—but not for damage to a satellite in orbit.59 According
to the Outer Space Treaty, a nation is responsible for anything launched from its soil, including
commercial spacecraft and payloads not owned or operated by the government. The treaty defines
“damage” as loss of life, personal injury, or other impairment of health.60
Article VII of the Liability Convention would likely apply to an accident involving a vehicle
launched from U.S. soil with foreign spaceflight participants aboard. However, the article
stipulates that the provisions of the treaty do not apply to damage caused by a space object of a
launching state to nationals of that state. In other words, compensation for injury to U.S. citizens

55 University of Arizona, “Prolonged Spaceflight Could W eaken Astronauts’ Immune Systems,” ScienceDaily, January
23, 2019, at http://www.sciencedaily.com/releases/2019/01/190123174405.htm.
56 Andrea Leinfelder, “Houston Company to T rain Private Astronauts at NASA Facilities,” Houston Chronicle, January
30, 2020, at https://www.houstonchronicle.com/business/bizfeed/article/Houston-company-to-train-private-astronauts-
at-15016337.php.
57 KBR, “In a Space Industry First, NASA Grants KBR the Right to T rain Private Astronauts at NASA Facilities,”
press release, January 30, 2020.
58 United Nations Office for Outer Space Affairs, “Convention on International Liability for Damage Caused by Space
Objects,” Com m ittee on the Peaceful Uses of Outer Space, September 1972.
59 United Nations, “T reaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space,
including the Moon and Other Celestial Bodies, Article VII,” Committee on the Peaceful Uses of Outer Space, October
1967.
60 Carl Christol, “International Liability for Damage Caused by Space Objects,” American Journal of International
Law, vol. 74, no. 2, February 27, 2017, pp. 346-371.
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and damage to property in the United States caused by a spacecraft launched from the United
States would be entirely a matter of U.S. law and is not subject to the Outer Space Treaty.
In order to launch a rocket in the United States, a commercial launch operator must receive a
license from FAA. One of the requirements for approval of a license is carriage of third-party
liability insurance.61 FAA requires an assessment of maximum probable financial loss (MPL)
from any accident claim and proof that the operator either has financial reserves equal to the MPL
estimate or has purchased that amount of liability insurance. Federal law places a statutory cap of
$500 million on third-party liability.62 The original Space Launch Amendments Act, passed in
1988, makes the U.S. government responsible for covering damage beyond the $500 million
cap.63
It is not clear whether that government coverage would extend to families of individuals aboard a
commercial space vehicle that experiences an accident. Under informed consent agreements
required by FAA, space tourists effectively waive the right to hold the launch operator liable for
loss of life or injury. However, the families of spaceflight participants are not required to sign any
such form and in theory could still sue the launch operator in the event of a catastrophic accident.
Whether the informed consent waiver would preclude the award of damages in such a case has
not been tested in court.64
Accident Investigation
There are no current federal guidelines delineating accident investigation jurisdiction should a
commercial spaceflight accident occur with passengers on board. According to a nonbinding
2004 memorandum of understanding between FAA, the National Transportation Safety Board
(NTSB), and the U.S. Air Force, the U.S. military wil investigate any accident that occurs during
a space launch aboard its rockets, and FAA and the NTSB wil be responsible for investigating
commercial accidents.65
FAA’s Office of Space Transportation is responsible for overseeing investigations of al accidents
associated with FAA-licensed space operations. However, by statute, the NTSB, an independent
agency, could also have jurisdiction to investigate a commercial space accident when the board
determines an accident related to the transportation of individuals is “catastrophic.”66 For
example, the NTSB conducted the investigation into the crash of SpaceShipTwo, a Virgin
Galactic-operated spacecraft that broke up in the air during a test flight, resulting in the death of
the craft’s copilot in 2014.67 That spacecraft was insured under an aviation hull and liability

61 51 U.S.C. §50914.
62 Federal Aviation Administration, “Risk-Sharing Regime for U.S. Commercial Space T ransportation,” April 2002 at
https://www.faa.gov/about/office_org/headquarters_offices/ast/media/FAALiabilityRiskSharing4-02.pdf.
63 Commercial Space Launch Act Amendments of 1988 (P.L. 100-657).
64 Jackie Wattles, “Why on Earth Would a Company Offer Insurance for Space T ravel?,” CNN Business, September 15,
2018, at https://money.cnn.com/2018/09/15/technology/business/space-insurance-industry/index.html.
65 Federal Aviation Administration, “Memorandum of Understanding Between the National T ransportation Safety
Board, Department of the Air Force, and Federal Aviation Administration Regarding Space Launch Accidents,”
September 2004, at https://www.faa.gov/about/office_org/headquarters_offices/ast/media/
mou_space_launch_accidents.pdf.
66 49 U.S.C. §1131.
67 Alwyn Scott, “Spacesuit? Helmet? Life Insurance? Space T ourist Loophole May End,” Reuters, November 5, 2014,
at https://www.reuters.com/article/us-space-crash-virgin-insurance-analysis/spacesuit -helmet -life-insurance-space-
tourist -loophole-may-end-idUSKBN0IP2XO20141106.
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policy by AIG for losses of $40 million to $50 million.68 There has been debate in Congress since
that time about whether the NTSB’s authority over commercial spaceflight accident
investigations needs to be more clearly codified in law and how jurisdiction should be shared
between FAA and the NTSB.
Considerations for Congress
Congress most recently addressed subjects with implications for space tourism in the Commercial
Space Launch Competitiveness Act of 2015. In that law, Congress determined that the nascent
commercial space transportation industry should go through a “learning period” lasting until at
least 2023 before it receives closer regulation by the federal government.69 Given the
development of the industry since that time, Congress may want to consider whether the law
restricting FAA’s authority to regulate the safety of commercial spacecraft with humans onboard
should be extended, lifted, or al owed to expire in phases. Congress also has supported the
development of voluntary safety standards by industry, interagency working groups, and the
aerospace medical community, and may want to consider whether the federal government should
adopt such standards as regulations.
The Department of Commerce’s Office of Space Commerce has a regulatory role in commercial
human spaceflight activities, pursuant to the department’s statutory responsibility to “foster the
conditions for the economic growth and technological advancement of the United States space
commerce industry” (51 U.S.C. §50702(c)(1)). Likewise, the National Institute of Standards and
Technology (NIST), a part of the department, has the authority to issue voluntary standards. To
date, the department has not authored any such standards related to commercial space activities
but has convened stakeholder workshops and issued best practice frameworks and standards in
areas such as cybersecurity, genetic testing technologies, and other chal enging technology
sectors as roadmaps for industry development and self-governance.
The National Space Council operates as part of the Executive Office of the President to provide
advice on civil, commercial, and military space issues and coordinate implementation of the
President’s space policies and strategies. The council is chaired by the Vice President and
includes the Secretaries of State, Defense, Transportation, and Commerce, among other
members.70 In 2018, the council directed the Department of Commerce to generate a legislative
proposal to establish an entity within the department for administering regulation of commercial
spaceflight activities not overseen by FAA.71 Such activities could potential y include asteroid
mining, on-orbit satel ite servicing, space traffic management, and other commercial endeavors.
In 2018, the Department of Commerce proposed designating its Office of Commercial Space as
an independent bureau with responsibility for commercial space traffic management, in addition
to other functions. A bil to create such a bureau and assign it responsibility for regulating
commercial spaceflight was introduced in the 115th Congress (H.R. 2809), but it did not advance.

68 Carolyn Cohn and Richa Naidu, “Virgin Galactic Spaceship Insured for $40 - $50 million, lead underwriter, AIG:
Sources” Reuters, November 3, 2014, at https://www.reuters.com/article/us-space-crash-virgin-insurance/virgin-
galactic-spaceship-insured-for-40-50-million-lead-underwriter-aig-sources-idUSKBN0IN0SP20141103.
69 P.L. 114-90, §111(5).
70 Executive Order 13803, “Reviving the National Space Council,” 82 Federal Register 31429, July 7, 2017.
71 White House, Office of the Press Secretary, “Space Policy Directive – 2, Streamlining Regulations on Commercial
Use of Space,” presidential memorandum, May 24, 2018 at https://www.whitehouse.gov/presidential-actions/space-
policy-directive-2-streamlining-regulations-commercial-use-space/.
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The bil was reintroduced in the 116th Congress (H.R. 3610), with no further action to date. A
September 2019 Senate Appropriations Committee report expressed concern that an independent
space commerce bureau might not be equipped to fully replace the military’s space traffic
management role, and the committee recommended an independent review by the National
Academy of Public Administration.72
Congress may at some point judge that the industry’s progress is sufficient to justify a formal
safety standard regime. In that circumstance, it could direct FAA to establish a licensing process
for launch vehicles carrying human occupants.
Another option for congressional action would be hearings to examine expert or industry views
on the need for closer government oversight of space tourism activities, to include launch and
reentry as wel as accommodations in orbit, if other than the ISS. Congress could also direct
additional studies on some of these topics by organizations such as the National Academy of
Public Administration, the National Academy of Sciences, or NIST.

Author Information

Alyssa K. King

Analyst in Transportation Policy

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72 S.Rept. 116-127.
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