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

机译：暴露于洞穴环境中的人体生理学：对航空航天医学的系统评价

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>Background: Successful long-duration missions outside low-Earth orbit will depend on technical and physiological challenges under abnormal environmental conditions. Caves, characterized by absence of light, confinement, three-dimensional human movement and long-duration isolation, are identifiably one of the earliest examples of scientific enquiry into space analogs. However, little is known about the holistic human physiological response during cave exploration or prolonged habitation.>Objectives: The aim of our review was to conduct a systematic bibliographic research review of the effects of short and prolonged exposure to a cave environment on human physiology, with a view to extend the results to implications for human planetary exploration missions.>Methods: A systematic search was conducted following the structured PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for electronic databases.>Results: The search retrieved 1,519 studies. There were 50 articles selected for further consideration, of which 31 met our inclusion criteria. Short-term cave exposure studies have investigated visual dysfunction, cardiovascular, endocrine-metabolic, immunologic-hematological and muscular responses in humans. Augmentations of heart rate, muscular damage, initial anticipatory stress reaction and inflammatory responses were reported during caving activity. Prolonged exposure studies mainly investigated whether biological rhythms persist or desist in the absence of standard environmental conditions. Changes were evident in estimated vs. actual rest-activity cycle periods and external desynchronization, body temperature, performance reaction time and heart rate cycles. All studies have shown a marked methodological heterogeneity and lack reproduction under controlled conditions.>Conclusions: This review facilitates a further comparison of the proposed physiological impact of a subterranean space analog environment, with existing knowledge in related disciplines pertaining to human operative preparation under challenging environmental conditions. This comprehensive overview should stimulate more reproducible research on this topic and offer the opportunity to advance study design and focus future human research in the cave environment on noteworthy, reproducible projects.
机译：>背景：成功完成低地球轨道以外的长期任务将取决于在异常环境条件下的技术和生理挑战。具有无光，禁闭，三维人体运动和长时间隔离的特征的洞穴无疑是对空间类似物进行科学探索的最早例子之一。但是，人们对于洞穴探索或长期居住期间的整体人类生理反应知之甚少。>目的：我们的审查目的是对短期和长期暴露于洞穴中的影响进行系统的书目研究。洞穴环境对人类生理学的影响，以期将结果扩展到对人类行星探索任务的意义。>方法：在结构化的PRISMA（系统评价和荟萃分析的首选报告项目）之后进行了系统的搜索）的电子数据库指南。>结果：搜索检索到1,519项研究。选择了50篇文章进行进一步审议，其中31篇符合我们的纳入标准。短期洞穴暴露研究已经研究了人类的视觉功能障碍，心血管，内分泌代谢，免疫血液学和肌肉反应。据报道，在探洞活动期间，心率，肌肉损伤，预期的初始应激反应和炎症反应增强。长期接触研究主要研究在没有标准环境条件下生物节律是否持续或停止。在估计的休息活动周期与实际的休息活动周期以及外部失步，体温，运动反应时间和心率周期之间，变化明显。所有研究均显示出在受控条件下方法学的异质性和缺乏再现性。>结论：本综述有助于将地下空间模拟环境的拟议生理影响与相关学科的现有知识进行进一步比较。在具有挑战性的环境条件下进行人类手术准备。这份全面的概述应激发有关该主题的更多可重复研究，并为推进研究设计提供机会，并将将来在洞穴环境中的人类研究重点放在值得注意的可重复项目上。

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