亚轨道太空旅游安全与健康风险评估专家共识（2026版）

Expert consensus on safety and health risk assessment for suborbital space tourism (2026 edition)

摘要

亚轨道商业航天的快速发展使太空旅游逐步从概念走向现实，对普通乘客的医学筛查提出了全新挑战。亚轨道飞行涉及超重过载（通常3～6 G）、短时微重力暴露及显著心理应激等特殊环境因素，现有航空医学适飞体系主要针对常规航空运输环境设计，难以覆盖其急性暴露特征；而职业航天员筛选模型内部差异显著，航天驾驶员以选拔极少数专业人员为目标采用极高标准，载荷专家虽要求相对最低但仍需系统适应性训练并承担任务导向医学目标，与以体验为目的的普通乘客存在本质差异。中国人群在体质特征、疾病谱分布及健康素养方面具有独特性，直接套用国外标准或职业航天员标准均存在适用性不足的问题，亟需建立适合中国人群的、基于循证的风险分层筛查共识。本共识由来自航天医学、急危重症医学、心血管病学、呼吸病学、神经病学、精神心理学、老年医学、内分泌代谢病学、风湿免疫学、血液病学、肿瘤学、消化病学、骨科学、泌尿外科学、妇产科学、眼科学、耳鼻咽喉头颈外科学、口腔医学、皮肤病学、核医学、公共卫生等21个领域的44位专家组成工作组，系统检索国内外相关标准及文献（2006年1月至2026年1月），采用改良德尔菲法进行2轮专家投票，结合GRADE分级形成60条推荐意见，涵盖一般状况、各系统疾病筛查、辅助检查、航天飞行前适应性训练及特殊人群管理。本共识创新性引入“功能储备”（旅客维持飞行安全所需的生理与心理功能潜能）与“环境应激匹配”（将个体功能储备与特定飞行任务环境应激进行动态适配）理念，建立三级风险分层模型及“太空旅客功能储备评估体系（SP-FRAS）”，涵盖心血管、神经-前庭、心理-认知、肌肉骨骼、代谢与营养五个维度，以及筛选标准、在轨维持、返回后恢复3个环节的监测要点；同时明确离心机高G值耐受训练、应急反应训练等必训项目及抛物线飞行微重力体验等推荐项目的具体要求，明确分阶段训练计划及训练机构资质要求。本共识旨在为中国亚轨道太空旅游安全标准制定与健康风险评估提供探索性、可操作的参考，后续仍需在临床实践中不断验证与迭代。

Abstract

The rapid development of suborbital commercial spaceflight has gradually transformed space tourism from a conceptual vision into tangible reality, presenting entirely new challenges for medical screening of ordinary passengers. Suborbital flight involves unique environmental factors including hypergravity exposure (typically 3-6 G), brief microgravity exposure, and significant psychological stress. Existing aviation medical fitness certification systems were primarily designed for conventional air transport environments and are insufficient to cover the acute exposure characteristics of suborbital flight. Meanwhile, professional astronaut selection models exhibit substantial internal heterogeneity: spaceflight pilots are selected from an extremely small pool of specialists under exceptionally stringent criteria; payload specialists, though subject to relatively lower requirements, still require systematic adaptive training and serve mission-oriented medical objectives-both fundamentally distinct from recreational passengers seeking experiential travel. Chinese populations possess unique characteristics in constitutional traits, disease spectrum distribution, and health literacy; direct application of foreign standards or professional astronaut criteria is inherently inadequate in applicability. There is an urgent need to establish an evidence-based, risk-stratified screening consensus tailored to Chinese populations. This consensus was developed by a working group comprising 44 experts from 21 disciplines: space medicine, emergency and critical care medicine, cardiovascular medicine, respiratory medicine, neurology, psychiatry and psychology, geriatrics, endocrinology and metabolism, rheumatology and immunology, hematology, oncology, gastroenterology, orthopedics, urology, obstetrics and gynecology, ophthalmology, otorhinolaryngology–head and neck surgery, stomatology, dermatology, nuclear medicine, and public health. The group systematically reviewed relevant domestic and international standards and literature (January 2006 to January 2026), employed a modified Delphi method through two rounds of expert voting, and formulated 60 recommendations graded according to the GRADE framework. These recommendations encompass general health status, system-specific disease screening, ancillary examinations, pre-flight adaptive training, and special population management. This consensus innovatively introduces the concepts of "functional reserve" (the physiological and psychological functional potential required for passengers to maintain flight safety) and "environmental stress matching" (dynamic adaptation of individual functional reserve to specific mission environmental stressors), establishing a three-tier risk stratification model and the "Space Passenger Functional Reserve Assessment System (SP-FRAS)" which covers five dimensions-cardiovascular, neuro-vestibular, psychological-cognitive, musculoskeletal, and metabolic-nutritional-along with monitoring priorities across three stages: screening criteria, in-flight maintenance, and post-flight recovery. The consensus also specifies mandatory training items such as centrifuge high-G tolerance training and emergency response training, as well as recommended items such as parabolic flight microgravity experience, with detailed requirements for phased training programs and training institution qualifications. This consensus aims to provide an exploratory and operational reference for the formulation of safety standards and health risk assessment for suborbital space tourism in China; subsequent validation and iterative refinement in clinical practice remain essential.

关键词

商业航天 / 太空旅游 / 医学筛查 / 专家共识 / 亚轨道飞行 / 功能储备 / 环境应激匹配

Key words

Commercial spaceflight / Space tourism / Medical screening / Expert consensus / Suborbital flight / Functional reserve / Environmental stress matching

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基金资助

广东省自然科学基金(2024A1515010000)

中山大学附属第三医院太空医学基金(2025TKYXMS02)