title: Statistical Evaluation of Causal Factors Associated with Astronaut Shoulder Injury in Space Suits.
abstract: BACKGROUND
  Shoulder injuries due to working inside the space suit are some of the most serious and debilitating injuries astronauts encounter. Space suit injuries occur primarily in the Neutral Buoyancy Laboratory (NBL) underwater training facility due to accumulated musculoskeletal stress. We quantitatively explored the underlying causal mechanisms of injury.
  
  
  METHODS
  Logistic regression was used to identify relevant space suit components, training environment variables, and anthropometric dimensions related to an increased propensity for space-suited injury. Two groups of subjects were analyzed: those whose reported shoulder incident is attributable to the NBL or working in the space suit, and those whose shoulder incidence began in active duty, meaning working in the suit could be a contributing factor.
  
  
  RESULTS
  For both groups, percent of training performed in the space suit planar hard upper torso (HUT) was the most important predictor variable for injury. Frequency of training and recovery between training were also significant metrics. The most relevant anthropometric dimensions were bideltoid breadth, expanded chest depth, and shoulder circumference. Finally, record of previous injury was found to be a relevant predictor for subsequent injury. The first statistical model correctly identifies 39% of injured subjects, while the second model correctly identifies 68% of injured subjects.
  
  
  CONCLUSIONS
  A review of the literature suggests this is the first work to quantitatively evaluate the hypothesized causal mechanisms of all space-suited shoulder injuries. Although limited in predictive capability, each of the identified variables can be monitored and modified operationally to reduce future impacts on an astronaut's health.
authors.forename: Allison P
authors.initials: AP
authors.lastname: Anderson
authors.forename: Dava J
authors.initials: DJ
authors.lastname: Newman
authors.forename: Roy E
authors.initials: RE
authors.lastname: Welsch
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000337:Aerospace Medicine / Q000379:methods*; D001134:Arm Injuries / Q000453:epidemiology* / Q000209:etiology; D018480:Astronauts / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008962:Models, Theoretical; D012372:ROC Curve; D000070599:Shoulder Injuries; D013026:Space Flight / Q000295:instrumentation*; D019442:Space Suits / Q000009:adverse effects / Q000706:statistics & numerical data*