Philip Scarpa


Alumnus Philip Scarpa is the immediate past president of the Aerospace Medical Association, an advisory board that advocates for the mental and physical safety of astronauts, jet pilots, and deep-sea divers. He is also the deputy chief medical officer at the Aerospace Medicine and Occupational Health branch at NASA’s Kennedy Space Center.

Rob Ostoski

When copilot Andreas Lubitz deliberately crashed Germanwings Flight 9525 in the French Alps in March, the catastrophe underscored the importance of the Aerospace Medical Association (AsMA) advocating for the physical and psychological well-being of pilots—as well as astronauts and deep-sea divers—who are routinely subjected to demanding vocational pressures. AsMA, founded in 1929, is the world’s premier aerospace medicine organization, comprising roughly 2,300 members—doctors, researchers, life scientists, academicians, employees of NASA and other aviation associations—who advocate for the care of those who fly high in the sky and dive deep in the ocean while improving the science of preventive medicine for those working in these extreme environments.

Alumnus Philip Scarpa is the immediate past president of the organization and is also the deputy chief medical officer of the Aerospace Medicine and Occupational Health branch at NASA’s Kennedy Space Center in Orlando, Florida, a position that Scarpa CC’83, RWJMS’88 has held for nearly two decades.

Rutgers Magazine: How does AsMA coordinate its efforts with the industries that it serves?

Philip Scarpa: AsMA is a scientific association. We serve as an expert source, but we don’t make law.  For example, we just reviewed the stand of the Federal Aviation Administration (FAA) on diabetes and flying. And we’ve also looked at the question of sleep apnea. Should pilots suffering from this condition be in the cockpit? We send our letters of recommendation to the head of the FAA.

After the Germanwings accident, members of AsMA commented frequently. After a JetBlue incident in 2012, we formed a working group on the question of mental health concerns with pilots and wrote a position paper. We didn’t find that it made sense to do extensive psychiatric evaluations on pilots, but did recommend that greater attention be paid to mental health issues by aeromedical examiners. So, our role at AsMA is to educate and make people aware of issues on a scientific basis.

RM: People engaged in jet travel, spaceflight, and deep-sea diving encounter different forces. Let’s start with flight.

PS: For the aviation environment, there are similar, but different problems compared to those that people are facing in space. Plane flight used to be slow and low, so humans weren’t affected by things like radiation exposure and G-forces. But as planes became more advanced, humans became the weak link.

Flying at high altitude with low oxygen causes problems, and a pilot can get the bends if the pressure changes too quickly. A pilot can black out if he’s “pulling Gs”—blood goes from the brain to the legs. Temperatures at high altitude can also affect thinking and cause mental errors.

RM: What are the dangers of space travel?

PS: Right now, astronaut Scott Kelly is essentially a guinea pig for a year. If we want to go to Mars, which is a three-year mission, we need to find out what happens to the body when it’s in space for an extended period. We know bodily fluid shifts from the lower to the upper body. Astronauts returning from space can’t stand up. Without gravity, the lungs get crushed a bit. People also get motion sickness in space because, without gravity, what you see and what you feel are out of sync.

The heart and blood vessels decondition in space; muscles atrophy; bone density is lost; the immune system weakens; and the body’s ability to fight infection decreases. Astronauts suffer from a touch of anemia because red blood cells aren’t being reproduced like they are on earth: they’re not needed to carry oxygen, so they’re not made.

Astronauts have radiation exposure. We can protect them against radiation from the sun, but they’re getting cosmic radiation from galaxies colliding, and that plows through their DNA. We’ve established that you’ll lose critical aspects of your brain if you don’t institute countermeasures against the exposure. Astronauts’ vision changes: they become more far-sighted. The fluid shifts in the eyeball and shortens it. Most of the conditions that manifest in space are reversible, but not changes in vision. There’s also lots of mental stress in space. You’re away from family and friends, you’re working long hours without many breaks, the environment is noisy, and so on.

RM: Does AsMA deal primarily with physical challenges or is there a psychological component as well?

PS: Our work is primarily geared toward physical issues, but mental health is also very important, something that was not addressed in the early days of the space program. It really wasn’t considered until we started doing longer missions, and the Russians didn’t address mental health at all. But mental health affects performance and mission success. 

RM: What have been some of AsMA’s efforts on behalf of people who work in the oceans?

PS: We do a lot of research and help divers deal with the bends. We help the navies of the world figure out how best to provide medical care for groups working underwater—what mix of gases is best, for example, for those staying underwater for a long time or at great depth. We help to design protective suits for people working in space, underwater, or at high altitude.

RM: What are some of the discoveries that AsMA has made that benefit earthbound patients?

PS: We’ve learned a lot about deconditioning and what the body can take. The body is a very efficient organism: if you don’t have gravity, the body dumps what it doesn’t need. So it really does become a factor of “use it or lose it.” Some of the things we’ve learned from studying deconditioning in space have translated into treatments for patients on earth suffering from injuries that leave them bedridden. AsMA has pioneered work on ejection seats in jets, and some of the things that we’ve worked on have transferred into civilian life. The anti-shock trousers that a pilot wears when pulling Gs are now used in emergency rooms for patients with excessive bleeding.

We’ve pushed the envelope on understanding the need for bone to reknit. And we’ve learned more about the immune system’s need for stimulation and what to do about it, because you see the same drop in immunity in a cancer patient that you see in someone in space. We’re also looking at gut flora. You need microbes to digest food, but if you change the environment radically, the gut flora may change as well. Bacteria without the stress of gravity grow three-dimensionally and become more resistant to antibiotics.

RM: Describe your general role as the deputy chief medical officer at the Aerospace Medicine and Occupational Health branch at NASA’s Kennedy Space Center.

PS: My job here at the Kennedy Space Center is to try to come up with answers to these issues on an ongoing basis. Every mission gives us one to two people to study, so we need to do multiple years of study.