TY - JOUR AU - Nicholson, Paul, J AB - This gouache on paper painting by the British artist and illustrator Wilf Hardy (1938–2016) was featured in the children’s educational magazine Look and Learn. Essentially gouache (or body colour) is opaque watercolour. Both types of paint are made from water-soluble pigments bound in gum Arabic or yellow dextrin; however, white pigment and chalk are added to gouache to make it thicker and opaque. Because gouache produces vibrant, solid and matt colours, it is particularly suited to paintings intended to be reproduced as illustrations and posters. Artists may also paint in mixed media using both watercolours and gouache. Open in new tabDownload slide Private Collection© Look and Learn/Bridgeman Images. Open in new tabDownload slide Private Collection© Look and Learn/Bridgeman Images. The painting depicts the historic event 50 years ago of Neil Armstrong being the first human to set foot on the Moon. Televised across the world and watched by hundreds of millions of people [1] many of us will recall watching the event on a black and white cathode ray tube TV and hearing those memorable words from Armstrong on 20 July 1969 ‘The Eagle has landed’ as the lunar module landed at the Sea of Tranquillity; and those even more immortal words as he stepped onto the Moon ‘That’s one small step for a man; one giant leap for mankind’ [2]. Hardy visualizes those words with the indentations from the soles of Armstrong’s lunar boots in the Moon’s dusty surface. In the background of the painting is the lunar module which transported Armstrong and Edwin ‘Buzz’ Aldrin to the Moon and the ladder which Armstrong could be seen descending in the televised broadcast. There is no sign in the painting of the command module which reminds us that this was orbiting the Moon controlled by its pilot Michael Collins. The occupants of both vehicles must have experienced a sense of isolation that is difficult to comprehend. While in radio contact with those on Earth this is lone working and indeed safety critical work taken to the extreme. As with more traditional flight the most critical moments include take-off and landing, added to which is the coordination of docking of the two modules to reconnect all astronauts for the return journey. Incapacitation of any one member of crew could have catastrophic consequences; so understandably the medical fitness standards for astronauts are particularly demanding [3]. In the painting Armstrong’s face is obscured by a dark visor to protect against the sun’s intense rays. This is the first clue to inform us that we should avoid thinking of the ‘space suit’ as simply even sophisticated personal protective clothing. To be precise Armstrong is in an extravehicular mobility unit (EMU) which provides the astronaut with a life-supporting atmosphere (pressurization and oxygen supply); thermal regulation; drinkable water; protection against high velocity dust particles; and a means of communication. In the vacuum of space heat cannot dissipate by conduction and convection, so thermal regulation is achieved by a ‘onesie’ cooling and ventilation undergarment that has a network of tubes to circulate cool water adjacent to the skin. That same vacuum would cause ebullism where water and body fluids boil at body temperature. Ebullism occurs when ambient pressure equals or is less than water vapour pressure at sea level—that is 6.3 kPa or 47 mm of mercury [4]; and occurs at altitudes above around 62 000 feet. This is referred to as the ‘Armstrong Limit’ after the physician Harry George Armstrong of the US Air Force Department of Space Medicine who first recognized the phenomenon [5]. It was discovered prior to manned space travel because high-altitude reconnaissance aircraft such as the SR71 Blackbird and the U2 operated above that limit requiring the pilots to wear fully pressurized suits and helmets. These connect to the aircraft, whereas the EMU is self-contained and is powered and supplied by the backpack. We can see in the painting that a taut hose connects the backpack to the astronaut’s space suit. The EMU is pressurized to 4.3 psi (~30% of atmospheric pressure at sea level) so the astronaut not only has to breathe 100% oxygen while wearing it but must also pre-breathe 100% oxygen while in the lunar module to purge nitrogen from the body and reduce the risk of decompression sickness while in the suit [6]. Apart from being an awkward assembly to don, when it is worn inflated the arms and legs of the EMU want to return to the straight positions making movement fatiguing [6]. Of course, Neil Armstrong has gone down in history and rightfully so for having ‘the right stuff’, but his fame would not have been possible without his crew mates and the countless people on which the astronauts were dependent for the success of the mission. That included those involved at all stages of the space programme at the time and previously. Someone on the ground may have had the lives of the astronauts in their hands, whether it was in the manufacture and maintenance of the Apollo spacecraft or in mission control. Only 2 years earlier the crew of Apollo 1 were killed during a simulated launch by a fire attributed to electric arcing from wires with damaged insulation; this ignited flammable material in an oxygen-rich environment. The investigation reported a series of oversights including that electrical wiring was not protected against accidental impact; an unnecessary excess of nylon, polyurethane foam and Velcro strewn around the module; and lack of provision for emergency egress such that it would take 90 seconds to open the hatch. Since there was no fuel in the Saturn rocket or the service module, the test was not deemed to be hazardous and so neither emergency personnel nor equipment were positioned at the launch pad [2]. Today when we are so familiar with the concept and practice of risk assessment and risk mitigation, it is easy to conjecture that the risks were foreseeable and the deaths avoidable. Fifty years on some private companies are committed to launch space tourism programmes. Roscosmos the Russian space corporation has already flown seven fare-paying passengers into space [7] and medical experts from the International Space Station developed medical standards and evaluation requirements for space tourists in 2007 [8]. In 2016, aviation and space medicine became a speciality in the UK and a curriculum of training was approved by the General Medical Council [9]. Those in training are expected to pass the Diploma in Aviation Medicine which has existed for many years under the auspices of the Faculty of Occupational Medicine. Naturally, the predominant occupational groups and passengers served by UK specialists will be those flying in traditional aircraft. Wilf Hardy was born in Brentford in the UK. His name would be known to aviation enthusiasts since for many years he illustrated the front covers of the Royal Air Force Yearbook and posters and brochure covers for air shows such as the Royal International Air Tattoo. Hardy provided illustrations for many books; his illustrations for a book detailing McDonnell Douglas aircraft over the years being described by a reviewer as ‘unmistakeable and renders full justice to the highly colourful markings of the period’ [10]. He was particularly prolific producing illustrations for Look and Learn and its associated children’s educational publications; a search of their picture library online reveals 914 artworks by Wilf Hardy. References 1. Wilford JN Neil Armstrong, First Man on the Moon, Dies at 82 . New York : The New York Times , 25 August 2012 . Google Preview WorldCat COPAC 2. Compton WD Where No Man Has Gone Before: A History of Apollo Lunar Exploration Missions . Washington : NASA , 1989 . Google Preview WorldCat COPAC 3. Hodkinson PD , Anderton RA , Posselt BN , Fong KJ An overview of space medicine . Br J Anaesth 2017 ; 119 ( Suppl_1 ): i143 – i153 . Google Scholar Crossref Search ADS PubMed WorldCat 4. Murray DH , Pilmanis AA , Blue RS et al. Pathophysiology, prevention, and treatment of ebullism . Aviat Space Environ Med 2013 ; 84 : 89 – 96 . Google Scholar Crossref Search ADS PubMed WorldCat 5. von Ehrenfried M Stratonauts: Pioneers Venturing into the Stratosphere. Cham : Springer International Publishing Switzerland , 2014 . Google Preview WorldCat COPAC 6. Harris M In pursuit of the perfect space suit . Air & Space Magazine . Washington, DC : Smithsonian Institution , September 2017 . Google Preview WorldCat COPAC 7. Waldek S How to become a space tourist: 8 companies (almost) ready to launch . Popular Science , 20 April 2018 . https://www.popsci.com/how-to-become-a-space-tourist ( 30 October 2018 , date last accessed). WorldCat 8. Bogomolov VV , Castrucci F , Comtois JM et al. International Space Station medical standards and certification for space flight participants . Aviat Space Environ Med 2007 ; 78 : 1162 – 1169 . Google Scholar PubMed WorldCat 9. Specialty Training Curriculum for Aviation and Space Medicine . London : Joint Royal Colleges of Physicians Training Board , 2016 . WorldCat COPAC 10. Mersky P Professional reading . Naval Aviation News 1991 ; 73 : 36 . WorldCat © The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) TI - Wilf Hardy, Neil Armstrong on the Moon, 20th century JO - Occupational Medicine DO - 10.1093/occmed/kqy169 DA - 2019-08-22 UR - https://www.deepdyve.com/lp/oxford-university-press/wilf-hardy-neil-armstrong-on-the-moon-20th-century-6QtdRHPpXR SP - 316 VL - 69 IS - 5 DP - DeepDyve ER -