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Horiuchi M, Mitsui S, Uno T. Influence of Smoking and Alcohol Habits on Symptoms of Acute Mountain Sickness on Mount Fuji: A Questionnaire Survey-Based Pilot Study. High Alt Med Biol 2024; 25:140-148. [PMID: 38416507 DOI: 10.1089/ham.2023.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Horiuchi, Masahiro, Satomi Mitsui, and Tadashi Uno. Influence of smoking and alcohol habits on symptoms of acute mountain sickness on Mount Fuji: a questionnaire survey-based pilot study. High Alt Med Biol 00:000-000, 2024. Background: Acute cigarette smoking or alcohol intake would cause opposing vasculature effects that may influence acute mountain sickness (AMS). The present study aimed to investigate the effects of smoking and alcohol consumption behaviors, and acute smoking and consuming alcohol during ascent on AMS on Mount Fuji. Methods: This questionnaire survey study included 887 participants who climbed Mount Fuji and obtained information regarding sex, age, and smoking and alcohol habits, including behavior during ascent. Results: AMS prevalence was 45% for all participants. A univariate analysis revealed that younger participants (20-29 years) were associated with increased AMS prevalence (effect size [ES] = 0.102, p = 0.057) and severity (ES = 0.18, p = 0.01). A prediction model using multiple logistic regression indicated that several factors influenced AMS risk: younger age (p = 0.001), daily smoking habits (p = 0.021), no smoking (p = 0.033), or alcohol consumption during ascent (p = 0.096). Alcohol consumption during ascent had no effect on the increased AMS risk in younger participants (20-29 years), while alcohol consumption during ascent increased AMS risk for middle-age participants (50-59 years). Conclusion: Younger individuals are more likely to experience AMS. Smoking habits are associated with an increased AMS risk. It may be recommended that middle-aged climbers should ascend without consuming alcohol.
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Affiliation(s)
- Masahiro Horiuchi
- Faculty of Sports and Life Science, National Institute of Fitness and Sports in KANOYA, Kanoya-City, Japan
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
| | - Satomi Mitsui
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
| | - Tadashi Uno
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
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Chen Y, Tang X, Zeng X, Han B, Xie H, Wang W, Sun L, Hu M, Gao Y, Xiao W. Gastrointestinal syndrome encountered during a train voyage to high altitudes: A 14-day survey of 69 passengers in China. Travel Med Infect Dis 2024; 59:102718. [PMID: 38582488 DOI: 10.1016/j.tmaid.2024.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The diagnosis and evaluation of the severity of acute mountain sickness (AMS) continue to be problematic due to a lack of consensus on the inclusion of symptoms in a scoring system. Recent investigations highlight the significance of gastrointestinal symptoms in identifying this condition. However, the specific gastrointestinal symptoms associated with AMS have not been thoroughly elucidated in previous studies, and the underlying risk factors remain inadequately comprehended. METHODS This study aimed to investigate the characteristics, trends, and risk factors related to gastrointestinal symptoms encountered during train travel to high altitude. A total of 69 passengers, specifically all with medical backgrounds, were surveyed 6 times over a period of 14 days. RESULTS The daily incidence of abdominal discomfort was higher than non-gastrointestinal symptoms within 14 days. Gastrointestinal symptoms demonstrated a greater prevalence, longer duration, and increased risk compared to non-gastrointestinal symptoms, such as headaches. The symptoms of abdominal distension and bowel sound hyperaction were found to be prevalent and persistent among patients diagnosed with AMS, exhibiting a high incidence rate. Gender, age, body mass index (BMI), smoking habits, and alcohol consumption were identified as risk factors associated with the occurrence and duration of gastrointestinal symptoms. CONCLUSION This study suggests that gastrointestinal symptoms are more common and persistent when traveling to the plateau by train. These symptoms should be taken into consideration in the further diagnosis and prevention of AMS. Therefore, this study provides a significant theoretical foundation for the prevention and treatment of AMS.
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Affiliation(s)
- Yihui Chen
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Xiaoqi Tang
- Department of Clinical Laboratory Medicine, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Xiong Zeng
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Ben Han
- Department of Nutrition, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Huichao Xie
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Wei Wang
- Department of Nutrition, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Lihua Sun
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Mingdong Hu
- Department of Geriatrics and Special Services Medicine, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
| | - Yuqi Gao
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Chongqing, 400038, China.
| | - Weidong Xiao
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
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Guo Y, Liu X, Zhang Q, Shi Z, Zhang M, Chen J. Can acute high-altitude sickness be predicted in advance? REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:27-36. [PMID: 36165715 DOI: 10.1515/reveh-2022-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
In high-altitude environments, the oxygen and air density are decreased, and the temperature and humidity are low. When individuals enter high-altitude areas, they are prone to suffering from acute mountain sickness (AMS) because they cannot tolerate hypoxia. Headache, fatigue, dizziness, and gastrointestinal reactions are the main symptoms of AMS. When these symptoms cannot be effectively alleviated, they can progress to life-threatening high-altitude pulmonary edema or high-altitude cerebral edema. If the risk of AMS can be effectively assessed before people enter high-altitude areas, then the high-risk population can be promptly discouraged from entering the area, or drug intervention can be established in advance to prevent AMS occurrence and avoid serious outcomes. This article reviews recent studies related to the early-warning biological indicators of AMS to provide a new perspective on the prevention of AMS.
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Affiliation(s)
- Yan Guo
- Medical College of Soochow University, Suzhou, Jiangsu Province, China
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai Province, China
| | - Xiao Liu
- Department of Basic Medical Sciences, The 960th Hospital of PLA, Jinan, Shandong Province, China
| | - Qiang Zhang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, Qinghai Province, China
| | - Zhongshan Shi
- Department of Intensive Care Medicine, Ge er mu People's Hospital, Ge er mu, Qinghai Province, China
| | - Menglan Zhang
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai Province, China
| | - Jie Chen
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai Province, China
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Tang X, Li X, Xin Q, Wang Q, Li S, Yang Y. Anxiety as a Risk Factor for Acute Mountain Sickness Among Young Chinese Men After Exposure at 3800 M: A cross‒sectional Study. Neuropsychiatr Dis Treat 2023; 19:2573-2583. [PMID: 38046832 PMCID: PMC10693273 DOI: 10.2147/ndt.s436438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose We aimed to explore whether anxiety is a risk factor for acute mountain sickness [AMS] in a young Chinese male population. Patients and Methods A total of 143 young Chinese men with a median age of 23 years (IQR, 21-25) were employed in the present study, and they were divided into the AMS+ and AMS- groups according to the Lake Louise AMS score [AMS-S] after exposure at 3800 m for two days. Participants' pulse oximeter saturation [SpO2] and heart rate [HR] were measured. AMS was evaluated using the AMS-S. The anxiety and sleep quality of the subjects were assessed using the Zung Self-Rating Anxiety Scale [SAS] and the Athens Insomnia Scale [AIS], respectively. Outcomes were analysed using Spearman's partial correlation and logistic regression analysis. Results After two days of exposure at 3800 m, the overall prevalence of AMS was 54% in the whole group. The HR was significantly higher in the AMS+ group than in the AMS- group, as well as the SAS score and AIS score. A converse pattern was observed for SpO2. A significant difference was observed for the change in SAS and AIS score between the AMS+ and AMS- groups. Correlation analysis showed that AMS-S was positively correlated with SAS score, AIS score, HR, ΔSAS score, ΔAIS score, and ΔHR but negatively correlated with SpO2. AIS score was positively correlated with SAS score. After logistic regression analysis was adjusted for HR, SpO2, ΔAIS and ΔHR, SAS score (OR=1.446, 95% CI 1.200-1.744, p<0.001), AIS score (OR=1.216, 95% CI 1.033-1.432) and ΔSAS score (OR=1.158, 95% CI 1.012-1.327) were identified as independent risk factors for AMS. Conclusion The present study suggests that anxiety is a risk factor for AMS among young Chinese men, and poor sleep quality may partially mediate the association.
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Affiliation(s)
- Xugang Tang
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, People’s Republic of China
- Department of Cardiology, The No. 37 Hospital of Chinese PLA, Ya’an, Sichuan, People’s Republic of China
| | - Xiuchuan Li
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, People’s Republic of China
| | - Qian Xin
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Qiang Wang
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, People’s Republic of China
| | - Shuang Li
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, People’s Republic of China
| | - Yongjian Yang
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, People’s Republic of China
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Fabries P, Gomez-Merino D, Sauvet F, Malgoyre A, Koulmann N, Chennaoui M. Sleep loss effects on physiological and cognitive responses to systemic environmental hypoxia. Front Physiol 2022; 13:1046166. [PMID: 36579023 PMCID: PMC9792101 DOI: 10.3389/fphys.2022.1046166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
In the course of their missions or training, alpinists, but also mountain combat forces and mountain security services, professional miners, aircrew, aircraft and glider pilots and helicopter crews are regularly exposed to altitude without oxygen supplementation. At altitude, humans are exposed to systemic environmental hypoxia induced by the decrease in barometric pressure (<1,013 hPa) which decreases the inspired partial pressure of oxygen (PIO2), while the oxygen fraction is constant (equal to approximately 20.9%). Effects of altitude on humans occur gradually and depend on the duration of exposure and the altitude level. From 1,500 m altitude (response threshold), several adaptive responses offset the effects of hypoxia, involving the respiratory and the cardiovascular systems, and the oxygen transport capacity of the blood. Fatigue and cognitive and sensory disorders are usually observed from 2,500 m (threshold of prolonged hypoxia). Above 3,500 m (the threshold for disorders), the effects are not completely compensated and maladaptive responses occur and individuals develop altitude headache or acute altitude illness [Acute Mountain Sickness (AMS)]. The magnitude of effects varies considerably between different physiological systems and exhibits significant inter-individual variability. In addition to comorbidities, the factors of vulnerability are still little known. They can be constitutive (genetic) or circumstantial (sleep deprivation, fatigue, speed of ascent.). In particular, sleep loss, a condition that is often encountered in real-life settings, could have an impact on the physiological and cognitive responses to hypoxia. In this review, we report the current state of knowledge on the impact of sleep loss on responses to environmental hypoxia in humans, with the aim of identifying possible consequences for AMS risk and cognition, as well as the value of behavioral and non-pharmacological countermeasures.
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Affiliation(s)
- Pierre Fabries
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,*Correspondence: Pierre Fabries,
| | - Danielle Gomez-Merino
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Fabien Sauvet
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Alexandra Malgoyre
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France
| | - Nathalie Koulmann
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France
| | - Mounir Chennaoui
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
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Vinnikov D, Krasotski V. Healthy worker survival effect at a high-altitude mine: prospective cohort observation. Sci Rep 2022; 12:13903. [PMID: 35974144 PMCID: PMC9381584 DOI: 10.1038/s41598-022-18331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
Very little is known about the factors of healthy worker survival effect at high-altitude mines. We conducted this cohort observation of the new hires for a high-altitude gold mine in Kyrgyzstan with the aim to ascertain predictors of survival at work. All new hires in 2009 through 2012 for a high-altitude gold mine (3600–4500 m above sea level) were followed up to January 2022. We tested the association of demographic, physiological predictors and diagnoses at the pre-employment screening with non-survival at work in Cox proportional hazards yielding hazard ratios (HR) with their 95% confidence intervals (CI). The cumulative observation time was 5190 person-years. Blood pressure at pre-employment, lung function, the diagnoses of essential hypertension, chronic obstructive pulmonary disease (COPD) or any other analyzed physiological variables were not associated with non-survival at work. However, smoking (HR 1.55; 95% CI 1.10; 2.17) increased the likelihood of non-survival at work, independent of any diagnosis or lowland residence (HR 1.95; 95% CI 1.31; 2.90). Adjusted for covariates and all diagnoses, having chronic rheumatic fever (HR 10.95; 95% CI 2.92; 33.92), hemorrhoids (HR 1.32; 95% CI 1.01; 3.75), adhesive otitis (HR 1.74; 95% CI 1.05; 2.89) or obesity (HR 1.71; 95% CI 1.01; 2.88) were associated with non-survival at work with time. This prospective observation of new hires for a high-altitude mining operation demonstrated that selected diagnoses, smoking and lowland residence elevated the risk of early exit in prospective workers.
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Affiliation(s)
- Denis Vinnikov
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, 050040, Kazakhstan. .,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
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Horiuchi M, Uno T, Endo J, Handa Y, Hasegawa T. Impact of Sleeping Altitude on Symptoms of Acute Mountain Sickness on Mt. Fuji. High Alt Med Biol 2018; 19:193-200. [DOI: 10.1089/ham.2017.0106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Masahiro Horiuchi
- Division of Human Environmental Science, Mt. Fuji Research Institute, Fuji-yoshida, Japan
| | - Tadashi Uno
- Division of Human Environmental Science, Mt. Fuji Research Institute, Fuji-yoshida, Japan
| | - Junko Endo
- Division of Human Environmental Science, Mt. Fuji Research Institute, Fuji-yoshida, Japan
| | - Yoko Handa
- Division of Human Environmental Science, Mt. Fuji Research Institute, Fuji-yoshida, Japan
| | - Tatsuya Hasegawa
- Division of Human Environmental Science, Mt. Fuji Research Institute, Fuji-yoshida, Japan
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Moraga FA, Miranda G, López V, Vallejos C, Silva D. Chronic Intermittent Hypobaric Hypoxia (4600 M) Attenuates Pulmonary Vasodilation Induced by Acetylcholine or Sodium Nitroprusside. High Alt Med Biol 2018; 19:149-155. [PMID: 29565678 DOI: 10.1089/ham.2017.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Moraga, Fernando A., Giselle Miranda, Vasthi López, Carmen Vallejos, and Daniel Silva. Chronic intermittent hypobaric hypoxia (4600 M) attenuates pulmonary vasodilation induced by acetylcholine or sodium nitroprusside. High Alt Med Biol. 19:149-155, 2018. BACKGROUND Previous studies performed in rats exposed to chronic intermittent hypobaric hypoxia (CIHH), at a simulated altitude of 4600 m, showed reduced nitric oxide (NO) production, increased arginase activity, and increased oxidative stress. However, studies on vascular function are scarce. Our aim was to measure plasma nitrate and nitrite (NOx) concentration and study pulmonary vascular function in rats exposed to CIHH in the presence of potassium chloride (KCl), acetylcholine (Ach), and sodium nitroprusside (SNP). METHODS Thirty male Wistar rats were divided into two groups: A control group (normoxia (N), n = 10) and a CIHH group (2N × 2H × 30 days, n = 20). CIHH exposure was performed in a hypobaric chamber at 428 Torr (4600 m). Noninvasive systolic blood pressure (SBP), heart rate, and body weight (BW) were measured. Blood samples were obtained to measure NOx levels and hematocrit (Hct). CIHH animals that gained BW and presented a Hct <20% and maintained SBP were classified as tolerant, and animals that lost >30% of their BW, increased Hct and SBP >20% were classified as intolerant. Animals were sacrificed and small pulmonary arteries (SPA) were obtained to perform concentration-response curves to KCl, Ach, and SNP. RESULTS AND CONCLUSIONS Intolerant rats (30%) had decreased NOx levels. SPA had a larger vasocontraction response to KCl and a lower dilation response to SNP in the SPA compared to tolerant and control animals. In addition, SPA had a lower dilatation response to Ach compared with the control. Together, these results show that CIHH alters endothelium-dependent vasodilation.
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Affiliation(s)
- Fernando A Moraga
- Laboratory of Physiology, Hypoxia and Vascular Function, Department of Biomedical Science, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Giselle Miranda
- Laboratory of Physiology, Hypoxia and Vascular Function, Department of Biomedical Science, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Vasthi López
- Laboratory of Physiology, Hypoxia and Vascular Function, Department of Biomedical Science, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Carmen Vallejos
- Laboratory of Physiology, Hypoxia and Vascular Function, Department of Biomedical Science, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Daniel Silva
- Laboratory of Physiology, Hypoxia and Vascular Function, Department of Biomedical Science, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
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Relationship between Smoking and Acute Mountain Sickness: A Meta-Analysis of Observational Studies. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1409656. [PMID: 29259975 PMCID: PMC5702408 DOI: 10.1155/2017/1409656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/12/2017] [Accepted: 06/06/2017] [Indexed: 12/27/2022]
Abstract
Aims Previous epidemiological investigations of the relationship between smoking and acute mountain sickness (AMS) risk yielded inconsistent findings. Therefore, a meta-analysis of observational studies was performed to determine whether smoking is related to the development of AMS. Methods Searches were performed on PubMed, Scopus, Embase, and Web of Science for relevant studies that were published before November 2016 reporting smoking prevalence and AMS. Two evaluators independently selected studies, extracted data, and assessed study quality. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were obtained using random-effects models. Subgroup analyses were performed according to the type of participant, altitude, and study design. Results A total of 11 observational studies involving 7,106 participants, 2,408 of which had AMS, were eligible for inclusion in this meta-analysis. The summary RR for AMS comparing smokers to nonsmokers was 1.02 (95% CI: 0.83 to 1.26). Specific analyses for altitude, type of participant, and study design yielded similar results. There was significant heterogeneity for all studies (Q = 37.43; P < 0.001; I2 = 73%, 95% CI: 51% to 85%). No publication bias was observed (Egger's test: P = 0.548, Begg's test: P = 0.418). Conclusions The meta-analysis indicates that no difference was found in AMS risk with regard to smoking status.
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Williams P. In this issue of Occupational Medicine. Occup Med (Lond) 2015; 64:477. [PMID: 25281571 DOI: 10.1093/occmed/kqu155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vinnikov D, Blanc PD, Steinmaus C. Is Smoking a Predictor for Acute Mountain Sickness? Findings From a Meta-Analysis. Nicotine Tob Res 2015; 18:1509-16. [PMID: 26419295 DOI: 10.1093/ntr/ntv218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/12/2015] [Indexed: 11/13/2022]
Abstract
AIM Studies of the potential association between cigarette smoking and acute mountain sickness (AMS) have reached contradictory conclusions. Our aim was to perform a meta-analysis of studies across a range of populations to ascertain better the true relationship between cigarette smoking and AMS. MATERIALS AND METHODS We used the PRISMA protocol to identify and screen eligible studies of smoking and AMS. Databases including Pubmed and Google Scholar were searched, using the terms "smoking" and "acute mountain sickness." We conducted a meta-analysis of the selected studies in order to evaluate causal inference, evaluate potential biases, and investigate possible sources of heterogeneity across studies. RESULTS We identified 3907 publications, of which 29 were eligible for inclusion by reporting smoking status and AMS. Of these, eight publications were excluded because they were duplicative or were lacking quantitative data. The 21 studies analyzed included 16 566 subjects. These fell into two groups: occupational/military (n = 8) or volunteers/trekkers/mixed (n = 13). Study heterogeneity was high (X (2) = 55.5, P < .001). Smoking was not statistically associated with increased risk of AMS: pooled OR = 0.88 (95% CI = 0.74-1.05). Stratification yielded similar risk estimates among the occupational/military studies versus all others and studies at relatively higher and lower altitudes. CONCLUSIONS Overall, smoking was not statistically significantly associated with AMS: there is no consistent effect of cigarette smoking acting as either a protective factor against or a risk factor for AMS. IMPLICATIONS This is the first quantitative assessment of published studies on smoking and AMS, which shows smoking to be neither a risk, nor protective. Studies specifically focusing on smoking as a risk factor, should guide further research on this issue. Although all smokers should be strongly advised to quit, studies on risk factors for AMS focusing on other exposures could shed light on the full range of risks for AMS.
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Affiliation(s)
- Denis Vinnikov
- School of Public Health, University of California Berkeley, Berkeley, CA;
| | - Paul D Blanc
- Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, CA
| | - Craig Steinmaus
- School of Public Health, University of California Berkeley, Berkeley, CA
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Smoking Increases the Risk of Acute Mountain Sickness. Wilderness Environ Med 2015; 26:164-72. [DOI: 10.1016/j.wem.2014.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 11/21/2022]
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