Hiking at High Altitude Can Be Risky

Summarized by Robert W. Griffith, MD
August 14, 2007

This short article comes to us from Blackwell Publishing, which occasionally sends out releases about medical articles in one of their journals that they consider important. We reproduce a slightly edited version here, with permission. Robert Griffith, Editor.

Summary

Acute mountain sickness is a potentially deadly condition that's easily preventable. Hikers at high altitudes need to be more aware of the risk it poses.

Introduction

Acute mountain sickness (AMS) affects almost half of those ascending to heights over 10,000 feet (3,000m) and may lead to life-threatening complications, such as pulmonary or cerebral edema. A new study appearing in the Journal of Travel Medicine details a prospective on-site study in the Himalayas between July and October 2004 in which the knowledge and practices concerning AMS were surveyed amongst trekkers.

The interest of the general public in AMS is thought to have increased over the past 25 years. This change is partly due to media exposure, trekking guidebooks and the wide availability of the Internet. In spite of these apparent changes, it is unknown whether there is an actual increased awareness among those who actually climb to these altitudes, and if this awareness is accompanied by a decrease in the prevalence of AMS. The survey aimed to characterize the knowledge among high-altitude trekkers regarding symptoms, prevention, and treatment of AMS, and to examine whether this knowledge is translated into practice.

The Study Findings

As many as 92% of the 192 respondents had heard of AMS prior to their current trip; 68% had received written or oral information. Overall, awareness of AMS among trekkers was good, particularly in regard to symptoms and modes of treatment. Almost 90% of the travelers were found to have basic knowledge of AMS and could recognize its symptoms (i.e. headache, plus 2 or more of the following: fatigue, dizziness, nausea, or insomnia). Seventy-two percent knew that descent was the primary mode of treatment. However, a fundamental treatment, oxygen, was known to less than 10% of the travelers.

Almost half (47%) of those surveyed had suffered from AMS, and half of these had experienced it after passing 10,000 feet. A third of those who had AMS had medication (acetazolamide) with them, but only half of them actually used it. Nearly 25% of the participants did not know that AMS could be prevented. Additionally, 15% of those surveyed believed AMS to start above 13,000 feet (4,000m), placing them at risk at altitudes between 10,000 and 13,000 feet.

Conclusions

Although there is seemingly adequate knowledge of AMS, Implementation is clearly lacking for translating this into practical action. The findings indicate that there is room for improvement, and they offer a major challenge to travel health care providers. Pre-travel consultation regarding AMS should be given by professionals with special attention to practical advice.

Source

• Are we doing our best to educate travelers about the risks of acute mountain sickness? An on-site prospective study in the Himalayas. A. Alona Paz, I. Steinfeld, I. Potasman , Journal of Travel Medicine , 2007, vol. 14, pp. 168--172

Related Links
An Altitude Tutorial
Acetazolamide (Diamox®)
Wiley-Blackwell's Dissect Medicine

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