Who should not go high: chronic disease and work at altitude during construction of the Qinghai-Tibet railroad.

Details

Serval ID
serval:BIB_21DB0754E1E8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Who should not go high: chronic disease and work at altitude during construction of the Qinghai-Tibet railroad.
Journal
High Altitude Medicine and Biology
Author(s)
Wu T.Y., Ding S.Q., Liu J.L., Yu M.T., Jia J.H., Chai Z.C., Dai R.C., Zhang S.L., Li B.Y., Pan L., Liang B.Z., Zhao J.Z., Qi de T, Sun Y.F., Kayser B.
ISSN
1527-0297 (Print)
ISSN-L
1527-0297
Publication state
Published
Issued date
2007
Volume
8
Number
2
Pages
88-107
Language
english
Notes
Comment in Who should not go high? [High Alt Med Biol. 2009]
Abstract
From 2001 to 2005, a new railroad linking Beijing with Lhasa was built by more than 100,000 workers, of whom 80% traveled from their lowland habitat to altitudes up to 5000 m to work on the railroad. We report on the medical conditions of 14,050 of these altitude workers, specifically with regard to preexisting illness. All subjects were seen at low and high altitude. Average age was 29.5 +/- 7.4 (SD) yr, range 20 to 62 yr; 98.8% of the subjects were men and 1.2% were women. Overall incidence of AMS upon first-time exposure was 51%, that of HACE 0.28%, and that of HAPE 0.49%. About 1% of the subjects were hypertensive before altitude exposure. Those with blood pressure >or=160/95 were excluded from employment at altitude. Altitude exposure led to a greater increase of blood pressure in hypertensives compared to normotensives. On prealtitude screening prevalence of cardiac arrhythmias was 0.33%. Since the majority of these were rather benign and occurring in young and otherwise healthy subjects, we allowed altitude employment. Follow-up at altitude was uneventful. Subjects with coronary heart disease and diabetes were excluded from altitude employment. Obesity was a risk factor for acute mountain sickness and for reduced work performance at altitude. Overweight subjects lost more weight during their altitude stay than subjects with normal weight. Altitude exposure was a risk factor for upper gastrointestinal tract bleeding, especially in combination with alcohol, aspirin, and dexamethasone intake. Asthmatic subjects generally did better at altitude compared to low altitude, with the exception of one subject who experienced an asthma episode from pollen exposure. In conclusion, careful evaluation of preexisting chronic illness and risk factors allowed prevention of altitude deterioration of a preexisting health condition, all the while allowing subjects with some specific conditions to work and live at altitude without problems.
Keywords
Acclimatization, Adult, Altitude, Altitude Sickness/diagnosis, Altitude Sickness/epidemiology, Anoxia/epidemiology, China/epidemiology, Chronic Disease, Gastrointestinal Hemorrhage/epidemiology, Humans, Hypertension, Pulmonary/epidemiology, Male, Occupational Diseases/diagnosis, Occupational Diseases/epidemiology, Prevalence, Pulmonary Edema/epidemiology, Questionnaires, Railroads, Tibet
Pubmed
Web of science
Create date
19/09/2013 9:29
Last modification date
20/08/2019 12:58
Usage data