Acute mountain sickness among tourists visiting the high-altitude city of Lhasa at 3658 m above sea level: a cross-sectional studyReportar como inadecuado

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Archives of Public Health

, 74:23

First Online: 01 June 2016Received: 15 February 2016Accepted: 17 April 2016DOI: 10.1186-s13690-016-0134-z

Cite this article as: Gonggalanzi, Labasangzhu, Nafstad, P. et al. Arch Public Health 2016 74: 23. doi:10.1186-s13690-016-0134-z


BackgroundTraveling to Tibet implies a risk for developing acute mountain sickness AMS, and the size of this problem is likely increasing due to the rising number of tourists. No previous study on AMS has been conducted among the general tourist population in Tibet. Thus, the aim of this study was to estimate the prevalence and determinants of AMS in a large tourist population visiting Lhasa.

MethodsA sample of 2385 tourists was recruited from seven randomly selected hotels in Lhasa between June and October 2010. Within three days of their first arrival, the participants filled in a questionnaire based on the Lake Louise Scoring System LLSS about AMS-related symptoms and potential contributing factors. AMS was defined as the presence of headache and a cumulative Lake Louise Score ≥4. After estimating the prevalence of AMS, a Log-Binomial Model was applied to analyse the relationship between AMS and selected risk factors.

ResultsThe prevalence of AMS was 36.7 % 95 % CI: 34.6–38.7 % and was not dependent on tourists’ country of origin. Among the participants who developed AMS, 47.6 % reported that they experienced symptoms within the first 12 h after arriving in Lhasa, and 79.0 % reported that they had to reduce their activity level. A poor or average health condition adjusted PR 1.63, 95 % CI 1.38–1.93, an age below 55 years adjusted PR 1.29, 95 % CI 1.04–1.60, a rapid ascent to Lhasa adjusted PR 1.17, 95 % CI 1.02–1.34 were independent AMS risk factors, while smoking adjusted PR 0.75, 95 % CI 0.59–0.96 and pre-exposure to high altitude adjusted PR 0.71, 95 % CI 0.60–0.84 reduced the risk of AMS.

ConclusionsAMS is commonly experienced by tourists visiting Lhasa Tibet, and often affects their activities. The tourists’ country of origin did not seem to affect their risk of AMS, and their age was inversely related to AMS. Subjects planning to visit a high-altitude area should be prepared for experiencing AMS-related problems, and consider preventive measures such as pre-exposure or a gradual ascent to high altitudes.

KeywordsAcute mountain sickness Tourist Tibet Abbreviations95 % CI95 % confidential interval

AMSacute mountain sickness

BMIbody mass index

HACEhigh-altitude cerebral edema

HAPEhigh-altitude pulmonary edema

LLSSLake Louise Scoring System

PRprevalence ratio

TARTibet Autonomous Region

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