Smoking increases the risk of acute mountain sickness.
OBJECTIVE
We aimed to ascertain risk factors for acute mountain sickness (AMS) in miners exposed to chronic intermittent high altitude conditions.


METHODS
All new hires (2009-2012) for mine employment (4000 m above sea level) were followed up for 12 months after first ascent. Demographics, physiologic data, and cigarette smoking were assessed at preemployment screening. Mine site clinic care for AMS defined incident events. Cox regression analysis estimated risk of AMS associated with smoking and selected covariates.


RESULTS
There were 46 AMS cases among 569 individuals during the first 12 months of employment. Adjusted for age, sex, and altitude of permanent residence, cigarettes smoked per day before hiring were prospectively associated with AMS (hazard ratio [HR], 1.9; 95% CI, 1.1 to 3.2 per 10 cigarettes smoked). This risk was higher in the subset of workers with less demanding physical work (n=336; HR, 3.3; 95% CI, 1.7 to 6.3), whereas among those with more physically demanding jobs (n=233), smoking was not associated with increased risk (HR, 0.6; 95% CI, 0.1 to 2.3).


CONCLUSIONS
In workers newly hired to work at high altitude, smoking increases the likelihood of AMS, but this effect appears to be operative only among those with less physically demanding work duties.
School of Public Health, University of California Berkeley, Berkeley, CA (Dr Vinnikov). Electronic address: denisvinnikov@mail.ru.
Denis
D
Vinnikov
Kyrgyz State Medical Academy, Department of Internal Diseases, Bishkek, Kyrgyz Republic (Dr Brimkulov).
Nurlan
N
Brimkulov
Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, CA (Dr Blanc).
Paul D
PD
Blanc
D000328:Adult; D000532:Altitude Sickness / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008906:Mining; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
acute mountain sickness; high altitude; mining; occupational; smoking