title: Acute Mountain Sickness (AMS) Knowledge Among High Altitude Marathon Runners Competing in the Everest Marathon.
abstract: OBJECTIVE
  Although there are a number of studies on trekkers' knowledge of acute mountain sickness (AMS), there is little current literature on other groups at altitude, for example, marathon runners. Increased knowledge of AMS is associated with a lower incidence of AMS. The purpose of this study was to determine AMS knowledge of marathon runners with an aim to improve AMS information distribution. Incidence of AMS was also determined.
  
  
  METHODS
  Participants completed a self-assessment AMS knowledge questionnaire in Kathmandu before starting the acclimatization trek for the Tenzing Hillary Everest Marathon in Nepal. Lake Louise Scoring questionnaires were completed every day of the 12-day acclimatization trek.
  
  
  RESULTS
  The majority (86%; 43 of 50) of participants obtained information about AMS before the marathon, with the Internet providing the most common source (50%; 25 of 50). Ninety-two percent (46 of 50) of participants rated their knowledge as average or above, and self-assessment correlated with knowledge questionnaire scores (r = .479, P < .001). However, 48% (24 of 50) did not know it was unsafe to ascend with mild AMS symptoms, and 66% (33 of 50) thought it was safe to go higher with symptoms relieved by medication. Only 50% (25 of 50) knew AMS could occur from 2500 m. Thirty-eight percent (19 of 50) of participants had AMS during the acclimatization trek, and 6% (3 of 50) experienced it during the race.
  
  
  CONCLUSIONS
  This study adds to previous literature regarding knowledge and incidence of AMS. It further highlights that more needs to be done to improve knowledge through better information dissemination, with inclusion of scenario-based information to aid application of this knowledge to practical situations.
authors.affiliation: Medical School, University of Birmingham, Birmingham, UK (Dr Letchford). Electronic address: abi.letchford@gmail.com.
authors.forename: Abigail
authors.initials: A
authors.lastname: Letchford
authors.affiliation: Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (Dr Paudel).
authors.forename: Rudra
authors.initials: R
authors.lastname: Paudel
authors.affiliation: Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK (Dr Thomas).
authors.forename: Owen D
authors.initials: OD
authors.lastname: Thomas
authors.affiliation: Locum GP, Shropshire, UK (Dr Booth).
authors.forename: Adam S
authors.initials: AS
authors.lastname: Booth
authors.affiliation: University of Warwick and the University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK (Dr Imray).
authors.forename: Christopher H E
authors.initials: CH
authors.lastname: Imray
mesh_terms: D000208:Acute Disease; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000523:psychology* / Q000706:statistics & numerical data; D009390:Nepal; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014142:Track and Field / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Nepal; altitude sickness; knowledge; marathon runners