Cross-sectional and prospective study of the association between lifestyle, individual risk factors, and acute mountain sickness

In recent years, there has been an increase in the attendance of people at high altitudes for both tourism and work, so high-altitude diseases represent a non-negligible public health problem. This research examined cross-sectional and prospective associations of lifestyle, individual risk factors, and acute mountain sickness (AMS) in a community-based sample recruited in the cross-border area (Switzerland, Italy, and France Alps). Questionnaires were administered in the five mountain locations in Aosta Valley between 1500 and 3500 m. Data were analyzed from 1002 subjects (males 68.7%, females 31.3%; mean age 42 ± 14 years) in a cross-sectional study (session T0) and from 1112 interviews in a longitudinal study on three consecutive days (session T1-T2-T3), n = 631 in T1, n = 300 in T2, and n = 181 in T3. According to Lake Louise Score self-reported, at session T0, 35.9% of the subjects were classified as mild AMS and 17.5% as moderate-severe AMS. Among the subjects enrolled in the prospective study, 36.5% were classified as mild or moderate/severe AMS in at least one of the 3 days. Predisposing factors to AMS detected in the prospective study were gender (male; odds ratio [OR] = 1.4, confidence interval [CI]: 2.9-11.7; p = 0.001), history of strenuous physical activity (>3 times per week) (OR = 3.1, CI: 2.1-8.7; p = 0.001), smoking >5 cigarettes per day (OR = 2.4, CI: 2.0-6.5; p = 0.001), difficulty sleeping (<=6 hours), and previous AMS episode (OR = 1.4, CI: 1.2-1.6; p = 0.001). Life style could increase AMS risk. Further studies are needed to investigate whether interventions in life style behavior can modify the impact in high-altitude diseases.