Incidence and symptoms of high altitude illness in South Pole workers: Antarctic study of altitude physiology (ASAP)

Paul J. Anderson, Andrew D. Miller, Kathy A. O'Malley, Maile L. Ceridon, Kenneth C. Beck, Christina M. Wood, Heather J. Wiste, Joshua J. Mueller, Jacob B. Johnson, Bruce David Johnson

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Introduction: Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL) to the South Pole (SP, 2835 m) providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS), patterns of altitude related symptoms and the feld effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr), accentuated hypobarism (relative to altitude), cold, and immediate exertion would increase altitude illness risk. Methods: Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m2) were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to defne AMS), and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health), during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results: At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T °C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defned AMS. The most common symptoms reported were exertional dyspnea-(87%), sleeping diffculty-(74%), headache-(66%), fatigue-(65%), and dizziness/lightheadedness-(46%). Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87). Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion: The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical altitude alone. Many symptoms persist, possibly due to extremely cold, arid conditions and the benefts of acetazolamide appeared negligible, though it may have prevented more severe symptoms in higher risk subjects.

Original languageEnglish (US)
Pages (from-to)27-35
Number of pages9
JournalClinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine
Volume5
Issue number1
DOIs
StatePublished - 2011

Fingerprint

Altitude Sickness
Acetazolamide
Incidence
Dyspnea
Dizziness
Oceans and Seas
Fatigue
Geographic Locations
Lakes
Humidity
Cough
Headache
Edema
Sleep
Oxygen
Pressure
Health

Keywords

  • Acute mountain sickness
  • Antarctica
  • Hypoxia
  • Rapid transport

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Incidence and symptoms of high altitude illness in South Pole workers : Antarctic study of altitude physiology (ASAP). / Anderson, Paul J.; Miller, Andrew D.; O'Malley, Kathy A.; Ceridon, Maile L.; Beck, Kenneth C.; Wood, Christina M.; Wiste, Heather J.; Mueller, Joshua J.; Johnson, Jacob B.; Johnson, Bruce David.

In: Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, Vol. 5, No. 1, 2011, p. 27-35.

Research output: Contribution to journalArticle

Anderson, Paul J. ; Miller, Andrew D. ; O'Malley, Kathy A. ; Ceridon, Maile L. ; Beck, Kenneth C. ; Wood, Christina M. ; Wiste, Heather J. ; Mueller, Joshua J. ; Johnson, Jacob B. ; Johnson, Bruce David. / Incidence and symptoms of high altitude illness in South Pole workers : Antarctic study of altitude physiology (ASAP). In: Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine. 2011 ; Vol. 5, No. 1. pp. 27-35.
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AU - O'Malley, Kathy A.

AU - Ceridon, Maile L.

AU - Beck, Kenneth C.

AU - Wood, Christina M.

AU - Wiste, Heather J.

AU - Mueller, Joshua J.

AU - Johnson, Jacob B.

AU - Johnson, Bruce David

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N2 - Introduction: Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL) to the South Pole (SP, 2835 m) providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS), patterns of altitude related symptoms and the feld effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr), accentuated hypobarism (relative to altitude), cold, and immediate exertion would increase altitude illness risk. Methods: Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m2) were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to defne AMS), and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health), during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results: At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T °C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defned AMS. The most common symptoms reported were exertional dyspnea-(87%), sleeping diffculty-(74%), headache-(66%), fatigue-(65%), and dizziness/lightheadedness-(46%). Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87). Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion: The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical altitude alone. Many symptoms persist, possibly due to extremely cold, arid conditions and the benefts of acetazolamide appeared negligible, though it may have prevented more severe symptoms in higher risk subjects.

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