Department of Health Service, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, P. R. China.
J Epidemiol. 2012;22(2):136-43. doi: 10.2188/jea.je20110058. Epub 2012 Feb 18.
Chronic mountain sickness (CMS) is a complex medical and public health problem that seriously affects highland immigrants. This study investigated relationships between community-level factors and CMS.
In this ecological study, data on age- and ethnicity-standardized CMS rates, community factors, and controlling variables were obtained from 2009-2010 surveys of 108 Chinese highland military units. Associations among variables were examined using correlation tests, analyses of covariance, and logistic regression.
The rate of CMS ranged from 1.25% to 36.58% (mean: 14.65%, standard deviation: 8.15%) among military units. Partial correlation tests indicated that medicine expenditure was strongly negatively correlated with CMS (r = -0.267, P = 0.005). Analyses of covariance indicated that communities with oxygen-generating systems had lower CMS rates (F = 9.780, P = 0.002), whereas urban location (F = 5.442, P = 0.022) and construction duty (F = 4.735, P = 0.011) were associated with higher CMS rates. The multiple logistic model showed that medicine expenditure (OR = 0.897, P = 0.022), oxygen-generating system (available vs unavailable: OR = 0.827, P = 0.020), community type (urban vs rural: OR = 1.228, P = 0.019), and occupation (construction vs logistics: OR = 1.240, P = 0.029) were significantly associated with CMS.
We identified community-level, health-related factors that were associated with CMS among young male immigrants. To alleviate the burden of CMS in these highland immigrant populations, further investment should be made in medicine and oxygen-generating systems, and preventive interventions should be implemented among construction workers. Further research should investigate the effects of urbanization on CMS development.
慢性高山病（CMS）是一种复杂的医学和公共卫生问题，严重影响着高原移民。本研究调查了社区水平因素与 CMS 之间的关系。
在这项生态研究中，我们从 2009 年至 2010 年对 108 个中国高原军事单位进行的调查中获得了年龄和种族标准化 CMS 率、社区因素和控制变量的数据。使用相关测试、协方差分析和逻辑回归检验变量之间的关联。
CMS 的发病率在军事单位之间的范围为 1.25%至 36.58%（平均值：14.65%，标准差：8.15%）。偏相关检验表明，医疗支出与 CMS 呈强烈负相关（r=-0.267，P=0.005）。协方差分析表明，有制氧系统的社区 CMS 发病率较低（F=9.780，P=0.002），而城市位置（F=5.442，P=0.022）和建筑任务（F=4.735，P=0.011）与较高的 CMS 发病率相关。多因素逻辑回归模型显示，医疗支出（OR=0.897，P=0.022）、制氧系统（有/无：OR=0.827，P=0.020）、社区类型（城市/农村：OR=1.228，P=0.019）和职业（建筑/物流：OR=1.240，P=0.029）与 CMS 显著相关。
我们确定了与年轻男性移民 CMS 相关的社区水平、与健康相关的因素。为了减轻这些高原移民人群中 CMS 的负担，应进一步投资于医疗和制氧系统，并在建筑工人中实施预防干预措施。应进一步研究城市化对 CMS 发展的影响。
