Medical Department, Kumtor Gold Company, Bishkek 720017, Kyrgyzstan,
Chair of Internal Diseases, Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan.
Occup Med (Lond). 2014 Oct;64(7):483-9. doi: 10.1093/occmed/kqu094. Epub 2014 Jul 7.
Studies of occupational acute mountain sickness (AMS) have not focused on the more severe end of the spectrum to date.
To examine risk factors associated with the development of occupational AMS severe enough to receive treatment in a compression chamber.
A nested case referent study in a cohort of high-altitude (4000 m) mine workers, comparing cases of severe, chamber-treated AMS to matched referents. Using logistic regression, we tested potential risk factors based on premorbid surveillance examinations, including cigarette smoking (current smoking, smoking intensity and exhaled carbon monoxide [CO]).
There were 15 cases and 30 controls. In multivariate analysis including age, sex and place of residence, current smoking was associated with increased risk of severe AMS (odds ratio [OR] 10.0; 95% confidence interval [CI] 1.5-67.4), taking into account any prior, less severe AMS event, which was also a potent risk factor (OR 33.3; 95% CI 2.8-390). Smoking intensity (cigarettes per day) and exhaled CO were also statistically significantly associated with severe AMS.
Cigarette smoking is a strong, previously under-appreciated risk factor for severe AMS. Because this is a modifiable factor, these findings suggest that workplace-based smoking cessation should be tested as an intervention to prevent such morbidity.
迄今为止，有关职业性急性高山病（AMS）的研究并未关注到该疾病谱的更严重端。
探讨与在压缩舱中接受治疗的职业性 AMS 严重程度相关的风险因素。
对高海拔（4000 米）矿区工人队列中的嵌套病例对照研究，将严重、需在压缩舱中治疗的 AMS 病例与匹配的对照进行比较。使用逻辑回归，我们根据发病前监测检查测试了潜在的风险因素，包括吸烟（当前吸烟、吸烟强度和呼出的一氧化碳[CO]）。
共有 15 例病例和 30 例对照。在包括年龄、性别和居住地的多变量分析中，当前吸烟与严重 AMS 的风险增加相关（比值比[OR] 10.0；95%置信区间[CI] 1.5-67.4），考虑到任何先前的、不太严重的 AMS 事件，这也是一个强烈的风险因素（OR 33.3；95% CI 2.8-390）。吸烟强度（每天吸烟量）和呼出的 CO 也与严重 AMS 有统计学显著关联。
吸烟是严重 AMS 的一个强烈的、以前被低估的风险因素。由于这是一个可改变的因素，这些发现表明，应该测试基于工作场所的戒烟措施作为预防这种发病率的干预措施。
