Sickness at high altitude: a literature review

When some individuals spend just a few hours at low atmospheric pressure above 1,500 m (5,000 ft)--such as when climbing a mountain or flying in a plane at high altitude--they become ill. Altitude sickness studies originally concentrated on life-threatening illnesses which beset determined and athletic climbers at extreme altitudes. In recent years, however, research attention is moving towards milder forms of sickness reported by a significant proportion of the growing number of visitors to mountain and ski resorts at more moderate altitude. Some of this research is also relevant in understanding the problems experienced by passengers in newer planes that fly at a significantly higher equivalent cabin altitude, i.e. 2,440 m (8,000 ft), than earlier designs. Engineering solutions--such as enriched oxygen in enclosed spaces at altitude, or in the case of aircraft, lower cabin altitudes--are possible, but for an economic assessment to be realistic an engineer needs to identify the scale of the problem and to understand the factors determining susceptibility. This review concentrates on the problems of mountain sickness in the ordinary population at altitudes of around 3,000 m (10,000 ft); this is a problem of growing concern as ski resorts develop, mountain trekking increases in popularity, and as higher altitude cabin pressures are achieved in aircraft.