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Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure

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NESTED CASE - CONTROL ANALYSIS OF THE RISK FACTORS FOR HIGH ALTITUDE PULMONARY OEDEMA.

Rajvir Bhalwar¹, Randhir Singh², R C Ahuja³

¹Reader, Dept of PSM, AFMC, Pune 411 040.

Medical Journal, Armed Forces India

|August 4, 2017

Summary

High altitude pulmonary edema (HAPO) incidence in soldiers is 1.42 per 1000. Moderate to strenuous physical exertion within 24 hours of arrival significantly increases HAPO risk and severity.

Keywords:

Altitude Nested case-control design Pulmonary oedema Risk factors

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Area of Science:

Altitude Medicine
Pulmonary Medicine
Military Health

Background:

High altitude pulmonary edema (HAPO) is a serious risk for individuals ascending to elevations above 2500 meters.
Understanding risk factors is crucial for prevention and management in military personnel deployed to high altitudes.

Purpose of the Study:

To determine the incidence of HAPO in soldiers deployed to high altitudes (11,000-16,000 feet) in the Western Himalayas.
To investigate the association between physical exertion, prior high altitude sickness, and other factors with HAPO incidence and severity.

Main Methods:

A nested case-control study was conducted on a cohort of soldiers.
Data collected included HAPO incidence, physical exertion levels within 24, 24-48, and >48 hours of arrival, previous high altitude sickness history, and other demographic/lifestyle factors.

Main Results:

The cumulative incidence of HAPO was 1.42 per 1000 inductions.
Moderate/strenuous physical exertion within 24 hours of arrival was significantly associated with HAPO (OR=3.19) and disease severity (OR=14.67).
Previous history of high altitude sickness was also a significant risk factor (OR=2.74).

Conclusions:

Physical exertion during the initial 24 hours at high altitude is a critical risk factor for HAPO and its severity.
Previous high altitude sickness history also increases HAPO risk.
Targeted preventive measures focusing on exertion in the first 24 hours are recommended for soldiers deployed to high altitudes.