Identification of risk factors for heavy clinical burden in electrical workers of highlands: a cross-sectional study

Acute and chronic mountain sickness, resulting from maladaptation to high-altitude hypoxia, poses a great health concern. This study aimed to identify risk factors for heavy symptom-based clinical burden among high-altitude electrical workers.

In this cross-sectional study, 444 electrical workers stationed in the highlands of Sichuan, China, completed a symptom questionnaire and were classified as heavy (≥3 symptoms) or light (<3) clinical burden. Univariable and multivariable logistic regression identified factors associated with heavy clinical burden. Restricted cubic spline (RCS) was used to examine the nonlinear relationship between total duration of high-altitude exposure and clinical burden.

Of the 444 electrical workers, 218 (49.10%) had a heavy clinical burden. The most frequent symptoms were headache (50.90%), sleep disturbance (46.40%), and fatigue (45.95%). Compared to those with light clinical burden, significant differences were detected in age, ethnicity, alcohol consumption, hypertension, and altitude of residence in the heavy group (p < 0.05), which were all associated with heavy clinical burden in univariable analyses, but only age (OR: 1.02; 95% CI: 1.01-1.04), alcohol consumption (OR: 2.36; 95% CI: 1.55-3.61), and hypertension (OR: 1.71; 95% CI: 1.09-2.70) remained statistic significance in multivariable analyses. RCS revealed a U-shaped relationship between total duration of high-altitude exposure and clinical burden, with increased risk at <6 months and >39 months.

Age, alcohol consumption, and hypertension are independent risk factors for heavy clinical burden in high-altitude electrical workers. Moreover, both short (<6 months) and prolonged (>39 months) duration of high-altitude exposure may confer risk for heavy clinical burden.