Risk of Falls and Acute Mountain Sickness Symptoms Among Japanese and Foreign Climbers on Mount Fuji

IntroductionNumerous foreign tourists climb Mount Fuji, but the factors influencing falls and the symptoms of acute mountain sickness (AMS) in Japanese and foreign climbers remain unclear.MethodsA questionnaire survey assessed fall occurrence, AMS symptoms, sex, age, climbing experience, use of a tour guide, awareness of fall risks, trekking-pole use, shoe type and sole condition, fatigue, height, body mass, and a single day or overnight climbing. Multiple logistic regression with Akaike information criterion-based model selection was used to identify predictors, including interaction effects of nationality.ResultsValid responses were obtained from 693 Japanese and 244 foreign climbers. The fall rate was 27% in both groups. Female sex and greater fatigue were associated with a higher fall risk regardless of ethnicity. Advancing age was associated with a lower fall risk among foreign climbers but a higher fall risk among Japanese climbers. The prevalence of AMS was 47% among Japanese climbers and 32% among foreign climbers. Younger age and higher fatigue increased AMS risk. Foreign climbers without guides had a lower risk of AMS, whereas guide status was not associated with AMS risk among Japanese climbers.ConclusionsThese findings highlight the importance of targeted preventive guidance to reduce fall risk among female climbers, those experiencing greater fatigue regardless of ethnicity, and older Japanese climbers as well as to reduce AMS risk among foreign climbers participating in guided tours on Mount Fuji.