Background
For travel to high altitudes, most experts advise a gradual ascent regimen to prevent acute mountain sickness (AMS). Such standard recommendations are applied to the general public. It is generally thought, however, that persons such as porters and guides whose work requires frequent rapid ascents, often made without preventive measures, experience substantial morbidity and potential mortality due to AMS.
Objective
The objective of this study is to show that the risk of such rapid ascents can be attenuated if performed with adherence to a structured nutrition and hydration plan, carrying controlled loads, and taking specific prescribed rest periods during the ascent.
Methods
The study group consists of 11 Nepali porters and guides and 2 Westerners making their first ascent of the Himalayan spring season. The ascent will take participants from Kathmandu (1400 m) to Kala Pattar (5600 m) with a return to Lukla (2800 m) in 8 days in late February and early March 2012. Physiological parameters (oxygen saturation, heart rate, respiration rate) and Lake Louise Criteria Score (LLCS) will be measured every 1000 feet and at each nightly stop (and upon waking) to measure the physiological effects on the group, who plan to ascend at rates more than twice as fast as is generally recommended. This aggressive profile mirrors routinely encountered work demands on professional porters and guides. Participants will eat and drink specified amounts, rest 5 minutes for every 25 minutes of ascent, and carry approximately 12 kg to 14 kg weight for each day's ascent.
Conclusions
It is suggested that a structured nutrition and hydration plan, carrying controlled loads, and prescribed rest periods will have a beneficial effect on persons whose duties require aggressive ascent profiles. Such modifications in working conditions are not construed as a substitute for conservative ascents, but as a harm reduction approach to reduce the documented hazards associated with this occupation.