Key result
Working at high altitude was associated with the development of cardiac abnormalities in over 60% of railroad maintenance workers, with older age and higher altitude as significant risk factors.
Why the study?
Exposure to high altitude can cause adverse cardiovascular effects, but alterations in cardiac morphology and function and their associated risk factors in high-altitude workers required investigation.
Does working at high altitude increase the risk of developing cardiac abnormalities in railroad maintenance workers?
Cohort (n=286)
Does working at high altitude increase the risk of developing cardiac abnormalities in railroad maintenance workers?
Working at high altitude is associated with a high incidence of echocardiographic cardiac abnormalities, particularly right heart enlargement and left ventricular diastolic dysfunction, highlighting the need for regular physical examinations in this population.
May warrant cardiac monitoring in high-altitude workers; leaves open causality and need for prospective confirmation.
OBJECTIVES: Exposure to high altitude can affect human health, including the development of adverse cardiovascular effects. This study aimed to investigate alterations in cardiac morphology and function in high-altitude workers and to identify risk factors associated with cardiac abnormalities. METHODS: A retrospective cohort study was conducted with 286 Qinghai-Tibetan Railroad maintenance workers. Participant data were collected from company personnel records. Data on echocardiography and diagnosis of cardiac abnormalities were extracted from participants' medical records. Time-to-event analysis was used to investigate the risk of cardiac abnormalities among participants with different baseline characteristics and identify risk factors associated with cardiac abnormalities that developed as a result of working at high altitude. RESULTS: A total of 173 participants had developed cardiac abnormalities during the follow-up period. The most common cardiac abnormality was right atrial enlargement, followed by left ventricular diastolic dysfunction and tricuspid regurgitation. Among participants with cardiac abnormalities, the median follow-up time was 17 months. Compared with participants who were younger than 20 years and working at altitude <4000 m, participants older at employment and working at extremely high altitude were more likely to develop cardiac abnormalities. Nearly 40% of the participants who worked at altitude <4000 m remained without cardiac abnormalities during the follow-up period. CONCLUSIONS: Over 60% of participants developed cardiac abnormalities after working at high altitude, predominantly right heart enlargement and left ventricular diastolic dysfunction. Age at employment and workplace altitude were significant risk factors for cardiac abnormalities. Enhanced regular physical examinations are recommended for high-altitude workers.
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Han et al. (2020) conducted a cohort in Cardiac abnormalities (n=286). Working at high altitude vs. Working at altitude <4000 m was evaluated on Development of cardiac abnormalities. Working at high altitude was associated with the development of cardiac abnormalities in over 60% of railroad maintenance workers, with older age and higher altitude as significant risk factors.
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