mattjmcd
03-27-11, 10:09
http://online.wsj.com/article/SB10001424052748703362904576218683033688352.html?KEYWORDS=altitude+sickness
"Benjamin Levine is spending the spring recruiting college students in Dallas for an all-expense-paid vacation to the Rocky Mountains. Naturally, there's a catch.
The students will spend their time in Breckenridge, Colo., doing sit-ups, push-ups, wind sprints and a 12-mile hike to an elevation of 12,000 feet. If all goes as planned, some will also get quite sick.
The $2.5 million research project, funded by the Pentagon, aims to solve a difficult problem for the military. When troops are parachuted into high-altitude battlefields, many come down with acute mountain sickness. Accompanying headaches, nausea, dizziness and fatigue can be so debilitating some troops have trouble standing, much less maneuvering in combat.
"That can be the difference between life and death in a place like Afghanistan," said Dr. Levine, director of the Institute for Exercise and Environmental Medicine in Dallas.
Several medications can treat and even help prevent altitude sickness, including acetazolamide (sold as Diamox) and sildenafil (better known as Viagra). But they can interact badly with other drugs and cause side effects including numbness, stomach upset and dehydration, so commanders typically don't distribute them en masse, said Stephen Muza, a research physiologist for the U.S. Army who specializes in altitude sickness.
The new research aims to develop a simple, inexpensive blood test that will predict which soldiers are most likely to get altitude sickness. Commanders could then plan accordingly—by distributing medication, giving troops who are sensitive to altitude time to acclimate at lower elevations, or even redrawing battle plans so those units most likely to be depleted by illness aren't sent out on crucial missions right away.
The Dallas-area college students will have their blood screened at sea level for the presence of six specific genes that seem to affect a person's susceptibility to mountain sickness. The students will then be whisked to an altitude of 9,600 feet and be put through physical-fitness challenges.
They will also be monitored for signs of mountain sickness. The goal is to see whether the sea-level blood test is, in fact, able to predict which students will be miserable and which will be chipper enough to hit the hiking trail.
Robert Roach, who directs the Altitude Research Center at the University of Colorado, performed a similar test last year, taking 28 research subjects to a simulated altitude of 16,000 feet by putting them in a special chamber that mimics the effect of a low-oxygen environment. A blood test, screening for those six genetic elements, was able to predict with 96% accuracy which of the 28 would fall ill.
(Matthew Staver for The Wall Street Journal
Dr. Robert Roach director of the Altitude Research Center, inside one chamber of the hypobaric chamber in the Altitude Research Center in Aurora, Colo.)
Now, Dr. Roach hopes to replicate those results on a broader scale; he designed the summer study that will take 140 college students to Breckenridge. If the blood test proves conclusive in this group as well, Dr. Roach plans to develop an Acute Mountain Sickness Prediction Kit that would be available for the military within three years.
That would be a welcome advance, said Rod Alne, an Air Force veteran who isn't connected to Mr. Roach's project. Mr. Alne's special-operations unit was dropped into high-altitude combat zones frequently, and he said he saw first-hand the impact of mountain sickness on even the fittest troops.
"These are all young, strong, Type-A personality guys and they think they're just going to gut it out. They believe they're bulletproof," Mr. Alne said. "But at 20,000 feet, it hurts just to think."
Military models indicate at least 25% of unacclimatized troops parachuting into a battlefield at 10,000 feet—and more than 80% of troops fighting at 13,200 feet—will get altitude sickness.
One military study of a prolonged operation in the high mountains of Afghanistan found 14% of troops evacuated for medical treatment didn't have combat injuries—they had altitude sickness.
Mountain Malaise
Projections for proportion of unacclimatized troops who will get sick at high altitudes.
10,000 feet – 25-35%
11,500 feet – 50-60%
13,200 feet – 80-90%
14,800 feet – 90-100%
Source: Stephen Muza, U.S. Army Research Institute of Environmental Medicine
Uncounted others, not sick enough to merit rescue by helicopter, were huddled in base camps while their units went out fighting, said Dr. Muza, the Army research physiologist. In most cases, acute mountain sickness dissipates within three days as the body adjusts to the elevation, though in severe cases, it can linger or lead to fatal complications.
While the military is funding the new research, a predictive blood test could also be marketed to the public, Dr. Roach said. That could benefit Colorado's ski industry, which says up to 40% of its visitors come down with mountain sickness. The Institute for Altitude Medicine in Telluride, Colo., estimates the illness damps spending at mountain resorts by $200 million a year, as afflicted tourists don't much feel like shopping, skiing or dining out.
Jennifer Rudolph, a ski-industry spokeswoman, said if tourists could learn from a simple blood test that they were susceptible, they would be more apt to take precautionary measures, such as spending a day at an interim altitude before hitting the slopes.
But Peter Hackett, executive director of the Telluride institute, isn't so sure a test would be useful for civilians.
"Would a New York family traveling to Colorado for vacation get a genetic test to see if they're susceptible to altitude sickness?" Mr. Hackett asked. "I doubt it."
Write to Stephanie Simon at stephanie.simon@wsj.com"
"Benjamin Levine is spending the spring recruiting college students in Dallas for an all-expense-paid vacation to the Rocky Mountains. Naturally, there's a catch.
The students will spend their time in Breckenridge, Colo., doing sit-ups, push-ups, wind sprints and a 12-mile hike to an elevation of 12,000 feet. If all goes as planned, some will also get quite sick.
The $2.5 million research project, funded by the Pentagon, aims to solve a difficult problem for the military. When troops are parachuted into high-altitude battlefields, many come down with acute mountain sickness. Accompanying headaches, nausea, dizziness and fatigue can be so debilitating some troops have trouble standing, much less maneuvering in combat.
"That can be the difference between life and death in a place like Afghanistan," said Dr. Levine, director of the Institute for Exercise and Environmental Medicine in Dallas.
Several medications can treat and even help prevent altitude sickness, including acetazolamide (sold as Diamox) and sildenafil (better known as Viagra). But they can interact badly with other drugs and cause side effects including numbness, stomach upset and dehydration, so commanders typically don't distribute them en masse, said Stephen Muza, a research physiologist for the U.S. Army who specializes in altitude sickness.
The new research aims to develop a simple, inexpensive blood test that will predict which soldiers are most likely to get altitude sickness. Commanders could then plan accordingly—by distributing medication, giving troops who are sensitive to altitude time to acclimate at lower elevations, or even redrawing battle plans so those units most likely to be depleted by illness aren't sent out on crucial missions right away.
The Dallas-area college students will have their blood screened at sea level for the presence of six specific genes that seem to affect a person's susceptibility to mountain sickness. The students will then be whisked to an altitude of 9,600 feet and be put through physical-fitness challenges.
They will also be monitored for signs of mountain sickness. The goal is to see whether the sea-level blood test is, in fact, able to predict which students will be miserable and which will be chipper enough to hit the hiking trail.
Robert Roach, who directs the Altitude Research Center at the University of Colorado, performed a similar test last year, taking 28 research subjects to a simulated altitude of 16,000 feet by putting them in a special chamber that mimics the effect of a low-oxygen environment. A blood test, screening for those six genetic elements, was able to predict with 96% accuracy which of the 28 would fall ill.
(Matthew Staver for The Wall Street Journal
Dr. Robert Roach director of the Altitude Research Center, inside one chamber of the hypobaric chamber in the Altitude Research Center in Aurora, Colo.)
Now, Dr. Roach hopes to replicate those results on a broader scale; he designed the summer study that will take 140 college students to Breckenridge. If the blood test proves conclusive in this group as well, Dr. Roach plans to develop an Acute Mountain Sickness Prediction Kit that would be available for the military within three years.
That would be a welcome advance, said Rod Alne, an Air Force veteran who isn't connected to Mr. Roach's project. Mr. Alne's special-operations unit was dropped into high-altitude combat zones frequently, and he said he saw first-hand the impact of mountain sickness on even the fittest troops.
"These are all young, strong, Type-A personality guys and they think they're just going to gut it out. They believe they're bulletproof," Mr. Alne said. "But at 20,000 feet, it hurts just to think."
Military models indicate at least 25% of unacclimatized troops parachuting into a battlefield at 10,000 feet—and more than 80% of troops fighting at 13,200 feet—will get altitude sickness.
One military study of a prolonged operation in the high mountains of Afghanistan found 14% of troops evacuated for medical treatment didn't have combat injuries—they had altitude sickness.
Mountain Malaise
Projections for proportion of unacclimatized troops who will get sick at high altitudes.
10,000 feet – 25-35%
11,500 feet – 50-60%
13,200 feet – 80-90%
14,800 feet – 90-100%
Source: Stephen Muza, U.S. Army Research Institute of Environmental Medicine
Uncounted others, not sick enough to merit rescue by helicopter, were huddled in base camps while their units went out fighting, said Dr. Muza, the Army research physiologist. In most cases, acute mountain sickness dissipates within three days as the body adjusts to the elevation, though in severe cases, it can linger or lead to fatal complications.
While the military is funding the new research, a predictive blood test could also be marketed to the public, Dr. Roach said. That could benefit Colorado's ski industry, which says up to 40% of its visitors come down with mountain sickness. The Institute for Altitude Medicine in Telluride, Colo., estimates the illness damps spending at mountain resorts by $200 million a year, as afflicted tourists don't much feel like shopping, skiing or dining out.
Jennifer Rudolph, a ski-industry spokeswoman, said if tourists could learn from a simple blood test that they were susceptible, they would be more apt to take precautionary measures, such as spending a day at an interim altitude before hitting the slopes.
But Peter Hackett, executive director of the Telluride institute, isn't so sure a test would be useful for civilians.
"Would a New York family traveling to Colorado for vacation get a genetic test to see if they're susceptible to altitude sickness?" Mr. Hackett asked. "I doubt it."
Write to Stephanie Simon at stephanie.simon@wsj.com"