There are a few pieces of literature I read in relation to mountain safety in high altitude.
1. Accessibility of mountaineering in high altitude mountain ranges are limited. Michale Apollo insists that for mountaineering, there are two accessibility factors.
- Destination accessibility (the transport system and the components of infrastructure)
- Real access – social, economic, weather and psychophysical environments
2. The value of life: Real risks and safety-related productivity
According to Goucher and Horrace, expeditions from 1987 to 2007, deaths can occur for a variety of reasons – avalanches, falls, high altitudes sickness (heart attack, stroke, cerebral edema and pulmonary edema), weather conditions related to death (hypothermia, blindness and frostbites).
“The 32 Everest expeditions in our data faced three-year average frequencies of 6.56 deaths in about 751 lives at risk for a death rate of 0.87%. The point is that deaths are fairly common, so our fatality rates, based on three-year moving averages, are potentially fairly precise”.
3. Lesson learned from avalanche survival patterns
Haegeli and co-authors point out that asphyxia was the most common cause of death during avalanche burial, especially in wetter and denser snow in CMAJ. They report survival curves from data for 301 complete avalanche burials in Canada from 1980 to 2005 and compare them with the standard survival curve derived from Swiss data for 946 complete burials during the same period. It shows that survival of more than 90% of people in the first 15 to 20 minutes of burial, followed by a steep decline in survival of 35% from 20 to 35 minutes of burial. They insist that prompt extrication with 10 minutes is crucial in avalanche survival.
4. Prediction of acute mountain sickness by monitoring arterial oxygen saturation during ascent
Karinen and co-authors found that the climbers who maintain their oxygen saturation at rest, especially with exercise, most likely do not develop AMS. They suggest that daily evaluation of Spo₂ (arterial oxygen saturation) and during ascent both at rest and during exercise can help to identify a population that does well at altitude. The authors recommend that the climbers take R-Spo2 (arterial oxygen saturation at rest) and Ex-Spo2 (arterial oxygen saturation after exercise) measurements to avoid AMS during the ascent.
5. Mountaineering and high mountain adventure tourism
According to Beedie and Hudson (2003), today, mountaineering in high altitude is no longer restricted to experienced mountaineers. The boundaries between mountaineering and tourism are increasingly blurred due to the diversification and commercialization of mountaineering.
6. Safer mountain climbing using the climbing heartbeat index
Sakai and Nose use CHI (the climbing heartbeat index) to prevent acute mountain sickness (AMS). They developed a method of planning a climb according to the climber’s heart rate and the climber’s fitness level. They believe CHI value takes a very important part in safe mountaineering.
7. Use of a hypobaric chamber for pre-acclimatization before climbing Mount Everest
Richalet and coauthors recommend the climbers take pre-acclimatization experience before they climb Mt Everest to save 1 to 3 weeks of time in mountain conditions. They found that the pre-acclimatization period showed a 12% increase in hemoglobin concentration and no change in ventilatory response to hypoxia. It shows an efficient ventilatory acclimatization.
Apollo, M. (2017). The true accessibility of mountaineering: The case of the High Himalaya. Journal of Outdoor Recreation and Tourism-Research Planning and Management, 17, 29-43. https://doi.org/10.1016/j.jort.2016.12.001
Goucher, J., & Horrace, W. C. (2012). The value of life: Real risks and safety-related productivity in the Himalaya. Labour Economics, 19(1), 27-32. https://doi.org/10.1016/j.labeco.2011.06.014
Karinen, H. M., Peltonen, J. E., Kahonen, M., & Tikkanen, H. O. (2010). Prediction of acute mountain sickness by monitoring arterial oxygen saturation during ascent. High Alt Med Biol, 11(4), 325-332. https://doi.org/10.1089/ham.2009.1060
Parati, G., Bilo, G., Faini, A., Bilo, B., Revera, M., Giuliano, A., . . . Mancia, G. (2014). Changes in 24 h ambulatory blood pressure and effects of angiotensin II receptor blockade during acute and prolonged high-altitude exposure: a randomized clinical trial. European Heart Journal, 35(44), 3113-+. https://doi.org/10.1093/eurheartj/ehu275
Richalet, J. P., Bittel, J., Herry, J. P., Savourey, G., Le Trong, J. L., Auvert, J. F., & Janin, C. (1992). Use of a hypobaric chamber for pre-acclimatization before climbing Mount Everest. Int J Sports Med, 13 Suppl 1, S216-220. https://doi.org/10.1055/s-2007-1024644
Sakai, A., & Nose, H. (2003). Safer mountain climbing using the climbing heartbeat index. Int J Biometeorol, 48(1), 15-19. https://doi.org/10.1007/s00484-003-0167-1