{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:39:36Z","timestamp":1775666376382,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"7","funder":[{"name":"The China Railway Corporation Science and Technology Research and Development Plan","award":["2014 Z005-B"],"award-info":[{"award-number":["2014 Z005-B"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2020,3,30]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2019 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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 &lt;4000\u2009m, 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 &lt;4000 m remained without cardiac abnormalities during the follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2019-106108","type":"journal-article","created":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T21:16:16Z","timestamp":1586380576000},"page":"447-453","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Alterations to cardiac morphology and function among high-altitude workers: a retrospective cohort study"],"prefix":"10.1136","volume":"77","author":[{"given":"Shurong","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0545-4194","authenticated-orcid":false,"given":"Lin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiwei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhangjian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiping","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guobin","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,8]]},"reference":[{"key":"2024110804401997000_77.7.447.1","doi-asserted-by":"crossref","first-page":"5093","DOI":"10.1113\/JP270651","article-title":"Impact of extreme exercise at high altitude on oxidative stress in humans","volume":"594","author":"Quindry","year":"2016","journal-title":"J Physiol"},{"key":"2024110804401997000_77.7.447.2","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.607169"},{"key":"2024110804401997000_77.7.447.3","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e3182a641e7"},{"key":"2024110804401997000_77.7.447.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00052606"},{"key":"2024110804401997000_77.7.447.5","first-page":"233","article-title":"Working over 5,000 M: medical check-up","volume":"28","author":"De Sio","year":"2016","journal-title":"Ann Ig"},{"key":"2024110804401997000_77.7.447.6","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1089\/ham.2016.0112","article-title":"Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease","volume":"18","author":"Riley","year":"2017","journal-title":"High Alt Med Biol"},{"key":"2024110804401997000_77.7.447.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.650796"},{"key":"2024110804401997000_77.7.447.8","doi-asserted-by":"publisher","DOI":"10.1089\/ham.2015.0067"},{"key":"2024110804401997000_77.7.447.9","first-page":"268","article-title":"Risk assessment for a high-altitude alpinist with coronary artery disease","volume":"7","author":"Vizzardi","year":"2015","journal-title":"Heart Lung Vessel"},{"key":"2024110804401997000_77.7.447.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.650994"},{"key":"2024110804401997000_77.7.447.11","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1001\/jama.2017.16192","article-title":"Does this patient have acute mountain sickness?: the rational clinical examination systematic review","volume":"318","author":"Meier","year":"2017","journal-title":"JAMA"},{"key":"2024110804401997000_77.7.447.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2010.02.012"},{"key":"2024110804401997000_77.7.447.13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/10803548.2015.1017945","article-title":"Work-health needs of high-altitude mountain guides (Sherpas) in Nepal - 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