{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:08:58Z","timestamp":1775628538582,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute and chronic mountain sickness, resulting from maladaptation to high-altitude hypoxia, poses a great health concern. This study aimed to identify risk factors for heavy symptom-based clinical burden among high-altitude electrical workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 444 electrical workers stationed in the highlands of Sichuan, China, completed a symptom questionnaire and were classified as heavy (\u22653 symptoms) or light (&amp;lt;3) clinical burden. Univariable and multivariable logistic regression identified factors associated with heavy clinical burden. Restricted cubic spline (RCS) was used to examine the nonlinear relationship between total duration of high-altitude exposure and clinical burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 444 electrical workers, 218 (49.10%) had a heavy clinical burden. The most frequent symptoms were headache (50.90%), sleep disturbance (46.40%), and fatigue (45.95%). Compared to those with light clinical burden, significant differences were detected in age, ethnicity, alcohol consumption, hypertension, and altitude of residence in the heavy group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), which were all associated with heavy clinical burden in univariable analyses, but only age (OR: 1.02; 95% CI: 1.01\u20131.04), alcohol consumption (OR: 2.36; 95% CI: 1.55\u20133.61), and hypertension (OR: 1.71; 95% CI: 1.09\u20132.70) remained statistic significance in multivariable analyses. RCS revealed a U-shaped relationship between total duration of high-altitude exposure and clinical burden, with increased risk at &amp;lt;6\u202fmonths and &amp;gt;39\u202fmonths.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Age, alcohol consumption, and hypertension are independent risk factors for heavy clinical burden in high-altitude electrical workers. Moreover, both short (&amp;lt;6\u202fmonths) and prolonged (&amp;gt;39\u202fmonths) duration of high-altitude exposure may confer risk for heavy clinical burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1787150","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:32:07Z","timestamp":1775626327000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of risk factors for heavy clinical burden in electrical workers of highlands: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Qingqing","family":"Su","sequence":"first","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghua","family":"He","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonglin","family":"Fu","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiying","family":"Xian","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Li","sequence":"additional","affiliation":[{"name":"Center for High Altitude Medicine, Sichuan Electric Power Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengming","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, 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