Xu-Gang Tang,1,* Jing Wen,2,* Yong-Jian Yang1 

1Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, People’s Republic of China; 2Department of Pediatrics, People’s Hospital of Hechuan District, Chongqing, 401520, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yong-Jian Yang, Department of Cardiology, The General Hospital of Western Theater Command, 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan, 610083, People’s Republic of China, Email yyjcdzyy@sina.com

Background: The unique environment of high altitude can affect the work capacity of those not accustomed to it, and in some cases, it can even endanger their lives. Studying the effect of high-altitude exposure on work capacity is important. Still, there are few reviews on this topic. We aimed to summarize the parameters used to evaluate work capability in a high-altitude environment, the potential pathophysiological mechanisms, and the available pharmacological and non-pharmacological strategies for improvement.
Methods: We conducted searches on PubMed, Google Scholar, and China National Knowledge Infrastructure to explore the existing literature including basic and clinical studies from 1968 to 2023, using keywords such as “work capability/performance and high-altitude hypoxia” or “work/exercise at high altitude”. Conference proceedings, notes, and case reports were excluded. The CiteSpace 6.1.R3 was used for de-duplication.
Results: A total of 727 papers were identified through search terms from the database. 486 papers were eliminated following the de-duplication process, lacking full text and deemed irrelevant to this article. Among the remaining 241 papers, 21 investigate the underlying mechanisms of reduced work capability due to altitude exposure, and 94 papers discuss measures to improve work capability when exposed to high altitudes.
Conclusion: In conclusion, this review summarizes the evaluation of indicators, pathomechanisms, and improvement measures for high-altitude exposure-related changes in work capability. More basic research on its mechanisms and large-sample, randomized controlled clinical studies to validate its effects are needed.

Keywords: high altitude, hypoxia, pathophysiological mechanisms, work capability