Lack of Altitude Medicine Knowledge Among Mountaineers in the Italian Alps

Abstract

Berendsen, Remco R., Dirk C A.A. de Vries, Alea Steger, Nadine Herold, Feico J.J. Halbertsma, Adriaan F. Norbart, Hannes Gatterer, and Bengt Kayser. Lack of altitude medicine knowledge among mountaineers in the Italian Alps. High Alt Med Biol. 00:00-00, 2025. Introduction: In 2022, expert consensus defined a set of minimum altitude medicine knowledge statements for laypersons traveling to high altitudes (STAK: strengthening altitude knowledge). We used these statements to assess knowledge among mountaineers in the Italian Alps. Methods: Mountaineers in a hut (3,647 m) completed an online STAK-based questionnaire, also indicating their confidence after each answer. A score of ≥19/28 was used as a statistical threshold, exceeding chance alone. Logistic regression assessed the link between confidence and correctness; multivariate regression explored demographic, educational, and behavioral predictors of achieving an above-threshold score. Results: Of 576 participants, 412 (72%) were included in the final analysis and 115 (28%) scored ≥19. Among them, 59% of medical professionals, 36% of mountain guides, and 23% of general participants reached the threshold; the medical professionals scored significantly higher than the general participants (p < 0.001). Both being a mountain guide (odds ratios [OR]: 2.3, 95% confidence intervals [CI]: 1.0-5.0, p < 0.05) and being a medical professional (OR: 4.5, 95% CI: 2.1-10.0, p < 0.001) were associated with higher scores. Conclusion: Using STAK as a benchmark, we found a substantial lack of altitude medicine knowledge in mountaineers, even among guides and medical professionals. These findings suggest a potential for targeted educational interventions.

Keywords: altitude sickness; attitudes; educational measurement; health knowledge; mountaineering; practice; surveys and questionnaires.