Knowledge, Attitude and Practices Regarding Extreme Environments and Cold Adaptation at Extreme Altitudes on the Himalayan Ranges

Introduction: Extreme-altitudes (5500 m/18045 ft and higher) pose environmental, psychophysiological, infrastructural, logistic, and ergonomic challenges that question explorer’s adaptability and mission-efficiency due to isolation, monotony, intimidating environment and terse health conditions. The assessment of an explorer’s comprehensive adaptability in extreme-altitudes is of paramount importance in ensuring mission-preparedness. Knowledge, attitude, and practices (KAP) of explorers staying on extreme-altitudes was assessed through personal interview technique. Methods: 125 healthy, acclimatized, mountain-trained explorers staying above 4570 m/15 000 ft in winter-season for at least 30 days on extreme-altitudes were assessed by a single cross-sectional study through personal interviews on KAP related to extreme-altitude and cold-adaptation. Results: Mean duration of stay on extreme-altitude was 55.7 days. All explorers knew about difficulties and health-problems at extreme-altitude. All explorers felt that mountain-training and acclimatization were beneficial. 92% felt that mission tenure of 90 days on the extreme-altitude was adequate. 92.8% felt they were adequately trained for the extreme-altitude; however, only 52% felt confident about health-training. 66.4% did preventive rewarming of extremities. 66.4% regularly smoked/chewed tobacco. 57.6% had sleep problems and 64% had altered appetite. 26.4% felt difficulties related to living conditions, infrastructure, and logistics. Conclusion: Explorers at extreme-altitude exhibited adequate knowledge and performed activities with progressive attitude and healthy practices. Explorers endured altered psychophysiology at extreme-altitude and regarded the utility of training and acclimatization programs. Knowledge-practice gap existed towards tobacco consumption. There was a felt need for the improvement of living conditions, infrastructure, logistics, and health-related training.