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Background . This study was designed to evaluate the incidence of acute mountain sickness (AMS) occurring on different climbing routes on Mount Damavand and the effect of beginning time of ascent in Iranian trekkers.  Methods . This study was a descriptive cohort investigation, performed in summer 2007. All trekkers who ascended Mount Damavand from northern, western, eastern, and southern paths and passed 4200 m altitude were included in the study. Two questionnaires were completed for each trekker (personal information and Lake Louise score questionnaire). Multiple logistic regression analysis was used to explore the independent predicting variables for AMS.  Results . Overall incidence rate of AMS was 53.6%. This rate was the highest in south route (61.5%) ( P  < 0.001). There was no difference in the incidence of AMS on other paths. AMS history, AMS history on Damavand, the beginning time of climbing, sleeping at 4200 m altitude, and home altitude had significant effect on AMS incidence, but by multiple logistic regression analysis south route and AMS history on Mount Damavand had positive effect on incidence of AMS ( P  = 0.019 and  P  < 0.001).  Conclusion . The path and the beginning time of ascent can affect incidence of AMS. The risk of occurrence of AMS was 1.9 times as large for trekkers who ascended from southern route.

The Effect of Path and Beginning Time of Ascending on Incidence of Acute Mountain Sickness around Mount Damavand in Iran (5671 m)