Abstract
Relevance. High-altitude work involves exposure to hypobaric hypoxia and risks of altitude illness, sleep and cognitive disturbances, and cardiovascular complications. Differences in national regulatory requirements hinder harmonisation of workers’ medical assessments. Objective. To compare selected Russian, Kazakhstani and Kyrgyz regulatory acts relevant to medical examinations for high-altitude work and assess their concordance with international guidance and scientific evidence. Materials and Methods. Three national regulatory acts and three international clinical documents from the Wilderness Medical Society, European Society of Cardiology and British Thoracic Society were analysed. A structured narrative review using Scopus and Web of Science included 23 scientific publications in the qualitative synthesis. Results. The Russian document addresses reduced pressure and reduced oxygen partial pressure in technologically maintained environments, but its applicability to natural high-altitude settings is not explicitly defined. The Kazakhstani document does not identify hypobaric hypoxia as a distinct harmful occupational factor. The Kyrgyz document covers selected occupations in high-altitude and remote areas. Within the provisions reviewed, no integrated system of altitude-specific risk stratification, validated occupational fitness criteria and explicit categories of restriction was identified. International clinical guidance addresses relevant risks but does not constitute an occupational fitness regulatory standard. Selected forms of haemorrhoids and hernias are included in the Kazakhstani and Kyrgyz documents; their regulatory context must be distinguished from contraindications specifically attributable to hypobaric exposure. Conclusion. National requirements would benefit from clearer definitions of occupational exposure to hypobaric hypoxia and individual, task-specific fitness assessment. International guidance may inform regulatory revision when adapted to occupational settings.