The correct option is C Have more RBCs and their haemoglobin has a lower binding affinity to oxygen
Although the composition of air remains more or less the same at sea level and high altitudes, the density of air gradually reduces as one goes higher up. As a result, arterial pO2 is also decreased. In order to survive, the body needs to take in a high amount of oxygen from the air, which is difficult, considering that the air has a low pO2. However, the affinity of haemoglobin for oxygen decreases, as oxygen delivery to the tissues would become difficult if haemoglobin had a high oxygen affinity. At the tissue level, an increase in 2,3 - bisphosphoglycerate would allow haemoglobin to unload oxygen. To compensate for the low partial pressure of oxygen, the body also produces a higher number of red blood cells in the body, so that there are more haemoglobin molecules to transport oxygen. Thus, people living at higher altitudes tend to have many more RBCs compared to people living at sea level. People who visit places at high altitudes, might experience altitude sickness initially, but gradually get acclimatized to it. In the case of people who have migrated six months ago from the planes to an area adjoining Rohtang Pass (which is a high mountain pass on the Himalayas, and situated at an altitude of around 3,900 m), the RBCs would have gone up to a much higher number in about 4 weeks of moving to the high altitude. Thus, within six months, these people would have a high number of RBCs, which as mentioned earlier, have haemoglobin with a lower affinity for oxygen.