Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia.
Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia.
J Travel Med. 2024 Jun 3;31(4). doi: 10.1093/jtm/taae042.
Global temperatures are on the rise, leading to more frequent and severe heatwaves with associated health risks. Heat-related illnesses (HRIs) are an increasing threat for travellers to hot climate destinations. This study was designed to elucidate the interplay between increasing ambient temperatures, incidence of HRIs and the effectiveness of mitigation strategies during the annual Hajj mass gathering over a 40-year period.
An observational study was conducted utilizing historical records spanning four decades of meteorological data, and the rates of heat stroke (HS) and heat exhaustion (HE) during the Hajj pilgrimage in Mecca, Saudi Arabia. With an annual population exceeding 2 million participants from over 180 countries, the study analysed temporal variations in weather conditions over two distinct Hajj hot cycles and correlated it with the occurrence of HS and HE. The effectiveness of deployed mitigation measures in alleviating health vulnerabilities between the two cycles was also assessed.
Throughout the study period, average dry and wet bulb temperatures in Mecca escalated by 0.4°C (Mann-Kendall P < 0.0001) and 0.2°C (Mann-Kendall P = 0.25) per decade, respectively. Both temperatures were strongly correlated with the incidence of HS and HE (P < 0.001). Despite the intensifying heat, the mitigation strategies including individual, structural and community measures were associated with a substantial 74.6% reduction in HS cases and a 47.6% decrease in case fatality rate.
The study underscores the escalating climate-related health risks in Mecca over the study period. The mitigation measures' efficacy in such a globally representative setting emphasizes the findings' generalizability and the importance of refining public health interventions in the face of rising temperatures.
全球气温上升，导致热浪频发且更为剧烈，由此带来相关健康风险。与热相关的疾病（HRI）对前往炎热气候目的地的旅行者构成越来越大的威胁。本研究旨在阐明在 40 年间，环境温度升高、HRI 发病率和缓解策略的有效性之间的相互作用，在每年的朝觐集会上。
本研究采用观察性研究方法，利用跨越 40 年的气象数据和沙特麦加朝觐期间中暑（HS）和热衰竭（HE）的发病率的历史记录。每年有超过 200 万来自 180 多个国家的参与者参加朝觐，研究分析了两个不同的朝觐热周期的天气条件的时间变化，并将其与 HS 和 HE 的发生情况相关联。还评估了两个周期之间部署的缓解措施在减轻健康脆弱性方面的有效性。
在整个研究期间，麦加的干球和湿球温度平均每年分别升高 0.4°C（Mann-Kendall P<0.0001）和 0.2°C（Mann-Kendall P=0.25）。这两种温度都与 HS 和 HE 的发病率密切相关（P<0.001）。尽管天气炎热加剧，但包括个人、结构和社区措施在内的缓解策略与 HS 病例减少 74.6%和病死率降低 47.6%密切相关。
本研究强调了在研究期间麦加与气候相关的健康风险不断升级。在这样一个具有全球代表性的环境中，缓解措施的有效性强调了研究结果的普遍性，以及在气温上升的情况下完善公共卫生干预措施的重要性。
