Perceptions of, and Practices for Coping with, Heat Exposure among Male Arab Pilgrims to the Hajj, 1436

Abstract

Background:The problems associated with exposure to excessive heat are a key health concern throughout the world, and are likely to become increasingly important as Earth’s climate warms. Heat exposure is particularly problematic when large groups of people gather, but there is relatively little literature on the subject. Islam requires all adherents who are able to undertake a pilgrimage to Mecca (Saudi Arabia), known as the Hajj. This can result in huge numbers of pilgrims travelling to Mecca in the summer months, during which the temperatures can be very high, and to undertake physically demanding activities.Objective:The aim of this study was to identify the perception level of heat-related health issues and the coping behaviors adopted by pilgrims in the face of excessive heat exposure.Methods:A cross-sectional study was conducted in Mecca, Saudi Arabia among male Arab pilgrims performing Hajj of the Islamic calendar year 1436 (Summer 2015). Sample was divided into two strata: domestic pilgrims and international Arabs. A total of 14 camps were selected randomly, seven from each stratum. A total of 412 participants completed the questionnaire.Results:Mean age was 43.48 (SD = 13.42) years. Majority of pilgrims had never performed Hajj before (68.2%). Almost 89.5% among pilgrims more than 40 years of age had more water intake compared to only 76.5% for people under 40 years. Only 7.3% of educated people used to go out at noon time, and almost two-fold of pilgrims with lower educational level did so (15.4%). Approximately 51.8% among those who were aware of Mecca’s weather used cotton clothes, compared to 36.0% among pilgrims unaware of Mecca’s weather.Conclusion:This study reveals the extent of pilgrims’ understanding of, and abilities to cope with, excessive heat and also suggests coping strategies and options for improved understanding of heat-related health issues world-wide.Al Mayahi ZK, Ali Kabbash I. Perceptions of, and practices for coping with, heat exposure among male Arab pilgrims to the Hajj, 1436. Prehosp Disaster Med. 2019;34(2):161–174

Knowledge, Attitude and Practice of Pilgrims Regarding Heat-Related Illnesses during the 2017 Hajj Mass Gathering

“…However, some important gaps in knowledge, as well as negative attitudes and wrong practices, were also noted. Similar observations were reported in studies investigating KAP regarding heat-illness and heat waves among Arab Hajj pilgrims and other communities internationally [14,15,16,17,18,21].…”

“…For instance, pilgrims originating from countries where exposure to the sun is more common, such as Egypt and Iraq, were the least likely to use sunscreen. Differences in pilgrims’ behavior related to preventing HRIs according to country of origin have been reported previously [9,21].…”

“…We found that most pilgrims (>80%) appear to know about Hajj weather conditions and the availability of free water during the event before traveling to KSA. A study among Arab pilgrims also reported that 80.6% were aware of Makkah’s climate before arrival, and that there was a strong link between the extent to which pilgrims were aware of Makkah’s weather and dressing according to hot weather conditions [21]. In the current study, most pilgrims knew that dark colored clothes were not appropriate in hot weather and declared that they dress based on weather conditions.…”

“…The knowledge of symptoms associated with HRIs is important for timely actions to reduce the impact of such conditions or avoiding them worsening. A study among Arab pilgrims found that most reported experiencing some manifestations of high temperature during Hajj [21]. Over 50% of pilgrims considered elevated body temperature, excessive sweating, dizziness, fatigue, and headaches to be the main symptoms of problematic heat exposure.…”

“…However, it is important that, whenever possible, Hajj missions plan activities so that to minimize the risk of heat illness and discourage pilgrims, especially vulnerable groups, from risky or unnecessary activities during hot times of the day. Venturing outside at noon during Hajj was reported to be common among pilgrims, with over half of those questioned stating that they do so sometimes or always [21].…”