Study of heat exposure during Hajj (pilgrimage)

Abstract

Heat stress presents a main problem to Muslim Hajeej (pilgrims) during Hajj (pilgrimage) season, particularly in summer. Records of the Saudi Ministry of Health show close relation between heat casualties and climatic heat load through consequent Hajj seasons. The present study was conducted to evaluate the climatic heat load in Hajj locations during summer of 1995 as well as just before and during the Hajj season of 1997. Heat measurements including: T (a), T (w), T (g), WBGT, relative humidity and air velocity were conducted through July-September 1995, and on March/April 1997, in 10 Hajj locations at morning, noon, afternoon and night. The highest WBGTs were at Haram court, Ghazzah area and Muna housing area, followed by Arafat areas and Muzdalefah, and the lowest at Azizia area. However, all the WBGTs were considerably higher than the ACGIH-TLV for safe heat exposure, particularly during daytime; meanwhile, heat exposure considerably exceeded the ASHRAE comfort zone at all locations all times. The natural climatic condition is a major contributing factor to the overall heat load; moreover, potentiated by heat dissipated from Hajj activities, including Hajeej crowds, human activities, and the vehicles' masses exhaust. This situation is further synergized by some pilgrims' misbehavior (e.g. living in open sunny areas, using vehicles without roofs) and lack of awareness of the seriousness of heat exposure among them. An outline for a control strategy has been suggested based on planting open areas of Arafat and Muna, provision of air conditioned housing and tents in Muna, segregation of pedestrians from vehicles and their provision of shaded roads and rest areas, establishing more water spatters in Arafat and Muna, checking the performance of large vehicles before issuing their permits for operation during Hajj, providing vehicles parking isolated areas away from Hajeej tents, provision of ample amounts of quality drinking water in all Hajj locations, provision of ample optimal ambulance services, and dissemination of educational information to Hajeej for their taking advantage of Fiqh (religion rules) waivers in performing Hajj rituals to minimize their heat exposure, and for their personal protection.

Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents

“…This may appear to occur because of the fact that between the months of April and October, UV exposure and total solar radiation are highest in Riyadh and the kingdom in general is excessively warm 20 . Indeed, these months are notorious for displaying the highest temperatures in the kingdom, exceeding 50 °C at noon times, consequently increasing occurrences of heat strokes, heat exhaustions and even mortality 21 . Because of such heat and UV exposure during the April–October period, people are advised to stay indoors with outdoor activities kept to a minimum, which is in stark contrast with the winter season (October–March), when temperatures become more tolerable for outdoor activities and sun exposure.…”

Reducing risks to health and wellbeing at mass gatherings: the role of the Sendai Framework for Disaster Risk Reduction

“…1 It is the annual mass gathering of over two million Muslims from all over the world and presents challenges to the authorities in Saudi Arabia. 1,10 The inevitable overcrowding in a confined area of such large numbers increases the risk of injuries, 11 heat exposure, 12 and a range of infectious diseases. The risk of infection was evident in the outbreaks of meningococcal W135 strains in 2000 and 2001 with their associated high mortality and potential for international spread.…”

Emergency Response of Indian Hajj Medical Missionto Heat Illness Among Indian Pilgrims in Tent-Clinics atMina and Arafat During Hajj, 2016

“…The provision of better heating-ventilation-air conditioning (HVAC) in tents, shaded/sun-proofed roads/causeways and heat relief shelters, more water sprinklers in Arafat and Mina, rapid cooling technology in tent-clinics, and ample ambulance services is mandated. [4][5][6]12 Clientele education is required for both selfhelp and first response. Self-help heat preparedness efforts involving choosing to perform the Hajj at a younger age; environmental assessments of temperature, humidity, and dry winds; risk assessment for physical exertion; availability of water, shade, and medical aid; and self-preparedness with light-weight heat/sun protective clothing, increased fluid intake, and intermittent avoidance of heat/sun/exertion are required.…”

“…Pilgrims, caretakers, administrators, and healthcare personnel should be kept in sync with health protection against heat illness through Heat Alert Response Systems based on Wet Bulb Globe Temperature-based assessment so as to prevent social attenuation in lean periods. 12,36 Technological advancements such as healthcare robots and drones can facilitate rapid relief, the provision of medical supplies, and can minimize human resource deployment in future Hajj pilgrimages. 38 The IPPC warns about the increasing frequency and/or intensity of heat waves leading to heat-related premature mortality of the urban poor and primarily the elderly in cities What Is Already Known?…”