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Abstract
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A large number of mass gatherings (religious events, sporting events, festivals, etc) are held at regular intervals globally, and millions of attendees and event participants face a range of public health threats. Among non-communicable disease threats, heat-related illnesses (including heat hyperpyrexia, heat stroke, and death) have become of increasing concern over the past decade.
Heatwaves have occurred in cities around the world and have increased in frequency, intensity, and extent. July, 2023, was the hottest month in Europe, and recent predictions of heat waves in Europe have raised heat-related illnesses as a priority concern for organisers of the Paris 2024 Olympic Games.7
Apart from high ambient temperatures, athletes have the additional risk of exertional stress and rising body temperatures. A 2023 review of weather and environmental hazards at mass gatherings8
showed that a 1°C increase in ambient temperature (from 20°C to 21°C) resulted in an 11% increase in the number of individuals requiring medical attention.
The recent annual Hajj pilgrimage in Saudi Arabia in June, 2024, attracted a total of 1·83 million pilgrims, 1·6 million of whom were from 182 other countries. The Hajj was held during peak Saudi Arabian summertime when temperatures reached a record of 51°C, and 1301 pilgrim deaths due to heat-related illnesses were reported by the Saudi authorities. This unprecedented number of deaths has focused the attention of global public health authorities since the deaths occurred despite Saudi Arabia's extensive range of carefully planned structural, operational, educational, and preventive measures, which have been developed over many years, to reduce the health risk of high ambient temperatures.
Saudi Arabia has also developed extensive surveillance systems to monitor health events at the Hajj but many deaths appear to have been compounded by large numbers of informal or unauthorised attendees who arrived on visitor rather than Hajj visas and were not authorised to perform the Hajj. These attendees walked long distances under direct sunlight without adequate shelter or comfort. Lessons from this tragedy need to be learnt and the information gained needs to be used for forthcoming recurring religious pilgrimages, which can attract between 10 million and 50 million pilgrims, such as the Kumbh Mela in India, the Arba'een in Iraq, and the Grand Magal in west Africa. Heat-related illness and deaths at mass gatherings could be prevented with strategic planning, preventive and remedial services, and greater education of attendees. Other variables such as the effects of climate change on environmental temperature over time will require more long-term strategic planning. ...
Language: en |