@article{ref1,
title="Heat-related illnesses in a mass gathering event and the necessity for newer diagnostic criteria: a field study",
journal="Environmental science and pollution research international",
year="2021",
author="Alrashood, Sara T. and Alkassas, Wesam and Zaman, Mohsin and Dibas, Mahmoud and Khan, Muhammad Ayub and Rajab, Ahmad Mamoun",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Heat-related illnesses (HRIs), mainly heat exhaustion (HE) and heat stroke (HS), are characterized by an elevation of core body temperature. In this study, we aimed to  explore the HRIs' types and patient characteristics among a sample taken from  various representative in-field points in the Hajj season. A cross-sectional study  was conducted in 2018 at 80 data collection points distributed in the field. Data  related to demographics, features and risk factors were collected and analyzed from  all encountered cases with suspected HRIs. Moreover, we developed a diagnostic tree  for HRIs by using the XGBoost model. Out of the 1200 persons encountered during the  study period, 231 fulfilled the criteria of HRIs spectrum and were included in this  study. Around 6% had HS and 20% had HE. All HS cases (100%) were from outside of  Saudi Arabia as compared with 72.5% diagnosed with HE (27.5% were from Saudi  Arabia). In addition, 16% were considered as heat-induced muscle spasms, and 7% had  limb heat edema. Additionally, most of HRIs cases were reported between 11 am and 1  pm. The HRIs diagnostic tree model gave a diagnostic accuracy of 93.6%. This study  highlights the magnitude of HRIs among pilgrims in Hajj and provides a diagnostic  tree that can aid in the risk stratification and diagnosis of these patients. We  advise the implementation of more educational campaigns to pilgrims regarding  preventable measures especially for the vulnerable groups (e.g. from outside Saudi  Arabia, those with comorbidities and light-skinned people).<p /> <p>Language: en</p>",
language="en",
issn="0944-1344",
doi="10.1007/s11356-020-12154-4",
url="http://dx.doi.org/10.1007/s11356-020-12154-4"
}