Ambient heat exposure and heat-related illness burden in Saudi Arabia: A retrospective cross-sectional analysis of national surveillance data (2016–2023)
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Saudi Arabia’s extreme arid climate, with summer temperatures routinely exceeding 45°C, constitutes a significant environmental health hazard. Despite projected intensification of heat stress under climate change, comprehensive national analyses of heat-related illness (HRI) incidence patterns and environmental determinants remain limited. Objectives: The objective of this study is to characterize the national burden of HRI in Saudi Arabia, describe temporal and geographic distribution patterns, identify high-risk demographic and occupational groups, and examine the associations with ambient temperature indicators. Materials and Methods: This cross-sectional, descriptive study analyzed secondary data from Saudi Ministry of Health Annual Statistical Yearbooks (2016–2023), General Authority for Statistics population records, and the Saudi Presidency of Meteorology and Environment climatological reports. HRI cases encompassed emergency department and inpatient diagnoses of heat exhaustion and heat stroke. Incidence rates were calculated per 100,000 population. Descriptive statistics characterized case distribution by year, region, season, and demographic subgroup. Spearman’s rank correlation was used to quantify the association between annual HRI incidence and ambient temperature indicators across the study period. Results: A total of 50,500 HRI (Heat-Related Illness) cases were recorded over the study period, yielding a mean annual incidence of 18.8 per 100,000 population. Annual incidence peaked in 2019 at 24.3 per 100,000, coinciding with a record 97 days exceeding 40°C nationally, before declining during 2020–2021 (coronavirus disease 2019-associated Hajj restrictions) and rebounding to 24.0 per 100,000 in 2023. The Western region (Makkah/Madinah) accounted for the highest case burden (38.2%), substantially attributable to Hajj pilgrimage seasons. Male individuals constituted 71.4% of cases and outdoor workers represented 58.3% of affected working-age adults. A total of 74.6% of annual cases were concentrated in June–August. Heat stroke constituted 18.7% of HRI cases, with a case-fatality rate of 6.2%. Conclusions: HRI represents a substantial and increasing environmental health burden in Saudi Arabia, disproportionately affecting outdoor workers, pilgrims, and male individuals during peak summer months. Occupational heat protection regulations, public heat-health warning systems, and climate-sensitive healthcare capacity planning are priority interventions to reduce this preventable burden.
Source: Environmental Disease
DOI: 10.4103/ed.ed_11_26
Author: Ahmed Abdulaziz Almohammadi
Institution: Ministry of Health
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W7218545623