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Human tolerance to extreme heat: evidence from a desert climate population

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 631–636 (2023)Cite this article

Abstract

Background

Ambient temperatures exceeding 40 °C are projected to become common in many temperate climatic zones due to global warming. Therefore, understanding the health effects of continuous exposure to high ambient temperatures on populations living in hot climatic regions can help identify the limits of human tolerance.

Objective

We studied the relationship between ambient temperature and non-accidental mortality in the hot desert city of Mecca, Saudi Arabia, between 2006 and 2015.

Methods

We used a distributed lag nonlinear model to estimate the mortality-temperature association over 25 days of lag. We determined the minimum mortality temperature (MMT) and the deaths that are attributable to heat and cold.

Results

We analyzed 37,178 non-accidental deaths reported in the ten-year study period among Mecca residents. The median average daily temperature was 32 °C (19–42 °C) during the same study period. We observed a U-shaped relationship between daily temperature and mortality with an MMT of 31.8 °C. The total temperature-attributable mortality of Mecca residents was 6.9% (−3.2; 14.8) without reaching statistical significance. However, extreme heat, higher than 38 °C, was significantly associated with increased risk of mortality. The lag structure effect of the temperature showed an immediate impact, followed by a decline in mortality over many days of heat. No effect of cold on mortality was observed.

Impact statement

High ambient temperatures are projected to become future norms in temperate climates. Studying populations familiar with desert climates for generations with access to air-conditioning would inform on the mitigation measures to protect other populations from heat and on the limits of human tolerance to extreme temperatures. We studied the relationship between ambient temperature and all-cause mortality in the hot desert city of Mecca. We found that Mecca population is adapted to high temperatures, although there was a limit to tolerance to extreme heat. This implies that mitigation measures should be directed to accelerate individual adaptation to heat and societal reorganization.

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Fig. 1: Location of Mecca city.
Fig. 2: Distribution of the average daily temperature of the city of Mecca per month during the study period.
Fig. 3: Relationship between ambient temperature and non-accidental mortality among Mecca residents.
Fig. 4: Lag response associations between key temperatures and all-cause non-accidental mortality for Mecca residents.

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Data availability

Anonymized data will be available from the corresponding author (SY) on a reasonable request and on an appropriate data sharing agreement, subject to review and after approval of a study proposal by the Saudi Ministry of Health General Department of Research and Studies (GDRS-IRB@moh.gov.sa).

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Author information

Authors and Affiliations

  1. Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

    Saber Yezli

  2. Global Centre for Mass Gathering Medicine, Ministry of Health, Riyadh, 12341, Saudi Arabia

    Saber Yezli, Yara M. Yassin, Anas A. Khan & Badriah M. Alotaibi

  3. Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences 11481, Riyadh, Saudi Arabia

    Saber Yezli & Abderrezak Bouchama

  4. Department of Biostatistics and Bioinformatics, King Abdullah International Center for Medical Research / King Saud bin Abdulaziz University for Health Sciences 11481, Riyadh, Saudi Arabia

    Altaf H. Khan

  5. Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, 12372, Saudi Arabia

    Anas A. Khan

Authors
  1. Saber Yezli
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  2. Altaf H. Khan
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  3. Yara M. Yassin
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  4. Anas A. Khan
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  5. Badriah M. Alotaibi
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  6. Abderrezak Bouchama
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Contributions

SY, AB, BMA, and AHK conceptualized the study and its design. SY, AB, and AHK participated in the literature search. SY and BMA were involved in data acquisition. SY, YMY, and AHK participated in data collection. SY and AHK participated in the data analysis. SY, AHK, and YMY participated in the visualization. All authors participated in the interpretation of the study results. SY, AB, and AHK participated in the writing of the first draft of the manuscript. All authors participated in reviewing and editing the original manuscript and reviewed and approved the final manuscript. SY, AB, and AHK verified the underlying data. All authors had full access to all the data in the study and had the final responsibility for the decision to submit for publication.

Corresponding authors

Correspondence to Saber Yezli or Abderrezak Bouchama.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of King Fahad Medical City and the Institutional Review Board (IRB log #:17-141E) and was carried out according to the Ethics Committee guidelines. Consent was waived, as this is an observational study that retrospectively analyzed aggregate deidentified mortality data.

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Yezli, S., Khan, A.H., Yassin, Y.M. et al. Human tolerance to extreme heat: evidence from a desert climate population. J Expo Sci Environ Epidemiol 33, 631–636 (2023). https://doi.org/10.1038/s41370-023-00549-7

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