Heatstroke During Arbaeen Walking and Its Prevention: A Review Study

Abstract

Context: In the past decade, the frequency of religious mass gathering ceremonies in Iraq has increased significantly. Annually, millions of participants from around the world travel to Karbala, either on foot or by other means, to partake in the religious ritual known as Arbaeen, which spans approximately 20 days. A significant challenge during this ceremony, particularly when held in the summer, is the risk of heatstroke. The body's cells require an optimal temperature to survive and perform normal functions, making a balanced temperature within a specific range crucial. If the ambient temperature exceeds or falls below this range, it can lead to severe complications for various organs of the body. Therefore, this study primarily investigates how heat and elevated air temperatures impact human activities and physiological functions. Results: This study employed a systematic review method, adhering to PRISMA guidelines, to explore heatstroke and preventive measures in mass gatherings, including the Arbaeen pilgrimage. Comprehensive searches were conducted across PubMed, Scopus, and ISI Web of Science databases. A total of 28 studies met the inclusion criteria and were selected for analysis. Notably, all included studies were observational in nature; no clinical trials were identified. Conclusions: The participation of pilgrims, particularly those traveling long distances on foot, underscores the necessity of providing safe water sources and adequate cooling devices. Given the scale of public gatherings in Iraq, it is imperative that preparations commence well in advance of the events.