Impact of heat exposure on health during a warm period in Cyprus

Abstract

People exposed to heat experience symptoms of varying severity, from mild manifestations to heat stroke. Due to global warming, interest in the impact of heat exposure on human health has been increasing. This study investigated the association between outdoor thermal conditions and heat-related symptoms experienced by pedestrians in a temperate-Mediterranean and hot semi-arid climate. In the study, pedestrians participated in questionnaire-based surveys at outdoor sites in Cyprus in summer and autumn 2019 while the weather conditions at the sites were recorded. In the surveys, pedestrians reported whether they had experienced heat-related symptoms. The physiologically equivalent temperature (PET) was used to estimate the effect of the thermal environment. Statistical analyses of the data included the use of multivariable logistic regression models. In total, 1880 individuals (999 males, 54.2%; mean age ± standard deviation 38.4 ± 18.4 years) responded to the surveys of heat-related symptoms. An increase of 1 °C in air temperature (adjusted odds ratio (aOR): 1.10, 95% confidence interval (CI): 1.04–1.16) or PET (aOR: 1.04, 95% CI: 1.01–1.07) was associated with an elevated probability of reporting heat-related symptoms. The magnitude of the association of PET with the reporting of heat-related symptoms was found to be higher for nonpermanent residents in Cyprus (aOR: 1.11, 95% CI: 1.02–1.21). Females were more likely than males to report heat-related symptoms (aOR: 2.36, 95% CI: 1.82–3.06). Visiting the monitoring site for work (aOR: 1.69, 95% CI: 1.26–2.26) or reporting a medical history of respiratory disease (aOR: 3.60, 95% CI: 2.39–5.42) were associated with an increased likelihood of reporting heat-related symptoms. The thermal conditions and participant characteristics were associated with increased reporting of heat-related symptoms during non-heat-wave but warm periods in Cyprus. These results could have implications for adaptation measures, healthcare delivery, and public health services.