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
degrees 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