Heat and Dust Impacts on the Health of Refugees in Zaatari Refugee Camp.

Climate-linked heatwaves and dust storms can exacerbate non-communicable disease (NCD) morbidity, yet quantitative evidence from displacement settings remains limited. We assessed short-term impacts of heat and dust events on symptom burden among Syrian refugees with non-communicable diseases (NCDs) in Jordan's Zaatari Camp. We conducted a prospective study of 660 adults receiving care at King Salman Humanitarian Aid and Relief Clinics (KS-Relief) clinics in Zaatari across three periods aligned to seasonal heatwaves. Self-reported symptoms following heatwaves and dust storms were collected via structured interviews. Repeated measures were analyzed using generalized linear mixed-effects models and generalized estimating equations with prespecified covariates. Heatwaves and dust storms were associated with increased symptom burden among participants with NCDs. Symptom burden was highest in Phase 1, the hottest period of 2024 in the Mafraq region (mean daily max 37.8°C; peak 43°C; multiple heatwave events and dust storm days), with more dyspnea, fatigue, and hypertension symptoms, especially among those with asthma or hypertension. Phase 2 (moderate heat with intermittent dust; mean daily max 34.1°C; peak 37°C) had lower odds of heatwave- and dust storm-related impacts than Phase 1 (odds ratio 0.54 and 0.62, respectively) with similar symptom profiles. Phase 3 (moderate heat; fewer dust storms; mean daily max 32.6°C) showed no significant change compared to Phase 2. Across phases, women, larger households, and asthma were associated with higher odds of adverse health impacts. In a displaced, low-resource setting, heatwaves and dust storms impose measurable, recurrent symptom burdens on adults living with NCDs, with heightened vulnerability among those with asthma and in larger households, and generally higher reported impacts among women. Camp-appropriate adaptation (improved cooling, shading, dust- mitigation) and targeted patient education and surveillance may reduce climate- sensitive NCD morbidity.