Sun protection awareness and ultraviolet protection factor product use among pilgrims and nurses during Hajj: A qualitative post-Hajj interview study

Background Pilgrims performing Hajj are exposed to extreme heat and ultraviolet (UV) radiation, which pose distinct risks: heat contributes to dehydration and heat-related illness, whereas UV radiation causes sunburn and eye damage and increases long-term skin cancer risk. While heat illness and infectious diseases have been widely studied, awareness and use of UV-protective measures, including sunscreen and ultraviolet protection factor (UPF)-rated clothing and umbrellas, remain underexplored in this context. Understanding both pilgrim and nursing perspectives is essential for developing effective interventions. Methods In this qualitative descriptive study, retrospective semi-structured interviews were conducted via Zoom between 20 June and 11 July 2025, within approximately one month after the 2025 Hajj season, with 16 Saudi pilgrims and 13 registered nurses who had worked in hospitals in Makkah and Madinah during Hajj. Interviews explored awareness, attitudes, and behaviors related to UV and sun protection. Data were analyzed thematically following Braun and Clarke’s six-phase approach. Lincoln and Guba’s criteria guided trustworthiness. Results Five major themes were identified: (1) physical and emotional impact of sun exposure, (2) limited awareness and knowledge gaps, (3) attitudes and cultural influences on UV/UPF use, (4) barriers and challenges to sun protection, and (5) recommendations and suggestions for improvement. Notably, many participants perceived sun exposure as a spiritual challenge rather than a health risk, UPF-rated products were poorly understood, and practical barriers such as cost, availability, and cultural clothing norms limited use of protection. Conclusions The findings highlight critical gaps in awareness and practice regarding sun protection during Hajj. Targeted education before and during Hajj, wider availability of affordable protective items, and culturally appropriate communication strategies are needed, with messages that distinguish heat-related illness from UV-related harm.