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this is an edited draft for final review before publication original article Ann Saudi Med 27(1) January-February 2007 www.saudiannals.net 1 Hajj is the fifth of the five pillars of Islam. Any healthy Muslim adult is obliged to perform Hajj once in his/her life if he/she is finan-cially and physically capable. The Hajj begins on the eighth day of Dhul-Hijjah, the twelfth month of the lunar Islamic year, and ends on the thirteenth day of the same month. Hajj has to be performed in three main locations in Makkah, namely, the sacred Kaaba (in the holy city of Makkah), and Mena and Arafat, which are approximately 5 and 18 kilometers from Makkah, re-spectively. Approximately, 2 to 3 million pilgrims per-form Hajj every year; one-third of them come from within Saudi Arabia and two-thirds come from other countries. Most pilgrims stay in fire-resistant air-con