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Public Health Threats in Mass Gatherings: A Systematic Review

Published online by Cambridge University Press:  28 June 2019

Manoochehr Karami Open the ORCID record for Manoochehr Karami [Opens in a new window] ,
Amin Doosti-Irani Open the ORCID record for Amin Doosti-Irani [Opens in a new window] ,
Ali Ardalan ,
Fathemeh Gohari-Ensaf ,
Zainab Berangi ,
Eduardo Massad ,
Mohammad Rebi Yeganeh ,
Mohsen Asadi-Lari  and
Mohammad Mehdi Gouya
Manoochehr Karami*
Affiliation:
Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Amin Doosti-Irani*
Affiliation:
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
Ali Ardalan
Affiliation:
Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Fathemeh Gohari-Ensaf
Affiliation:
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Zainab Berangi
Affiliation:
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Eduardo Massad
Affiliation:
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
Mohammad Rebi Yeganeh
Affiliation:
Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
Mohsen Asadi-Lari
Affiliation:
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Mohammad Mehdi Gouya
Affiliation:
Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
*
Correspondence and reprint requests to Amin Doosti-Irani, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran (e-mail: [email protected]).
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Abstract

Mass gatherings (MGs) are held throughout the world. The aim of this review was to assess and identify the health threats based on the type of the MG, type of diseases, and injuries. Research platforms such as Web of Science, Medline, and Scopus were searched through June 2017. All epidemiologic studies that investigated the health threats during the MGs, such as communicable diseases, injuries, high-risk behaviors, and environmental health problems, were included in this review. Out of 1264 references, 45 articles were included in the review.

Three main types of MGs include religious, festival, and sporting event; and fairs such as trade, book, and agricultural types were also reported in the selected studies. In the religious MGs, infectious diseases were the most common health threat. Road traffic accidents and environmental health problems were additional health threats. At MG sporting events, injuries were the most common health problems. Infectious diseases and alcohol and drug-related disorders were other reported public health concerns. In the festival MGs, alcohol and drug-related problems were commonly reported. This review showed that health threats vary, based on the type of mass gathering. The health organizers of MGs should consider the type of the MG and the health needs and safety of the participants to help them plan their action and provide the needed health care services.

Keywords

illnessinfectious diseasesinjuriesmass gatherings
Type
Systematic Review
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 5-6 , December 2019 , pp. 1035 - 1046
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

Lund, A, Turris, S. The event chain of survival in the context of music festivals: a framework for improving outcomes at major planned events. Prehosp Disaster Med. 2017;32(4):437–443.CrossRefGoogle ScholarPubMed
Shafi, S, Booy, R, Haworth, E, et al. Hajj: health lessons for mass gatherings. J Infect Public Health. 2008;1(1):27–32.CrossRefGoogle ScholarPubMed
Eberhardt, KA, Vinnemeier, CD, Dehnerdt, J, et al. Travelers to the FIFA World Cup 2014 in Brazil: health risks related to mass gatherings/sports events and implications for the summer Olympic games in Rio de Janeiro in 2016. Travel Med Infect Dis. 2016;14(3):212–220.CrossRefGoogle Scholar
Gallego, V, Berberian, G, Lloveras, S, et al. The 2014 FIFA World Cup: communicable disease risks and advice for visitors to Brazil– a review from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis. 2014;12(3):208–218.CrossRefGoogle Scholar
Karami, M. Public health surveillance and Hajj pilgrimage as a mass gathering. Iran J Public Health. 2013;42(7):791–792.Google ScholarPubMed
Wilson, ME, Chen, LH. Health risks among travelers to Brazil: implications for the 2014 FIFA World Cup and 2016 Olympic games. Travel Med Infect Dis. 2014;12(3):205–207.CrossRefGoogle ScholarPubMed
Al-Tawfiq, JA, Gautret, P, Benkouiten, S, Memish, ZA. Mass gatherings and the spread of respiratory infections. Lessons from the Hajj. Ann Am Thorac Soc. 2016;13(6):759–765.CrossRefGoogle ScholarPubMed
Al-Tawfiq, JA, Memish, ZA. Mass gathering medicine: 2014 Hajj and Umra preparation as a leading example. Int J Infect Dis. 2014;27:26–31.CrossRefGoogle ScholarPubMed
Locoh-Donou, S, Guofen, Y, Welcher, M, et al. Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types. Am J Emerg Med. 2013;31(5):843–846.CrossRefGoogle ScholarPubMed
Venkatesh, S, Memish, ZA. Bioterrorism– a new challenge for public health. Int J Antimicrob Agents. 2003;21(2):200–206.CrossRefGoogle ScholarPubMed
Zeitz, K, Zeitz, C, Kadow-Griffin, C. Injury occurrences at a mass gathering event. Australas J Paramed. 2015;3(1):1–10.CrossRefGoogle Scholar
Steffen, R. Mass gatherings– health risks and preventive strategies. Therapeutische Umschau. 2013;70(6):350–352.CrossRefGoogle ScholarPubMed
Arbon, P. The development of conceptual models for mass-gathering health. Prehosp Disaster Med. 2004;19(03):208–212.CrossRefGoogle ScholarPubMed
Gautret, P, Steffen, R. Communicable diseases as health risks at mass gatherings other than Hajj: what is the evidence? Int J Infect Dis. 2016;47:46–52.CrossRefGoogle ScholarPubMed
Tam, JS, Barbeschi, M, Shapovalova, N, et al. Mass Gatherings Health 6 Research agenda for mass gatherings: a call to action. Lancet Infect Dis. 2012;12(3):231–239.CrossRefGoogle Scholar
Riccardo, F, Manso, MD, Caporali, MG, et al. Event-based surveillance during EXPO Milan 2015: rationale, tools, procedures, and initial results. Health Secur. 2016;14(3):161–172.CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–269.CrossRefGoogle ScholarPubMed
Abdullah, S, Sharkas, G, Sabri, N, et al. Mass gathering in Aqaba, Jordan, during Eid AI Adha, 2010. East Mediterr Health J. 2013;19(Suppl 2):S29–33.CrossRefGoogle Scholar
Alqahtani, AS, BinDhim, NF, Tashani, M, et al. Pilot use of a novel smartphone application to track traveller health behaviour and collect infectious disease data during a mass gathering: Hajj pilgrimage 2014. J Epidemiol Global Health. 2016;6(3):147–155.CrossRefGoogle ScholarPubMed
Al-Shaqsi, S, McBride, D, Gauld, R, et al. Are we ready? Preparedness of acute care providers for the Rugby World Cup 2011 in New Zealand. Emerg Med J. 2013;30(8):611–614.CrossRefGoogle ScholarPubMed
Arbon, P, Bridgewater, FH, Smith, C. Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):150–158.CrossRefGoogle ScholarPubMed
Athanasopoulos, S, Kapreli, E, Tsakoniti, A, et al. The 2004 Olympic games: physiotherapy services in the Olympic village polyclinic. Br J Sports Med. 2007;41(9):603–609.CrossRefGoogle ScholarPubMed
Baranwal, A, Anand, A, Singh, R, et al. Managing the Earth’s biggest mass gathering event and WASH conditions: Maha Kumbh Mela (India). PLoS Curr. 2015;7:1–9.Google Scholar
Bledsoe, B, Songer, P, Buchanan, K, et al. Burning Man 2011: mass gathering medical care in an austere environment. Prehosp Emerg Care. 2012;16(4):469–476.CrossRefGoogle Scholar
Bortolin, M, Ulla, M, Bono, A, et al. Holy Shroud Exhibition 2010: health services during a 40-day mass-gathering event. Prehosp Disaster Med. 2013;28(3):239–244.CrossRefGoogle ScholarPubMed
Burton, JO, Corry, SJ, Lewis, G, Priestman, WS. Differences in medical care usage between two mass-gathering sporting events. Prehosp Disaster Med. 2012;27(5):458–462.CrossRefGoogle ScholarPubMed
Chen, Z, Zhang, YL, Wan, LD, et al. Analysis on characteristics of 802 emergency cases transported from venues of the Beijing 2008 Olympic games. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2010;22(1):32–35.Google ScholarPubMed
Crabtree, N, Mo, S, Ong, L, et al. Retrospective analysis of patient presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014. Prehosp Disaster Med. 2017;32(2):187–194.CrossRefGoogle ScholarPubMed
Dutch, MJ, Senini, LM, Taylor, DJ. Mass gathering medicine: The Melbourne 2006 Commonwealth Games experience. Emerg Med Australas. 2008;20(3):228–233.Google ScholarPubMed
Elliot, AJ, Hughes, HE, Hughes, TC, et al. Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic games. Emerg Med J. 2012;29(12):954–960.CrossRefGoogle ScholarPubMed
Feldman, MJ, Lukins, JL, Verbeek, RP, et al. Half-a-million strong: the emergency medical services response to a single-day, mass-gathering event. Prehosp Disaster Med. 2004;19(4):287–296.CrossRefGoogle ScholarPubMed
Friedman, MS, Plocki, A, Likourezos, A, et al. A prospective analysis of patients presenting for medical attention at a large electronic dance music festival. Prehosp Disaster Med. 2017;32(1):78–82.CrossRefGoogle Scholar
Gocotano, AE, Dico, FD, Calungsod, NR, et al. Exposure to cold weather during a mass gathering in the Philippines. Bull World Health Organ. 2015;93(11):810–814.CrossRefGoogle ScholarPubMed
Hadjichristoulou, C, Mouchtouri, V, Soteriades, ES, et al. Mass gathering preparedness: the experience of the Athens 2004 Olympic and Para-Olympic games. J Environ Health. 2005;67(9):52–57.Google Scholar
Hassan, S, Imtiaz, R, Ikram, N, et al. Public health surveillance at a mass gathering: urs of Baba Farid, Pakpattan district, Punjab, Pakistan, December 2010. East Mediterr Health J. 2013;19(Suppl 2):S24–28.Google Scholar
Hawkins, ER, Brice, JH. Fire jumpers: description of burns and traumatic injuries from a spontaneous mass gathering and celebratory riot. J Emerg Med. 2010;38(2):182–187.CrossRefGoogle ScholarPubMed
Hoy, D, Saketa, ST, Maraka, RR, et al. Enhanced syndromic surveillance for mass gatherings in the Pacific: a case study of the 11th Festival of Pacific Arts in Solomon Islands, 2012. Western Pac Surveill Response J. 2016;7(3):15–20.CrossRefGoogle ScholarPubMed
Hutton, A, Ranse, J, Verdonk, N, et al. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehosp Disaster Med. 2014;29(2):160–166.CrossRefGoogle ScholarPubMed
Hutton, A, Savage, C, Ranse, J, et al. The use of Haddon’s Matrix to plan for injury and illness prevention at outdoor music festivals. Prehosp Disaster Med. 2015;30(2):175–183.CrossRefGoogle ScholarPubMed
Joseph, JK, Babu, N, Dev, KA, Pradeepkumar, AP. Identification of potential health risks in mass gatherings: a study from Sabarimala pilgrimage, Kerala, India. Int J Disaster Risk Reduct. 2016;17:95–99.CrossRefGoogle Scholar
Kao, WF, Kuo, CC, Chang, H, et al. Characteristics of patients at a Taipei summer rock concert festival. Chinese Med J (Taipei). 2001;64(9):525–530.Google Scholar
Lim, HC, Cutter, J, Lim, WK, et al. The influenza A (H1N1-2009) experience at the inaugural Asian Youth Games Singapore 2009: mass gathering during a developing pandemic. Br J Sports Med. 2010;44(7):528–532.CrossRefGoogle ScholarPubMed
Loncarevic, G, Payne, L, Kon, P, et al. Public health preparedness for two mass gathering events in the context of pandemic influenza (H1N1) 2009– Serbia, July 2009. Euro Surveill. 2009;14(31):19296.CrossRefGoogle Scholar
Memish, ZA, Assiri, A, Almasri, M, et al. Prevalence of MERS-CoV nasal carriage and compliance with the Saudi health recommendations among pilgrims attending the 2013 Hajj. J Infect Dis. 2014;210(7):1067–1072.CrossRefGoogle ScholarPubMed
Mirza, TA, Fillimban, A, Maimini, O, et al. Predictors of asthma severity during the pilgrimage to Mecca (Hajj). Polskie Archiwum Medycyny Wewnetrznej. 2011;121(10):327–332.Google Scholar
Morimura, N, Katsumi, A, Koido, Y, et al. Analysis of patient load data from the 2002 FIFA World Cup Korea/Japan. Prehosp Disaster Med. 2004;19(3):278–284.CrossRefGoogle ScholarPubMed
Munn, MB, Lund, A, Golby, R, Turris, SA. Observed benefits to on-site medical services during an annual 5-day electronic dance music event with harm reduction services. Prehosp Disaster Med. 2016;31(2):228–234.CrossRefGoogle ScholarPubMed
Pakravan, AH, West, RJ, Hodgkinson, DW. Suffolk show 2011: prehospital medical coverage in a mass-gathering event. Prehosp Disaster Med. 2013;28(5):529–532.CrossRefGoogle Scholar
Perez-Gomez, HR, Ramos-Zuniga, R, Gutierrez-Padilla, JA, et al. Mass-gathering medical strategies: the experience in the international book fair in Guadalajara. Gac Med Mex. 2015;151(4):519–524.Google ScholarPubMed
Piat, SC, Minniti, D, Traversi, D, et al. Torino 2006 winter Olympic games: highlight on health services organization. J Emerg Med. 2010;39(4):454–461.CrossRefGoogle ScholarPubMed
Selig, B, Hastings, M, Cannon, C, et al. Effect of weather on medical patient volume at Kansas speedway mass gatherings. J Emerg Nurs. 2013;39(4):e39–44.CrossRefGoogle ScholarPubMed
Sindy, AI, Baljoon, MJ, Zubairi, NA, et al. Pattern of patients and diseases during mass transit: the day of Arafat experience. Pak J Med Sci. 2015;31(5):1099–1103.CrossRefGoogle ScholarPubMed
Todkill, D, Hughes, HE, Elliot, AJ, et al. An observational study using English syndromic surveillance data collected during the 2012 London Olympics– What did syndromic surveillance show and what can we learn for future mass-gathering events? Prehosp Disaster Med. 2016;31(6):628–634.CrossRefGoogle ScholarPubMed
Milsten, AM, Seaman, KG, Liu, P, et al. Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehosp Disaster Med. 2003;18(4):334–346.CrossRefGoogle ScholarPubMed
Youbi, M, Dghoughi, N, Akrim, M, et al. Preparedness and health risks associated with Moulay Abdellah Amghar moussem, Morocco, 2009–2010. East Mediterr Health J. 2013;19(Suppl 2):S19–23.CrossRefGoogle ScholarPubMed
Varon, J, Fromm, RE, Chanin, K, et al. Critical illness at mass gatherings is uncommon. J Emerg Med. 2003;25(4):409–413.CrossRefGoogle ScholarPubMed
Yazawa, K, Kamijo, Y, Sakai, R, et al. Medical care for a mass gathering: the Suwa Onbashira festival. Prehosp Disaster Med. 2007;22(5):431–435.CrossRefGoogle ScholarPubMed
Abd El Ghany, M, Alsomali, M, Almasri, M, et al. Enteric infections circulating during Hajj seasons, 2011–2013. Emerg Infect Dis. 2017;23(10):1640–1649.CrossRefGoogle ScholarPubMed
Anikeeva, O, Arbon, P, Zeitz, K, et al. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368–374.CrossRefGoogle ScholarPubMed
Khan, ID, Khan, SA, Asima, B, et al. Morbidity and mortality amongst Indian Hajj pilgrims: a 3-year experience of Indian Hajj medical mission in mass-gathering medicine. J Infect Public Health. 2018;11(2):165–170.CrossRefGoogle ScholarPubMed
Sokhna, C, Mboup, BM, Sow, PG, et al. Communicable and non-communicable disease risks at the Grand Magal of Touba: the largest mass gathering in Senegal. Travel Med Infect Dis. 2017;19:56–60.CrossRefGoogle ScholarPubMed
White, P, Saketa, S, Johnson, E, et al. Mass gathering enhanced syndromic surveillance for the 8th Micronesian games in 2014, Pohnpei State, Federated States of Micronesia. Western Pac Surveill Response J. 2018;9(1):1–7.CrossRefGoogle ScholarPubMed
Yazawa, K, Kamijo, Y, Sakai, R, et al. Medical care for a mass gathering: the Suwa Onbashira festival. Prehosp Disaster Med. 2007;22(5):431–435.CrossRefGoogle ScholarPubMed
Hutton, A, Brown, S, Verdonk, N. Exploring culture: audience predispositions and consequent effects on audience behavior in a mass-gathering setting. Prehosp Disaster Med. 2013;28(3):292–297.CrossRefGoogle Scholar
Algarni, H, Memish, ZA, Assiri, AM. Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)– 2015. J Epidemiol Global Health. 2016;6(1):7–9.CrossRefGoogle ScholarPubMed
Ganjeh, M, Einollahi, B. Mass fatalities in Hajj in 2015. Trauma Mon. 2016;21(5):e43253.CrossRefGoogle ScholarPubMed
Noweir, MH, Bafail, AO, Jomoah, IM. Study of heat exposure during Hajj (pilgrimage). Environ Monit Assess. 2008;147(1-3):279–295.CrossRefGoogle Scholar
Leeka, J, Schwartz, BG, Kloner, RA. Sporting events affect spectators’ cardiovascular mortality: it is not just a game. Am J Med. 2010;123(11):972–977.CrossRefGoogle ScholarPubMed
Kelly, B, Windsor, S, Delaney, A, Maguire, B. Acute psychiatry day hospital referral rates during the World Cup. Irish Med J. 2003;96(4):121.Google ScholarPubMed
Glassman, T, Werch, CE, Jobli, E, Bian, H. Alcohol-related fan behavior on college football game day. J Am Coll Health. 2007;56(3):255–260.CrossRefGoogle ScholarPubMed
Merlo, LJ, Ahmedani, BK, Barondess, DA, et al. Alcohol consumption associated with collegiate American football pre-game festivities. Drug Alcohol Depend. 2011;116(1):242–245.CrossRefGoogle ScholarPubMed
van Gemert, C, Dietze, P, Gold, J, et al. The Australian national binge drinking campaign: campaign recognition among young people at a music festival who report risky drinking. BMC Public Health. 2011;11(1):482.CrossRefGoogle Scholar
Goldberg, SA, Maggin, J, Molloy, MS, et al. The Gillette stadium experience: a retrospective review of mass gathering events from 2010 to 2015. Disaster Med Public Health Prep. 2018;12(6):752–758.CrossRefGoogle Scholar
Guy, A, Prager, R, Turris, S, Lund, A. Improving data quality in mass-gatherings health research. Prehosp Disaster Med. 2017;32(3):329–332.CrossRefGoogle ScholarPubMed
Karami, M. Sporting mass gatherings: public health preparedness and responsibility of health. J Res Health Sci. 2018;18(3):e00422.Google Scholar