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Drug and Alcohol Related Patient Presentations to Emergency Departments during Sporting Mass-Gathering Events: An Integrative Review

Published online by Cambridge University Press:  25 March 2020

Catherine Delany Open the ORCID record for Catherine Delany [Opens in a new window] ,
Julia Crilly  and
Jamie Ranse
Catherine Delany*
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
Julia Crilly
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
Jamie Ranse
Affiliation:
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
*
Catherine Delany, RN, BNurs, GradCert EmergNurs, Emergency Department, LG- D Block, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4215, E-mail: [email protected]
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Abstract

Background:

Drug and alcohol consumption at sporting mass-gathering events (MGEs) has become part of the spectator culture in some countries. The direct and indirect effects of drug and alcohol intoxication at such MGEs has proven problematic to in-event health services as well as local emergency departments (EDs). With EDs already under significant strain from increasing patient presentations, resulting in access block, it is important to understand the impact of sporting and other MGEs on local health services to better inform future planning and provision of health care delivery.

Aim:

The aim of this review was to explore the impact of sporting MGEs on local health services with a particular focus on drug and alcohol related presentations.

Method:

A well-established integrative literature review methodology was undertaken. Six electronic databases and the Prehospital and Disaster Medicine (PDM) journal were searched to identify primary articles related to the aim of the review. Articles were included if published in English, from January 2008 through July 2019, and focused on a sporting MGE, mass-gathering health, EDs, as well as drug and alcohol related presentations.

Results:

Seven papers met the criteria for inclusion with eight individual sporting MGEs reported. The patient presentation rate (PPR) to in-event health services ranged from 0.18/1,000 at a rugby game to 41.9/1,000 at a recreational bicycle ride. The transport to hospital rate (TTHR) ranged from 0.02/1,000 to 19/1,000 at the same events. Drug and alcohol related presentations from sporting MGEs contributed up to 10% of ED presentations. Alcohol was a contributing factor in up to 25% of cases of ambulance transfers.

Conclusions:

Drug and alcohol intoxication has varying levels of impact on PPR, TTHR, and ED presentation numbers depending on the type of sporting MGE. More research is needed to understand if drug and alcohol intoxication alone influences PPR, TTHR, and ED presentations or if it is multifactorial. Inconsistent data collection and reporting methods make it challenging to compare different sporting MGEs and propose generalizations. It is imperative that future studies adopt more consistent methods and report drug and alcohol data to better inform resource allocation and care provision.

Keywords

alcoholic intoxicationcrowdingemergency medicinemass behaviorsports
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 3 , June 2020 , pp. 298 - 304
Copyright
© World Association for Disaster and Emergency Medicine 2020

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References

Hodgetts, TJ, Cooke, M. The largest mass gathering. BMJ. 1999;318(7189):957–958.CrossRefGoogle ScholarPubMed
Yezli, S, Alotaibi, B. Mass gatherings and mass gatherings health. Saudi Med J. 2016;37(7):729–730.CrossRefGoogle ScholarPubMed
World Health Organization (WHO). Public Health for Mass Gatherings: Key Considerations. https://apps.who.int/iris/bitstream/handle/10665/162109/WHO_HSE_GCR_2015.5_eng.pdf;jsessionid=D542D2D90B2E3238A0C3108FF7BACD71?sequence=1. Published 2015. Accessed July 29, 2019.Google Scholar
Ruest, SM, Stephan, AM, Masiakos, PT, Biddinger, PD, Camargo, CA, Kharasch, S. Substance use patterns and in-hospital care of adolescents and young adults attending music concerts. Addict Sci Clin Pract. 2018;13(1):1.CrossRefGoogle Scholar
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
Arbon, P, Bottema, M, Zeitz, K, et al.Nonlinear modelling for predicting patient presentation rates for mass gatherings. Prehosp Disaster Med. 2018;33(4):362–367.10.1017/S1049023X18000493CrossRefGoogle ScholarPubMed
Thackway, S, Churches, T, Fizzell, J, Muscatello, D, Armstrong, P. Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia. BMC Public Health. 2009;9:324.CrossRefGoogle ScholarPubMed
Steffen, R, Bouchama, A, Johansson, A, et al.Non-communicable health risks during mass gatherings. Lancet Infect Dis. 2012;12(2):142–149.CrossRefGoogle ScholarPubMed
Eberhardt, KA, Vinnemeier, CD, Dehnerdt, J, Rolling, T, Steffen, R, Cramer, JP.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
Alquthami, AH, Pines, JM. A systematic review of noncommunicable health issues in mass gatherings. Prehosp Disaster Med. 2014;29(2):167–175.CrossRefGoogle ScholarPubMed
Grange, JT, Baumann, GW, Vaezazizi, R. On-site physicians reduce ambulance transports at mass gatherings. Prehosp Emerg Care. 2003;7(3):322–326.CrossRefGoogle ScholarPubMed
Hutton, A, Ranse, J, Munn, MB. Developing public health initiatives through understanding motivations of the audience at mass-gathering events. Prehosp Disaster Med. 2018;33(2):191–196.CrossRefGoogle ScholarPubMed
Zeitz, K, Bolton, S, Dippy, SSR, et al.Measuring emergency services workloads at mass gathering events. Australian Journal of Emergency Management. 2007;22(3):23–30.Google Scholar
Milsten, AM, Seaman, KG, Liu, P, Bissell, RA, Maguire, BJ. Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehosp Disaster Med. 2003;18(4):334–346.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
Liberati, A, Altman, DG, Tetzlaff, J, et al.The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W65–W94.CrossRefGoogle ScholarPubMed
Whittemore, R, Knafl, K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546–553.CrossRefGoogle ScholarPubMed
Ranse, J, Hutton, A, Turris, SA, Lund, A. Enhancing the minimum data set for mass-gathering research and evaluation: an integrative literature review. Prehosp Disaster Med. 2014;29(3):280–289.CrossRefGoogle Scholar
National Health and Medical Research Council. NHMRC Additional Levels of Evidence and Grades for Recommendations for Developers of Guidelines. https://www.mja.com.au/sites/default/files/NHMRC.levels.of.evidence.2008-09.pdf. Published 2008. Accessed August 1, 2019.Google Scholar
Ranse, J, Hutton, A. Minimum data set for mass-gathering health research and evaluation: a discussion paper. Prehosp Disaster Med. 2012;27(6):543–550.CrossRefGoogle ScholarPubMed
Boeke, PS, House, HR, Graber, MA. Injury incidence and predictors on a multiday recreational bicycle tour: the Register's annual great bike ride across Iowa, 2004 to 2008. Wilderness Environ Med. 2010;21(3):202–207.CrossRefGoogle ScholarPubMed
Hostettler-Blunier, S, Muller, N, Haltmeier, T, et al.Public medical preparedness at the “Swiss Wrestling and Alpine Games 2013” descriptive analysis of 1,533 patients treated at the largest 3-day sporting event in Switzerland. Emerg Med Int. 2017;2017:9162095.CrossRefGoogle Scholar
Lyons, N, Jackson, S, Bhangu, A. A summer of cricket: prospective evaluation of all contacts with medical services at Edgbaston cricket ground during summer 2009. Eur J Emerg Med. 2011;18(3):172–175.CrossRefGoogle ScholarPubMed
Ho, WH, Koenig, KL, Quek, LS. Formula One night race in Singapore: a 4-year analysis of a planned mass gathering. Prehosp Disaster Med. 2014;29(5):489–493.CrossRefGoogle ScholarPubMed
Miller, P, McDonald, L, McKenzie, S, O’Brien, K, Staiger, P. When the cats are away: the impact of sporting events on assault- and alcohol-related emergency department attendances. Drug Alcohol Rev. 2013;32(1):31–38.CrossRefGoogle ScholarPubMed
Todkill, D, Hughes, H, Elliot, A, 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
Schwartz, B, Nafziger, S, Milsten, A, Luk, J, Yancey, A. Mass gathering medical care: resource document for the National Association of EMS physicians position statement. Prehosp Emerg Care. 2015;19(4):559–568.Google ScholarPubMed
Zeitz, KM, Zeitz, CJ, Arbon, P. Forecasting medical work at mass-gathering events: predictive model versus retrospective review. Prehosp Disaster Med. 2005;20(3):164–168.CrossRefGoogle ScholarPubMed
Yancey, AH, Fuhri, PD, Pillay, Y, Greenwald, I. World Cup 2010 planning: an integration of public health and medical systems. Public Health. 2008;122(10):1020–1029.CrossRefGoogle ScholarPubMed
Lloyd, B, Matthews, S, Livingston, M, Jayasekara, H, Smith, K. Alcohol intoxication in the context of major public holidays, sporting and social events: a time–series analysis in Melbourne, Australia, 2000–2009. Addiction. 2013;108(4):701–709.CrossRefGoogle Scholar
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
DeMott, JM, Hebert, CL, Novak, M, Mahmood, S, Peksa, GD. Characteristics and resource utilization of patients presenting to the ED from mass gathering events. Am J Emerg Med. 2018;36(6):983–987.CrossRefGoogle ScholarPubMed
Bullock, M, Ranse, J, Hutton, A. Impact of patients presenting with alcohol and/or drug intoxication on in-event health care services at mass-gathering events: an integrative literature review. Prehosp Disaster Med. 2018;33(5):539–542.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
Varon, J, Fromm, RE, Chanin, K, Filbin, M, Vutpakdi, K. Critical illness at mass gatherings is uncommon. J Emerg Med. 2003;25(4):409–413.CrossRefGoogle ScholarPubMed
Hughes, HE, Colón-González, FJ, Fouillet, A, et al.The influence of a major sporting event upon emergency department attendances: a retrospective cross-national European study. PLoS One. 2018;13(6):e0198665.CrossRefGoogle Scholar
Martin-Gill, C, Brady, WJ, Barlotta, K, et al.Hospital-based healthcare provider (nurse and physician) integration into an emergency medical services–managed mass-gathering event. Am J Emerg Med. 2007;25(1):15–22.CrossRefGoogle ScholarPubMed
Redelmeier, DA, Vermeulen, MJ. Emergency department visits during an Olympic gold medal television broadcast. Open Med. 2011;5(2):e112–119.Google ScholarPubMed
Furyk, JS, Lawlor, JM, Franklin, R, et al.Emergency department presentations during the State of Origin rugby league series: a retrospective statewide analysis. Med J Aust. 2012;197(11-12):663–666.CrossRefGoogle ScholarPubMed
McGreevy, A, Millar, L, Murphy, B, Davison, GW, Brown, R, O’Donnell, ME. The effect of sporting events on emergency department attendance rates in a district general hospital in Northern Ireland. Int J Clin Pract. 2010;64(11):1563–1569.CrossRefGoogle Scholar
Indig, D, Thackway, S, Jorm, L, Salmon, A, Owen, T. Illicit drug-related harm during the Sydney 2000 Olympic Games: implications for public health surveillance and action. Addiction. 2003;98(1):97–102.CrossRefGoogle ScholarPubMed
Chhabra, N, Gimbar, RP, Walla, LM, Thompson, TM. Emergency department patient burden from an electronic dance music festival. J Emerg Med. 2018;54(4):435–439.CrossRefGoogle ScholarPubMed
Perez, SR, Keijzers, G, Steele, M, Byrnes, J, Scuffham, PA. Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: a randomized controlled trial. Emerg Med Australas. 2013;25(6):527–534.CrossRefGoogle ScholarPubMed
Institute of Alcohol Studies. Alcohol's Impact on Emergency Services. http://www.ias.org.uk/uploads/Alcohols_impact_on_emergency_services_full_report.pdf. Published 2015. Accessed July 29, 2019.Google Scholar