Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-18T02:41:10.271Z Has data issue: false hasContentIssue false
  • English
  • Français

Mass-gathering Health Research Foundational Theory: Part 2 - Event Modeling for Mass Gatherings

Published online by Cambridge University Press:  17 November 2014

Sheila A. Turris ,
Adam Lund ,
Alison Hutton ,
Ron Bowles ,
Elizabeth Ellerson ,
Malinda Steenkamp ,
Jamie Ranse  and
Paul Arbon
Sheila A. Turris
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada School of Nursing, University of Victoria, Victoria, British Columbia, Canada Justice Institute of British Columbia, New Westminster, British Columbia, Canada
Adam Lund*
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada Justice Institute of British Columbia, New Westminster, British Columbia, Canada
Alison Hutton
Affiliation:
Flinders University, World Health Organization Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University of South Australia, Adelaide, South Australia, Australia
Ron Bowles
Affiliation:
Justice Institute of British Columbia, New Westminster, British Columbia, Canada
Elizabeth Ellerson
Affiliation:
Flinders University, World Health Organization Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University of South Australia, Adelaide, South Australia, Australia
Malinda Steenkamp
Affiliation:
Flinders University, World Health Organization Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University of South Australia, Adelaide, South Australia, Australia
Jamie Ranse
Affiliation:
University of Canberra, Faculty of Health, Bruce, Australian Capital Territory, Australia
Paul Arbon
Affiliation:
Flinders University, World Health Organization Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University of South Australia, Adelaide, South Australia, Australia
*
Correspondence: Adam Lund, MD, FRCPC Emergency Department Royal Columbian Hospital 330 East Columbia Street New Westminster, British Columbia, V3L 3W7, Canada E-mail adam.lund@ubc.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Current knowledge about mass-gathering health (MGH) fails to adequately inform the understanding of mass gatherings (MGs) because of a relative lack of theory development and adequate conceptual analysis. This report describes the development of a series of event lenses that serve as a beginning “MG event model,” complimenting the “MG population model” reported elsewhere.

Methods

Existing descriptions of “MGs” were considered. Analyzing gaps in current knowledge, the authors sought to delineate the population of events being reported. Employing a consensus approach, the authors strove to capture the diversity, range, and scope of MG events, identifying common variables that might assist researchers in determining when events are similar and might be compared. Through face-to-face group meetings, structured breakout sessions, asynchronous collaboration, and virtual international meetings, a conceptual approach to classifying and describing events evolved in an iterative fashion.

Findings

Embedded within existing literature are a variety of approaches to event classification and description. Arising from these approaches, the authors discuss the interplay between event demographics, event dynamics, and event design. Specifically, the report details current understandings about event types, geography, scale, temporality, crowd dynamics, medical support, protective factors, and special hazards. A series of tables are presented to model the different analytic lenses that might be employed in understanding the context of MG events.

Interpretation

The development of an event model addresses a gap in the current body of knowledge vis a vis understanding and reporting the full scope of the health effects related to MGs. Consistent use of a consensus-based event model will support more rigorous data collection. This in turn will support meta-analysis, create a foundation for risk assessment, allow for the pooling of data for illness and injury prediction, and support methodology for evaluating health promotion, harm reduction, and clinical response interventions at MGs.

TurrisSA, LundA, HuttonA, BowlesR, EllersonE, SteenkampM, RanseJ, ArbonP. Mass-gathering Health Research Foundational Theory: Part 2 - Event Modeling for Mass Gatherings. Prehosp Disaster Med. 2014;29(6):1-9.

Keywords

mass gatheringsmass-gathering healthminimum data setpopulationtheoretical modeling
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 6 , December 2014 , pp. 655 - 663
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Arbon, P. Introduction to the compendium on mass gatherings. Prehosp Disaster Med. 2010;25(6):1-2.Google Scholar
2. Arbon, P. The development of conceptual models for mass-gathering health. Prehosp Disaster Med. 2004;19(3):208-212.Google Scholar
3. Arbon, P, Cusack, L, Verdonk, N. Mass gathering public health and emergency medicine literature review: levels of evidence. Austalasian J of Paramed. 2013;10(1):1-5.Google Scholar
4. Memish, ZA. Jeddah declaration on mass gatherings health. Lancet. 2011;11(5):342-343.Google Scholar
5. Ranse, J, Hutton, A. Minimum data set for mass gathering health research and evaluation: a discussion paper. Prehosp Disaster Med. 2012;27(6):1-8.CrossRefGoogle ScholarPubMed
6. Turris, SA, Lund, A. Minimum data set for mass-gatherings health research and evaluation: a response. Prehosp Disaster Med. 2013;28(2):191-193.Google Scholar
7. Lund, A, Turris, SA, Bowles, R, et al. Mass-gathering health research foundational theory: part 1 - population models for mass gatherings. Prehosp Disaster Med. In press.Google Scholar
8. Alquthami, AH, Pines, JM. A systematic review of noncommunicable health issues in mass gatherings. Prehosp Disaster Med. 2014;29(2):1-9.Google Scholar
9. Steffen, R, Bouchama, A, Johansson, A, et al. Non-communicable health risks during mass gatherings. Lancet. 2012;12(2):142-149.Google Scholar
10. Abubakar, I, Gautret, P, Brumnette, GW, et al. Global perspectives for prevention of infectious diseases associated with mass gatherings. Lancet. 2012;12(2):66-74.Google Scholar
11. Botelho-Nevers, E, Gautret, P. Outbreaks associated to large open air festivals, including music festivals, 1980-2012. Eurosurveill. 2013;18(11):1-10.Google Scholar
12. Centers for Disease Control and Prevention Web site. http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-8-advising-travelers-with-specific-needs/travel-to-mass-gatherings. Accessed November 13, 2013.Google Scholar
13. Chowell, G, Nishiura, H, Viboud, C. Modeling rapidly disseminating infectious disease during mass gatherings. BMC Med. 2012;10:159-169.Google Scholar
14. Khan, K, McNabb, SJN, Memish, ZA, et al. Infectious disease surveillance and modeling across geographic frontiers and scientific specialties. Lancet. 2012;12(3):222-230.Google Scholar
15. Memish, ZA. The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Euro Surveill. 2010;15(39):196.Google Scholar
16. Shafi, S, Booy, R, Haworth, E, Rashid, H, Memish, ZA. Hajj: health lessons for mass gatherings. J Infection Public Health. 2008;1(1):27-32.Google Scholar
17. Tam, JS, Barbeschi, M, Shapovalova, N, Briand, S, Memish, ZA, Kieny, MP. Research agenda for mass gathering: a call to action. Lancet. 2012;12(2):231-239.Google Scholar
18. Johansson, A, Batty, M, Hayashi, K, Al Bar, O, Marcozzi, D, Memish, ZA. Crowd and environmental management during mass gatherings. Lancet. 2012;12(2):150-156.CrossRefGoogle ScholarPubMed
19. Memish, ZA. Emergency of medicine for mass gatherings: lessons from the Hajj. Lancet. 2012;12(1):56-65.Google Scholar
20. Soomaroo, L, Murray, V. Disasters at mass gatherings: lessons from history. PLOS Currents. 2012;4:1-12.CrossRefGoogle ScholarPubMed
21. Turris, SA, Lund, A, Bowles, R. Mass casualty incidents at mass gatherings – a review of the literature. Disaster Med Pub Health Preparedness. 2014;7(1):1-7.Google Scholar
22. Begum, AA. Unnatural deaths during Zakat distribution. Bangladesh Med Res Conc Bull. 1993;19(3):99-102.Google Scholar
23. Hsieh, YH, Ngai, KM, Burkle, FM, Hsu, EB. Epidemiological characteristics of human stampedes. Dis Med Public Health Prep. 2009;3(4):217-223.Google Scholar
24. Jangi, S. Under the medical tent at the Boston Marathon. NEJM. 2013;368(21):1953-1955.Google Scholar
25. Lund, A, Turris, SA, Bowles, R. Conceptualizing the impact of special events on community health service levels: an operational analysis. Prehosp Disaster Med. 2014;29(5):525-532.Google Scholar
26. Mahoney, EJ, Harrington, DT, Biffl, WL, Metzger, J, Oka, T, Cioffi, WG. Lessons learned from a nightclub fire: institutional disaster preparedness. J Trauma. 2005;58(3):487-491.Google Scholar
27. Hnatow, DA, Gordon, DJ. Medical planning for mass gatherings: a retrospective review of the San Antonio Papal Mass. Prehosp Disaster Med. 1991;6(4):443-450.Google Scholar
28. Kenar, L, Pharm, TK. Medical preparedness against chemical and biological incidents for the NATO Summit in Istanbul and lessons learned. Prehosp Disaster Med. 2006;21(4):268-271.Google Scholar
29. Leonard, RB, Winslow, JE, Bozeman, WP. Planning medical care for high-risk mass gatherings. Internet J of Rescue & Disaster Med. 2007;6(1):1-15.Google Scholar
30. Milsten, AM, Maguire, BJ, Bissell, RA, Seaman, KG. Mass-gathering medical care: review of the literature. Prehosp Disaster Med. 2002;17(3):151-162.Google Scholar
31. Nguyen, RB, Milsten, AM, Cushman, JT. Injury patterns and levels of care at a marathon. Prehosp Disaster Med. 2008;23(6):19-25.Google Scholar
32. Rose, WD, Larid, SL, Prescott, JE. Emergency Medical Services for collegiate football games: a six and one-half year review. Prehosp Disaster Med. 1992;7(2):157-159.Google Scholar
33. Turris, SA, Lund, A, Gutman, SJ, Mui, J, Wang, P, Lewis, K. An organized medical response for the Vancouver International Marathon (2006-2011): when the rubber hits the road. Cur Sports Med Reports. 2014;13(3):147-154.Google Scholar
34. Yazawa, K, Kamijo, Y, Sakai, R, Ohashi, M, Owa, M. Medical care for a mass gathering: the Suwa Onbashira Festival. Prehosp Disaster Med. 2007;22(5):431-435.CrossRefGoogle ScholarPubMed
35. Zeitz, KM, Schneider, D, Jarrett, D. Mass gathering events: a retrospective analysis of patient presentations over seven years. Prehosp Disaster Med. 2002;17(3):147-150.Google Scholar
36. Feldman, MJ, Lukins, JL, Verbeek, RP, MacDonald, RD, Burgess, RJ, Schwartz, B. 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
37. Zielioski, A, Pawlak, BJ. Toolbox for implementation of surveillance at mass gatherings. WP 4: surveillance during mass gatherings. http://www.rki.de/EN/Content/Prevention/React/Work/wp4/WP_4_ToolBox.pdf?__blob=publicationFile. Accessed May 1, 2014.Google Scholar
38. Arbon, P. Planning medical coverage for mass gatherings in Australia: what we currently know. J Emerg Nurs. 2005;31(4):346-350.CrossRefGoogle ScholarPubMed
39. Hutton, A, Brown, S, Verdonk, N. Exploring the role of culture as a psychosocial motivator at mass gathering events. Prehosp Disaster Med. 2009;28(5):292-297.Google Scholar
40. Morimura, N, Katsumi, A, Koldo, Y. Analysis of patient load data from FIFA World Cup Korea/Japan. Prehosp Disaster Med. 2004;19(3):278-284.CrossRefGoogle ScholarPubMed
41. Pinkert, M, Bloch, Y, Schwartz, D, et al. Leadership as a component of crowd control in a hospital dealing with a mass-casualty incident: lessons learned from the October 2000 riots in Nazareth. Prehosp Disaster Med. 2007;22(6):522-526.Google Scholar
42. Salhanick, SD, Sheahan, W, Bazarian, JJ. Use and analysis of field triage criteria for mass gatherings. Prehosp Disaster Med. 2003;18(4):347-352.Google Scholar
43. Emergency Management Australia. Safe and healthy mass gatherings: a health, medical and safety planning manual for public events. http://www.nationalcapital.gov.au/downloads/events_and_venues/assessment_criteria/ESA_Mass_gatherings.pdf. Accessed May 1, 2014.Google Scholar
44. Gutman, SJ, Lund, A, Turris, SA. Mass medical support for the 2009 World Police and Fire Games: a descriptive analysis of a large scale participation event and its impact. Prehosp Disaster Med. 2011;26(1):33-39.Google Scholar
45. Hewitt, S, Jarrett, L, Winter, B. Emergency medicine at a large rock festival. J Accid Emerg Med. 1996;13(1):26-27.Google Scholar
46. Tewari, S, Khan, S, Hopkins, N, Srinivasan, N, Reicher, S. Participation in mass gatherings can benefit well-being: longitudinal and control data from a North Indian Hindu pilgrimage event. PLOS One. 2012;7(10):1-5.Google Scholar
47. Zeitz, KA, Zeitz, C, Arbon, P, Cheney, F, Johnston, R, Hennekam, J. Practical solutions for injury surveillance at mass gatherings. Prehosp Disaster Med. 2008;23(1):76-81.Google Scholar
48. Bledsoe, B, Songer, P, Buchanan, K, Westin, J, Hodnick, R, Gorosh, L. Burning man 2011: mass gathering medical care in an austere environment. Prehosp Disaster Med. 2012;16(4):469-476.Google Scholar
49. Ma, O, Pirrallo, R, Rubin, J. Survey of medical services at major league baseball stadiums. Prehosp Disaster Med. 1995;10(4):268-271.Google Scholar
50. Milsten, AM, Seaman, KG, Lui, 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.Google Scholar
51. Arbon, PA. Mass gathering medicine: a review of the evidence and future directions for research. Prehosp Disaster Med. 2007;22(2):131-135.Google Scholar
52. Turris, SA, Lund, A. Triage during mass gatherings. Prehosp Disaster Med. 2012;27(6):531-535.Google Scholar
53. Erickson, TB, Koenigsberg, M, Bunney, EB, et al. Prehospital severity scoring at major rock concert events. Prehosp Disaster Med. 1997;12(3):195-199.Google Scholar
54. Carmont, MR, Sedgwick, DM. The impact of an extreme sports event on a district general hospital. Scot Med J. 2005;50(3):106-108.Google Scholar
55. Lund, A, Turris, SA. Electronic dance music events (EDME) – risks, patient presentations and public health care costs. Submitted to: Canadian J of Emergency Med. (in review).Google Scholar
56. Giulianotti, R. Football and the politics of carnival: an ethnographic study of Scottish fans in Sweden. Int Rev Socio Sport. 2013;48(5):191-220.Google Scholar
57. Marsh, P, Fox, K, Carnibella, G, McCann, J, Marsh, J. Football violence and hooliganism in Europe. 1996. http://www.sirc.org/publik/fvexec.html. Accessed May 14, 2013.Google Scholar
58. Peiterson, B. Supporter culture in Denmark: the legacy of the ‘world's best supporters’. Soccer and Society. 2009;10(3-4):374-385.Google Scholar
59. Stott, C, Adang, O. Understanding and managing risk: policing football matches. Bavnekbanke Press. 1995;995:7-14.Google Scholar
60. Malloy, MS, Sherif, Z, Natin, S, McDonnell, J. “Management of mass gatherings.” In: Koenig KL, Shultz CH. Disaster Medicine: Comprehensive Principles and Practices. Cambridge, United Kingdom: Cambridge University Press, 2010.Google Scholar
61. Public Health Western Australia. http://www.public.health.wa.gov.au/cproot/2542/2/Medical%20Risk%20Classification.pdf. Accessed February 25, 2014.Google Scholar
62. World Health Organization. 2008. Communicable disease alert and response: key considerations. http://www.who.int/csr/Mass_gatherings2.pdf. Accessed February 26, 2014.Google Scholar
63. Sun, L, Li, X, Wenhu, Q. Simulating realistic crowd based on agent trajectories. Computer Animation Virtual Worlds. 2013;24(3-4):165-172.CrossRefGoogle Scholar
64. Berk, RA. A gaming approach to crowd behavior. American Sociol Rev. 1974;39:355-373.Google Scholar
65. Polus, A, Schofer, JL, Ushpiz, A. Pedestrian flow and level of service. J Transp Eng. 1983;109:46-56.Google Scholar
66. Ngai, KM, Burkle, FM, Hsu, A, Hsu, EB. Human stampedes: a systematic review of historical and peer-reviewed sources. Dis Med Pub Health Prep. 2009;3(4):191-195.Google Scholar
67. Ackermann, O, Lahm, A, Pfohl, M, et al. Patient care at the 2010 love parade in Duisburg, Germany. Deutsches Arzteblatt International. 2011;108(28-29):483.Google Scholar
68. Bemelman, M, Leenen, L. Mass casualty event during a musical parade: lessons learned. European J Trauma Emerg Surg. 2008;5:451-456.Google Scholar
69. Helbing, D, Johansson, A, Al-Abideen, HZ. The dynamics of crowd disasters: an empirical study. Phys Rev. 2007;75(4):1-7.Google Scholar
70. World Health Organization. Risk reduction and emergency preparedness. 2007. http://www.who.int/hac/techguidance/preparedness/emergency_preparedness_eng.pdf. Accessed April 11, 2014.Google Scholar
71. Ahmed, QA, Arabi, YM, Memish, ZA. Health risks at the Hajj. Lancet. 2006;367(9515):1008-1015.Google Scholar
72. Bruce, ASW, Tunstall, C, Boutler, MJ, Coneybeare, A. A treatment algorithm for mass heat casualties. JF Army Med Corps. 2008;154(1):19-20.CrossRefGoogle ScholarPubMed
73. 17 injured in lightning strike at Toronto food festival. http://www.cbc.ca/news/canada/toronto/story/2012/07/15/toronto-whitby-lightning-strike.html. Accessed February 25, 2013.Google Scholar
74. 93 die in Nepal stadium stampede: soccer fans rush to locked exits in sudden hailstorm. http://news.bbc.co.uk/2/hi/uk_news/768380.stm. Accessed April 2, 2013.Google Scholar
75. Deal, KE, Synovitz, CK, Goodloe, JM, King, B, Stewart, CE. Tulsa, Oklahoma Oktoberfest ten collapse report. Emerg Med Int. 2012:1-9.Google Scholar
76. Howell, W. Airshow calamity tests Reno's hospital preparedness. Hosp Health Network J. 2011;85(12):16-17.Google Scholar
77. Spanish church fireworks display explodes. CBC News. August 14, 2012. http://www.cbc.ca/news/world/story/2012/08/14/accidental-fireworks.html. Accessed May 14, 2013.Google Scholar
78. Fireworks explode in crowd in China. Telegraph. October 14, 2012. http://www.telegraph.co.uk/news/worldnews/asia/china/9607552/Fireworks-explode-in-crowd-in-China.html. Accessed February 27, 2013.Google Scholar
79. Several injured during Liberty Park fireworks show. July 25, 2010. http://www.abc4.com/news/local/story/Several-injured-during-Liberty-Park-fireworks-show/mxIoGVnciUew-hxWMBLG8g.cspx. Accessed February 27, 2013.Google Scholar
80. Fireworks explosion kills 21. http://ntdtv.org/en/news/china/2010-03-01/040965832541.html. Accessed February 27, 2013.Google Scholar
81. Suphan Buri fireworks display affects 500. The Nation; January 26, 2012. http://www.nationmultimedia.com/national/Suphan-buri-fireworks-disaster-affects-500-30174526.html. Accessed February 27, 2013.Google Scholar
82. Dance safe. http://www.dancesafe.org/. Accessed April 18, 2014.Google Scholar
83. Kerr, GW. Emergency medical planning at soccer matches. Int J Sports Med. 2003;4(1):1-5.Google Scholar
84. Engledow, S, Yancey, A. EMS to the extreme. Firechief. 2012;30-36.Google Scholar
85. Rubin, AL. Safety, security, and preparing for disaster at sporting events. Curr Sports Med Rep. 2004;3(3):141-145.Google Scholar
86. Arbon, P, Bridgewater, FHG, Smith, C. A predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):150-158.Google Scholar
87. 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.Google Scholar
88. Aly, M. Dynamics of riots. Resilence. 2013:32-34.Google Scholar