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An Analysis of Mass Casualty Incidents in the Setting of Mass Gatherings and Special Events

Published online by Cambridge University Press:  16 April 2014

Sheila A. Turris*
Affiliation:
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada School of Nursing, University of Victoria, Victoria, British Columbia, Canada
Adam Lund
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Ronald R. Bowles
Affiliation:
Centre for Applied Research, Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, New Westminster, British Columbia, Canada
*
Correspondence and reprint requests to Sheila A. Turris, PhD, Central Health Center, Floor 6, 132 W Esplanade, North Vancouver, British Columbia V7M 1A2, Canada (e-mail: [email protected])

Abstract

Objectives

Mass gatherings (MGs) and special events typically involve large numbers of people in unfamiliar settings, potentially creating unpredictable situations. To assess the information available to guide emergency services and onsite medical teams in planning and preparing for potential mass casualty incidents (MCIs), we analyzed the literature for the past 30 years.

Methods

A search of the literature for MCIs at MGs from 1982 to 2012 was conducted and analyzed.

Results

Of the 290 MCIs included in this study, the most frequently reported mechanism of injury involved the movement of people under crowded conditions (162; 55.9%), followed by special hazards (eg, airplane crashes, pyrotechnic displays, car crashes, boat collisions: 57; 19.6%), structural failures (eg, building code violations, balcony collapses: 38; 13.1%), deliberate events (26; 9%), and toxic exposures (7; 2.4%). Incidents occurred in Asia (71; 24%), Europe (69; 24%), Africa (48; 17%), North America (48; 27%), South America (27; 9%), the Middle East (25; 9%), and Australasia (2; 1%). A minimum of 12 877 deaths and 27 184 injuries resulted.

Conclusions

Based on our findings, we recommend that a centralized database be created. With this database, researchers can further develop evidence to guide prevention efforts and mitigate the effects of MCIs during MGs. (Disaster Med Public Health Preparedness. 2014;0:1-7)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

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References

1. Lund, A, Gutman, SJ, Turris, SA. Mass gathering medicine: a practical means of enhancing disaster preparedness in Canada. CJEM. 2011;13(4):231-236.Google Scholar
2. Jangi, S. Under the medical tent at the Boston Marathon. N Engl J Med. 2013;368(21):1953-1955.Google Scholar
3. Soomaroo, L, Murray, V. Disasters at mass gatherings: lessons from history. PLOS Curr. 2012;4:1-12.Google Scholar
4. Hsieh, YH, Ngai, KM, Burkle, FM Jr, Hsu, EB. Epidemiological characteristics of human stampedes. Disaster Med Public Health Prep. 2009;3(4):217-223.Google Scholar
5. Polinder, S, Haagsma, JA, Lyons, RA, etal. Measuring the population burden of fatal and nonfatal injury. Epidemiol Rev. 2012;34:17-31.CrossRefGoogle ScholarPubMed
6. Stratton, SJ. Use of structured observational methods in disaster research: “recurrent medical response problems in five recent disasters in the Netherlands”. Prehosp Dis Med. 2010;25(2):137-138.CrossRefGoogle Scholar
7. Koshashvili, Y, Loebenberg, MI, Lin, G, etal. Medical consequences of suicide bombing mass casualty incidents: the impact of explosion setting on injury patterns. Injury. 2009;40:698-702.Google Scholar
8. Ngai, KM, Burkle, FM, Hsu, A, Hsu, EB. Human stampedes: a systematic review of historical and peer-reviewed sources. Disaster Med Pub Health Prep. 2009;3(4):191-195.Google Scholar
9. Ripley, A. The Unthinkable: Who Survives When Disaster Strikes—and Why. New York, New York: Crown Publishers; 2008, chap 6, pp 141-162.Google Scholar
10. Armstrong, G. Hooligans: Know the Score. Oxford, England: Berg Publishers; 2003.Google Scholar
11. Dunning, E. Toward a sociological understanding of football hooliganism as a world phenomenon. Eur J Criminal Policy Res. 2000;8:141-162.Google Scholar
12. Frosdick, S, March, P. Football Hooliganism. Gloucester, United Kingdom: Willan Publishing; 2005.Google Scholar
13. Giulianotti, R. Participant observation and research into football hooliganism: reflections on the problems of entrée and everyday risks. Sociol Sport J. 1995;12(11):1-20.CrossRefGoogle Scholar
14. Giulianotti, R. Football and the politics of carnival: an ethnographic study of Scottish fans in Sweden. Int Rev Sociol Sport. 2013;48(5):191-220.Google Scholar
15. Marsh, P, Fox, K, Carnibella, G, McCann, J, Marsh, J. Football Violence and Hooliganism in Europe. Oxford, England: Social Issues Research Center, The Amsterdam Group; 1996. http://www.sirc.org/publik/football_violence.html. Accessed May 14, 2013.Google Scholar
16. Peiterson, B. Supporter culture in Denmark: the legacy of the ‘world's best supporters’. Soccer Soc. 2009;10(3-4):374-385.Google Scholar
17. Stott, C, Adang, O. Understanding and Managing Risk: Policing Football Matches. Slagelse, Denmark: Bavnekbanke Press; 1995, pp 7-14.Google Scholar
18. Stott, C, Livingstone, A, Hoggit, J. Policing football crowds in England and Wales: a model of ‘good practice’. Policing Soc. 2008;18(3):258-281.CrossRefGoogle Scholar
19. Stott, C, Adang, O, Livingstone, A, Schreiber, M. Tackling football hooliganism: a quantitative study of public order, policing and crowd psychology. Psychol Public Pol Law. 2008;14(2):115-141.Google Scholar
20. Stott, C, Reicher, S. How conflict escalates: the inter-group dynamics of collective football crowd ‘violence’. Sociology. 2013;47(5):875-886.Google Scholar
21. Head, J. Turkey bans men from football match. BBC News. September 23, 2011:1-3. http://www.bbc.co.uk/worldservice/learningenglish/language/wordsinthenews/2011/09/110923_witn_football.shtml. Accessed May 14, 2013.Google Scholar
22. Lee, D. Are African football stadiums too dangerous? BBC News. November 4, 2010:1-3. http://www.bbc.co.uk/news/world-africa-11665801. Accessed May 14, 2013.Google Scholar
23. Begum, AA. Unnatural deaths during Zakat distribution. Bangladesh Med Res Conc Bull. 1993;19(3):99-102.Google Scholar
24. 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.CrossRefGoogle ScholarPubMed
25. Spanish church fireworks display explodes. CBCNews. August 14, 2012. http://www.cbc.ca/news/world/story/2012/08/14/accidental-fireworks.html. Accessed May 14, 2013.Google Scholar
26. 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
27. Several injured during Liberty Park fireworks show. abc4 Utah; July 25, 2010. http://www.abc4.com/news/local/story/Several-injured-during-Liberty-Park-fireworks-show/mxIoGVnciUew-hxWMBLG8g.cspx. Accessed on: Feb 27, 2013.Google Scholar
28. Fireworks explosion kills 21. Available at: http://ntdtv.org/en/news/china/2010-03-01/040965832541.html. Accessed February 27, 2013. .Google Scholar
29. 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
30. Court to pronounce verdict on Lamehorse Club fire case. ITAR-Tass; March 10, 2008. http://www.itar-tass.com/en/c32/649636.html. Accessed February 17, 2013.Google Scholar
31. 13 Held for Shenshen club fire that killed 43. China Daily; September 9, 2008. http://english.sina.com/china/2008/0921/187595.html. Accessed February 17, 2013. .Google Scholar
32. Nightclub fire kills 16 in Equador. CNN.com; April 10, 2008. http://articles.cnn.com/2008-04-19/world/ecuador.fire_1_nightclub-blaze-nightclub-fire-rock-band?_s=PM:WORLD. Accessed February 18, 2013.Google Scholar
33. Carley, S, Mackway-Jones, K, Donnan, S. Major incidents in Britain over the past 28 years: the case for the centralised reporting of major incidents. J Epidemiol Community Health. 1998;52:392-398.Google Scholar
34. Lennquist, S. Protocol for reports from major accidents and disasters in the International Journal of Disaster Medicine . Eur J Trauma Emerg Surg. 2008;5:486-492.Google Scholar
35. Marres, GMH, Eijk, J, Bemelman, M, Leenen, LPH. Evaluation of admissions to the major incident hospital based on a standardized protocol. Eur J Trauma Emerg Surg. 2011;37:19-29.Google Scholar
36. Coppola, DP. (ed.) International Disaster Medicine. Oxford, England: Butterworth-Heinemann Limited; 2004.Google Scholar
37. Barillo, DJ, Wolf, S. Planning for burn disasters: lessons learned from one hundred years of history. J Burn Care Res. 2006;27(8):622-634.CrossRefGoogle ScholarPubMed
38. Welling, L, Van Harten, SM, Patka, P, etal. Medical management after indoor fires: a review. Burns. 2005;31:673-678.Google Scholar