Tsouros D., Efstathiou Panos A. (eds), mass gatherings and public health—The experience of the Athens 2004 Olympic Games WHO Regional Office for Europe, Copenhagen, 2007, 377 pp., ISBN 978 92 890 7288 5

✍ Scribed by Michael Rigby

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 32 KB
• Volume: 25
• Category: Article
• ISSN: 0749-6753
• DOI: 10.1002/hpm.1045

✦ Synopsis

When large numbers of people come together into a mass gathering of any kind, providers of all types of response and support services have reason to plan for potential problems, while the crowd members themselves have come together for an enjoyable and carefree experience. Normally a mass gathering is defined as being over either 1000 or 25 000 persons.

Not only can normal health events be expected on that multiple of their normal incidence, but the very nature of the event, with its related emotions and crowd effects, the strange surroundings and travel and tiredness, will exacerbate underlying issues. That is on top of other risks such as mass catering, self-catering without cool storage, exposure to the weather and possibly the effects of excess alcohol.

Thus organizers of any mass gathering have to be prepared for a wide range of events, from early onset of labour to sunstroke, from food poisoning to group violence, as well as imported infectious conditions, in parallel with colleagues dealing with sanitation, water supply, crowd control and free-flowing transport. Potentially it is a thankless job-underestimate the needs of an unusual occurrence within the event, or combination of unlikely incidents, and distress and suffering will occur and probably lives will be lost. Consequently, the public criticism will be harsh. But plan to perfection, and be lucky and have no incidents to deal with, and there may well be claims of over-reaction and serious waste of expenditure on facilities and staff who remain idle.

But move the scale of the mass gathering up by several orders of magnitude, to a rare but very public event such as the Olympic Games, and the issues multiply-as does the visibility. The attendees are numbered in their millions, they include high profile participants and visitors, the press are present in strength, and also the global focus means that disruptive elements are also attracted to exploit the situation-and indeed previous Games have been the subject of terrorist activities.

Planning for this scale of mass event thus takes on a different order of magnitude and significance. This book very well documents this, combining aspects of large-scale planning; all types of physical and environmental health risk elevation; and the need to anticipate malevolent disruptive occurrences such as bioterrorism. Health planning on this scale requires assembling the full services for a new small city, welding them into an effective team, coping with the unknown and disassembling them shortly afterwards-all with a clustering of VIPs and global media ever present.

No wonder that WHO takes an active interest in such events, and the lessons to be learned. This excellent book distils previous lessons and documents the Athens experience in depth. Health topics are systematically covered, but so are essential aspects such as command and communication systems, of a kind not normally common in the health domain. There is sound analysis of scientific aspects of communication, such as interpretation of intelligence (or 'signals') feeding from laboratories and treatment centres so as to alert to epidemics or adverse events, as well as monitoring capacity of operational services to cope. The Athens planning is