Citation

Sharma A, McCloskey B, Hui DS, Rambia A, Zumla A, Traore T, Shafi S, El-Kafrawy SA, Azhar EI, Zumla A, Rodrigues-Morales AJ. Travel Med. Infect. Dis. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.tmaid.2022.102524

PMID

36516965

Abstract

On October 29, 2022, a celebration night for Halloween in Seoul, South Korea, tens of thousands of revellers dressed in costumes crowded into the Itaewon district for the first unrestricted Halloween festivities since over two years of COVID-19 lockdowns. The large cumulative numbers of partygoers assembling in narrow streets with constrained access and exit points created a lethal combination. Videos taken over that night show people were trapped, crushed and unable to move or breathe, exacerbating panic that rapidly spiralled out of control. That resulted in one of the worst stampede disasters in South Korea, which caused 156 deaths and crush injuries in 170 [1]. Twenty-six of the deceased were from 14 countries, including the U.S.A, France, Thailand and Japan. Whilst the specific underlying factors leading to this tragedy is being determined; initial reports point towards inadequacies in pre and during-event planning, risk assessment, anticipated hazards, police response, and absence of effective rapid emergency response mechanisms, crowd management strategies and non-structural risk reduction measures. Whilst overcrowding, crowd surges due to unexpected events and stampede-associated crush injuries and deaths are well recognised as one of the most major non-communicable public health hazards at mass gathering events (Table 1), the South Korean Halloween night tragedy highlights that the current knowledge and understanding of these disasters is inadequate.

With the ease of travel, the world is experiencing an ever-increasing number of people travelling across continents to attend recurring mass gatherings due to sporting, religious, political, festive, and cultural events [2,3]. A review of a range of mass gathering events occurring globally (Fig. 1) shows that apart from extremes of temperatures and other weather-related events, the most common cause of mortality in mass gatherings are crush injuries resulting from overcrowding, crowd surges, crowd collapses and stampedes. In addition, environmental threats at mass gathering events, such as the collapse of infrastructures, fire incidents, terrorist attacks, and riots with violence, can all contribute to crowd panic, crowd surges, stampedes, restricted movement and flow of people inducing crush injuries and death [4]. Even an initial minor altercation, accident or an unfounded rumour can trigger a local disturbance which can have a rippling effect with disastrous consequences. Besides high crowd densities and periodic surges, impulsive human behaviour and psychological responses complicate crowd control and management issues. Thus, determining underlying factors causing crowd disturbance is essential for ensuring the safety of attendees and local populations during mass gathering events. Current knowledge on underlying causes of rapid crowd surges, stampedes and crush injuries is mainly based on a small sample of large recurrent mass gatherings due to religious, sporting and festival events. However, risk factors identified from the study of past incidents, mostly at high profile annually recurring mass gathering events, have guided the development of basic frameworks and recommendations on hazard identification and execution of mitigation measures for human crowd surges, crowd chaos and stampede risk reduction and preventing crush injuries and deaths ...

Language: en

Keywords

Crowd management; Crush injuries; Mass gatherings; Stampedes; Travel medicine