Elsevier

Public Health

Volume 122, Issue 11, November 2008, Pages 1229-1238
Public Health

Review paper
The Olympic and Paralympic Games 2012: Literature review of the logistical planning and operational challenges for public health

https://doi.org/10.1016/j.puhe.2008.04.016Get rights and content

Summary

Objective

To undertake a review of the literature relating to public health planning and interventions at previous summer Olympic and Paralympic Games and other relevant major summer sporting events or mass gatherings, with a focus on official publications and peer-reviewed articles.

Study design

Literature review.

Methods

A literature review was undertaken using all biomedical databases and a freetext search using Google to widen the search beyond peer-reviewed publications. Search terms used were: Olympics; Paralympics; mass gatherings; mass gathering medicine; sporting events; weather; planning; and organisation. Citations within articles were searched to identify additional references that would inform this review. This literature review concentrates on the public health aspects of population care at mass gatherings, particularly the Olympic and Paralympic Games which are set over several weeks, focusing on surveillance, prevention and health service quality.

Results

The literature identified 10 areas of public health planning: public health command centre and communication; surveillance, assessment and control; environmental health and safety; infectious disease outbreaks; implications of weather conditions; health promotion; travel information; economic assessments; public transport and reduction of asthma events; and preparing athletes for potential allergies. The following themes emerged as crucial factors for the success of any public health interventions at Olympic and Paralympic Games: detailed planning of deliverables; pre-identification of critical success factors; management of risk; detailed contingency planning; and full testing of all plans prior to the event.

Conclusions

The 2012 Olympic Games will provide an exciting challenge for public health providers and systems. Preparation requires early detailed planning of policies, procedures and on-site health promotion events, in addition to helping to set up the surveillance and monitoring systems that will capture public health activity alongside medical activity. Learning from the literature review will support the identification of critical success factors and help to formulate recommendations that will allow optimal utilization of public health initiatives. All plans require full costings in advance which are supported by internal and external health-related agencies, voluntary organizations and sponsors. A risk assessment should be undertaken as part of the planning process leading to risk management plans for mitigating identified potential risks. All surveillance and monitoring systems, communication, policies and procedures will require full testing prior to commencement of the Games.

Introduction

The London 2012 Games will be held between 27 July and 12 August (Olympic Games) and 29 August and 9 September (Paralympic Games) 2012. Although the majority of events will be held in London, some events will take place in various stadia across the UK. All events of this size require the provision of temporary medical and public health services in places that are different from usual, serving populations significantly larger than that of the local population.

All mass gatherings vary in their complexity and pose unique challenges for maintaining the public's health, as well as providing medical and personal safety needs for the competitors, officials and spectators to the Games and related entertainments, as well as the indigenous population surrounding the venue sites. The duration, size and locations of the gatherings, the possibility of terrorism, and the effects of hot or cold weather need to be taken into account when planning and running the Games.

Thousands of mass gathering events are held each year, at national, regional and local levels. Spectator sports, ceremonies, rallies and fairs are just some of the events held across the UK. The definition of a ‘mass gathering’ in published literature has been accepted as over 1000 people1; however, most of the published literature reflects much larger events, generally >25,000 spectators.

This literature review covers the public health planning identified in previous temporary events focusing on generic surveillance issues, prevention and health service quality. It does not cover surveillance monitoring systems, data collected and collection points, health protection from terrorism, mass casualty care, physical layout of venues with regard to emergency access to stadia etc. as these will be dealt with by other stakeholders, nor does it cover the logistical provision of emergency medical services, as these are outlined elsewhere.2

Section snippets

Search strategy and overview

A literature search was carried out using Medline from 1959, Cinhal, Cochrane, Bandolier and King's Fund, and reports from the Sydney Olympics and International Olympic Committee (IOC). Keywords used were: Olympics; Paralympics; mass gatherings; mass gathering medicine; sporting events; weather; planning; and organisation. Freetext searches were undertaken to widen the search further to identify literature that may not have been published in medical or biomedical databases. References from

Planning and organization

Managing and operating mass gatherings requires a great deal of planning and forethought, starting many years in advance, particularly for events as large, prolonged and complex as the 2012 Games.

For the Sydney Games, it has been estimated that a minimum of 127,000 people converged on Sydney, including athletic teams, volunteers, media and 100,000 visitors.3, 4 An estimated 1.5 million people congregated around Sydney Harbour for the closing night celebrations.

There were an estimated 2 million

Public health and the 2012 games

Managing the risk and impact of public health issues presents significant challenges when planning for the Games. Experience at previous Games has shown that major anticipated medical problems that require medical services and activity include heat-related illnesses,5, 10 foodborne and waterborne illnesses,5, 11 sexually transmitted diseases (STDs)12 and communicable diseases.4 Most patient encounters are likely to be minor complaints such as headache, fatigue, minor abrasions, lacerations,

Recommendations

Whilst the literature was not able to fully document all public health planning for the Games, lessons from the past can be itemised.

Limitations of this review

Several areas have not been discussed in this review as no literature was found to inform the subjects. However, these are important and should be given careful consideration by the Games organizers. These relate specifically to establishing clear lines of accountability:

  • a.

    the hierarchy of relationships between the different stakeholders, e.g. local authorities, London Strategic Health Authority, Department of Health, Olympic Development Authority and London Organizing Committee for 2012 Olympic

Conclusion

The 2012 Games will provide an exciting challenge for public health providers and systems. The emerging themes from this review suggest that the critical success factors to the public health interventions at the Games are:

Detailed planning of deliverables and defined funding; adequate staffing in all areas; pre-identification of critical success factors for public health; management of risk by detailed contingency planning; testing planned interventions in the years preceding the Games;

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