Review paperThe Olympic and Paralympic Games 2012: Literature review of the logistical planning and operational challenges for public health
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;
References (47)
- et al.
An analysis of medical care at mass gatherings
Ann Emerg Med
(1986) - et al.
Gac Sanit
(1995) - et al.
Paediatric emergency preparedness for mass gatherings and special events
Disaster Manag Response
(2004) - et al.
Critical illness at mass gatherings is uncommon
J Emerg Med
(2003) - et al.
The remote location of an air medical service to the 1995 Special Olympic World Games
Air Med J
(1996) Planning medical coverage for mass gatherings in Australia: what we currently know
J Emerg Nurs
(2005)- et al.
A paramedic-staffed medical rehydration unit at a mass gathering
Prehosp Emerg Care
(2004) - et al.
A springtime olympics demands special consideration for allergic athletes
J Allergy Clin Immunol
(2000) Medical services: technical manual on medical services
(2005)- et al.
Illicit drug-related harm during the Sydney 2000 Olympic Games: implications for public health surveillance and action
Addiction
(2003)