title: Mass-gathering medical care: retrospective analysis of patient presentations over five years at a multi-day mass gathering.
abstract: BACKGROUND
  There is a scarcity of analytical data regarding mass-gathering medical care. The purpose of this study was to identify and evaluate the range and nature of illness and injury for patrons of an annual, multi-day, mass gathering.
  
  
  METHODS
  Encounter data from all patients seen by emergency physicians at the New York State Fair Infirmary during the past five years were analyzed. From these data, a category list was consolidated to 36 reasons for the visit based on chief complaint, nursing notes, and physician notes. The most common reasons for being seen by a physician were analyzed to determine age and gender discrepancies.
  
  
  RESULTS
  The average number of attendees at the Fair per year from 2004-2008 was 950,973. Emergency physicians evaluated a total of 2,075 patients from 2004-2008. The average patient presentation rate over the past four years (2005-2008) was 4.8 +/-1.1/10,000 patrons. The average transport to hospital rate over the past four years was 2.7 +/-1.1/100,000 patrons. The average age of all patients seen was 34.4 +/-21.6 years, and 58.1% of the patients were female. The most common reasons to seek medical attention included: dehydration/heat-related illness (11.4%); abrasion/laceration (10.6%); and fall-related injury (10.2%). Two groups, dehydration/heat-related illness 74% (t (4) = 2.90, p <0.05), and fall-related injury (68%; t (4) = 5.17, p <0.05) were disproportionately female. There also was a direct relationship between age and female gender within the fall-related injury category (X(2) (1, n = 213) = 11.41, p <0.05).
  
  
  CONCLUSIONS
  Patron data from fairs and expositions is a valuable resource for studying mass-gathering medical care. A majority (58%) of patients seen at the infirmary were female. The most common reason for being seen was dehydration/heat-related illness, which heavily favored females, but favored no age groups. The abrasion/laceration category did not contribute to the gender discrepancy. Patients who fell tended to be females >40 years of age. Further analysis is required to determine the reason for the gender discrepancies. Planners of multi-day mass gatherings should develop public education programs and evaluate their impact on the at-risk populations identified by this analysis.
authors.affiliation: Department of Emergency Medicine, State University of New York Upstate Medical University, Syracuse, New York, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Grant
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Nacca
authors.forename: Louise A
authors.initials: LA
authors.lastname: Prince
authors.forename: Jay M
authors.initials: JM
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000846:Anniversaries and Special Events; D002648:Child; D002675:Child, Preschool; D003441:Crowding; D003681:Dehydration / Q000453:epidemiology; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D005392:First Aid / Q000706:statistics & numerical data*; D006285:Health Planning; D018882:Heat Stress Disorders / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology