Spectator medicine at an international mega sports event: Rugby World Cup 2019 in Japan

Abstract

Background The Rugby World Cup (RWC) is one of the biggest international mega sports events in the world. This study was conducted to identify and evaluate the volume, nature, and severity of spectator medical care in the stadiums of 12 venues across Japan during RWC 2019. Method This was a retrospective review of medical records from spectator medical rooms of 45 official matches of RWC 2019 between September 20 and November 2, 2019. All patients in the stadium who visited the spectator medical room and were transferred to a hospital were included. The wet bulb globe temperature (WBGT) value at the kick-off time of each match, the number of visits to the spectator medical room, and the number of transfers to a hospital were reviewed and analyzed. The patient presentation rate (PPR) was calculated per 10,000 attendees. Severity categories were defined as mild or severe. Mild cases were considered non-life threatening requiring minimal medical intervention, and severe cases required transport to a hospital. Result The total number of visits to the spectator medical room was 449 with a PPR of 2.63. Most cases (91.5%) were mild in severity. The PPR was significantly higher for the matches held with a WBGT over 25 °C than for the matches under 21 °C (PPR 4.27 vs 2.04, p = 0.04). Thirty-eight cases were transferred to a hospital by ambulance; the PPR was 0.22. The most common reasons for transfer to the hospital were heat illness and fracture/dislocation, at a rate of 15.8% each. The incidence rate of cardiopulmonary arrest per 10,000 attendees was 0.0059 during RWC 2019. Conclusion Preparation and provision of appropriate medical service for spectators is a key factor for mass-gathering events. During RWC 2019, the majority (91.5%) of patients who sought medical attention did so for minor complaints, which were easily assessed and managed. On the other hand, a higher WBGT situation contributes significantly to an increased PPR (< 21 versus > 25, 2.04 versus 4.27, p = 0.04). Careful medical preparation, management, and development of public education programs for higher WBGT situations will be required in the future for similar international mega sports events.

Quantitative Metrics in Mass-Gathering Studies: A Comprehensive Systematic Review

“…29 Even though not explicitly stated as OHCA in the literature, there are also studies providing the incidence rate of cardiopulmonary arrest per 10,000 attendees. 18,59 A high OHCA rate or incidence rate of cardiopulmonary arrest in mass-gathering events suggests a high demand for emergency medical interventions and services such as responding to heart attacks. On the other hand, a low rate suggests a lower demand for emergency health care services during the event, and organizers may require fewer emergency resources.…”

Epidemiology of emergency transport at sports stadiums and facilities in Japan

“…Conversely, Tajima et al [4] conducted a study focusing on spectators, finding that 15.8% of spectators who were rushed to the hospital during the tournament suffered from heat stroke and fractures and/or dislocations respectively. The highest incidence was among men in their 70s, followed by men in their 80s [2].…”

“…These large-scale sporting events are viewed as mass gatherings with a potential for injuries and illnesses [3]. Therefore, stadium emergency medical systems must be prepared to handle not only athletes, but also spectators and officials [4]. To establish an adequate emergency medical system, it is crucial to understand the patterns of injuries and illnesses that occur among athletes and spectators.…”

Social norms and risks at mass gatherings: A systematic review

“…Risky behaviours related to the normativity of alcohol and drug consumption have been identified at sporting mass gatherings. For example, at Rugby World Cup, some rugby fans engage in risky behaviours, such as drinking large quantities of alcohol (e.g., beers) [186] which may increase the likelihood of alcohol-related risks (e.g., alcohol poisoning and vomiting). The normativity of alcohol consumption was, also, associated with increased aggression and violence at Rugby Matches [152] and fights at the FIFA World Cup, which increases the likelihood of injuries [150,153].…”