Human stampedes: an updated review of current literature[1]
Summary
Review of peer-reviewed and grey literature on human stampedes, their prevention, preparedness and response, searching PubMed, Google Scholar, Web of Science, WHOLIS and ReliefWeb against pre-defined eligibility criteria. Sixty-four publications were included, 34 of them published between 2013 and 2016. The most studied events were the 2010 Love Parade in Duisburg (n=6) and the 1989 Hillsborough Stadium disaster (n=4). The review found conflicting definitions of human stampedes across the literature; that the common belief stampedes result from an irrational and panicking crowd "has progressively been replaced by studies suggesting that successive systemic failures are main underlying causes"; that prevention measures are mainly related to crowd management and venue design but their effectiveness has not been studied; that drills are recommended in the preparedness phase; and that delay in decisions, poor triage, or loss of medical records are common problems in the response which may worsen outcome. There is a lack of systematic reporting, making news reports often the only available source.
So what
Two sentences in this review should govern how MGMI writes about crowd safety. First, the field has abandoned panic as the explanation in favour of successive systemic failure — which relocates the intervention upstream, into design and management, and away from crowd control at the moment of crisis. Second, and harder: the prevention measures that follow from that understanding have never been tested for effectiveness. Every strategy in every guidance document, including ours, rests on mechanism and engineering judgement rather than on evidence of reduced mortality. That is not a reason to abandon them — there is no ethical trial design available — but it is a reason to state their evidentiary status wherever they are published. The response failures named are the most directly clinical finding in this domain and none is a deficit of clinical skill: decision latency, triage discipline under an unrehearsed casualty profile, and documentation collapse.
Read the paper
- Publisher (DOI) ↗may be paywalled
- PubMed ↗abstract · free