1 Department of Health in Disasters and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences Department of Health Services Management, Kerman University of Medical Sciences, Kerman, Iran

2 Departments of Environmental Health Engineering

3 Departments of Physical Medicine and Rehabilitation

4 Departments of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5 Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences


CONTEXT: Mass gatherings (MGs) are established for different religious, social, political, cultural,
and sport motivations. Many risks threaten the participants` health in MGs for different reasons. One
duty of health‑care system is to identify the risks and manage them to reduce the participants` injuries
in MGs. This study aimed to identify and classify the risks threatening the health of participants in
MGs and review related articles systematically.
SUBJECTS AND METHODS: In this study, we investigated electronic databases including Science
Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic
review investigated those health articles which studied MGs published after 2000. Keywords that were
searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster
OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively
by STROBE article assessment checklist, and then the data extracted from the results of the articles
were analyzed and reported.
RESULTS: Initially, a total of 1874 articles were found, qualitative exclusion and inclusion
criteria were applied, and finally 29 full‑text articles were selected for the analysis. More than
forty health‑related risks were recognized. In order to better understand the risks and use of the
results more efficiently, the risks were classified and reported into the following five domains:
environmental risks, individual risks, psychological risks, public health risks, and management
CONCLUSION: Many risks threaten the health of participants in MGs. Recognizing and managing
the risks are considered the primary and basic essentials of health sector for the better management
of MGs.


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