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Ngai india Stampede 2001-2010 Final Presentation

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Ngai india Stampede 2001-2010 Final Presentation

  1. 1. Human Stampedes: A ComparativeTwo Search Method Analysis toAssess Underestimation of AvailableDataK. Gordon Ngai, MD, MPH1,2, Wing Yan Lee, MBBS, MPH, Aditi Madan,MDM3, Saswata Sanyal, MDM3, Frederick M. Burkle, Jr, MD, MPH, DTM3,Nobhojt Roy3, Edbert B. Hsu, MD, MPH41The Icahn School of Medicine at Mount Sinai, New York City, USA2Bellevue Hospital/NYU Langone Medical Center, New York City, USA3Jamsetji Tata Centre for Disaster Managmenet, Tata Institute of Social Sciences, Mumbai, Indai3Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA4Office of Critical Event Preparedness and Response, Johns Hopkins University, Baltimore, MD, USADepartment of Emergency Medicine
  2. 2. Disclosures and Disclaimers▶ I do not have any financial conflicts of interest todisclose▶ My views do not reflect those of my department,employers, affiliations, or government entities▶ This work is partially supported by:The National Heart Lung and Blood Institute,Mount Sinai Emergency Medicine ResearchCareer Development Program5K12HL109005-02Department of EmergencyMedicine
  3. 3. Objectives▶ Background▶ Review of Events in India▶ Study Methods▶ Results▶ Future Directions▶ Acknowledgement▶ Q&ADepartment of EmergencyMedicine
  4. 4. Background—Global PatternDepartment of EmergencyMedicine
  5. 5. India—September 26, 2001Department of EmergencyMedicinehttp://www.hindu.com/thehindu/2001/09/26/stories/0426201l.htm Assessed 5/23/2013
  6. 6. India—November 18, 2001Department of EmergencyMedicinehttp://www.hindu.com/thehindu/2001/11/18/stories/0218000a.htm Assessed 5/23/2013
  7. 7. India—September 29, 2002Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/2286571.stm Assessed 5/23/2013
  8. 8. India—August 28, 2003 (Mela)Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/3184477.stm Assessed 5/23/2013
  9. 9. India—August 28, 2004Department of EmergencyMedicinehttp://www.apnewsarchive.com/2004/Stampede-Kills-5-at-India-River-Festival/id-4b0a6266b4d631f045c252fAssessed 5/23/2013
  10. 10. India—November 14, 2004Department of EmergencyMedicinehttp://www.arabnews.com/node/258112 Assessed 5/23/2013
  11. 11. India—January 25, 2005Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/4204877.stm Assessed 5/23/2013
  12. 12. India—November 6, 2005Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/4727763.stm Assessed May 23, 2013
  13. 13. India—December 18, 2005Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/4539192.stm Assessed May 23, 2013
  14. 14. India—November 4, 2006Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/6116002.stm Assessed May 23, 2013
  15. 15. India—November 23, 2006Department of EmergencyMedicinehttp://www.hindustantimes.com/News-Feed/NM19/Stampede-for-jobs-in-prison/Article1-176948.aspxAssessed May 23, 2013
  16. 16. India—August 13, 2007Department of EmergencyMedicinehttp://www.india-forums.com/news/religion/44643-five-women-die-in-jharkhand-temple-stampede-lead.htm Assessed May 23, 2013
  17. 17. India—October 3, 2007Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/7026262.stm Assessed May 23, 2013
  18. 18. India—July 4, 2008Department of EmergencyMedicinehttp://news.bbc.co.uk/2/hi/south_asia/7490218.stm Assessed May 23, 2013
  19. 19. India—December 1, 2008Department of EmergencyMedicinehttp://www.prokerala.com/news/articles/a19131.html Assessed May 23, 2013
  20. 20. India—April 14, 2010 (Mela)Department of EmergencyMedicinehttp://news.bbc.co.uk/1/hi/world/south_asia/8619088.stm Assessed May 23, 2013
  21. 21. 2011
  22. 22. ObjectiveDepartment of EmergencyMedicine▶ To estimate the degree of underreporting bycomparing two epidemiologic surveillancemethods by Ngai and Roy▶ To identify additional sources that willstrengthen the inclusiveness of the existingglobal stampede database.
  23. 23. Method—The Ngai MethodDepartment of EmergencyMedicine▶ LexisNexis® Academic search method with the searchterms “stampede” & “Injur*”, and Headline(stampede), source: News (all, English, full text)▶ Hand searching of Newso British Broadcasting Corporation (BBC) Newso The New York Timeso Arab Newso Cable News Network (CNN)o Reuterso Internet searches were conducted on PubMed, Wikipedia,crowddynamics.com, and mapreport.com
  24. 24. Method—The Ngai MethodDepartment of EmergencyMedicine▶ Location (City, State, Country)▶ Region▶ Type of event (Sports, Religion, Music, Political,Others)▶ Day vs. Night▶ Indoor vs. Outdoor▶ Mechanism (Unidirectional vs. Turbulence)▶ Trigger (descriptive)▶ Number of Participants, Injuries and Death
  25. 25. Method—The Roy MethodDepartment of EmergencyMedicine▶ The Times of India, The Hindu and The IndianExpress▶ Keywords were “stampede”, “mass gathering”,“mass-gathering events”, “mass-gathering incidents”,“crowd”, and “crowd management.”
  26. 26. Method—The Roy MethodDepartment of EmergencyMedicine▶ Location (City, State/Provence)▶ Trigger (descriptive)▶ Number of Participants, Injuries and Death
  27. 27. Results—The Ngai MethodDepartment of EmergencyMedicine
  28. 28. Results—The Ngai MethodDepartment of EmergencyMedicine
  29. 29. Results—The Ngai MethodDepartment of EmergencyMedicine▶ Globally 350 events, a total of 10,243 deathsand, 22,445 injuries in 83 countries▶ 34 events occurred in India in the study period2001 to 2010
  30. 30. Results—The Roy MethodDepartment of EmergencyMedicine▶ 27 events occurred in India in the study period2001 to 2010▶ 9 events not in the Ngai methodo 3were in exclusion criteriao 6 were additional events not in Ngai method
  31. 31. Results—By ClassDepartment of EmergencyMedicineClass Ngai Method Roy MethodI (No Deaths) 2 0II (1-10 Deaths) 21 18III (11-100 Deaths) 8 6IV (101-1000 Deaths) 3 3Total No. Events 34 27
  32. 32. Results—By Fatalities and InjuriesDepartment of EmergencyMedicineNgai Method Roy MethodMedian Fatalities (IQR) 5.5 (2-17) 5 (2-39)Median Injuries (IQR) 13.5 (5-31) 17 (10-45.5)Pearson Correlaion Coefficient 0.81 (p<0.001) 0.63 (P=0.003)
  33. 33. Results—Multivariate AnalysisDepartment of EmergencyMedicineCharacteristics Relative No. Deaths (95% CI) P-ValueTime of DayNight vs. Day 1.88 (0.43-7.86) 0.408LocationIndoor vs. Outdoor 1.92 (0.61-6.01) 0.268Type of EventReligious vs. Other 6.52 (1.73-24.66) 0.006Political vs. Other 277.09 (5.12-15001.96) 0.006MechanismUnidirectional vs. Turbulence 0.73 (0.23-2.32) 0.589
  34. 34. Future DirectionsDepartment of EmergencyMedicine
  35. 35. 2013 Manchester
  36. 36. 2015 Cape Town
  37. 37. 2017
  38. 38. Acknowledgements▶ Research Team Dr. Skip Burkle (Harvard, USA) Dr. Edbert Hsu (Johns Hopkins, USA) Dr. Nobhojit Roy (Tata Institute, India) Aditi Madan (Tata Institute, India) Saswata Sanyal (Tata Institute, India) Dr. Wing Lee (my wife)▶ This work is partially supported by: NIH NHLBI 5K12HL109005-02Department of EmergencyMedicine
  39. 39. Thank YouDepartment of EmergencyMedicine?

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