To study the diagnoses of patients presenting to a medical facility within a mass-gathering public event, “The Great New York State Fair” (NYSF) based on chief complaints, diagnoses, and time of arrival. The goal of the study was to assess the need for increased staffing, services, or supplies during certain times of day for an event that gathers approximately 1 million patrons over a 12-day span. Patrons occupy the grounds between the hours of 10 am and 11 pm, while workers and staff are on the grounds around the clock.

Triage data gathered by trained medical students was collected from all of the patients seen during the 2009 NYSF from 12 am to 11:59 pm. Triage information was categorized based on the nature of complaint, physician impression, and time of arrival to assess for trends in the distribution of common chief complaints and diagnoses at a mass-gathering medical care facility.

The early hours of the NYSF were occupied mostly with treatment of minor first aid complaints, while later hours were occupied more commonly by orthopedic complaints. Insect stings were the most frequent complaint throughout the day.

Daytime and evening hours at the fair have a significant number of orthopedic diagnoses and may benefit from specific staff and equipment sufficient to handle these complaints. Stings and minor first aid injuries are also significant and may benefit from adequate stocking of the infirmary for such events. Major medical complaints, including cardiac and neurological complaints, did occur but were a minor part of the total patient population.

NaccaK , ScottJ , GrantW . Diagnosis According to Time of Arrival at “The Great New York State Fair”Prehosp Disaster Med. 2014;29(1):1-3.

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.

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.

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 (χ2 (1, n = 213) = 11.41, p <0.05).

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.