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11 July 2007

Health advice for those attending indoor and outdoor festivals

 Medical facilities and travel insurance

• Travellers should have adequate travel insurance. They also should be in possession of a European Health Insurance Card (EHIC) which is valid in European Union (EU) countries and some non- EU countries by agreement with the EU. (see links below).
• Well organised events may provide emergency medical aid stations where advice and first aid can be administered [1].
• Be aware of where advice and first aid facilities are located (i.e. festival medical services, drug support services etc).

Safety and security

• Check the Foreign and Commonwealth Office (FCO) website for safety and security issues before travelling (see links below).
• Respect the host country’s cultural code.
• Avoid antagonistic and confrontational situations.
• Be aware that crowds may suddenly surge or riot resulting in crush injury.
• Minimise the risk of fire: familiarize yourself with fire exits, do not use naked flames near tents.
• Be aware of swimming risks: diving into unfamiliar waters, swimming at night, swimming after drinking alcohol, swimming in fresh water where schistosomiasis is a risk (e.g. Lake Malawi in Africa) (see links below).

Vaccinations and malaria risk

• Discuss travel plans with your practice nurse or travel clinic at least six weeks prior to departure if travelling to countries where vaccinations or malaria prevention tablets might be recommended (see links below).

Heat, cold and wet

• Be prepared for extremes of weather and changing weather conditions and dress accordingly (light clothing in hot conditions, layered clothing in cold conditions, waterproofs for wet weather).
• Keep warm and dry in cold/wet weather. Prolonged exposure to cold and wet may result in hypothermia. Temperatures may drop rapidly at night.
• Avoid overheating. Drink plenty of water, especially during very hot weather and whilst physically active. Sports’ drinks may help maintain electrolyte balance.
• Avoid prolonged exposure to strong sunlight (use shade areas where available). Use sun hats and sun-screens (see links below).

Drugs and alcohol

Dealing or using illegal drugs is prohibited, and a no-tolerance policy is usually enforced with the support of local law enforcement agencies.  However, illegal drugs, herbal drugs and nitrous oxide (NOS) may be available within the confines of event venues. Alcohol may be prohibited, restricted or freely available, depending on event policy. Drug and alcohol use may result in unpleasant, unpredictable and sometimes life threatening side effects. Depending on substance taken, effects may include paranoia, depression, violent behaviour, hyperthermia (overheating) and hyponatremia (low blood sodium levels) [2,3]. In order to minimise your risk:

• Do not take a banned substance to the event venue.
• Do not ingest any illegal substance during the event.
• Do not drink anything that may have been tampered with.
• If needed, seek help and advice from support agencies available at the venue.
• If you choose to take drug/alcohol risks, know what substance you or your friends have taken in order that the correct action can be taken in an emergency situation.
• Where necessary, needles should be discarded so that they do not pose a risk to other individuals.
• Ecstasy (methylenedioxmethamphetamine or MDMA) may result in hyperthermia, hyponatremia (due to excess water consumption) and other complications [2,3]. Users should understand the importance of controlling body temperature and regulating fluid intake (see links below).
• Do not drive under the influence of any illegal substance.

Noise

Exposure to noise levels of over 80 decibels may damage hearing. The risk of damage increases as the noise level becomes greater (see links below). In order to reduce the risk of hearing damage from noise:

• Have regular breaks from high noise levels where possible.
• Use earplugs (sometimes available at the venue).

Food and water hygiene

Food and water hygiene may be poor at large events. Lavatory facilities may be basic and sanitary conditions may deteriorate as the event progresses. 

• Faecal-oral transmitted infections can be minimised by adhering to strict food and water hygiene measures (see links below).

Insect bite precautions

• Infections caused by organisms transmitted from insects can be avoided by insect bite avoidance measures, e.g. repellents, protective clothing, sleeping in screened accommodation (see links below).

Sexual Health

• Unsafe sexual practice should be avoided to avoid sexually transmitted infections such as chlamydia, HIV and human papillomavirus.
• Condoms may not be easily obtained at some venues. Be sure to carry a personal supply of condoms which carry the British Kite standard mark.

Tattooing and body piercing

Tattoos and body piercing should be avoided because of the risk of blood borne infection (HIV, Hepatitis B & Hepatitis C). 

References

1.  Milsten AM, Maguire BJ, Bissell RA, Seaman K. Mass-gathering medical care: a review of the literature. Prehospital Disaster Med 2002;17:151-62.

2. Department of Health. A guide to the risk and harms associated with substance misuse January 2003; Department of Health Publications. Available at: http://www.dh.gov.uk/en/Policyandguidance/

Healthandsocialcaretopics/Substancemisuse/AtoZofSubstance

MisuseGuidancePublications/index.htm?indexChar=D

3. Gowling LR, Henry-Edwards SM, Irvine RJ, Ali RL. The health effects of ecstasy: a literature review. Drug Alcohol Rev 2002;21:53-63.

Links

Brake: the road safety charity: http://www.brake.org.uk/

Deafness research UK: http://www.deafnessresearch.org.uk/Noise-induced+hearing+loss+1640.twl

European Health Insurance Card information: http://www.ehicard.org/?gclid=CJ2FzMfg-YwCFRkiEAodxEmScQ

Foreign and Commonwealth Office: Travel Information: http://www.fco.gov.uk/en/travelling-and-living-overseas/

NaTHNaC. Insect bite avoidance http://www.nathnac.org/pro/factsheets/iba.htm

NaTHNaC. Prevention of food and water borne diseases http://www.nathnac.org/pro/factsheets/food.htm

Rough Guide World Party: http://worldparty.roughguides.com/

NaTHNaC Schistosomiasis information

http://www.nathnac.org/pro/factsheets/schisto.htm

Department of Health. The truth about drugs: know the score. July 2006. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/

PublicationsPolicyAndGuidance/DH_4137440

Talk to Frank: http://www.talktofrank.com/