Events play a vital role in developing the cultural and social aspects of communities.

Successful events can support mental and social wellbeing, while promoting community inclusiveness.

Organisers have the ability to influence the culture and standards of an event to ensure it is safe and enjoyable for all.

 

Large gatherings have a range of potential health risks and benefits. The World Health Organization defines a mass gathering as an event where the “number of people attending is sufficient to strain the planning and response resources of the community, city, or nation hosting the event”. Examples of mass gatherings may include, festivals, sporting events, concerts and cultural events.

The COVID-19 pandemic reinforced the role of events in infectious disease spread. However, there are a number of other factors relating to events of all sizes that impact health including, sanitation, weather, food, alcohol and other drugs, and the risk of injury.

There are a number of ways that events can support the health and wellbeing of attendees, as well as supporting the health of the local community. A coordinated and proactive approach to risk reduction and emergency management will facilitate providing a successful event.

The guidance below explains factors relevant to public health and provides recommendations for how to protect and promote health at events. Bearing in mind every event is different the information please seek professional advice from relevant stakeholders in the planning stages as required.  Liaising with stakeholders early will support you to develop a successful event. Key stakeholder can include local council, emergency services, transport, food vendors and health service providers.

 

Getting started

Completing a risk assessment is a key element in planning a successful event. By identifying potential risks that may impact event goers and local community they can be evaluated, and precautions or management plans can be developed. Risks may not be limited to the event goers but could impact the community and have national implications e.g. an outbreak of measles.


Examples of factors that may impact the risk include:

  • Type and size of audience
  • Location
  • Duration
  • Time of the year and day
  • Type of activity

 

The steps to complete in a risk assessment are outlined below.

  1. Identify hazard and risk: the aim is to identify all hazards and associated risks, regardless of
    whether they are within the control of the event organiser.
  2. Analyse the risks: determine the likelihood of the risk and its potential consequences. This involves determining the severity of each risk.
  3. Evaluate the risks: using the resulting risk levels, rank those risks and develop a prioritised list of risks requiring attention. This supports allocation of resources to those risks of greatest priority.
  4. Risk reduction and management: risk can be controlled in a number of ways, and the first objective should be to avoid or eliminate the risk entirely. Where elimination is not possible, exposure to risk should be reduced as much as is reasonably practicable.

Use the risk assessment table below to help categorise potential risks.

 

Considerations for event planners

Alcohol and recreational drugs

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Events are legally required under the Sale and Supply of Alcohol Act 2012 to minimise harm caused by excessive or inappropriate alcohol consumption. Key harms from excessive alcohol intake may include, injury, intoxication, crime and violence, including sexual violence. Alcohol harm can be reduced through careful planning and harm minimisation policies. We recommend considering whether alcohol is necessary at the event, particularly when young people and children are key attendees.

Key areas to consider to prevent intoxication and alcohol harm at your event include:

  • Maximum number of beverages in single purchase
  • Have a range of lower alcohol options available
  • Cheaper pricing for low and no alcohol options
  • Free and easily accessible water
  • Affordable and accessible food options
  • Avoiding promotion of alcoholic beverages, particularly high percentage beverages

Further guidance can be found here: Guidelines for Managing Alcohol at Large Events

Staff should be trained to identify and manage intoxicated people. The intoxication assessment tool is a useful training option. Queues may provide staff with an opportunity to assess patrons. Ensure that staff and security have clear communication and management plans to safely deal with intoxicated people as required.

 

Recreational drugs

A drug harm reduction strategy can improve the safety of an event. This includes setting and communicating clear expectations to attendees and providing information on safety and support services available. Staff training should include knowing when and how to intervene and having a plan on how to respond situations of life-threatening overdose.

Other ways to minimise harm include having a chill space/safe zone to support intoxicated people who need care, and a drug checking service. Drug checking services allow people to check what their drugs contain and receive advice on how to be safe. If drug contamination or concerning substances are detected at the event, have a plan for how this will be effectively communicated to attendees.

More advice on reducing drug harm at your event can be found at the drug foundation website.

Communications

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Consider what communication channels will be best for relaying event related information.

Communications may be routine proactive messaging or may be needed in response to an emergency. Communications plans need to include both attendees and other agencies involved in planning and responding to the event.

The best mode of communicating messages will depend on the demographics of the attendees.

Messaging should consider the event culture that organisers want to build and how to set expectations for attendees. Partnership with health and harm reduction services may be beneficial to tailor messaging for the event. Stakeholder engagement for testing and development of messaging can be beneficial.

Examples of health promoting themes for messaging could include:

  • Hand hygiene to reduce spread of infectious diseases
  • Sun safety
  • Hydration
  • Alcohol and recreational drug harm reduction messaging
  • Promoting active and public transport to the event

Health related advice, or emergency management messages may need to be delivered quickly through communication channels before, during and after events. Attendee and stakeholder contact lists should be assembled prior to the event and easily available to facilitate urgent communications. Consider testing systems to ensure there is capacity for rapid dissemination of information in the event of an emerging issue or emergency.

Disease prevention

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Large gatherings with crowds and shared facilities pose a risk for the spread of infectious disease, such as COVID-19, gastroenteritis, and measles.1 If there is a current outbreak of an infectious disease in the community, this will need to be considered as it may impact the risk to your event.


High density and indoor events are higher risk for the spread of infectious diseases.1 Events can limit the spread of disease by ensuring good hygiene practices with clear messaging and policies to encourage attendees to stay home if they are unwell. To support this, consider allowing for refunds if attendees are unwell and need to stay home.

Indoor events should ensure there is adequate ventilation. This can be done by:

  • Opening windows and doors to prioritise fresh air
  • Consider using air filters if the venue does not have a modern air filtration system

More information on reducing spread of infectious diseases can be found in additional resources below.

Specific ticketing and scanning in for sections of an event, or transport, can be helpful to aid public health teams to accurately complete contact tracing for infectious diseases if required. Additionally, ensure there are contact lists for post event communication of health messages.


Immunisation is safe and effective way to prevent the harms of serious infectious diseases, such as measles. Particularly for events with children, consider messaging to promote immunisation prior to the event.

Contact with Toi Te Ora or the Te Whatu Ora communications teams may be able to support messaging, or provide existing social media or other communications resources for the event.

Further information

 

Emergency Management

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Managing emergency situations and emerging threats is a core element of event planning. Organisers should involve health, emergency and council services of the event and consider the potential impact on resources.  An emergency management plan should be developed with and communicated to emergency services prior to the event. Examples of potential emergencies include earthquakes, fire, storms, infectious disease outbreaks, or road closures. Event organisers are responsible for ensuring that patrons are safe and can safely travel home or to a safe place in the event of an emergency.


To aid in emergency management, it is advisable to contact relevant stakeholders and consider stakeholder meetings in the lead up to the event to establish relationships and understand roles in the event of an emergency. This also enables services to plan ahead and consider staffing levels for the event duration. Mass events are likely to put pressure on health and emergency services, particularly in peak holiday seasons. Rostering for such services occurs many months in advance, soinvolvement in the planning stages allows emergency services to be prepared. Distribute the emergency management plan to relevant stakeholders with contact details so that they can get in touch before, during and after the event.


Ensure that in your site planning, emergency services can easily access the event. This will include consideration of traffic movements on site, ability to access roads, exits and entrances are not blocked and alternative entry and exit points are available if required.

Food and Water

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Food considerations include food safety, availability, and affordability. Food must be available for the duration of the event and is required under the Sale and Supply of Alcohol Act 2012if alcohol is available.  Additionally, events can promote good health by having nutritious and affordable options for attendees to choose.


Business that are supplying food must comply with Food Standards Code for Australia and New Zealand. Food safety and hygiene is essential to reduce the risk of food-borne illnesses at events. The Ministry for Primary Industries Food Act officers in local council hold responsibility for food safety. Some councils also have bylaws regulating the operation and location of mobile food vendors so check with your local council in the first instance should your event involve food.

Water

Water intake can mitigate the effects of alcohol and drugs and protect from dehydration and heat exhaustion3. If you are selling alcohol, you are legally required to provide readily available, and free, drinking water (Sale and Supple of Alcohol Act 2012).


Ensure there is adequate supply of free drinking water to attendees. Consider encouraging attendees to bring a reusable bottle to have with them and refill on site.


Water intake will depend on the type of event and environmental conditions, however as a guide for a single day event provide at least 2 litres of drinking water per patron, and for overnight events 20 litres of water per day per person will be required (drinking and non-potable water included).


To facilitate water consumption by attendees, there should be a minimum of one water station per 500 people.3 Keep water outlets separate from commercial outlets and bars and have them clearly visible with signage. Water outlets at entry and exit points are encouraged. "Roaming provision of water” by event/festival staff, such as through crowds and queues, are an effective way to ensure patrons can easily access water.

Health and Support Services

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Medical services providers

There are a number of options for health care services at events which may depend on the duration, size and risk profile of the event. Options range from first aid provision, to having onsite medical care at the event. The New Zealand Ambulance Standard sets out the appropriate compliance cover required for medical services providers at an event. Consider what level of support the event may need and engage with services like St Johns to assess what may be suitable.


Where possible, events should be able to manage routine first aid and medical concerns. Most concerns will be able to be managed on site with adequate cover and experience, it is expected that approximately 1% of those requiring attention will need transport to hospital services. Factors that can increase the likelihood of medical care includes the numbers of patrons, duration of event.

Peer based support

Working with a peer-based harm reduction service can be effective to help attendees feel safe and supported. Peer-based support can identify attendees that may need assistance, provide supplies to attendees, and help attendees to problem solve.


Peer-based support can also participate in brief interventions to reduce alcohol and drug harm at your event. Brief interventions are an effective method of identifying problematic behaviour and working with an individual in a personalised supportive manner. Peer-supporters should also be situated in a safe zone to facilitate care and recovery of attendees alongside medical services as required.

More information about peer based support can be found here.

Inclusion and Accessibility

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Inclusive events are those which seek to meet the needs of all attendees and are open to adapting and learning in order to meet accessibility needs of attendees.


Approximately 20% of Aotearoa New Zealand population identify as living with a disability, this includes physical, sensory, mental health or intellectual disabilities. Ensuring the event is accessible for all is important to make the event safe and enjoyable for attendees. Site planning must allow for those with access needs to safely travel to the venue, enter and exit, use facilities and easily participate in the event and communicate with staff.


Promotional material should include information on:

  • wheelchair access
  • ramp access
  • safe viewing areas
  • accessible transport options, and
  • contact details for those with accessibility needs to get in touch.

Outbreak Response

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Toi Te Ora Public Health is responsible for investigating and managing outbreaks of infectious diseases.

Contact information for attendees can support the ability to rapidly respond to outbreaks.

Ensuring tickets include full names, phone numbers and email addresses can help to rapidly identify and support contact tracing.

If you are aware of concerns around disease spread at the event, it is recommended that you contact the public health service for advice and support.

Safe Zones

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Safe zones are a designated area that is set up to provide supervision and support to attendees. Safe zones are an essential element of minimising alcohol and drug related harm at events. They can also be useful for distressed, lost or unwell attendees to seek support.


Events must be set up to provide wellbeing support to intoxicated persons. A safe zone can ensure that intoxicated people have a dedicated alcohol-free space to be supervised and supported while arrangements are made for getting home safely, or for first aid care to be provided. Safe zones should be staffed by personnel who are proficient in first aid with clear escalation pathways for help if required.

A suggested safe zone layout and referral flowchart for consideration of whether patrons need further medical support are below.

 

Source: Te Whatu Ora Guidelines for Patron Welfare at Large Events

Sanitation Facilities

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Toilets and handwashing facilities should be well lit and have adequate access to meet the needs of attendees. This includes ensuring wheelchair access and disability access toilets. Local council can advise on the minimum requirement for sanitation facilities.

Liquid soap and single use hand drying facilities must be available, and stocks should be regularly checked. The provision of hand sanitiser for people to use once they have cleaned their hands is optional. 

Hand sanitiser should not be used as an alternative to providing adequate soap and water. Include hand hygiene signage to promote hand washing at the event. Locate sanitation facilities away from food storage and food service areas.

Waste and recycling bins must be large enough and be regularly checked for emptying.
Needle disposal units can be housed in toilet blocks and should be easily accessible with clear signposting.

Have separate comfort areas available for families and caregivers, and breastfeeding and expressing parents if the event is catered to all ages or families. This should be comfortable and private space.

Sexual Health

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Particularly for young people at music festivals, there is a risk of spread of sexually transmitted infections, unplanned pregnancies and sexual harm. Unsafe alcohol intake and recreational drug use increases the risk of sexual violence and unsafe sex practices at events.

Events organisers can play an important role in messaging and fostering a culture that promotes safe and respectful sex and relationships. Messaging should be delivered through a range of formats from prior to the event to after the event.

Consider providing staff with bystander training and how to respond appropriately to reports of sexual violence and ensure there are clear procedures for responding. If a safe zone is established at your event, this can be used to provide safe sex messaging and products to attendees.

Further information to support planning to promote sexual health and wellbeing can be found here. While this resource was developed for Australia, this is relevant to events in New Zealand to consider while planning.

Transport

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Increased pressure on transport systems may occur with large gatherings. A traffic management plan is usually required by councils to ensure that streets can be safely accessed.


Choosing a venue that is connected to existing public transport and active transport infrastructure can help to reduce car dependency and traffic congestion. It is also important to promote active and public transport to travel to the event. If the venue is not already connected to public transport, or if attendees will exceed the existing transport systems capacity, offer a designated bus service to transport attendees to and from the event. Transport options can also be linked in with accommodation providers for events with a large number of visitors to the area. Limited car parking at the event is a tool to disincentivise car travel or promote carpooling.


Reducing the ability for cars to access the event and surrounds can make the venue and streets safer for attendees arriving and leaving, particularly more vulnerable attendees such as children, elderly and people with disabilities.


Ensure that accessibility is considered when planning transport options for the event. Designated buses, or transport options for those with accessibility needs should be available for those who wish to use them. Specified parking for disabled people at the event should be arranged.

Weather

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Weather conditions can influence the potential health impacts of an event. In the event of extreme weather events, consider early event postponement or cancellation. Early decisions will reduce risk by ensuring people are not out in potentially dangerous conditions, risking the health of attendees and others.


In planning stages, organisers should set clear trigger points for when an event will be cancelled. Extreme weather events may include, heavy rain, flooding, cyclones, heat waves or low temperatures. Each pose significant risks to health, including injury, death, increased risk of infectious diseases and dehydration, particularly for more vulnerable groups such as children and elderly. Review of the weather will be required throughout the event.


Particularly for summer events, high temperatures and sun can increase the risk of health effects such as dehydration, drug and alcohol harm, and heat exhaustion. Children, elderly and those with medical conditions are more vulnerable to the effects of heat. Strategies to mitigate heat can be to start later in the day when it is cooler, having a shorter event or scheduling in cooler months.


At the event, ensure there is adequate shade available, including areas where there may be long queues to reduce heat exposure. Shade may need to be provided through temporary structures however, natural shade is the best form of shade. Existing shaded spots should be utilised when planning the event layout. Air conditioning and industrial fans should be used indoors. Shaded areas are also important as sun protection for attendees. Providing access to water resistant SPF-30+ sunscreen encourages sun safety. Ensure sunscreen stations are visible and provide sun safety messaging.


Similarly, events held in cold temperatures need to consider ways to ensure attendees are warm and dry. Heating and drying stations, and provision of hot drinks can be considered as precautions

Toi Te Ora (NPHS) is available to be contacted for Public Health advice and support. It is best to contact us as early in the planning stages (at least six months prior to the event) or as soon as issues arise.

 

To download a copy of this guidance click here

 

Further resources and information