Social norms and risks at mass gatherings: A systematic review

Mass gatherings pose a set of serious health risks to attendees. Yet, the risks at mass gatherings have not been systematically reviewed and categorised, and there has been a lack of research onthe role of social norms in shaping risks. This systematic review aimed to identify the types of risks and their prevalence at each type of mass gathering and to evaluate whether social normsare considered in the mass gatherings literature. We conducted our review following the PRISMA checklist and searched the literature comprehensively in May 2021 via six electronic databases: MEDLINE, PubMed, Web of Science, Scopus, PsycINFO, and CINAHL Plus. Articles were includedif they met our inclusion criteria in the five domains: population, mass gatherings, risks, methods,and studies characteristics. The review included 183 articles about more than 83 mass gatheringsin 42 countries. There were four types of planned mass gatherings: religious, sporting, music festivals, and other/cultural festivals, and four main types of risks: health, behavioural, environmental, and other/mental health risks. Social norms were mentioned in 5 articles. This is the first comprehensive systematic review of the literature regarding risks at mass gatherings with a specific focus on the role of social norms in shaping risks. Each mass gathering poses different types of risks depending on the nature of the event, and social norms can partially explain this. However, social norms are minimally considered in the literature and further studies about the role of identity-related norms in shaping risks at mass gatherings are needed.