Risk Assessment Tools for Mass Gatherings: a Narrative Review

Events with a high population density, commonly referred to as mass gatherings (MGs), necessitate additional precautions in the areas of situational management, safety, and public health. Various tools for risk assessment at these events have been developed to meet this requirement. Nonetheless, the necessity for a comprehensive review is highlighted by the variety, dispersion, and variations in the structure and context of application of these tools. This study was conducted as a narrative review following the general principles of high-quality narrative synthesis. The reporting structure was informed by the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines. A comprehensive search was conducted in PubMed, Scopus, Google Scholar, and authoritative organizational documents (e.g., WHO), complemented by manual reference screening. Publications that explicitly describe or evaluate such tools were chosen, and key data on their development, features, and applications were systematically gathered. A narrative synthesis and thematic analysis were employed to compare their strengths, limitations, and practical considerations, which were summarized in a comparative table. Six key tools were identified, including the World Health Organization (WHO) tool, the Jeddah tool, the Indian tool (MGRAT), the Swedish tool (MAGRAT), and the SALEM framework in Saudi Arabia. These tools encompassed a range of approaches tailored to resource-limited settings, including multi-hazard assessment, Reputational Risk analysis, and interagency collaboration. Global tools, like those offered by the WHO, are comprehensive and adaptable. Meanwhile, regional tools such as SALEM and Jeddah have been effectively utilized in specific cultural and religious contexts. However, gaps exist in the coverage of various events, and there is a lack of integration of new technologies in low-income countries. Risk assessment tools for large gatherings require further development and standardization, particularly for specific contexts and emerging threats. Combining localized and global tools and leveraging technologies such as artificial intelligence and real-time data could be an effective way to enhance the practical assessment of risks.