Preventive Measures and Crowd Management Strategies to Mitigate the Risk of Stampedes in Public Gatherings: A Systematic Review.

Abstract

Objectives: To evaluate crowd-management strategies used at mass public gatherings and to identify the evidence gaps and priorities that reduce the risk of stampedes.

Methods: Following PRISMA 2020 and PRISMA-S guidelines, the paper searched PubMed, Scopus, Web of Science, Google Scholar (gray literature), and the WHO Global Health Library (gray literature) published between January 1, 2010 and December 30, 2025. Eligible studies included observational, quasi-experimental, and simulation-based evaluations of crowd-safety interventions. Two reviewers independently screened records, extracted data, and appraised study quality using ROBINS-I and JBI checklist. A narrative (thematic) synthesis grouped interventions into engineering, operational, technology, and communication approaches.

Results: Of 833 unique records identified, 13 studies met the inclusion criteria. Included studies were mainly observational analyses, simulation/modeling studies, or quasi-experiments from diverse settings (pilgrimages, festivals, sports events). Multi-modal strategies combining environmental design (one-way flows, barriers), operational controls, real-time monitoring, and trained personnel were consistently associated with improved crowd-flow indicators (shorter evacuation times).

Conclusion: Integrated crowd-management approaches can mitigate stampede risks, but require high-quality empirical evaluations and standardized outcome metrics to strengthen evidence for policy and practice.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251142906, identifier CRD420251142906.