Concert Violence

It is a common perception that concert violence is a modern phenomenon, but history contradicts this belief.

Tanzwuth
Middle Age minstrel shows were occasionally marred by outbreaks of Tanzwuth, or "dancing mania." Tanzmuth epidemics were belived to accompany minstrels whose music was particularly loud and "intoxicating." Early episodes of Tanzwuth were often characterized by audience members dancing wildly until collapse; however, by the 14th century, we have reports of afflicted audiences tossing each other into the air and colliding repeatedly. Tanzwuth epidemics often associated with consumption of copious amounts of wine, and musicians whose performances elicited these outbreaks often found their services in high demand. (Morens, 1995)

Stravinsky
An early example of concert violence accompanied the 1813 debut of Igor Stravinsky's ballet, The Rites Of Spring (Le Sacre de Printemps). Though now a familiar, much-beloved work, the piece, which is characterized by musical dissonance and radical, even scandalous, choreography, resulted in a full-blown riot upon its premiere. The atonal score and pagan themes incited catcalls within minutes of the curtain's rising, and several fights erupted among audience members. The show's producer tried, albeit unsuccessfully, to quell the violence by repeatedly flashing the houselights, and Stravinsky slipped out of the theater moments before police arrived. (Ross)

The Birth of Rock-and-Roll
Despite concerns of the "evil effects of rock and roll" in the 1950, there are precious few examples of documented concert violence. However, DJ Alan Freed, the man who ostensibly coined the term "rock and roll," found himself near the epicenter of the decade's two main incidents. In March of 1952, Freed staged the Moondog Coronation Ball at a 10000 seat venue in his hometown of Cleveland, and a "near riot" broke out when many of the estimated 25000 fans were not admitted. Later, in 1958, violence reportedly erupted outside a Boston venue immediately following a Freed show, and Freed was indicted for inciting a riot.

Woodstock
Early attempts to report and quantify concert violence coincided with the birth of the rock festival in the late 60s and early 70s. The forebear of all festivals, Woodstock, represented the initial attempt to quantify burdens placed on the event's makeshift medical facilities, which researchers estimated at 125 patients per ten-thousand (PPTT). A similar study conducted at a 1973 Watkins Glen festival reported 130 PPTT. (Whipkey et al, 1976) It must be pointed out, however, that the researchers in both cases made no attempt to categorize medical usage, and subsequently statistics on violence-related trauma cannot be separated from medical incidents like bee stings, dehydration and "bad trips."

Altamont
Through no reporting mechanisms were in place, the most infamous incident of concert violence during this period occurred at Altamont Speedway in northern California in December of 1969. Billed as "Woodstock West," the event was marred by logistical problems, most significantly offering the local Hell's Angels chapter $500 worth of beer to provide security. Numerous fights ensued, Mick Jagger was punched in the face seconds after emerging from his helicopter and Jefferson Airplane lead singer Marty Balin was punched in the head and knocked unconscious by a Hell's Angel mid-set. The violence culminated in the fatal stabbing of concertgoer Meredith Hunter during the Rolling Stones' set, an incident captured on film and featured in the documentary, Gimme Shelter.

The Who in Cincinnati
The first highly-publicized incident of concert violence occurred in Cincinnati during The Who's 1979 U.S. tour. Eleven concertgoers were crushed to death when the band's soundcheck was mistaken as the beginning of the show and forced entry into the arena. This high-profile incident garned national attention thanks to a subsequent cover story in People magazine and a special episode of the hit TV show WKRP in Cincinnati that dealt with the tragedy.

Woodstock '99
Despite efforts of promoters to recapture the sentiment of the original event, Woodstock 99 will instead be remembered as one of the worst, and highly publicized, examples of concert violence as concertgoers rioted, destroying the stage and burning the campgrounds. In addition to numerous injuries, four rapes were reported and countless sexual assaults are believed to have transpired. (Tully, 1999 and Vider, 2004)

With a multitude of performance venues and spotty reporting mechanisms, it is difficult to assess the true magnitude of concert violence. Between 1992 and 2002, Chicago-based Crowd Management Strategies conducted an annual concert safety survey in which they selected a number of concert events worldwide, and quantified injuries and deaths based on medical files, police reports and eyewitness accounts, and attempted to extrapolate the annual number of injuries worldwide as a result of concert violence. Unfortunately, CMS provided no methodology for their research. The fact that CMS's business model involved selling reports, newsletters and consulting services to the entertainment industry suggests these reports are subject to selection bias. Repeated attempts to contact CMS and their primary researcher for additional clarification, proved futile.

Nonetheless, the CMS reports provide some interesting data. Their 2002 report analyzed 31 concerts, fifteen of which took place in the United States, with the remaining 16 staged in England, Australia, South Africa, Philippines, China, France and Thailand. These 31 events resulted in a total of 4,567 violence-related injuries and 20 violence-related deaths. Based upon these figures, CMS estimated that between 20,000 and 40,000 concertgoers sought violence-related medical attention in 2002. I suspect all CMS-reported statistics are somewhat conservative based on their preoccupation with large events.

Not surprisingly, it is the exceptional incidents of concert violence that capture the attention of the public and generate concern. Deaths are not uncommon, typically at festivals. Some of the most high-profile incidents of recent years were Denmark's 2000 Roskilde Festival, which was marred by the deaths of nine concertgoers in the mosh pit directly in front of the stage during Pearl Jam's set, and the 2004 mid-performance shooting of Damageplan guitarist, "Dimebag" Darrell Abbott.

Despite the publicity bestowed upon these high-profile incidents, concert violence typically results in a limited variety of outcomes, including head injuries, lacerations, abrasions, puncture wounds caused by foreign bodies, eye injuries and various musculoskeletal injuries, including fractures. A large study of concert medical usage rates, found dermal injuries (33%) to be the most common cause of audience trauma when the study's 405 concerts were evaluated as a whole; however, head injuries, which accounted for 19% of total concert trauma, where responsible for approximately 31% of rock concerts injuries. (Grange, 1999)

The prevalence of head injury at rock concerts is corroborated by a study of the 1992 Monsters of Rock Festival which reported 123 head injuries, of which over 50% were the result of missiles thrown by audience members. The majority of missiles were large plastic containers (in which beer was sold, but often contained human urine at the time of impact) or wooden replica LP souvenirs that were given away to attendees as promotional items. (Hewitt, 1996) A more recent study of four large concerts reported that 20% of all concertgoers who sought medical attention presented with musculoskeletal trauma (researchers elected not to count head injuries as a unique category) and 10% with lacerations and abrasions. (Janchar, 2000)

A significant limitation to the determination of the true magnitude of concert violence, and perhaps the most significant barrier to prevention, is the fact that there is little protocol for reporting incidents. Large venues typically employ private security agencies, a luxury not afforded to smaller venues, which employ bouncers as security. Private security agencies may file reports on violent incidents, but these are for their private records. In addition, enforcement of reporting policy may be lax, and it may be difficult for researchers to obtain copies of the reports. Smaller venues are unlikely to document violent incidents unless they require police intervention. In all instances, there is no way to guarantee the completeness or accuracy of reporting. Subsequently, much of the data on violent incidents, even if it can be obtained, will be of questionable worth.

If an incident escalates to the point of police intervention, a report should be filed with the police department, but this cannot be guaranteed, and there is no way to ensure that the report will be sufficient to assess outcomes, risk factors, etc. A similar situation faces researchers attempting to gauge concert violence from emergency department reports. In this case, the outcome and certain risk factors (e.g., drugs and alcohol use) will be well-documented; however, information regarding motive may be deficient, and depending upon the cooperation/condition of the victim, the report may not even link the incident to a concert event.

Due to these limitations, one might assume that music festivals with integrated security and medical care would be the preferred source of data, as incidents are clearly linked to a concert event and risk factors can be accurately ascertained. Unfortunately, logistical issues and demand for medical attention at festivals frequently overwhelm the available resources, and data collection is neglected. (Schlicht, 1972) In addition, concertgoers who are injured in violent incidents may be tentative about seeking medical attention for fear of retaliation or removal.

The previous section addressed many barriers to assembling high-quality data. Additionally, it is not logistically feasible to study concert violence prospectively without the use of models and simulations. (Vider, 2004) These methods, while useful, cannot accurately predict the volatile actions of crowds interacting with multiple unique variables. Therefore, concert violence is most accurately studied in retrospect, and many of these studies are reliant upon eye-witness accounts and other alternative measures such as photos and blog entries to collect information. (Hsieh, 2009)
A handful of studies exist in which researchers have attempted to quantify concert violence in terms of traumatic events and their resultant medical usage rates (MUR). For the sake of comparison, I have, whenever possible, transformed available statistics into a common MUR, patients per ten-thousand (PPTT). As discussed previously, Woodstock (1969) and Watkins Glen (1973) provided the earliest opportunities to study concert MUR. Determining exact attendance at both festivals is specious at best, but an estimated 400,000 attended Woodstock, and Watkins Glen event was attended by an estimated 600,000, making it perhaps the largest concert event ever. Onsite medical facilities at these festivals reported MUR of 125 PPTT and 130 PPTT respectively. A 1970 study conducted at an outdoor festival in Madeley, England attended by 40,000 reported comparable MUR of 123 PPTT (Levens, 1971), and these studies gave birth to the belief that 1 of 75 (133 PPTT) outdoor concertgoers would require medical attention (Whipkey, 1976), a figure which a subsequently amended to 100 PPTT. (Sanders, 1986)

The 1982 US Festival was attended by an estimated 410,000 concertgoers and reported an overall MUR of 64 PPTT, likely a testament to improved planning and facilities, as well as a greater proportion of pop and "soft" rock performers. (Ounanian, 1986) Lest we be wary of claims that music type is associated with incidents, a MUR of 177 PPTT was reported for the 62,000 concertgoers attending the 1992 Monsters of Rock Festival, a festival dedicated to heavy metal that included bands such as Iron Maiden and Slayer, whose performances invite formation of mosh pits and whose fanbases are largely young males. (Hewitt, 1996)

In each of these studies, however, the reported MUR fail to make a distinction between medical visits (headaches, bee stings, etc.) and traumatic visits as a result of violent behaviors such as fights and mosh pit incidents. Fortunately, the Madeley study includes an itemized casualty list, which can be used to make educated guesses as to which of the medical visits was violence-related. A very liberal re-assessment suggests a violent behavior-related MUR of 19 PPTT, which when compared to the overall MUR of 123 PPTT, suggests this was a relatively mellow audience with many medical issues. (Levens, 1971) Nonetheless, this study can be compared to a 1996 study of four Chicago-area concerts which reported an overall MUR of 12 PPTT and a trauma-related MUR of 5.1 PPTT, statistics likely biased by the selection of bands (Grateful Dead, Pink Floyd and The Rolling Stones) not typically associated with violent audience behavior at this stage of their careers. (Erickson, 1996)

The largest study of concert MUR to date analyzed 405 concerts over a five-year period (1991-1995) at five Southern California venues to determine whether music type, overall attendance, temperature or indoor/outdoor setting were associated with MUR The study reported a median usage rate of 2.1 PPTT, a statistic biased by the fact that 206 of the concerts (51%) analyzed were of classical music. Rock concerts were characterized by higher MUR than non-rock (13.7 PPTT vs. 7.1 PPTT), and the largest number of reported incidents (79) and largest MUR (71 PPTT) were observed at concerts by Metallica and an all-day punk festival respectively, both of which featured prominent mosh pits. Subsequently, the investigators concluded that music type might be the best predictor of MUR, with rock concertgoers being 2.5 (2.0-3.0) times more likely to require medical attention than non-rock concertgoers. However, the investigators were careful to note that "concert-to-concert variability was far higher than the predictive strength of music type," as well as the fact that gospel/Christian music displayed the study's highest median MUR (12.6 PPTT), likely a product of chance given limited events (3) and the lowest median age of concertgoers (15). (Grange, 1999) Despite the methodological flaws, this study introduced to concept of mosh pits as a significant risk factor in concert violence. A later study of a 4-day festival in Washington D.C. in the late 1990s, recognizing the significance of aggressive audience behaviors, reported an overall MUR of 83 PPTT, along with a mosh pit-specific MUR of 25 PPTT. (Janchar, 2000)

The most recent study of concert violence attempted to identify variables predictive of concert violence, and further elucidate the impact of mosh pits on MUR by analyzing 21 concerts held between 1997-1999 at two outdoor venues in the Washington D.C. area. An overall MUR of 30 PPTT was reported; however, after stratifying on presence/absence of a mosh pit, investigators reported a MUR of 7.5 PPTT at concerts without mosh pits, and a MUR of 110 PPTT at those with mosh pits. In addition, the overall MUR at the venue which allowed mosh pits was 7 times greater than the venue at which mosh pits were banned. Interestingly, precipitation was also predictive of traumatic-related incidents (OR = 1.86, 95% OR = 1.37-2.54), while age and gender were not. (Milsten, 2003)

Studies of concert violence, though limited, have uncovered a handful of common risk factors that are regularly associated with an increased risk of concert violence.

Music Type (Genre)
Numerous studies have suggested that music type may be associated with concert violence. (Chan, 2003 and Milsten, 2003) One study reported that audience members at rock concerts have 2.5 times the probability of seeking medical attention compared to audience members at non-rock concerts; however, this finding was somewhat undermined by the researchers' conclusion that music type accounted for only 4% of the variability in observed medical usage rates, and concert-to-concert variability far surpassed the predictive strength of musical genre. (Grange, 1999) It has also been suggested that an association exists between particularly "heavy" musical types (punk and the various permutations of metal) and aggressive behavior; however, it is less clear which direction the arrow of causality points. (Arnett, 1992)

Aggressive Audience Behaviors (Mosh Pits)
The prevalence of aggressive audience behaviors (including mosh pits, slam dancing, crowd surfing and stage diving) is positively associated with concert violence. The evidence of mosh pits as a risk factor supported by several studies which reported that, controlling for other variables, concerts with mosh pits resulted in more violent incidents than those without. (Janchar, 1999 and 2000; Grange, 1998; Milsten, 2003)

Volume
Despite the fact that it often goes hand-in-hand with music type, studies have suggested that volume is an independent risk fact for concert violence. Studies of the behavioral effects of music volume report that loud music shares many similarities with alcohol and mood-altering drugs, specifically its ability to create arousal in the listener while simultaneously elevating his/her pain and tactile thresholds. (Whipple, 1992 and Florentine, 1998) This finding is supported by studies which have reported that risk behaviors in noisy environment far exceed those observed in quieter environments. (Bohlin, 2007)

Audience Mobility
The suggestion of audience mobility as a risk factor for concert violence is significant as this posits that mobility, moreso than audience size (which Chan, 2003 and Grange, 1999 found to minimally significant), is associated with violence-related incidents. Certainly any discussion of audience mobility requires an examination of general admission seating, which increases density of the audience near the stage as concertgoers jostle for position, encourages crowd surfing and facilitates the formation of mosh pits. (Milsten, 2003) It is worth noting that in the wake of The Who's Cincinnati tragedy, general admission concert seating was banned in the city for 25 years.

Concert Duration
At least one study has reported that concert duration works in concert (no pun intended) with audience mobility as a predictor of concert violence. (Milsten, 2003) This finding partially challenges the findings of an earlier study which suggested that shorter festivals held over a weekend were subject to more violence than longer festivals that were staged during the week. (Schlicht, 1972)

Age
Several studies suggested younger audience members are more likely to imbibe in excessive amounts of drugs and alcohol and participate in aggressive behaviors; however, many disagreed regarding the role that age plays in concert violence. One reported that only 9% of violent incidents involved concertgoers over the age of 30 (Janchar, 2000), another reported no apparent association (Milsten, 2003), while yet another elected to not analyze age data due to it being included in only 40% of all records. (Grange, 1999)

Drugs and Alcohol
In is paper The Human Choice: Individuation, reason, and order versus deindividuation, impulse and chaos, Zimbardo suggests that drugs and alcohol may lead to deviant behaviors in crowds owing to their ability to minimize the individual's abilities of "self-observation" and "self-evaluation." (Zimbardo, 1970) Available studies agree on the role of drugs and alcohol as a risk factor for concert violence: Chan and Quinn reported that 45% of all cases (trauma and medical combined) at rock concerts were related to drug and alcohol use, whereas this figure fell to 22% for pop concerts. One study that attempted to assess the role of drugs and alcohol in violence-related trauma reported 27% of the concertgoers who sought medical attention admitted to drug and alcohol use prior to their visit. (Erickson, 1996) A second study reported a figure of 11% (Grange, 1999)

Availability of Missiles
Multiple studies reported ready availability of missiles as a risk factor for concert violence. Missiles, promotional items, often given to concertgoers, capable of being thrown were found to be positively associated with violence directed both at performers and concertgoers. (Milsten, 2003 and Hewitt, 1996)

Additional Risk Factors
A study of outdoor music festivals suggested that the use of inexperienced or untrained security guards, particularly with dogs, was a risk factor for concert violence. (Schlicht, 1972) While this was the only study to suggest this association, it is worth noting that the violence at Altamont was largely blamed on Hell's Angels motorcycle club providing security services in exchange for beer.

Weather also proved to be an interesting variable in studies of concert violence at outdoor festivals. Most studies reported that temperature had no association with violent behavior after controlling for other variables, while one study (likely the only one unfortunate enough to encounter inclement weather) suggested that temperatures above 80° and precipitation were both positively associated violence-related trauma. (Milsten, 2003)

Determining the risk factors positively associated with concert violence is challenging, but studies suggest many opportunities for intervention in an attempt to reduce the incidence and seriousness of concert violence.

Better data collection and reporting
Venues must do a better job of anticipating and planning for violent audience behaviors. (Janchar, 2000) To this end, public health must do a better job of collecting and disseminating data. A national database on concert violence should be established to allow venue owners to identify acts whose performances are regularly accompanied by violence. Reporting of incidents should be mandatory for all venues, regardless of size; however, as an interim step, venues should be contacted regularly by local health department employees for oral reporting. This database would allow alerts triggered by trends in concert violence surveillance, not unlike infectious disease.

No more general admission
While no study explicitly identified general admission policies as being positively associated with concert violence, several alluded to its role in increased crowd density and formation of mosh pits. (Milsten, 2003) It also bears mentioning that in the aftermath of The Who's Cincinnati tragedy, general admission concerts were banned in the city for almost 25 years. In addition, venues should be cautioned about selling beyond capacity, and should be subject to random fire marshal inspections.

Keep to schedule
The Cincinnati tragedy is raises an important issue about scheduling and communication. Venues should advertise times at which doors will open, as well as times at which each performer will take the stage, and then adhere to the schedule. Potential delays should be clearly communicated to audiences to squelch rumors.

Professional security
The additional cost may be prohibitive, but all venues should utilize professional security services. (Chapman, 1982) Furthermore, venue management should insist that security services provide accurate documentation of all violent incidents.

Onsite medical care
Onsite medical care should be required for all large concerts and multi-day festivals. Smaller venues should be required to have a specified proportion of employees certified in first aid.

Transport
Venue should plan and coordinate with local law enforcement and emergency departments to draft procedures for transporting injured concertgoers. (Chapman, 1982)

Limiting Drug and Alcohol Use
The majority of existing studies of concert violence acknowledge the suspected contribution of alcohol and drugs; however, none have attempted to assess it directly. Given the documented association of alcohol and drugs with aggressive behaviors, venues should observe strict policies of denying admittance to/not serving obviously intoxicated individuals, as well as removing intoxicated individuals at the first indication of violent behavior.

Limiting Projectiles
Multiple studies identified thrown projectiles as a major risk factor, and one which could easily be attenuated by limiting promotional giveaways and serving drinks in small, lightweight cups. (Hewitt, 1996; Milsten, 2003)

Lower volumes
Given the research on the association of volume and aggressive behavior (as well as physiological conditions such as tinnitus), venues should take steps toward reducing volume levels.

Teaching safer moshing
As long as "heavy" music and general admission policies exist, so will aggressive audience behaviors. Following the deaths at the 2000 Roskilde Festival, crowdsurfing was banned at the majority of European festivals. If moshing and crowdsurfing policies cannot be banned, or policies not enforced, it may be beneficial to put the burden on concertgoers themselves. To this end, artists such as Ian MacKaye of Fugazi and Minor Threat and Billy Corgan of Smashing Pumpkins have been known to address the risks of moshing during shows. Furthermore, if concert violence is recognized as a problem, resources such as Paul Wertheimer's Can Moshing Be Made Safer? might make "mosher-friendly" techniques more popular. (Wertheimer, 1995)

As long as music is viewed as a commodity, people will gather for performances. The rise of digital music distribution, legal and illegal, has resulted in artists becoming even more dependent upon live performances, as ticket and merchandise sales are far more lucrative to artists than CD sales and downloads. Despite common perceptions, concert violence is not a new phenomenon; however, incidents are becoming more frequent, more serious and more highly publicized. Clearly concert violence is the result of an unpredictable and complex cocktail of risk factors, but venue owners and promoters must begin actively taking steps to minimize those factors which are within their control.

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