Hosting UEFA EURO 2024 in Germany: changes in substance-related emergency department utilization

Introduction

Mass-gathering events (MGEs) have important public health implications. Large-scale sporting events, which often increase the social acceptance and availability of substances, can amplify consumption behaviors and lead individuals to exceed their usual limits. However, evidence on short-term changes in substance-related healthcare utilization remains limited and heterogeneous in Germany. Accordingly, the Robert Koch Institute analyzed routine ED data from the AKTIN Registry to detect changes in substance-related ED visits during the men’s UEFA EURO 2024 hosted in Germany.

Methods

Three syndrome definitions based on ICD-10-GM diagnoses, chief complaints, and age criteria were developed to identify intoxication patterns: any psychotropic substance intoxication (SATX), acute alcohol intoxication (ATX), and substance intoxication excluding alcohol (STX). Cases during the tournament period (14 June–14 July 2024) were compared with a reference period including pre- (17 May–2 June) and post-tournament phases (15–28 July). Analyses were stratified by sex, age group and triage level. Relative changes (Δ%) were calculated as percentage differences between periods.

Results

Between 1 January 2018 and 9 September 2024, 5.6 million ED visits from 39 EDs were analyzed. Substance-related intoxications accounted for 2.6% (SATX), 1.2% (STX), and 1.1% (ATX) of all visits. During the tournament period, moderate increases were observed across all indicators. Cases were more frequent among males, with further increases during the tournament (SATX: +4.9%; ATX: +5.1%; STX: +3.3%), and predominantly affected middle-aged adults. A moderate rise in less urgent visits (triage level 4) was observed.

Conclusions

Increases in substance-related ED visits were observed during EURO 2024; however, absolute case numbers remained moderate, indicating that an anticipated surge in substance use may not have materialized at the national level across participating EDs.

Key messages

• This study provided a first multicentre perspective on dynamics of substance-related ED utilization at the national level in Germany.

• Findings provide reassurance that the EURO 2024 did not result in an alarming additional burden on participating EDs that would have required immediate public health intervention.