The Ecstasy and the agony

Dr Chris Luke (right) treats 700 people a year for club-related injuries. Emma Cook on the perils of a good night out

The days of Saturday Night Fever are back. This time it's nothing to do with John Travolta, but an epidemic of injuries, illnesses and ailments caused by hours spent nightclubbing.

For clubbers, the morning after a night spent dancing and drinking can bring a range of complaints from Techno Toe to Ravers' Rash and PVC Bottom. Heat illnesses and fungal and viral infections, as well as painful joints and stiff muscles caused by dancing on a concrete rather than fully sprung floor, are all familiar problems.

Now the staff of Accident and Emergency departments have become so concerned about the growing ranks of young people ending up in casualty that a conference on the issue is to be held at the end of this month.

As well as looking at how to cope with the rise in nightclub injuries, including those that are drink- and drug-related, the conference, organised by Liverpool University's department of public health, will focus on how to promote better health in nightclubs. Dr Mark Bellis, senior lecturer in public health at the university and one of the conference organisers, said: "Clubbing's an important part of a generation's pastime. The more we can understand about it the better - and the more we can introduce healthy measures."

The cause for the rise in injuries is the familiar dance culture formula: take hundreds of clubbers, pour into a confined space, infuse with sweat, drugs and alcohol, increase heat and mix vigorously for at least six hours. Among those attending the Health of the Clubbing Nation conference at Liverpool's Cream nightclub will be Dr Chris Luke, A & E consultant of the Royal Liverpool University Hospital. He has spent several evenings in nightclubs in the course of his research over the past two years and admits: "What struck me is how little we understand about this scene - even the language and words clubbers use have moved on so quickly.

He mentions "beaked up", which means snorting cocaine and "sledging", an adverse reaction to Ecstasy, as relatively recent terms. Dr Luke estimates he treats 700 people a year for club-related injuries. "What's new is the scale of the problem. Now an estimated 1 million people go clubbing every weekend; the NHS is absolutely creaking under the workload."

He estimates that 80 per cent of the clubbing accidents he sees are alcohol- related, leading to violence and glass injuries, while 10 per cent are drug induced, such as heat illness, panic attacks and dehydration. Many of the injuries are "self-limiting" such as being poked in the eye, falling off platform shoes and, infamously, "nightclub nettle".

At The End, a club in central London, it is speed garage night and Tony, aged 30, explains how he got the nettle rash. He had spent the night dancing in his vest in a packed club.

"I woke up with this rash all over my chest and back that looked like nettle stings but with big red halos around them. Apparently it was a rare virus that you can pick up in close contact with lots of other people." He admits that in a "monged" state his biggest problem has been walking into mirrors.

Nearby two student friends, Janet, aged 22, and Charlotte, aged 23, standing at the bar in black Lycra, recall a near disaster in a north London club last year. "You used to get off your head in the loos then pile down thisiron spiral staircase that was a hazard, especially in platforms."

Among other ailments afflicting clubbers are PVC Bottom - friction burns caused by wearing manmade fibres on sweating bodies; Techno Toe - chunks of flesh gouged out by toenails after hours of dancing, and Ravers' Rash - a form of heat rash.

Dr Patrick French, of the Mortimer Market Clinic, says: "In clubs there are increased risks of sweat rashes, fungal infections such as tinea in the groin area,the sort of symptoms you'd expect if you worked out too much."

Meanwhile, Professor John Henry at St Mary's Hospital, Paddington, says a mix of amphetamines and excessive dancing on concrete floors could put stress on backs and joints.

Dr Luke, who compares clubbing to marathon running, makes the experience sound like a medieval vision of hell. "They are cauldrons in comparison to old-fashioned discotheques," he says, with people "writhing and dancing and sweating".

The problem is "writhing and dancing and sweating" is part of the appeal. Attempting to remove or reduce the noise, heat, sweat and friction would miss the point. Dr Luke argues: "Clubs need to take responsibility for their clientele; to monitor their heat, water availability, and get rid of glass."

Tony Wilson, managing director of Factory Records and co- owner of Manchester's Hacienda club, will discuss the success of the city's "safer dance policy" of free water and chill-out rooms in all clubs, at the conference.