Risks Associated With Artificial Turf Playing Fields

by Philip J. Landrigan, MD, MSc, Chair of the Department of Preventive Medicine, the Ethel H. Wise Professor of Pediatrics, Director of the Children's Environmental Health Center, and Healthy Child Healthy World Scientific Advisory Board member

Artificial turf fields have multiplied over the past decade. Many questions remain as to how
these fields may affect children's health. Where installation of turf fields is still under consideration, I recommend delaying the decision until the questions about the safety of artificial turf have been studied more thoroughly.

Not all turf fields are constructed the same way. First generation fields, or Astroturf, is the spongy carpet-style surface, while second generation turf fields are layered synthetic surfaces with plastics blades of grass infilled with a mixture of rubber pellets and sand or just rubber. Note that each company has its own installation method and source for rubber, so there will be variation from field to field.

Proven hazards to children's health are three: (1) heat, (2) "turf burns" or abrasions, and (3) turf toe. In addition, recycled tires are known to contain a mix of chemicals. These chemicals include, among others, rubber chemicals, polycyclic aromatic hydrocarbons (PAHs) and heavy metals - lead, zinc and cadmium. What is not yet known is the extent to which these chemicals may get in to the bodies of children playing on turf fields, their associated health risks, or the extent to which they may leach from the fields into the surrounding environment, soil and groundwater. More recently, traces of lead have been detected in the pigment of the plastic blades of some grass and in the carpet-style Astroturf, causing further grounds for concern.

Dangerous Temperatures

Studies show that the temperatures on artificial turf fields and in the area just above where children play can reach dangerously high levels that are significantly greater than temperatures of grass fields. When the air temperature is in the 80's or 90's, temperatures above the turf can exceed 150° F. Any temperature above 122° F can injure or burn skin in less than 10 minutes. Also, heat stress and heat stroke are possible for children playing strenuously on the hot fields.
Temporary measures to combat the elevated temperatures, such as watering the fields, are already being used. However, at least one study shows that the temperature rebounds very
quickly after being watered.

Staph Infections

Injuries resulting from normal play-such as from sliding or falling- cause larger than normal abrasions or "turf burns" on turf fields. Links between the rise in cases of MRSA (methicillin-resistant staphylococcus aureus), an antibiotic-resistant staph infection, to artificial turf fields raise additional questions about safety. In response to the increased threat of infections, some have suggested spraying synthetic fields with antimicrobials or even including them in the plastic components that make up the fields. Increasing children's exposure to bacteria fighting chemicals, however, carries its own risk.

Turf Toe

Another proven injury is turf toe, which is so named because it often occurs in football and soccer players when playing on artificial turf. Turf toe is a sprain of the base of the big toe at the point where it meets the foot. It frequently occurs when a player hyperextends his or her foot by stopping suddenly on a playing field. One possible way of preventing injury is to wear stiff-soled athletic shoes when playing sports.

In order to reduce your child's risk of exposure:

  • Do no use the turf fields on extremely hot days.

  • Be sure to clean and monitor any "turf burns" obtained while playing.

  • Attempt to remove the pellets from shoes and clothes prior to leaving the fields.

  • At home, shake out your children's equipment and clothes in the garage or over the garbage.

  • Have your child shower and wash thoroughly after playing on the field.