Artificial Turf: Links and
Summaries
Published Reports on Safety
The following abstracts are from
articles published in respected medical journals. Because
artificial turf quality and construction has changed considerably
in recent years, the AFC decided to select studies published
since 2000. The abstracts are a bit technical; we're
putting together an annotated summary, which will be ready
when we get done. If you want to do your own search, you
might try Google
Scholar and type in "artificial turf safety"
Incidence, causes, and severity of high school football
injuries on FieldTurf versus natural grass: a 5-year prospective
study.
Am J Sports Med. 2004 Oct-Nov;32(7):1626-38 Meyers
MC, Barnhill BS., Human Performance Research Center, West
Texas A&M University,
Canyon, Texas
BACKGROUND: Numerous injuries have been attributed to playing
on artificial turf. Recently, FieldTurf was developed
to duplicate the playing characteristics of natural grass.
No long-term study has been conducted comparing game-related,
high school football injuries between the 2 playing surfaces.
HYPOTHESIS: High school athletes would not experience any
difference in the incidence, causes, and severity of game-related
injuries between FieldTurf and natural grass.
STUDY DESIGN: Prospective cohort study.
METHODS: A total of 8 high schools were evaluated over 5
competitive seasons for injury incidence, injury category,
time of injury, injury time loss, player position, injury
mechanism, primary type of injury, grade and anatomical location
of injury, type of tissue injured, head and knee trauma, and
environmental factors. RESULTS: Findings per 10 team games
indicated total injury incidence rates of 15.2 (95% confidence
interval, 13.7-16.4) versus 13.9 (95% confidence interval,
11.9-15.6). Minor injury incidence rates of 12.1 (95% confidence
interval, 10.5-13.6) versus 10.7 (95% confidence interval,
8.7-12.7), substantial injury incidence rates of 1.9 (95%
confidence interval, 1.4-2.6) versus 1.3 (95% confidence interval,
0.8-2.1), and severe injury incidence rates of 1.1 (95% confidence
interval, 0.7-1.7) versus 1.9 (95% confidence interval 1.2-2.8)
were documented on FieldTurf versus natural grass, respectively.
Multivariate analyses indicated significant playing surface
effects by injury time loss, injury mechanism, anatomical
location of injury, and type of tissue injured. Higher incidences
of 0-day time loss injuries, noncontact injuries, surface/epidermal
injuries, muscle-related trauma, and injuries during higher
temperatures were reported on FieldTurf. Higher incidences
of 1- to 2-day time loss injuries, 22+ days time loss injuries,
head and neural trauma, and ligament injuries were reported
on natural grass.
CONCLUSIONS: Although similarities existed
between FieldTurf and natural grass over a 5-year period
of competitive play, both surfaces also
exhibited unique injury patterns that warrant further investigation.
Does the Use of Artificial Turf Contribute to Head Injuries?
(Abstract)
Journal of Trauma-Injury Infection & Critical
Care. 53(4):691-694, October 2002. Naunheim, Rosanne
MD; McGurren, Michael MD; Standeven, John PhD; Fucetola,
Robert PhD; Lauryssen, Carl MD; Deibert, Ellen MD
Background : A number of high-profile professional
football players have suffered career-ending concussions. The
purpose of this article is to test the surfaces used by a professional
team to determine their impact-attenuating properties.
Methods : An accelerometer was dropped from
a height of 48 inches onto three different playing fields in
the St. Louis area: an indoor artificial turf practice field,
a grass outdoor practice field, and the artificial turf field
at a domed stadium. The accelerometer was dropped 20 times
from a height of 48 inches onto each surface.
Results : Statistical analysis of the peak
Gs for impacts onto each surface indicate all three are statistically
different. The artificial surface of the domed stadium was
the hardest surface, with an average peak acceleration of 261
Gs compared with 183 Gs for the indoor artificial turf practice
field and 246 Gs for the outdoor grass field.
Conclusion : The surface used to play league
games has the least impact attenuation of any field tested
and may contribute to the high incidence of concussion in football
players.
(C) 2002 Lippincott Williams & Wilkins, Inc.
A comparison of artificial turf.
Naunheim R, Parrott H, Standeven J., From the Departments
of Emergency Medicine (R.N., H.P.) and Neurosurgery (J.S.),
Washington University, St. Louis, Missouri., J Trauma.
2004 Dec;57(6):1311-4.
BACKGROUND:: In an attempt to decrease injuries, newer forms
of artificial turf have been marketed. The purpose of this
study was to determine whether a new shredded rubber-based
turf improves impact attenuation. METHODS:: An instrumented
computerized impact recording device (IRD, Techmark, Lansing,
MI) was dropped 20 times from a height of 48 inches onto five
types of turf used by a professional football team. RESULTS::
Duncan's multiple range test shows that the new rubber-based
field and the older foam field are not significantly different.
There were significant differences, however, between sites
on the shredded rubber-based field. CONCLUSION:: The change
from a foam-based system to a shredded rubber-based system
had no effect on impact attenuation overall. However, areas
in the shredded rubber-based field were significantly compacted,
causing some sites to be much harder than the foam-based surface
it replaced.
A high-morbidity outbreak of methicillin-resistant Staphylococcus
aureus among players on a college football team, facilitated
by cosmetic body shaving and turf burns.
Clin Infect Dis. 2004 Nov 15;39(10):1446-53. Epub 2004 Oct
26
Begier EM, Frenette K, Barrett NL, Mshar P, Petit S, Boxrud
DJ, Watkins-Colwell K, Wheeler S, Cebelinski EA, Glennen
A, Nguyen D, Hadler JL
BACKGROUND: Athletics-associated methicillin-resistant Staphylococcus
aureus (MRSA) infections have become a high-profile national
problem with substantial morbidity. METHODS: To investigate
an MRSA outbreak involving a college football team, we conducted
a retrospective cohort study of all 100 players. A case was
defined as MRSA cellulitis or skin abscess diagnosed during
the period of 6 August (the start of football camp) through
1 October 2003. RESULTS: We identified 10
case patients (2 of whom were hospitalized). The 6 available
wound isolates had indistinguishable pulsed-field gel electrophoresis
patterns (MRSA strain USA300) and carried the Panton-Valentine
leukocidin toxin gene, as determined by polymerase chain
reaction. On univariate analysis, infection was associated
(P<.05) with
player position (relative risk [RR], 17.5 and 11.7 for cornerbacks
and wide receivers, respectively), abrasions from artificial
grass (i.e., "turf burns"; RR, 7.2), and body shaving
(RR, 6.1). Cornerbacks and wide receivers were a subpopulation
with frequent direct person-to-person contact with each other
during scrimmage play and drills. Three of 4 players with
infection at a covered site (hip or thigh) had shaved the
affected area, and these infections were also associated with
sharing the whirlpool > or =2 times per week (RR, 12.2;
95% confidence interval, 1.4-109.2). Whirlpool water was
disinfected with dilute povidone-iodine only and remained
unchanged between uses. CONCLUSIONS: MRSA was likely spread predominantly during
practice play, with skin breaks facilitating infection. Measures
to minimize skin breaks among athletes should be considered,
including prevention of turf burns and education regarding
the risks of cosmetic body shaving. MRSA-contaminated pool
water may have contributed to infections at covered sites,
but small numbers limit the strength of this conclusion. Nevertheless,
appropriate whirlpool disinfection methods should be promoted
among athletic trainers
Epidemiology of concussion in collegiate and high school football
players.
Guskiewicz KM, Weaver NL, Padua DA, Garrett WE Jr.
Department of Exercise and Sport Science, University of North
Carolina, Chapel Hill 27599-8700, USA, Am J Sports Med. 2000
Sep-Oct;28(5):643-50
Abstract: Despite evolutionary changes in protective equipment,
head injury remains common in football. We investigated concussion
in football and associated epidemiologic issues such as
1) incidence of injury, 2) common signs and symptoms, and
3) patterns in making return-to-play decisions. We received
242 of 392 surveys (62%) that were sent to high school and
collegiate certified athletic trainers at the beginning
of three football seasons. Of the 17,549 football players
represented, 888 (5.1%) sustained at least one concussion,
and 131 (14.7% of the 888) sustained a second injury during
the same season. The greatest incidence of concussion was
found at the high school (5.6%) and collegiate division
III (5.5%) levels, suggesting that there is an association
between level of play and the proportion of players injured.
Players who sustained one concussion in a season were three
times more likely to sustain a second concussion in the
same season compared with uninjured players. Contact with
artificial turf appears to be associated with a more serious
concussion than contact with natural grass. Only 8.9% of
all injuries involved loss of consciousness, while 86% involved
a headache. Overall, 30.8% of all players sustaining a concussion
returned to participation on the same day of injury.
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