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.