Weighing the complex public health and community impacts of artificial turf
Why are people so concerned about artificial turf?
Since 2015, when soccer coach Amy Griffin went public with her concerns about seemingly elevated cancer rates among young soccer players, parents have expressed concern regarding potential toxic exposures to children. Although Coach Griffin’s concerns were investigated and found to be unwarranted, it is easy to see why crumb rubber elicits such worry. The crumb rubber used in most artificial turfs is a recycled material (a waste product) and it does not stay on the field. Instead, it gets caught up in clothing and equipment and is often found in vehicles, in homes, and even on the body while bathing or showering after a match. The non-natural character of this material, and the fact that it follows us into our homes, are factors that greatly elevate or amplify perceived risk, especially when those exposed are children.
What does research say about the toxicity of artificial turf?
A great deal of research has looked into the potential toxic effects of artificial turf exposure, using a process known as a human health risk assessment (HHRA). An HHRA is a systematic procedure that uses physical and chemical characteristics, as well as toxicological studies in animals, to determine whether a known amount of exposure is likely or unlikely to result in harmful health effects in humans. The NCCEH provides an overview of HHRA methodology and HHRAs pertaining to artificial turf on our website. To date, no peer-reviewed HHRA has identified an unacceptable risk of adverse health effects in adult players, youth players, spectators, or field workers.
Two other small-scale health studies have looked at the incidence of childhood cancer in relation to artificial turf exposure (the Washington State investigation and another ecologic study done in California), and found no association. Although these studies can’t rule out the possibility of childhood cancer due to artificial turf exposure, they demonstrate in principle why such an association is highly unlikely and certainly negligible compared to other exposures that most certainly do impact children’s health. For example, childhood exposure to UV is strongly linked to both long-term skin damage and skin cancer, a critical exposure that can and does affect children throughout their entire lives. Thus, crumb rubber is certainly not the most dangerous thing on a soccer field.
Does that mean artificial turf is safe?
Although artificial turf exposure is unlikely to cause adverse toxicological effects, playing on artificial turf does have other positive and negative benefits on players. Many studies have looked at the effects of artificial turf on head injuries, on musculoskeletal injuries, on the risk of heat stress from playing on a hot field, on “turf burns,” and on the risk of infection. However, effects on players appear to vary based on sex, age, and intensity of play, making it very difficult to come to some determination as to whether artificial turf is overall harmful or beneficial to players. This is an area of ongoing research.
Another important but poorly understood aspect of artificial turf is what effect is has on healthy physical activity in a community. When children and adults are physically active, as in playing soccer, they reduce their risks of obesity and other illnesses (including cancer). If choosing an artificial turf means that more fields can be built, that more people can access fields, or that fields can be played on all year long, then artificial turfs may have a very positive impact on population health by promoting physical activity.
Thus, the answer as to whether artificial turf is “good” for a community is a complex question, and should consider both the potential impacts and benefits.
What are the alternatives to artificial turfs?
There are more and more commercially available alternatives to crumb rubber in artificial turf, including more “natural” products (e.g., cork, coconut fiber) and other types of synthetic fills. However, it is important to note that all of these alternatives must be assessed with respect to performance, health impacts and benefits, and other parameters. Choosing a new and relatively unknown material may not necessarily be the fastest or most efficient way to get to a safe, healthy, and equitable play space.
In addition to other types of artificial turf, some communities have expressed the interest in simply returning to natural turfs. There are two important considerations for this approach. First, it should be considered whether using natural turfs will impose limits on how much play can occur, and what effect will this may have on physical activity levels and overall health, as mentioned above. Secondly, it is important to recognize that a “natural” turf may not be inherently healthier than an artificial turf. After all, grassy fields grown in an urban environment will be subject to the same deposition of pollutants (from traffic or industrial emissions) as nearby artificial turfs. Previous research has shown that natural turfs are similar or worse than artificial turfs in terms of the presence of toxic agents and potential human health risks. Therefore, a natural turf field may also be a source of exposure to toxic chemicals (not to mention animal feces) and users should be strongly encouraged to wash their hands after play and before eating. Good hand hygiene prevents many ills.
What else should we be thinking about?
The choice between a natural vs. an artificial turf (of various types) is further complicated by a host of non-health-related factors that may be relevant to the community. A full discussion of these factors is out of the scope of this short blog, but may include:
- Promoting equity and social justice by providing high-quality play space to all children in the community;
- Operational considerations, including the costs of maintenance, availability of water, and appropriate climate;
- Threats to the environment, such as the generation of leachable microplastics;
- Climate resilience, which may be affected by artificial turf-related urban heat islands;
- Climate accountability, by considering the carbon emissions embodied in the installation, use, and disposal of playing field materials.
The available evidence does not indicate that exposure to crumb rubber from artificial turf is toxic to humans. Although crumb rubber does contain toxic substances, neither players nor spectators interact with it in a way that could lead to poisoning or toxic effects.
However, as with most public health issues, the matter is not as simple as discounting toxicity. Artificial turfs may not pose a toxicological health risk, but their cumulative effects on human health – in terms of injury, thermal stress, abrasions, and infections – are unclear, and may in fact depend on the age, sex, and skill level of the player. Furthermore, artificial turfs have other positive and negative effects on communities, so much so that it may not be clear what type of field best promotes overall health in a particular community.
So how do we know what’s “right” for our communities? Such determinations can only come through dialogue and (more importantly) explicitly and fairly considering the very real tradeoffs that occur when choosing among the various turf alternatives. Throughout this process, however, we must remain focused on what is important, which is what will give our children happy, active childhoods and long, healthy lives.
Check out the NCCEH’s other resources on our Artificial Turf and Crumb Rubber topic page, and check out the Environmental Health Review article entitled “Artificial Turf: The contributions and limits of toxicology in decision-making.”