www.SynTurf.org

On This Page  [see also Players' View and Beckham's Lament]


No. 14   Connection between turf and concussions (July 2008).

No. 13   Orthopedic/sports medicine surgeon says athletes get hurt on turf as often as on grass (June 2008).

No. 12   Synthetic Turf: A Question of Ingestion (a video clip) (June 2008).

No. 11   Protecting users and public with help of informational signs at turf fields (June 2008).

No. 10   South African soccer legend cautions about artificial turf (June 2008).

No. 09   Argonauts' running back injured by turf (June 2008).

No. 08  Footwear technology to reduce injury from turf (May 2008). 

No. 07  Is turf especially cruel to female athletes? (April 2008).

No. 06  MLS urged to encourgae natural grass fields. March 2008 

No. 01  Editor's Note.

No. 02  Synthetic turf playing fields present unique dangers.

No. 03   Staph infection at Winchester High School.

No. 04  Field of nightmares. 

No. 05  San Francisco Parks Poised To Infect. February 2008. A Pictorial 

[No. 14] Connection between turf and concussion in female field players: a hypothesis. SynTurf.org, Newton, Mass. July 17, 2008. A recent news story in The Boston Globe reported that female athletes suffer more head injuries than males. The article described the concussion suffered by a University of Massachusetts’ midfielder when she went up for a header and was knocked off balance by the impact of another player’s head hitting hers. The article was focused on girls experiencing concussion at rates 27% more than boys in soccer, 66% in basketball and 80% in ice hockey. See Jordana Bieze Foster, “Female athletes suffer more head injuries than males,” The Boston Globe, July 14, 2008, Health/Science section, at page A7, available at   http://www.boston.com/news/science/articles/2008/07/14/female_athletes_suffer_more_head_injuries_than_males/ .

The article did not mention the surface or speed as a contributing factor to the concussion suffered by the midfielder. Nevertheless, here is however a hypothesis about the role of turf and speed in contributing to collisions that may result in concussion.

One of the characteristics of artificial turf fields is the superior, no-skid traction that artificial turf provides to the athlete, come rain or shine. That characteristic alone contributes to running speed. In a sport lie soccer, the athlete foot speed is further warranted be cause of the faster speed by which the ball moves on the turf surface. The faster the ball speed and faster players combined to generally speed up the game. It is, therefore, a matter of reasonable inference, collisions in soccer games that are played on turf fields are often unavoidable and with harder impact. It is SynTurf.rg’s view, while the size of the arena, athleticism and type of surface in ice hockey and basketball generate speed, which need not be the case in soccer. In girls’ soccer (as well as in boys), speed can be reduced if the game is played on natural grass. This especially should be the case for youth soccer.

[No. 13] Orthopedic surgeon: Athletes get hurt on turf as often as on grass. SynTurf.org, Newton, Mass. June 26, 2008. Dr. Craig McKirgan is an orthopedic surgeon with the Center for Orthopedics & Sports Medicine (COSM) in Indiana, Pennsylvania. According to a news story in Indiana Gazette, on Monday, June 23, 2008, McKirgan’s 45-minute PowerPoint presentation to the Indiana Area School Board showed “that athletes get hurt playing on artificial turf as often as they do playing on natural grass.”  He also told the Board “that players have higher risks of contracting MRSA, a drug-resistant bacteria, from sitting in a whirlpool or sharing towels than they do from falling on artificial turf.” McKirgan said his PowerPoint presentation will be posted next week on his company's Web site, www.pacosm.com. Source: Chauncy Ross, “IASD: Prthopedic surgeon weighs in on turf issue,” in Indiana Gazette, June 24, 2008, available at http://online.indianagazette.com/index.php?option=com_content&task=view&id=30793&Itemid=52 .

[No. 11] Protecting users from heat and health hazards of turf fields. SynTurf.org, Newton, Mass. June 22, 2008. On June 19, 2008, the Centers for Disease Control and Prevention issued an advisory about lead in artificial turf fields.[1] In practice, many municipalities have taken to advising players and parents along the lines recommended by the New Jersey Department of health and Senior Services – “[to] perform aggressive hand and body washing after playing on the field, and clothing used on the field should be washed separately.”[2] The New Jersey Department of Health guidelines suggest restricting children under age 7 from using fields with high lead levels, watering down the surface to suppress dust and thoroughly washing hands, bodies and clothing after using the fields.[3] When elevated level of lead forced the closure of the turf field at the Camp Henry (Taegu, South Korea), Dr. (Maj.) Remington Nevin, of the 18th Medical Command’s preventive medicine section, stated “The field at Camp Henry does pose a potential for exposure to lead, provided that children actually ingest whatever dust might come from degradation of that field. Lead should be avoided by adults but is more likely to cause health problems if ingested by children 6 years old or younger. The primary risk is to younger children prone to hand-to-mouth activities. Parents can minimize lead exposure to children by keeping shoes off while in the home, vacuuming with a HEPA filter, cleaning off dust, washing hands and encouraging proper hygiene.”[4] Should such information be posted at the fields as well? The lead dust controversy that began in New Jersey may very well trigger a requirement by the insurance carriers to have municipalities post health signs at artificial turf fields.

The irony here is that turf facilities have a long list of installer/owner-recommended warnings about activities that could damage the carpet. Yet, so far, there has been very little movement on the part of public officials to require posting of health-related signage at artificial turf fields.

Prompted by a recent inquiry as to whether any turf field in the country has a “heat” warning about posting of heat signs at turf fields, SynTurf.org surveyed its readership for any heat or other health related posting at artificial turf fields. It would seem that there is only one such signage anywhere in the country: “Stay healthy: Wash your hands and any cuts, scrapes or burns after play,” reads the sign at South Sunset Playground, San Francisco, California.[5]

In April 2008, SynTurf.org reported on two Massachusetts towns where public health officials were considering signs at turf fields that warned about the heat effect on the fields. “On hot, sunny days, artificial turf can reach turf ground temperatures up to 20 degrees hotter than black asphalt surfaces and/or up to 50 degrees hotter than natural turf. Please be aware that direct contact with these surfaces by you, your children or pets when the temperature is elevated may lead to contact skin burns and/or heat prostration. In addition due to the increased temperature in the over all field environment during these periods, coaches, players and participants are advised to keep fluids readily available and pay close attention to staying hydrated to avoid metabolic heat stress.”[6] There has been no indication if caution overcame the unwillingness of the pols in of Wayland and Weston.    

In annals of turf heat studies, the 2002 measurements by Frank & Williams at Brigham Young University is especially a propos because the study was triggered by complaints from the football coach, who reportedly too suffered blisters on his feet. The Utah Study[7]  soon gave rise to more localized measurements and many of these from Missouri to New York City and Massachusetts have been featured on SynTurf.org.[8] When it came to ascertaining practical health tips and sound field practices, it was all the more appropriate for SynTurf.org to see how they do things at Brigham Young University.      

In a telephone conversation on June 16, 2008, Roy Peterman, director of grounds department (801-422-5410), stated there is no sign or written policy as such to warn players against elevated field temperatures. In the summer months, when the fields receive sunlight as the same angle and with equal severity of southern California, the fields are used 50 minutes at a time, with ten minutes set aside for players to rest and watering the fields. “We use an irrigation system that the supervisors can activate with the push of a button,” he said. The irrigation is necessary to keep the field temperature to below 120 degrees, he said. The university’s approach to combating the heating effect of the turf fields is helped by the fields being closed facilities, with no free play on the part of students or members of the public.    

Peterman considers the proper maintenance of the fields as a greater preoccupation. “Contaminants is a problem with turf fields. You’ve got to maintain the fields. If you have leaves, for example, pathogens is a high possibility.” Another factor in both play and promotion of pathogen is humidity. If the area is humid that is one issue; then by watering the field the humidity goes up, he said. Another problem is the compaction of the field if not maintained properly. “This, Peterman said, “can result in juries.” Already, even on a well-maintained turf field, Peterman noted, last year there were 13 more injuries on artificial turf than on natural grass fields. “The turf is tight, it grabs the cleat when making a cut, and the bounce off the turf rebounds back to the knee and shins.”      

In a municipal setting, Peterman said, “It is probably a good idea to put a sign warning about temperature and humidity,” to protect players.

[No. 10] South African soccer legend Lucas Radebe cautions about artificial turf. SynTurf.org, Newton, Mass. June 10, 2008. The Republic of South Africa is the venue for the 2010 World Cup soccer games. In an effort to meet the demand for international class playing fields, a few new pitches are being readied.

On Sunday, June 8, 2008, the South African soccer legend Lucas Radebe was at hand to mark the opening of FNB Wadley Stadium in Pietermaritzburg. The venue has South Africa’s first full sized artificial turf field.  

While there are reasons why artificial turf might make sense for the 2010 World Cup games in South Africa, Radebe, who played for and captained Leeds United in the 1998/99 season in England, nonetheless has concerns about artificial turf.  He told SuperSport "I used to train on it (artificial turf) in England during my playing days and some of the guys used to complain about their ankles or knees hurting. It does and will affect the joints if a player or a team uses it everyday. I don't see a professional team using it everyday as a training ground or for matches on a weekly basis. It definitely is good for tournaments and games now and again, but not on a regular basis."

Source: “Radebe cautions about artificial turf,” in SuperSport.co.za (South Africa), June 9, 2008, available at http://www.supersport.co.za/football/article.aspx?id=257315&headline=Radebe%20cautious%20about%20artificial%20turf .

[No. 09]  Argonauts’ running back injured by artificial turf. SynTurf.org, Newton, Mass. June 6, 2008. It is a very familiar sight at most public meetings that considers the installation of artificial turf fields – a youngsters takes the microphone and relates an episode that resulted in an ankle injury because of the deplorable conditions of the town’s natural grass field. The implication here is that artificial turf field will not cause injury or as many. This is a fallacious marketing point that the turf industry advances and the municipalities buy it with as much readiness as the notion that a turf field needs no maintenance.     

“[National Football League] trainers and physicians are looking to prevent some of the most common foot and ankle injuries among players, primarily high-ankle sprains and turf toe, an ailment involving joint tears, swelling and intense pain often linked to playing on artificial surfaces,” according to an Associated Press story that appeared in the International Herald Tribune,  on May 10, 2008. See below for details.

Next month, an NFL Injury and Safety subcommittee will see the device for the first time.

League trainers and physicians are looking to prevent some of the most common foot and ankle injuries among players, primarily high-ankle sprains and turf toe, an ailment involving joint tears, swelling and intense pain often linked to playing on artificial surfaces.

Dr. Michael Coughlin, co-chairman of the NFL subcommittee on foot and ankle injuries, contends the new playing surfaces may create more of a risk for ankle and foot injuries.

"We have some preliminary information that leads us to believe that there may be a higher injury rate on the newer infill surfaces compared to grass," Coughlin said.

Associated Press, “Research could lead to fewer turf-related injuries,” in International Herald Tribune, May 10, 2008, Sports, available at http://www.iht.com/articles/ap/2008/05/10/sports/FBN-Artificial-Turf.php.

[No. 07  ] Is artificial turf especially cruel to female athletes? SynTurf.org, Newton, Mass. April 15, 2008. In September 2007, SynTurf.org published a brief called “Beckham’s Lament”  (http://www.synturf.org/beckhamslament.html). It explored the relationship between foot fixation injuries and artificial turf. These are injuries that result from damage to ligaments and joints because of the kind of speed, stops and cuts that an athlete can achieve because of the traction of the turf.

On other pages SynTurf.org has reported also on general athletic health and the degree to which turf compromises it http://www.synturf.org/athletichealth.html. We have reported on staph infections http://www.synturf.org/staphnews.html and http://www.synturf.org/staphturfbrief.html. The daily lamentation about playing on turf is recorded at http://www.synturf.org/playersview.html, while another page reports on teams blaming turf for their performances http://www.synturf.org/miscellanea.html.

None of the athlete-related materials reported on SynTurf.org makes a distinction between male and female athletes. However, as it turns out for the most part the reporting has been from the male athletic perspective, especially professional soccer and football. That may well change, as we learn more about “Women athletes win[ning] equal time on injury list.” That is the title of an article by Judy Foreman for the Health/Science section of The Boston Globe (April 14, 2008), pages C1-C2, available at http://www.boston.com/news/health/articles/2008/04/14/women_athletes_win_equal_time_on_injury_list. The article does not discuss turf in particular, but does point out to the greater risk of injury in areas in which the female athlete is more vulnerable than a male athlete because of the difference their physiologies. SynTurf.org asks: If certain parts of the male anatomy takes a beating from playing on turf, would not playing on turf be more damaging to the same but weaker body part in a female?  

Here are excerpts from the Foreman article that should answer the question: Is Artificial Turf Especially Cruel to Female Athletes?

According to the National Federation of State High School Associations, more than 3 million high school girls play sports. “But there's a dark side to this terrific news: The more girls and women play sports, the more they, like boys and men, get hurt. And - attention athletes, coaches, and parents - they get hurt in different ways.”

Basketball is “brutal on that most vulnerable part of the female athlete's anatomy: the knees.” “And even plain old running seems to be tougher on women's legs than on men's, though it's not clear why.”

“[A]thletic activities can cause different injuries in women and girls than in men and boys. Female athletes and their coaches should pay increased attention to the anatomical differences that put girls and women at disproportionate risks for certain injuries.”

“The sports injuries that seem to disproportionately affect women include:

- Tears in the ACL, or anterior cruciate ligament, in the knee, a problem that hits basketball and soccer players especially.

- Plantar fasciitis, in which activity can cause tiny tears in heel tissue.

- Compartment syndrome in runners, in which lower leg muscles get too tight for the surrounding space, causing severe pain.

 - Shin splints in runners, in which repetitive stress can lead to pain and even fractures in the lower leg.

- Kneecap pain.

- Pain along the outside portion of the leg in the iliotibial band, between the knee and the hip, known as iliotibial band friction syndrome.”

“Women's knees are more vulnerable than men's because the "Q-angle" - the angle between the hip and the knee - is greater in women than in men. While wide hips are good for childbearing, they mean there is more stress on the knee in moves like landing from a jump and twisting. This torque can shred the ACL, a ligament that helps stabilize the knee. This is a major reason why female athletes have four times more ACL tears than men do, said Dr. George Theodore, a Red Sox team physician and sports medicine specialist at Massachusetts General Hospital.”

“Making matters worse for women's knees, especially among basketball players, is that women tend to ‘cut,’ or suddenly change direction, differently from men.” "There's more of a tendency for women to change direction on just one foot, maybe because of the width of the pelvis, while men often use two feet."

“Wider hips also mean that there may be more ‘pull’ on the kneecap, which can cause pain when running uphill. Kneecap cartilage also seems to wear down more in women than in men. And women's kneecaps slide around more from side to side, in part because women have more estrogen, which can make women's ligaments more flexible than men's.

[No. 06] MLS urged to go with natural grass. SynTurf.org, Newton, Mass. March 4, 2008. In this morning’s Boston Globe (4 March, 2008, Sports section, page D8), Frank Dell’Apa stated that the Major league Soccer should not approve artificial turf for the new stadium that will be the home of the newly approved Philadelphia soccer franchise. The stadium will in Chester, Pennsylvania. See “Soccer Notes: Opportunity is there for someone to strike” (item subtitle: Grass is greener) available at http://www.boston.com/sports/articles/2008/03/04/opportunity_is_there_for_someone_to_strike/?page=2.

Dell’Apa reported that by next season 12 of the 14 current teams will be playing on grass fields, with New York and Real Salt Lake going with natural grass, “a trend that should be encouraged,” Dell’Apa wrote. The reason for this exhortation by Dell’Apa is quite clear to the fans of SynTurf.org and other advocates seeking to limit, regulate or outright ban artificial turf fields. Here is what Dell’Apa wrote:

The exposure of young vital organs to potentially harmful substances that turf fields contain may well result in far greater health complications. On the other hand, the ill effects of pesticides and fertilizers used on natural grass fields can be replaced with organic versions of both. Types of grass now exist that grow faster and in much more adverse climates than before. Meanwhile, it should be no secret, the artificial turf fields themselves require substantial amount of bactericide and fungicide and pesticides and other treatments in order to have them kept in a decent playing condition. For more background on maintenance issues associated with artificial turf, go to  http://www.synturf.org/maintenance.html.

2003 -- A study titled “Sports Safety in Australia,” July 2003, concluded “It has been suggested that lower limb injuries, particularly in elite Australian Rules Football, are related to ground conditions and surfaces or the pace of the game. However, specific examination of these factors in community-level sport has yet to be undertaken.” In this assessment the study relied on a 2003 study by Murphy and others on risk factors for lower limb injuries, published previously in the British Journal of Sports Medicine. In that study, three factors were sited for lower limb injury in general: competition settings versus training, artificial turf versus grass or gravel, and previous injury coupled with inadequate rehabilitation. http://www.ausport.gov.au/fulltext/2004/dha/ch6.pdf. The Murphy study was cited also in “Epidemiology of Soccer Injuries in Rwanda: A Need for Physiotherapy Intervention,” a supervised masters of science thesis by Janvier Twizere, Department of Physiotherapy, University of the Western Cape, South Africa (November 2004) http://ww3.uwc.ac.za/docs/%20Library/Theses/Theses%202005%201st%20Grad/Twizere_j.pdf.  

At Michigan State University’s Spartan Stadium the artificial turf has been replaced with the new natural turf integrated modular technology. The Michigan State Spartans had decided to switch from the 8 season-old artificial turf to grass because it was worn out. The conversion was instigated at the request of coach, Bobby Williams, because he believed that natural turf cuts down on injuries. http://www.sportsvenue-technology.com/projects/greentech/.

For an article on the hazards of turf from a player's perspective, please go this site (www.syntruf.org), page called "WarpUpArticles," Article No. 1 (Beckham's Lament).

No. 03] Staph infection at Winchester High School.  http://www.boston.com/news/local/massachusetts/articles/2007/10/20/winchester_sports. The recent Staph infection (methicillin-resistant staphylococcus aureus) suffered by a member of Winchester High School [Massachusetts] football team is shedding more light on the prevalence of MRSA infections in our schools. The article repeats the common understanding that people should not share personal items used by others, wash their hands and maintain good hygiene in order to minimize the chance of getting this bacterial infection from others. Stephen Smith “Winchester sports team is checked for MRSA,” The Boston Globe, October 20, 2007, pages B1, and B5 ( The article makes no mention of the abrasions that athletes sustain when they play on artificial surfaces and how that renders them all the more susceptible to getting Staph infection when they come into contact with a person or items bearing the bacteria, possibly including the turf surface itself. The article makes it clear that the bacteria survive on open surfaces like razors, towels, drink bottles, and other things. While turf dos not cause Staph, it is capable of contributing to the contagion because the contact (impact, slide) with the turf does cause abrasions and burns on the skin and, if not treated appropriately, Staph infection can enter the body by way of the abrasion. Unlike natural grass and soil that breakdown and eliminate bacteria, the turf does not have the self-cleaning capability and must be cleansed with bactericides.

A "wrap up" article on turf-related Staph infection appears on this site (www.synturf.org), at "WrapUpArticles" page, Item No. 3.

No. 04] Field of Nightmares: Can playing sports on artificial turf kill you? As the debate rages on, parents need to hear the story of one young Texas athlete who's lucky to be alive, by Patricia Kilday hart, in Texas Monthly,  Volume 34,  Isssue 5 (Austin: Texas Monthly, a Division of Emmis Publishing, LP),  May 2006), available at http://www.texasmonthly.com/preview/2006-05-01/hart.

Abstract (Summary)
Boone's doctors don't know where the MRSA originated, though they believe it entered his body through the turf burn. Westlake trainer Brad Hawkins says he knows of no MRSA cases at the school, leading him to conclude that the school's artificial turf is not contaminated. But Westlake athletic director and head football coach Derek Long acknowledges that the school once scrubbed down its field following a staph outbreak (not of the MRSA variety), in 2003.

IT HAPPENED ON THE MOST ordinary of plays. Sixteen-year-old Boone Baker, playing wide receiver on the Austin High Maroons junior varsity last October 7, sprinted a quick five yards before turning and snagging a short pass from his
quarterback sometime in the second half of a Friday night game against archrival Westlake High. Immediately after Boone caught the pass, he was tackled, hard, with his left shoulder crashing into the artificial turf of Chaparral Stadium. He remembers feeling a burning abrasion on his shoulder when he got up, but he shrugged it off and returned to the huddle.

As football games go, it was a mundane moment, with nothing to presage the medical nightmare that three months later would almost cost Boone his life and temporarily rob him of his mobility and his eyesight in one eye. On that seemingly insignificant play, this strapping, 176-pound, six-foot-two-inch teenager unknowingly joined the swelling ranks of athletes--from the National Football League to high school wrestlers--plagued by a new killer "superbug," a pernicious staph infection that mimics the flu, races through the body with lightning-quick speed, and resists normal penicillin-based antibiotics. Known as MRSA (methicillin-resistant Staphylococcus aureus ), this bacterial infection first emerged in hospitals five years ago, attacking vulnerable postoperative patients with compromised immune systems. But in the past two years, MRSA has made its deadly presence known in the community at large, with athletes being a prime target, since the bacteria thrives in steamy settings like locker rooms and enters the body through nicks, abrasions, and cuts.

But it's not just athletes who are affected; a Fort Worth woman died in February from an infection suspected to be MRSA, which she contracted during a routine pedicure. But athletes constitute a high-risk category in which MRSA
continues to show up in clusters, with disastrous consequences. In 2003 MRSA claimed the life of Ricky Lannetti, who played football for Lycoming College, in Pennsylvania, and sidelined ten football players at a Connecticut college,
hospitalizing two. That same year, the infection attacked five members of the St. Louis Rams. In Texas serious outbreaks have been reported among football teams in Denton County, Pasadena, and South Texas, where an alarming 81 cases
were reported in 2004.

Health care professionals--from the National Athletic Trainers' Association to the Texas Department of State Health Services--have begun campaigns to educate the public, and especially coaches and athletes, about how to prevent and
detect the infection. "I almost don't go to a meeting anymore that it is not a topic on the agenda," says Allen Hardin, the co-director of sports medicine at the University of Texas, where the football team has gone to single-use disposable towels in its war to combat transmission of the infection. At the University Interscholastic League, which oversees public high school athletics, a medical advisory committee is developing a poster to place in locker rooms across the state, featuring pictures of an early-stage infection, which can look as harmless as a mosquito bite, and recommending tips for locker room cleanliness.

Neither the Centers for Disease Control and Prevention nor the state health department keeps statistics on how many cases have occurred in Texas or around the country, but one CDC study suggests that MRSA may occur in as many as 25 out of every 100,000 people. Anecdotal evidence is frightening: One Austin pediatric surgeon in a four-physician practice reported to me that she and her partners averaged ten surgeries per week to drain MRSA abscesses. Officials at
Texas Children's Hospital, in Houston, say that the incidences of MRSA have more than doubled since 2003, and the new bacteria now accounts for 77 percent of otherwise healthy patients with staph infections there. Since 2002, the
hospital has lost six patients to MRSA, some of them infants. "This is not an athlete problem--it's a people problem," says Dr. Sheldon L. Kaplan, the chief of the hospital's infectious-disease clinic.

As Boone Baker's case illustrates, MRSA often starts out by disguising itself as an innocuous skin wound resembling a pimple or an ingrown hair. Immediately after the Westlake game, Boone showered and applied an antibiotic ointment to
his shoulder burn and continued to do so all weekend. But after practice the following Monday, Boone noticed that the burn had become a purplish boil and showed it to a trainer, who directed him to see a doctor. The next day, his
doctors lanced and drained the wound, cut out the pustule, took a culture, and identified the infection as MRSA. That called for a specific type of antibiotic, Septra, which, unlike penicillin-family drugs, can still knock out MRSA. Ten days later, Boone was cleared to return to football.

"I thought it was completely behind us," says Missy Baker, Boone's mom. When Boone fell ill with the flu this January, as did many other students at Austin High, the thought of a recurrence of MRSA, attacking his flu-weakened immune system, never entered her mind. Suffering nausea and a high fever, Boone lay on a couch for several days while Missy consulted his pediatrician's nurse by phone. Certain that Boone's lethargy was brought on by dehydration, Missy plied
her son with Gatorades, but nothing about his condition made her panic.

Until Thursday, January 19. Early in the day, Boone complained of excruciating back pain. He rebounded, but soon the pain returned with scarier symptoms: fast and shallow breathing, neck pain, and a sudden inability to move his legs.
Fearful that Boone had meningitis, Missy and her husband, Coalter, raced their son to an emergency room.

Life-threatening infections like Boone's could be avoided with some basic health precautions. Yet a CDC study released in February about the Rams' experience indicates that, even at the professional level, trainers have been slow to appreciate the risk of MRSA. On an average week, Rams players reported two to three "turf burns," severe abrasions where the skin is rubbed raw by high-velocity contact with artificial turf. Most of the burns were left uncovered during subsequent play. Trainers who treated the wounds on the sidelines did not have ready access to hand-washing or sanitizing materials. Players shared soap, towels, whirlpools, and workout equipment. The CDC study also determined that the infected players had a history of unusually high use of antibiotics, which could have made them more susceptible to the methicillin-resistant strain of staph. In fact, researchers believe that overuse of antibiotics in the community at large has enabled the new strain of bacteria to emerge. The CDC is advising schools that the best way to prevent MRSA is to
disinfect common areas, like whirlpools and showers; stop the practice of sharing towels and soap; and encourage frequent hand washing. Players should see trainers about every abrasion, which should be cleaned and covered
immediately.

If the prevention of MRSA is relatively simple, the treatment is anything but. When Boone arrived at Brackenridge Hospital, he was immediately placed in the intensive-care unit. For the first night, he was given fluids intravenously
while awaiting the results of blood tests to determine whether he had MRSA. By the time the infection was confirmed as MRSA, two days later, the bacteria had erupted in pustules all over his body. Doctors ordered massive doses of
antibiotics and waited for his system to respond. But it didn't. Something was blocking the antibiotics from taking effect. Boone's heart was racing at a rate that doctors compared to running a marathon at top speed. His midsection became
bloated as his kidneys and liver began to fail. "He was dying, effectively," his dad recalls.

By this time, whole teams of doctors were standing at Boone's bedside. A decision was made to conduct a full-body MRI. After a torturous five-hour session (the MRI was halted several times when Boone's temperature spiked and
sent him into uncontrollable chills), doctors found the source of his paralysis: two baseball-size abscesses around the base of his spine. On Monday, Boone underwent back surgery to drain and remove the abscesses and received another round of intensive antibiotics. He remained in the ICU, and doctors immediately began to see progress.

But Wednesday brought another scare: Upon removal of the breathing tube that had been placed down his throat during surgery, Boone said, "Mom, I can't see out of my right eye." Yet another specialist was called in, who confirmed that
the MRSA was indeed attacking his eye. For the next couple days, Boone would need to be awakened every hour so a nurse could administer three types of antibiotic eyedrops.

On Super Bowl Sunday, seventeen days after he had arrived at the hospital, Boone was allowed to have visitors. A physical therapist helped him take his first painful steps with the aid of a walker. But Boone experienced another setback when it was discovered that he had some blood clots and that a small pustule on his lung had not responded to the antibiotics. More surgery would be needed.

While Boone had fought for his life in the hospital, his illness had become a statistic in one of the ongoing issues involving MRSA: whether artificial turf can cause the infection. This is a question that affects sports at all levels and can have a major economic impact on companies that produce artificial turf. The CDC, however, is not inclined to blame turf. In its study of the St. Louis Rams outbreak, testing of the turf did not turn up evidence of contamination. "We didn't really feel it was the main mechanism for transmission," says Jeff Hageman, an epidemiologist for the CDC. Rather, Hageman said, researchers found a high incidence of infection among players with the most skin-to-skin contact.

But that has not stopped the MRSA scare from fueling the prolonged dispute between natural-turf and artificial-turf advocates. Brad Fresenburg, a University of Missouri turf grass expert, recently conducted studies of the temperature of his school's synthetic field and found an astonishing 173-degree temperature on a 98-degree day, a temperature disparity he believes contributes to bacterial proliferation. "Natural grass has a microbial system. It's self-
cleaning," Fresenburg wrote. "These synthetic fields don't have that." He suggests that synthetic turf be sprayed with a disinfectant when an infection is suspected.

Advocates for synthetic fields disagree, noting that the new generation of turf contains ground automobile tires, which include sulfur and zinc, agents that kill bacteria. "There's no evidence to support the theory that synthetic turf breeds bacteria," says Andrew McNitt, an assistant professor of soil science at Penn State University. "The majority of the data shows that the fact that there are more abrasions means the athletes have more entry points for the bacteria
to get in their bodies."

Yet the industry itself is concerned about the possibility of bacterial contamination. In November Astro Corporation unveiled a new product containing an antibacterial agent that it says will protect the turf from corrosion. Several companies have developed products to fight MRSA, including Cleveland-based Pioneer Manufacturing, which, in addition to making paint used to mark athletic fields, now sells an artificial-turf disinfectant called Titan Turf Gard. But the CDC's Hageman believes that the best way to prevent MRSA from spreading is for trainers to immediately treat and cover wounds like Boone's.

Boone's doctors don't know where the MRSA originated, though they believe it entered his body through the turf burn. Westlake trainer Brad Hawkins says he knows of no MRSA cases at the school, leading him to conclude that the School's artificial turf is not contaminated. But Westlake athletic director and head football coach Derek Long acknowledges that the school once scrubbed down its field following a staph outbreak (not of the MRSA variety), in 2003. The Bakers aren't interested in assigning blame but want parents, kids, and trainers to know what to watch for and how to avoid infections. Coalter is haunted by a doctor's comment that Boone would have died if he and Missy had waited another day to get him to the emergency room .

Shortly before Boone left the hospital, I took my son, Michael, who is a friend of Boone's, for a brief visit. Missy had prepared us to expect him to look like a prisoner of war. She wasn't exaggerating: He had lost 41 pounds. Finally, on
February 14, more than three weeks after he had been rushed to the emergency room, Boone was cleared to go home, where he remained for a couple months, staying current on his schoolwork and taking his antibiotics intravenously. His
vision has returned, but he can't return to playing sports until he finishes all his medicine--July at the earliest--and an orthopedic specialist determines that no bones have been compromised.

I dropped in to see him a few days after he got home, and though he had put on a few pounds, he still looked gaunt. He was sitting in a chair with an IV in his arm. We chatted for a few minutes, and then I asked him: "Will you play
football again?" His answer was immediate. "Oh, sure," he said, as if nothing had ever happened.

[No. 05] Picture This! SynTurf.org, Newton, Mass. February 16, 2008. What do vomit, spit, sweat and other human and animal discharge, and mold and bacterial growth look like in the fibers of artificial turf?  Wonder no more!

Courtesy of http://sfparks.googlepages.com/silvtermrsa -- here is a pictorial presentation titled San Francisco Play Fields Poised To Infect.  All photos were taken in 2008 at Silver Terrace Play Fields (San Francisco) and Garfield Soccer Field (San Francisco).