[No. 07] EHHI director of toxicology takes on the Massachusetts Department of Public Health’s dismissive response to Medway citizens’ concerns about artificial turf. SynTurf.org, Newton, Mass. 1 May 2015. On 24 February 2015, the health agent with the Office of Board of health in Medway, Massachusetts, wrote a letter to the Bureau of Environmental Health at the Massachusetts Department of Public Health, (MDPH/BEH), to evaluate health concerns related to the use of crumb rubber infill material for artificial turf fields in Medway. On 23 March 2015, MDPH/BEH replied that MDPH/BEH staff evaluated the more recent information on potential exposure opportunities to artificial turf components, including crumb rubber infill, and evaluated health concerns, including cancer, in relation to exposure to such turf. The reply then proceeded to give a summary of their review. What follows here below if the summary of the MDPH/BEH’s review followed by comments (in bold letters) from Environment and Human Health Inc., by its director of toxicology, Dr. David Brown, to some of the assertions made by MDPH/BEH.
Updated Literature Review
[MDPH/BEH]: Our previous evaluations noted that crumb rubber infill has been found to contain chemicals, including polycyclic aromatic hydrocarbons (PAHs), volatile organic
compounds (VOCs), and metals. We further stated that although these chemicals are in
the material itself, information available at that time did not suggest significant exposure
opportunities to the chemicals in the materials such that we would expect health effects.
We noted that the most relevant study on this topic at the time was a study conducted
by the California Office of Environmental Health Hazard Assessment (CA OEHHA).
[EHHI]: This study assumed that a one day exposure would give an accurate assessment of children and students' exposures playing on synthetic turf fields. This study and its conclusions are inappropriate and cannot accurately assess what a student and athlete's exposures will be.
[MDPH/BEH]: Since that time, the CA OEHHA conducted additional evaluations of chemicalconcentrations in air above crumb rubber turf fields under active use (CA OEHHA2010). Air samples were taken above fields and analyzed for VOCs and metals.
Results suggested that adverse health effects were unlikely to occur from inhalation ofVOCs or metals in particulates above these fields. To assess the potential for skininfections due to bacteria or to skin abrasions on these fields, tests for bacterialcontamination were performed and the frequency of skin abrasions was assessed.
Researchers found fewer bacteria detected on the artificial turf compared to natural turf,suggesting that the risk of infection to athletes using these fields was actually lower.However, more skin abrasions were observed in athletes using artificial turf fields thannatural turf fields, and the study authors made various recommendations to help preventskin abrasions (e.g., protective equipment or clothing) and prompt treatment of skinabrasions.
[EHHI]: The exposure pathways are not just from inhalation - there are other routes of exposures as well. No study has looked at carbon black exposures - which is a carcinogen. Carbon black makes up 20%-30% of every tire - and there are 40,000 rubber tires in every synthetic turf field. That is a lot of carcinogens. There are now carbon black nano-particles in rubber tires - and no one has looked at those exposures either.
[MDPH/BEH]: In another study, the state of Connecticut conducted air sampling at four outdoorartificial turf fields with crumb rubber infills (most relevant to Medway) under summerconditions (Simcox et al. 2011). Air measurements were taken using stationary airsampling monitoring devices as well as personal samplers (placed on people using thefields). They concluded that exposure opportunities to turf contaminants were notassociated with elevated health risks and suggested that their findings were consistentwith other studies available at the time. A letter prepared by the ConnecticutDepartment of Public Health reiterates these conclusions (CTDPH 2015).
[EHHI]: The Connecticut Study looked at four fields with 4 or 5 people walking/running on them. This does not recreate the real life exposures of a soccer player in a game with 22 people running up and down a field. Even so -- the study with its conclusions were at the edge of claiming a health risk - when they decided to change the wording of their press release so not to scare people who were already playing on synthetic turf fields.
[MDPH/BEH]: A 2014 study by researchers at the Rutgers Robert Wood Johnson Medical School in New Jersey evaluated opportunities for exposures to PAHs, semivolatile organic compounds (SVOCs), and heavy metals from exposures to artificial turf fibers and crumb rubber infills by measuring these constituents in simulated body fluids (digestive fluids, lung fluids, sweat) that represented different routes of exposure (ingestion, inhalation, dermal). This bioaccessibility study aimed to provide a better measure of the actual amount of these contaminants that might be absorbed into the body after exposure . The researchers found that PAHs were routinely below the limit of detection and SVOCs that have environmental regulatory limits to use for comparison were identified at levels too low to quantify. Some metals were detected but at concentrations at which health risks were low, with the exception of lead from the field sample collected. That sample indicated lead at levels in the simulated digestive fluids that the authors reported could result in blood lead levels above the current U.S. Centers for Disease Control and Prevention (CDC) reference value for blood lead in children (5ug/dL). It should be noted that the lead concentration of the materials used in this study included a sample of turf fiber with a lead concentration of 4,400 mg/kg. This level contrasts with information on the Medway artificial turf components, which reportedly either contained lead at 39 mg/kg (crumb rubber infill) or had no lead (turf fibers) (see discussion later in this letter). Based on the lead result from this one field sample, the authors suggested that components of artificial turf fields should be certified for low or no lead content prior to use. Overall, however, the authors concluded that opportunities for exposure to constituents in these fluids presented very low risk among all populations that would use artificial turf fields (Pavilonis et al. 2014).
[EHHI]:The samples - and there were less than a dozen tested -- were in the order of micrograms. Size-wise that is less material tested than what material is in a package of artificial sweetener. That does not approach the amount that a child would be exposed to in a single day. As well, lead is always shown to have low levels in synthetic turf fields. By showing low lead levels it is hoped that everyone will be satisfied and knowing that fact will make people think the fields are safe. This does not make the fields safe.
[MDPH/BEH]: A study conducted in 2010 in the Netherlands assessed the exposure of soccer players to PAHs after playing sports on a rubber crumb field. Urine testing in participants indicated that uptake of PAHs by the participants following exposure to artificial turf with rubber crumb infill was minimal. If there is any exposure, the authors reported, uptake is minimal and within the normal range of uptake of PAHs from environmental sources ' and/or diet observed in healthy individuals (van Rooij and Jongeneelen 2010).
[EHHI]: Again, this is a very narrow study, as it only looked at PAHs - and even so - it does show that PAHs do show up in players' urine.
[MDPH/BEH]: It is probably worthwhile to also note that MDPH/BEH reviewed testing data for artificial turf for the Town of Needham, as reported in our letters of 2011 and 2013 to the Needham Board of Health. The Town of Needham contracted with an environmental testing firm to conduct environmental tests including, air measurements of volatile organic compounds taken in the laboratory and heavy metals (arsenic, cadmium, chromium, lead, mercury, selenium, zinc) content of crumb rubber materials. Our review and conclusions for that testing, did not indicate exposures of health concern.
[EHHI]: Interesting. The MA Health Department concluded that the laboratory testing -- although not real world testing - did not indicate a health concern for players on synthetic turf fields.
Material in Medway
[MDPH/BEH]: MDPH/BEH reviewed available information provided by the Medway Board of Health regarding the specific materials used in the Medway fields. These included the APT Gridiron turf system and Liberty Tire Recycling 10+20 BM Rubber Crumb Brantford, ON.
Among the materials provided for these products were statements or test results forvarious constituents in these products.APT submitted a written statement dated October 29, 2014, that reported that the APTGridiron turf systems (essentially the grass fibers of the artificial turf) are manufacturedand installed without the use of any lead or heavy metals. They reported that thisincluded all materials used for the turf fibers and backings. No other documentationabout this product, including any testing results, was provided to support this statement.
[EHHI]: What other chemicals did they test for in the synthetic grass for? Doesn't sound like they were asked to test for anything but heavy metals. Heavy metals are in the crumb rubber not in the synthetic grass.
[MDPH/BEH]: With respect to the 10+20 BM Crumb Rubber infill product, laboratory testing results were provided for this product, although it is not clear whether the testing was for the materials specifically used in turf applied in Medway . Testing was conducted for metals content as well as emissions of volatile organic compounds (VOCs). It appears that testing included the following: (1) testing for VOCs emitted into a confined air space in the laboratory after heating the product to 73 degrees F; and (2) content testing for eight heavy metals, including lead. The laboratory compared results to criteria established by the Greenguard certification program, part of Underwriters Laboratory, that uses among its criteria for certification health-based levels derived by the CA OEHHA.
Testing results for metals content of the product indicated a lead concentration of 39 mg/kg, which is less than the current Consumer Product Safety Improvement Act (CPSIA) limit of 100 mg/kg for lead in children's products (Ulirsch et al. 2010). N o other metals were detected.
[EHHI]: Again - lead is not the issue. However, huge amount of zinc are in rubber tires. At the levels that zinc is in rubber tires - it can cause respiratory issues.
[MDPH/BEH]: Test results measuring emissions off-gassing from heated material were provided in measurements that cannot be compared to any health-based standards or guidelines and thus, MDPH/BEH did not further evaluate this information. Typically, when certain products raise health concerns, health agencies review Material Safety Data Sheets (MSDS). An MSDS provides information on health risks associated with use of the product. An industry group, Synthetic Turf Council, provides a sample template MSDS for crumb rubber infill material (Synthetic Turf Council 2014). Although this sample MSDS is not specific to any particular product, it appears to be applicable to crumb rubber infill in general. In the section under "Hazardous Ingredients," the MSDS notes that the product can contain fine fibers that may cause irritation symptoms (e . g., itching, irritation of mucous membranes, eye irritation). The MSDS notes that the crumb rubber material is generally thought to be a nuisance dust.
[EHHI]: This is the most amazing claim of all. Instead of using a Material Safety Data Sheet (MSDS) for the individual chemicals off-gassing from the synthetic turf—Synthetic Turf Industry provides a sample MSDS applicable to the crumb rubber in general. It notes, "the MSDS sates that that the product can contain fine fibers that may cause irritation symptoms (e . g., itching, irritation of mucous membranes, eye irritation). The MSDS notes that the crumb rubber material is generally thought to be a nuisance dust."
So the dust from the crumb rubber -- instead of noting that it contains all the chemicals from the rubber tires -- it is just categorized as a "nuisance dust."AMAZING!!!
Concerns About Cancer Among Soccer Players
[MDPH/BEH]: As noted earlier in this letter, some recent news reports suggested that the incidence of cancers among soccer players, particularly goal tenders exposed to artificial turf, might be atypical. These reports included many cancer types, but some focused specifically on NHL, Hodgkin Lymphoma, and osteosarcoma in three individuals. We thought it would be helpful to provide additional information on cancers in general and known risk factors for NHL, Hodgkin Lymphoma, and osteosarcoma.
[EHHI]: First of all, most of the cancers among the players who have played on synthetic turf are blood cancers -- leukemias and lymphomas. Rubber tires contain at least two chemicals that affect blood cancers - 1,3 butadiene and benzene. 1,3 butadiene is linked to lymphoma and benzene is linked to leukemia. The numbers of players who have gotten blood cancers are way out of line with what you might expect to see in that age group. Osteosarcoma was not a major cancer found among those players and therefore is not applicable.
Cancer in General
[MDPH/BEH]: Understanding that cancer is not one disease, but a group of diseases, is veryimportant. Research has shown that there are more than 100 different types of cancer, each with separate causes, risk factors, characteristics and patterns of survival. A riskfactor is anything that increases a person's chance of developing cancer and caninclude hereditary conditions, medical conditions or treatments, infections, lifestyle factors, or environmental exposures. Although risk factors can influence the development of cancer, most do not directly cause cancer. An individual's risk for developing cancer may change over time due to many factors and it is likely thatmultiple risk factors influence the development of most cancers. In addition, anindividual's risk may depend on a complex interaction between their genetic make-upand exposure to environmental agents, including infectious agents and/or chemicals.This may explain why some individuals have a fairly low risk of developing a particulartype of cancer as a result of an environmental exposure, while others are morevulnerable.
[EHHI]: Just the point! There are 100 different types of cancer -- but when you see just one type -- such as mainly blood cancers -- that's when you have to look for a particular exposure/exposures.
[MDPH/BEH]: Cancers in general have long latency or development periods that can range from 10 to 30 years in adults, particularly for solid tumors. In some cases, the latency period may be more than 40 to 50 years. It is important to note, however, that latency periods forchildren and adolescents are Significantly shorter than for adults.
[EHHI]:Not in children - otherwise we would not have 10 year olds with cancer. However, most of the students who have contracted blood cancers have been playing on synthetic turf for years. They are in college by the time they report their cancers.
[MDPH/BEH]: Hodgkin Lymphoma is most common in young adults between the ages of 15 and 40, especially in individuals in their 20s. Among adolescents, it is the most common type of cancer. Hodgkin Lymphoma occurs specifically in a type of B lymphocyte (or white blood cell) called the Reed-Sternberg cell while other lymphomas (non-Hodgkin's types) occur in different cells .
Established risk factors for Hodgkin Lymphoma include: exposure to the Epstein-Barr virus (EBV); a previous diagnosis of mononucleosis (mono is caused by the EBV); family history; and certain hereditary conditions (such as ataxia telangiectasia) associated with a weakened immune system. The Epstein-Barr virus is very prevalent in the general population. Even though most of us have been exposed to the virus (which remains latent in our bodies), most people do not develop mononucleosis or Hodgkin Lymphoma. EBV is thought to account for about 20% or 25% of the diagnoses of classical Hodgkin's in the US. Higher socioeconomic status is also a possible risk factor. This is thought to be due to delayed infectious exposures in childhood.
Occupational exposures as risk factors have been studied extensively and none have emerged as established risk factors. Likewise, there is very little evidence linking the risk of Hodgkin Lymphoma to an environmental exposure, other than the EBV.
[EHHI]:The rate of lymphomas in the exposed population to synthetic turf is way out of proportion to what you would expect to find in this age group.
Non-Hodgkin Lymphoma (NHL)
[MDPH/BEH]: NHL refers to a diverse group of cancers that are characterized by an increase in malignant cells of the immune system. Each subtype of NHL may have different risk factors associated with its development. The specific cause of NHL in most individuals is unknown.
Although some types of NHL are among the more common childhood cancers, more than 95% of diagnoses occur in adults. Incidence generally increases with age, and most diagnoses occur in people in their 60s or older .
Established risk factors for NHL include a weakened immune system, associated with various medical conditions, and exposure to various viruses. An increased risk is faced by individuals taking immunosuppressant drugs following organ transplants; individuals with autoimmune disorders, such as rheumatoid arthritis and lupus; and individuals who have taken certain chemotherapy drugs for other cancers. Several viruses have been shown to playa role in the development of NHL, including the human immunodeficiency virus (HIV), the human T-ceilleukemiallymphoma virus (HTLV-1), and the Epstein-Barr virus.
Exposure to high-dose radiation (for example, by survivors of atomic bombs and nuclear reactor accidents and possibly by patients who have received radiation therapy for aprevious cancer) may pose an increased risk. Some studies have also suggested thatexposure to chemicals such as benzene and certain herbicides and insecticides may belinked with an increased risk of NHL. Smoking has been associated in some studieswith certain types of NHL.
[EHHI]: Again, we are seeing lymphoma rates among athletes who have played on synthetic turf fields in disproportional numbers to what would normally be expected among college age students.
[MDPH/BEH]: Osteosarcoma is a type of malignant bone cancer which accounts for about 2% of childhood cancers in the United States. It is the most common type of cancer that develops in bone and comprises about 66% of malignant bone tumors in children in Massachusetts. Most osteosarcomas occur in children and young adults between the ages of 10 and 30. Teenagers comprise the most commonly affected age group and are at the highest risk during their growth spurt. However, osteosarcoma can occur in people of any age, with about 10% of all osteosarcomas occurring in people over the age of 60.
Established risk factors for osteosarcoma include certain inherited syndromes (such as retinoblastoma, the Li-Fraumeni syndrome, and others) and certain bone diseases (such as Paget disease of the bone and hereditary multiple osteochondromas). Individuals with these syndromes and bone diseases have an increased risk of developing osteosarcoma. People who have received radiation treatment for a previous cancer may have a higher risk of later developing osteosarcoma in the area that was treated. Being treated at a younger age and with higher doses . of radiation both increase the risk. Because the risk of osteosarcoma is highest between the ages of 10 and 30, especially during the teenage growth spurt, experts believe that there may be a link between rapid bone growth and the risk of a bone tumor. Children with osteosarcoma are often tall for their age, which supports the link with rapid bone growth. Other than radiation, there are no known lifestyle or environmental risk factors associated with osteosarcoma. Asides from these risk factors, the causes of most osteosarcomas are unknown.
[EHHI]: There are very few of these cancers reported in the exposed population and therefore this is not applicable.
[MDPH/BEH]: In summary, the scientific literature continues to suggest that exposure opportunities to artificial turf fields are not generally expected to result in health effects.
[EHHI]: That is not an answer that one would normally expect to receive from a health department. To quote, "exposure opportunities to artificial turf fields are not generally expected to result in health effects." NOT GENERALLY EXPECTED TO RESULT IN HEALTH EFFECTS?" -- SO ONE COULD ASSUME FROM THIS STATEMENT -- THAT THE SYNTHETIC TURF FIELDS COULD RESULT IN HEALTH EFFECTS?
Environment and Human Health, Inc. believes that children should not be purposely exposed to carcinogens. There are a myriad of carcinogens in synthetic turf fields.
o Children breathe more air, drink more water, and eat more food per unit of body weight, compared to adults.
o Children's organ systems are developing rapidly. A toxic exposure during a critical window of development can have life-long consequences.
o Children's detoxification mechanisms are immature, so an exposure that might not have an important effect on an adult could have an important effect on a child.
o Cancer is a disease that can develop years after exposure. and for this and other reasons, it is particularly important to avoid carcinogenic exposures during childhood.
[MDPH/BEH]: Testing results on the crumb rubber infill indicated lead content less than CPSIA statutory limitsestablished for children's products. For the turf fibers, APT provided a statement thatthis material did not have lead used in its manufacture, but no additional documentationwas provided.
[EHHI]: Lead had never been the problem or the issue
[MDPH/BEH]: With respect to cancer concerns reported in media stories, it is important to note that the reports of cancers were of a wide variety of different types, each with its own set of risk factors. In addition, our staff reviewed cancer incidence data for the Town of Medway. The Massachusetts Cancer Registry (MCR) is a population-based surveillance system that began collecting information in 1982 on Massachusetts residents diagnosedwith cancer in the state. All newly diagnosed cancer cases among Massachusettsresidents are required by law to be reported to the MCR within six months of the date ofdiagnosis (MGL, c.111, s.111 B). This information is kept in a confidential database andreviewed for accuracy and completeness.
Available information on the occurrence of cancers in children living in Medwayindicates no diagnoses of Hodgkin Lymphoma, NHL, or osteosarcoma have beenreported to the MCR in a search of their files from 2006 to the present. Although it ispossible that a very recent diagnosis may not yet have been reported to the MCR, thefact that there are no reports of such cancers is reassuring.
[EHHI]: The fact that one town does not have resulting cancers from playing on synthetic turf is certainly good news and we hope it stays this way -- however, it does not prove anything.
[MDPH/BEH]: Although available resources cannot support MDPH conducting environmental testing ofthis material, we would be happy to assist the Town of Medway in developing asampling and analysis plan as well as provide technical support in interpreting results, similar to the assistance that we provided to the Town of Needham.
As we stated in our letters to Needham officials, while available information does notindicate exposure opportunities of health concern, MDPH/BEH continues to recommendcommon sense ways to minimize any potential exposure to chemicals that may becontained in synthetic turf fields made of crumb rubber. MDPH/BEH suggests washinghands after playing on the field and before eating, particularly for younger children withfrequent hand-to-mouth activity, and taking off shoes before entering the house to prevent tracking in any crumb rubber particles. Also, there are studies that indicate heatlevels on artificial turf fields may rise as outdoor temperatures increase (New YorkState2009). Thus, for protection of the players, MDPH/BEH recommends increasinghydration, taking frequent breaks, and watering down the field to cool it on hot days toprevent the potential for burns or heat stress. Finally, based on recent work inCalifornia, MDPH/BEH recommends that steps be taken to minimize the potential forskin abrasions (e.g., protective equipment) and that skin abrasions be treated promptly to prevent potential infections.
[No. 06] EHHI’s Research Brief.www.Synturf.org, Newton, Mass. 1 November 2014. In the aftermath of the NBC investigative report about the possible link between cancer and playing on artificial turf fields that have crumb rubber from used tires, David Brown, who is a public health toxicologist and Director of Public Health Toxicology for Environment and Human Health, Inc (www.ehhi.org) in North haven, Connecticut, told SoccerWire.com (14 October 2014) that he “was not surprised when he read the recent NBC News report alleging links between artificial grass surfaces and cancer.” Tim Froh, “Former CDC toxicologist unsurprised by alleged link between artificial turf, cancer,” on SoccerWire.com, 14 October 2014, at http://www.soccerwire.com/news/a-level-of-risk-former-cdc-toxicologist-unsurprised-by-alleged-link-between-artificial-turf-cancer/ .
“I don’t try to scare the hell out of everybody, but it’s necessary for a sober, factual look at what’s going on,” Brown said. “The primary weakness[ ] in the existing literature is that they did not identify the compounds that were present. They reached several conclusions that I thought were not supported by the literature. They assumed that all the products are exactly the same. When actually, depending on what the rubber was designed for in its original form, it had differing amounts of various chemicals, particularly some carcinogenic chemicals that had been put into the crumb rubber. We know that about a third of the tires have high levels of oils that are called poly[cyclic] aromatic oils, that are in them.” Brown also believes that while most researchers and industry experts acknowledge the presence of known carcinogens in rubber tire crumbs, no long-term studies have been conducted on these carcinogens and the effects of sustained and consistent exposure to them.
According to Brown, as reported by SoccerWire, most of the major studies have downplayed the possible pathways for human exposure to the carcinogens in rubber tire crumbs. “I thought there was a really strong dermal pathway, where [users] would get it on their hands, and then wipe or put their hands in their mouths,” he said. “There’s also a strong air pathway that’s there.” Users come into frequent contact with the tire crumbs, whether from dives, tackles or kicks. These crumbs can cover multiple surfaces, including skin, hair and shoes. Sustained exposure to crumb rubber could have serious long-term health consequences, NBC News’ report suggested, and children may be at greatest risk. In a 2005 paper assessing susceptibility to cancer from early-life exposure to carcinogens, the Environmental Protection Agency found several reasons why children are more susceptible to certain kinds of cancers. These include more frequent cell division, certain cells’ lack of key DNA repair enzymes, an immune system that’s not fully developed, and hormonal systems that operate at different levels at different life stages.
“The nature of cancer – what happens physiologically – is that the cell nucleus is changed a bit when the carcinogen gets in there,” Brown explained.” But then it can repair itself if it doesn’t divide.” “If the cell is there and the nucleus is changed, the nucleus can repair itself, but it takes about three or four days for that to happen in an adult. It takes about four or five hours for it to happen in a child because they’re growing so much faster.” Brown supports a more cautious approach to the use of fields utilizing crumb rubber. There isn’t enough content there to answer [the cancer question],” he said. “[Artificial-turf advocates] are deluding themselves.”
When asked what advice he would give parents thinking of letting their children play on turf fields, Brown was adamant. “My basic advice is, don’t do it,” he replied. “I think they would have to understand that there is a level of risk that the child is incurring.”
In the absence of conclusive long-term studies on the known carcinogens found in some artificial turf fields, Brown believes it’s better to be safe than sorry. “If I had to make recommendations, I would never have a soccer goalie practice on the turf fields. Play on it, but not practice on it. The very young children, I’d get them off those fields,” Brown told SoccerWire.com.
The artificial turf industry is very fond of citing some 16 studies that, as they say, conclude that artificial turf is safe to play on. In a recent communication to EHHI’s distribution list, Brown provided a list of questions to be asked as a “Response to synthetic turf studies and literature review summaries:” (1) Does the study have sufficient analytical power to detect exposures? (2) Is this study based on original analytical data or secondary source data? (3) the findings and conclusions supported by the factual information? In order to assess a health risk such as cancer, neurotoxicity, or respiratory actions it is necessary to know (1) Chemicals present in the product; (2) The mechanisms of transfer to humans; and (3) The amount that could enter the blood and bioaccumulate.
One example of an inadequate study that then results in misleading or inaccurate conclusions is the study by Environmental and Occupational Health Studies Institute in New Jersey, which is funded by the New Jersey Department of Environmental Protection, Recycling Program and Planning. They tested seven fields, each with sample sizes of less than a gram (200 mg). When the authors detected no VOCs, it was concluded that there is no potential exposure to a regulated VOC.“The sensitivity of the study,” Brown states “would be considered low at best but the Connecticut Experiment Station has clearly shown a series of VOCs using only water as a solvent.” According to Brown, “[t]he inhaled and ingested exposure levels [is] far beyond 1 gram.It is also well known that many of the chemicals of concern do not have regulatory standards.“The authors do note some limitations to their study in the body of the report,” he noted.
“General studies lack the sensitivity or the exposure durations to achieve these minimal goals,” according to Brown. “Thus one finds the language used in their summaries become, for example, ‘'no evidence was found etc.’. “The overwhelming facts are,” Brown wrote, “there has not been any investigation by the industry or government that completely determine the array of chemicals in or on a turf field.” “Nor can there be because the industry does not have quality control procedures,” he noted. “With 4,000 ground up rubber tires in each field—who knows where each tire has come from.”
According to brown, “[n]o organization has assessed the health of players on these fields. That question is asked by nearly every community considering the fields.The typical answer is: ‘many reports have found nothing to be concerned about.’ But it is known that there are carcinogens and other toxic materials in the crumb rubber and possibly other infills,that children ingest the crumbs, track them into school rooms, school bused, private cars and homes. Thus there are exposures across the country and no effort to determine what it means.”
Brown has put forth an outline of the absolute minimum data that is needed to determine whether a synthetic turf field is safe or not. That would be: (1) Complete chemical analysis of content of the crumb rubber used in each field; (2) Quantification of all known carcinogenic chemicals, respiratory toxins and neurotoxins; (3) Identification of chemicals of unknown or untested toxicity; (4) Determination of residence times of each of the ingested chemicals in the body; (5) Determination of rates of dispersion from fields to school rooms, locker rooms and vehicles and residences; and (6) Maximum hourly exposure to participants on the fields. While no study has established direct link between playing in crumb rubber and cancer or other harm, Brown points out that it has been established that substantial human exposure occurs when playing on turf fields. Therefore there are exposures to carcinogens, neurotoxins and respiratory toxins. “Cancer risks are present,” he notes “and cancer is a plausible outcome. The cancer cluster that has been observed in 38 children who have played extensively on synthetic turf fields is plausibly associated with their exposures from those fields.” “Finally,” he notes, “there is no attempt to follow-up on the health status of persons who have been exposed to the crumb rubber by any Federal, State or Private entity. There is no collection of either cancer or asthma data of those who have been exposed on those fields over a period of time.”
Following the NBC report a few schools moved to replace the crumb rubber infill with something that is called in the industry as “Nike Grind,” presumably the ground up rubber sole of the athletic footwear. http://www.nbcnews.com/news/investigations/high-school-changes-plans-artificial-turf-field-n232686 . While it may allay the fear of parents and liability-conscience officials at schools at town halls—to move away from 100 tons of ground up used tires to seemingly benign 6 million sneaker bottoms, the fact of the matter still remains that Nike grind too is untested by independent researchers and therefore the public does not know what is in it. “May we say one more time,” wrote Nancy Alderman, the President of EHHI, to her readers, “What ever happened to grass?Can you imagine if they invested one million dollars in a grass field what that field would be like.”
On the question of increased concern about cancer patterns in synthetic turf fields, Alderman and Brown believe that when one looks at the cancers that the soccer goalies who played on synthetic field are getting - most of the cancers are lymphomas. Lymphomas are cancers that are heavily influenced by environmental factors. The infill of synthetic turf fields is made up of ground up rubber tires that contain many carcinogenic compounds. Scientist understand today, that when a population that is exposed in a particular setting comes down with one type of cancer it is often caused by an exposure to a specific group of chemical carcinogens that are in that particularenvironment. The presence of a single type of tumor, or cancer, rather than the normal distribution of cancers expected in the overall population of that age group, is in itself an indication that the affected population is being exposed to the same chemical carcinogens.
According to Alderman and Brown, the number of lymphomas in the population of athletes who played on synthetic turf collected by [soccer coach] Amy Griffin is much higher than would be normally expected. Thissuggests that the athletes who have come down with lymphomas and have played on synthetic turf for years, may have all been exposed to the same chemical carcinogens just like those found in rubber tire infill. Among the distribution of lymphomas in 15 to 19 year olds who are treated for cancer nationally, 13.5% for Hodgkin’s lymphoma, 8.3% for non-Hodgkin’s Lymphoma;and 1.1% for Burkitt's Lymphoma according to EPA’s “America’s Children and the Environment” http://www.epa.gov/ace/publications/ace_2003.pdf . The percentage of lymphomas in the population of athletes who played on synthetic turf collected by Amy Griffin [38 U.S. soccer players with blood cancers, including 34 goalkeepers] is much higher than this.
Being one of the first to call for a moratorium of creating more artificial turf fields around the country, EHHI believes that it may be time for a Congressional hearing on synthetic turf fields. “While we have been focused on the health risks to children and athletes who play on synthetic turf fields,” says Nancy Alderman, “we just heard form a person who runs a company that maintains synthetic turf fields. He and his men are getting sick.This is what is happening to them: They are having respiratory problems andchest restrictions; when they blow their noses black mucous comes out; they are getting cuticle infections from touching the fields; they are getting headaches and watering eyes; the hotter the fields the worse the symptoms; the dryer the fields the worse the symptoms; and they are very worried.” “These symptoms correspond to the chemicals that are found in rubber tires; this is another whole group of people being made sick by synthetic turf fields; this is extremely serious; is it time for a Congressional hearing on these fields,” she asks. “We must think about the continual exposures that students areNOW being subjected to. (1) First a toddler plays on a playground covered with rubber tire playground mulch. (2) Then that child—s till healthy—goes off to a grammar school where they might—or they might not—have a synthetic turf field filled with rubber tire crumb infill that the child plays on. (3) Then the child, now older, goes to high school where they very well might have a synthetic field that he or she will play on. (4) Then the student, goes to college, and if an athlete, will play on synthetic turffields with rubber tire infill. These exposures are now for far longer periods of time than the college students who are now getting sick were exposed -- as they probably did not have playgrounds with rubber mulch in them -- and might not have had grammar schools with rubber tire infill. The point being—things can get a lot worse,” says Alderman.
[No. 05] EHHI to schools: Recent artificial turf study shows carcinogens and toxins in synthetic turf fields. On August 30, 2010, Environment and Human Health, Inc. released a statement, warning schools that the recent Connecticut study on artificial turf fields has shown the presence of carcinogen and toxins in synthetic turf playing fields. A copy of the statement is available here. Environment and Human Health, Inc. (EHHI) is a nine-member, non-profit organization composed of doctors, public health professionals and policy experts. It is dedicated to protecting human health from environmental harms through research, education and improving public policy. EHHI does not receive any funds from businesses.
The release stated, “A sampling of just some of the chemicals off-gassing from the fields includes benzothizole - according to the Material Safety Data Sheet (MSDS) is harmful if swallowed or inhaled; toluene - the MSDS says is a skin, eye, and respiratory irritant and can cause headaches; acetone - the MSDS safety sheet says is a skin, eye, and respiratory irritant, and can affect the central nervous system; zinc - a respiratory irritant; acenaphthene - a carcinogen; and naphthalene - which is listed as a possible carcinogen.”
After performing a peer review of the Connecticut Department of Environmental Protection’s Artificial Turf Study, the state Academy of Science and Engineering (CASE) advised that the findings “be softened” in order to avoid alarming the public. CASE warned, “Parents may be motivated to withdraw their children from beneficial athletic activities, and schools and towns will consider the financially wasteful removal of existing fields.”
According to EHHI, “The health assessment looked at one chemical at a time for the artificial turf's affect on people's health - yet the data indicates that children are being exposed to a soup of toxins from these fields, and these exposures are experienced all at the same time. The data also shows that the more people who are playing on a field the more toxins are released -- and thus the greater the exposures to students. The study indicates a very high variability of the levels of toxins found in each field. Since there are 40,000 used tires in each field, enormous variability of toxins would be expected.”
“The actual field-testing took place last summer when temperatures were unusually cool, between 70 and 80 degrees. Environment and Human Health, Inc. (EHHI) points out that the temperatures this summer have consistently reached 90 degrees with fields frequently exceeding temperatures over 135 degrees. If the testing had been done this summer, the off-gassing of chemicals would have been higher and health risks shown in the report would have been greater.”
EHHI stated, “The National Center for Catastrophic Sport Injury Research at the University of North Carolina reported that more than 40 football players nationwide have died of heatstroke since 1995 -- 31 of whom were high school athletes.” It is therefore essential that one have “better measurements of individual exposures from artificial turf during periods of high temperatures, as many children participate in sports on these fields throughout the summer months when the high heat causes greater exposures to multiple toxic compounds simultaneously,” according to Dr. D. Barry Boyd, Oncologist at the Greenwich Hospital and the Yale Cancer Center, quoted by EHHI in its statement. “Although new fields off-gas more chemicals, all the fields tested were two years old or older,” EHHI said.
[No. 04] EHHI critiques the Connecticut turf study, porcess. In July 2010 the state of Connecticut released its multi-agency study of artificial turf fields, as reported here at http://www.synturf.org/westportbrief.html(Item No. 09). On August 5, 2010, Yahoo Financial News carried the following critique of the study by Environment and Human Health Inc. Entitled: “Connecticut's Artificial Turf Study's Risk Estimates Were Modified to Avoid Alarming the Public, Warns Environment and Human Health, Inc.,” the piece is available at http://sg.finance.yahoo.com/news/Connecticuts-Artificial-Turf-pz-2922305234.html?x=0 . It stated:
HARTFORD, Conn., Aug. 5, 2010 (GLOBE NEWSWIRE) -- Environment and Human Health, Inc. (EHHI) was astonished to learn that despite the significant health and safety concerns shown in the Connecticut Department of Public Health's (DPH) Artificial Turf Study, the state agency was urged to re-frame its press release so as not to alarm the public.
Unbelievably, the Connecticut Academy of Science and Engineering (CASE), which performed the study's peer review, advised that the findings of the artificial turf study "be softened" to avoid causing the public to be alarmed.
The CASE report urged the DPH to change its press release headline from "The Results Indicate Cancer Risks Slightly Above De Minimis Levels for All Scenarios Evaluated" to the more reassuring headline, "Result of State Artificial Turf Study: No Elevated Health Risk."
The CASE summary urged the DPH:
"To revise its risk assessment and then present its findings with appropriate cautions. At the least, the various assumptions underlying the risk assessment should be compiled and presented in a manner so that they can be understood by non-scientists (e.g., parents and journalists) reading the report."
CASE continued, "[We are] very aware of the shrinking resources available to support our children's and recreation activities. It is almost certain that the 'headline' conclusion of the CT Department of Public Health (DPH) report will become the focus of media reports and will unnecessarily frighten parents as well as school and municipal supervisors. Parents may be motivated to withdraw their children from beneficial athletic activities, and schools and towns will consider the financially wasteful removal of existing fields. This would be an unfortunate result, one that would likely pose greater risks to the welfare of Connecticut than the continued use of outdoor Artificial Turf Fields."
Testing of the artificial turf fields took place last summer when temperatures were unusually cool, between 70 and 80 degrees. EHHI points out that this summer temperatures have consistently reached 90 degrees with fields frequently exceeding temperatures over 135 degrees. If the testing had been done this summer, offgassing of chemicals would have been higher and health risks shown in the report would have been higher. Although new fields offgas more chemicals, all the fields tested were two years old or older.
According to the DPH's press release and executive summary, many toxic chemicals were found in the fields. "The field investigation detected a variety of compounds that were present above the fields at concentrations greater than the range seen in background samples. Based upon the pattern of detection, it is considered likely that benzothiazole, acetone, toluene, methyl ethyl ketone, methyl isobutyl ketone, butylated hydroxytoluene, naphthalenes and several other [polycyclic aromatic hydrocarbons] PAHs were field-related, with other detected chemicals less certain to be field related. For example, benzene, methylene chloride, methyl chloride and acrolein were detected only in personal monitoring samples and not in the stationary samplers placed just above the field."
The laboratory testing found numerous toxic chemicals off-gasing from the crumb rubber. According to their report, "The laboratory studies showed offgassing of numerous compounds including polycyclic aromatic hydrocarbons (particularly naphthalenes), VOCs (e.g., benzene, hexane, methylene chloride, styrene, toluene), and rubber-related SVOCs (benzothiazole, tert-octylphenol, butylated hydroxytoluene). The primary constituent detected by both laboratories was benzothiazole. Pre-weathering the crumb rubber outdoors for ten weeks decreased the volatile emissions 20-80%."
The report went on to say that indoor synthetic turf fields are offgassing toxic chemicals at high enough levels for the DPH to call for greater ventilation of such facilities. "However, it would be prudent for building operators to provide adequate ventilation to prevent a buildup of rubber-related VOCs and SVOCs at indoor fields. New indoor fields should consider alternatives to crumb rubber infill as a cushioning agent."
The study showed very high variability in the levels of toxins that were found in each field. Since there are 40,000 tires in each field, enormous variability of toxins would be expected.
The stormwater sampling detected various metals and semi-volatile compounds. Zinc was found in high enough levels to cause risks to surface waters and aquatic organisms. "Three samples exhibited acute toxicity for both Daphnia pulex and Pimephales promelas. The only analyte in the stormwater detected in concentrations exceeding acute aquatic toxicity criteria for surface waters was zinc. Zinc exceedences of the acute criteria were detected in the same three stormwater samples that exhibited acute toxicity for both Daphnia pulex and Pimephales promelas. These results showed that there is a potential risk to surface waters and aquatic organisms associated with whole effluent and zinc toxicity of storm-water runoff from artificial turf fields." The results of the ground water sampling documented in this press release leads us to not only believe ground-up rubber tires are not good for children, but are also not good for the environment.
There is nothing in this press release and executive summary that reduces EHHI's concern about children playing on ground-up rubber tires. The study looked at the safety of chemical exposures one chemical at a time and yet it is clear from this study that the exposures are to many chemicals at the same time. If the study had been conducted when the ambient temperatures had been more in line with normal July temperatures in Connecticut, the off gassing of chemicals would have been greater and that would have pushed the risk levels higher. As well, the data show that more people playing on a field will cause more chemicals to be released from the crumb rubber, as the players' impacts on the turf cause more toxins to be released into the air. The data collected in this study are very important -- EHHI's strong disagreement is with the interpretation of that data.
Read the report's executive summary on the Conn. Department of Environmental Protection's website:
Environment and Human Health, Inc. (EHHI) is a nine-member, non-profit organization composed of doctors, public health professionals and policy experts. It is dedicated to protecting human health from environmental harms through research, education and improving public policy. EHHI does not receive any funds from businesses or corporations.
[No. 03] LEED’s counting of artificial turf as “green” is problematic. SynTurf.org, Newton, Mass. June 27, 2010. The U.S. Green Building Council's LEED is a rating and certification system, which gives points to buildings according to sustainability of sites, water efficiency, energy and atmosphere, materials and resources, indoor environmental quality, and innovation and design. ‘LEED’ stands for Leadership in Energy and Environmental design. In a report conducted by Environment and Human Health, Inc (EHHI), North Haven, Connecticut ( http://www.ehhi.org/leed/ ) calls on LEED to pay more attention to human health issues. The report is called The Green Building Debate: LEED Certification Where Energy Efficiency Collides with Human Health. It is available at http://www.ehhi.org/reports/leed/LEED_report_0510.pdf .
According to a news story in Kansas City Star (June 14, 2010), the EHHI report identified “several health threats that are overlooked by the LEED rating system. These health threats fall into two different categories: indoor air quality and drinking water. The use of artificial turf was also identified as a third health threat but is in a category of its own.” “EHHI's concerns with drinking water include plastics, bisphenol-A (BPA), PVC and phthalates, and perfluorooctanoic acid (PFOA). While a building can earn points for its water management systems, there is nothing in place to address the quality of the water used in LEED certified buildings.” “The use of artificial turf is also problematic. Although artificial turf has come a long way since the 1970s from an aesthetics standpoint, it is still toxic. Many types of artificial turf use recycled rubber tires (crumb rubber) and this can cause a multitude of health problems. EHHI's analysis of the crumb rubber shows that it contains a bevy of chemicals including known carcinogens, neurotoxicants, and suspected endocrine disruptors. Artificial turf also adds to the heat island effect, is not biodegradable, and disposing it at the end of its useful life can be difficult at best. However, artificial turf is water efficient and thus can earn a LEED registered project up to four points in the Water Efficiency category as well as additional points in Materials and Resources and Innovation in Design.” “Overall, EHHI's concern is that consumers will translate the term LEED certified into healthy for humans and that isn’t always the case.” Source: Melissa Hincha-Ownby, “Is LEED missing something?,” in Kansas City Star, June 14, 2010 (Mother Nature Network - mnn.com), available at http://www.kansascity.com/2010/06/14/2015587/is-leed-missing-something.html
[No. 02] Hartford, Connecticut: EHHI testimony before the Connecticut state legislature on March 2, 2009.
RAISED BILL S.B. 924 AN ACT CONCERNING A MORATORIUM ON ARTIFICIAL TURF PLAYING FIELDS AND THE POSTING OF WARNING SIGNS
Chairs Senator Ed Meyer, Representative Richard Roy, and Members of the Environment Committee:
My name is Nancy Alderman.I am President of Environment and Human Health, Inc. a non-profit organization comprised of nine members who are physicians and public health professionals dedicated to protecting human health from environmental harms.
Environment and Human Health, Inc., is in strong support of Bill 924. Taxpayer's dollars should not be going into installing synthetic turf fields that can cost up to a million dollars until we know far more about the health implications from these fields.
What we presently know:
1.We know that rubber tires contain toxic chemicals and heavy metals.
2.We know that when you grind up these tires the chemicals and heavy metals do not disappear.
3.We know that the tiny particles of the ground up rubber tires get into children's hair, ears, noses, shoes and socks when they play on these fields.
4.We know that these ground up rubber tires have a lot of crumb-rubber dust that is created when they are on the fields.
5.We know that the dust contains the same chemicals as the tires -- only now the dust is so small in size that it is capable of being breathed in deep into the lungs.
(1) After playing on the field, individuals are encouraged to perform aggressive hand and body washing for at least 20 seconds using soap and warm water.
(2) Clothes worn on the field should be taken off and turned inside out as soon as possible after using the field to avoid tracking contaminated dust to other places. In vehicles, people can sit on a large towel or blanket if it is not feasible to remove their clothes. These clothes, towels, and blankets should be washed separately and shoes worn on the field should be kept outside of the home.
(3) Eating while on the field or on turf product is discouraged.Avoid contaminating drinking containers with dust and fibers from the field.When not drinking, close them and keep them in a bag, cooler, or other covered container on the side of the field.
These things alone should cause legislators to pass this Bill.
Environment and Human Health Inc. (EHHI) is concerned about the new synthetic turf fields that are being installed by schools and towns all over this country. These fields are made of a synthetic grass like material to which large amounts of recycled ground-up rubber tires have been added as "in-fill." It is the chemicals released from the ground-up rubber tire "crumbs" as well as the dust from the tire crumbs that pose the greatest health concerns.
EHHI is a 10-member, nonprofit organization composed of physicians, public health professionals and policy experts dedicated to protecting human health from environmental harm through research, education and improving publicpolicy. The new "synthetic turf" fields are not turf in any sense of the word. They are large surfaces, the size of football fields, covered with material derived from grinding up used rubber tires until they are the size of grains of coarse sand. These fields can cost up to $1 million apiece.
In terms of weight, there are more than 100 tons of ground-up rubber tire crumbs on each field. There is no barrier between the rubber crumbs and the athletes playing on the fields. The rubber crumbs are unstable and get into the shoes, stockings, clothing and even the hair and ears of those who play on the fields. Dust particles from these crumbs are easily inhaled.
Numerous studies have been cited in the past to justify the safety of the rubber tire crumbs that constitute the major portion of synthetic turf fields.
However, when EHHI members reviewed the findings of many of these studies, they consistently found that there would indeed be exposures to the components of the tire crumbs.
Many studies found that dust from the rubber crumbs contained carcinogens that could be inhaled into the deepest portions of the lung. Most studies indicated that there were serious limitations to their research due to insufficient safety testing of some of the components released from the tire crumbs.
Norway, Sweden and now Italy have recommended that there be no further construction of fields with rubber tire crumbs in their countries.
Norway's concern was that some people are allergic to latex, a component of rubber tires. Sweden considers rubber tire crumbs to be a hazardous substance and therefore recommends that no new fields containing them be installed, and Italy considers the rubber tire crumbs to be carcinogenic.
Because of the studies that had been done, EHHI decided to initiate a study with the testers for the state of Connecticut - the Connecticut Agricultural Experiment Station - to examine whether the rubber tire "crumbs" out-gassed harmful chemicals into the air or were capable of leaching into ground water.
Although many chemicals were found, the four compounds that were conclusively identified with confirmatory tests were benzothiazole; butylated hydroxyanisole; n-hexadecane; and 4-(toctyl) phenol. Approximately two dozen other chemicals were indicated at lower levels. The four chemicals found have the following reported actions:
• Benzothiazole: Skin and eye irritation, harmful if swallowed. There is no available data on cancer, mutagenic toxicity, teratogenic toxicity, or developmental toxicity.
• Butylated hydroxyanisole: Recognized carcinogen, suspected endocrine toxicant, gastrointestinal toxicant, immunotoxicant (adverse effects on the immune system), neurotoxicant (adverse effects on the nervous system), skin and sense-organ toxicant. There is no available data on cancer, mutagenic toxicity, teratogenic toxicity, or developmental toxicity.
• n-hexadecane: severe irritant based on human and animal studies. There is no available data on cancer, mutagenic toxicity, teratogenic toxicity, or developmental toxicity.
• 4-(t-octyl) phenol: corrosive and destructive to mucous membranes. There is no available data on cancer, mutagenic toxicity, teratogenic toxicity, or developmental toxicity.
People are asked by the synthetic turf manufacturers to assume that the amount of exposures from the rubber crumbs - as well as exposures from the rubber crumb dust - are insufficient to produce any health effect, irrespective of the age of the child or the number of hours, days or years that a person plays on these fields. Those who promote the safety of these fields provide no measurements in which to support these assumptions.
It is clear that children will be exposed to these rubber crumbs, their dusts and their vapors on these fields. A simple exercise in arithmetic will show the scale of the number of children/hours of exposure there would be from one synthetic turf athletic field.
To summarize, children will be exposed to recognized hazardous substances on these synthetic turf fields.
Although the health implications at this time are unclear, the evidence is sufficient to create a burden of proof of safety before more fields are installed. At the very least, more testing should be done before any new synthetic turf fields with ground-up rubber tires are installed.
Nancy Alderman is the presidentof Environment and HumanHealth Inc., North Haven, Conn.