www.SynTurf.org

[No. 10] EHHI takes on plant-based and EPDM infills. In a year-end op-ed communiqué titled “Yet Another Reason Environment and Human Health, Inc. (EHHI) Continues to Maintain that Grass is the Best Surface for Students and Athletes to Play on,” EHHI notes that “Quinnipiac University has a synthetic turf field infilled with Geofill. Geofill for synthetic turf fields is commonly known as coconut husks and cork infill. Industry says it is 90% coconut and 10% natural derived plant based matter and claims Geofill is an environmentally-friendly alternative infill for synthetic turf systems. Quinnipiac University is presently in the process of vacuuming-up Geofill out of its synthetic turf field - why would this be? What could have gone wrong?," asks EHHI. As for ethylene propylene diene monomer (EPDM) rubber infill, EHHI points out that EPDM contains toxic and irritant chemicals and one of these – carbon black - is a possible carcinogen. The product “has never  been proven to be safe for children and students to play on,” says EHHI. For the text of the EHHI communiqué go here.

[No. 09] EHHI's 12 Steps to a Healthier School Project Report. The following report 12 Steps to a Healthier School (dated 14 September 2018) is the work of Healthier School Project (Patricia Taylor, Director) of Environment and Human Health, Inc.

In September 2017, Environment and Human Health, Inc. (EHHI) embarked on a new project "12 Steps to a Healthier School." On this project EHHI visited 169 CT municipalities and 69 CT local health departments and superintendents of schools. The new brochure that lists 12 ways to make schools healthier environments for students was brought to, and discussed with all offices visited.  The Connecticut Health Foundation underwrote the writing and printing of the brochure. The project concluded today. Below is the report:

 * EHHI visited 169 municipalities in Connecticut this year. We went to the local Superintendent of School offices and the 69 corresponding Health Departments for these towns and cities.

   * EHHI asked the Superintendents of Schools in each district to share the brochure with their Boards of Education and/or the community.

   * EHHI emailed the towns before and after the visits to Health Directors and after the visits to Superintendent of Schools.

   * On our visits, we collected information about whether the school or the town had any playgrounds surfaced with rubber mulch. We also emailed the Facility Managers in the towns to see about the towns' or schools' playgrounds.

   * In total, EHHI received responses from 91 (54%) school districts and 73 (43%) towns.

 * From the information collected, we identified 12 rubber mulch playgrounds in Connecticut. They are:

 Ansonia Public Schools - 1

 Canterbury Public Schools - 2

 Town of Cromwell - 1

 Hamilton Elementary School - 1

 Scotland Elementary School - 2

 Town of New Fairfield - 1

 Town of Putnam - 1

 Plymouth Public Schools - 1

 Town of Sterling - 1

Importantly, there are no rubber mulch playgrounds in the large municipalities of Bridgeport, Hartford, New Haven, and Norwalk. These communities have playgrounds surfaced with wood chips or wood chips with rubber safety mats. Some have poured-in-place rubber surfaces which make them available for use for those who have disabilities. Other large municipalities have not been responsive to our queries, to date.

EHHI has written to the towns that do have rubber mulch surfacing in their playgrounds and asked that the rubber mulch be removed. We have also asked them to let us know when the rubber mulch is removed.

Ansonia responded with information that their town is working toward total removal of the rubber mulch surfacing. In Scotland we spoke to the school principal and had a follow-up email exchange about the safety and funding for a new playground.

 * EHHI has maintained call sheets and an Excel spreadsheet on contact information as well as where the rubber mulch surfaces are in Connecticut.

 * So far, everyone has been very receptive to our brochure and our information about playground safety.

Details and Process Notes -

EHHI's Healthier Schools Brochures have been distributed to Superintendents of Schools and Health Directors representing every community in Connecticut.

We have distributed the brochures in person, asking the districts to share the information with the Board of Education or anyone else appropriate in their community.

In addition to brochure drops, we have sent emails to Health Directors before and after the visit to their office and to the office of the Superintendents of Schools. The emails include information about EHHI, about rubber mulch playgrounds, and a link to the brochure. In that way, they can share the brochure electronically or download and copy it.

During our visits, we met and spoke with three Superintendents of Schools, one Elementary School Principal, a Vice-Principal, several Directors of Health, and many Administrative Assistants, Sanitarians, and desk personnel. We have been in email communication with some of them, as a result. We are attempting to get constructive feedback from them - but to date we have not received any.

A number of contacts have confirmed that they will share the material with their school boards, health & wellness committees, school nurses, and at facilities meetings. The response to the material has been positive and our face-to-face conversations have been pleasant. In addition, our email queries about rubber mulch playgrounds to Directors of Facilities, Parks and Recreation Directors, and other town personnel have all been pleasant and productive exchanges.

As an aside, we have also reported idling school buses in two districts: Orange and Easton. Both issues were resolved positively.

EHHI has also distributed brochures to ACES in North Haven (Area Cooperative Educational Services). They are the Regional Educational Service Center (RESC) for the twenty-five school districts in south central Connecticut.

Additional information about Connecticut -

Some municipalities are within shared regional school districts or health districts.

Some school districts may have an elementary school superintendent as well as taking part in a regional school district.

A few small towns have their Parks and Recreation Department or the Department of Public Works maintain their school playgrounds. Larger school districts maintain their own facilities, including their playgrounds.

The rubber mulch playgrounds we have identified seem to be older playgrounds.  For instance, the two in Scotland were installed before 2006 and were installed to satisfy NAEYC (early childhood) requirements at that time for facilities serving preschool children.

[No. 08] EHHI releases its new report Synthetic Turf: Industry's Claims Versus the Science.  On 7 November 2017 EHHI – www.ehhi.org – published its new report on synthetic turf titled  Synthetic Turf: Industry's Claims Versus the Science . For the complete report go to http://www.ehhi.org/NewTurf_Final.pdf .

The news release by EHHI noted that this new report “shows industry's claims of safety do not hold up to scientific examination.” Here is a synopsis of the report as provided by EHHI:         

Shredded waste tires have been sold as crumb rubber infill for synthetic turf fields and as rubber mulch to surface our youngest children's playgrounds before testing was done to see if the material was safe for these uses.

Industry continues to claim that there are studies that prove the synthetic turf fields and playgrounds surfaced with rubber mulch are safe. If no one actually reads and analyzes these studies, then there is no one to dispute these claims. Environment and Human Health, Inc. (EHHI) has spent the past year carefully reading these studies and summarizing their findings in an easily accessible report for all to read and understand.

Many of the studies that the Synthetic Turf Industry cites, claiming that the synthetic turf fields are safe, actually show numerous heavy metals, chemicals, and carcinogens in the samples tested.

Although industry admits that many studies find numerous toxic compounds, they claim that the levels are too low to be dangerous to human health. Yet the National Institute of Environmental Health Sciences (NIEHS) reports that even when there is low-level exposure to an individual chemical that might not cause cancer, when many low level chemicals act together they can indeed cause cancer. This important finding emerged from an international task force of more than 170 cancer scientists, known as the Halifax Project, who collaboratively assessed the carcinogenic potential of low-dose exposures to chemical mixtures in the environment.

Lead was found in every study that looked for it. One study found lead in one field to be 500 to 1,000 times the lead concentration of the other fields tested. This shows how variable the samples of crumb rubber can be, and why one study sample cannot be assumed to be the norm for all samples or for all fields.

Benzothiazole (BZT), an eye, skin and respiratory irritant, was found to be emitted in nearly all the air samples tested and was also found leaching from crumb rubber samples.

Because of the variability of the fields, one study called for the testing of every artificial field to measure its risk to players, especially children. Many cautioned that more research was needed before any conclusions could be made about the safety or harmful effects of crumb rubber or artificial turf.

None of the studies examined the important issue of being exposed to many chemicals at the same time and what these simultaneous multiple exposures mean for the health of those who play on these fields.

None measured the health impacts to children with asthma or allergies when they play either on artificial turf fields or playgrounds surfaced with waste tire rubber mulch.

None of the studies considered additional exposures that happen when crumb rubber pellets migrate from the fields into cars, schoolrooms and homes. Crumb rubber pellets are carried off the field in players' socks, shoes, hair and ears.

The one indoor field that was tested found high levels of toxins in the air above the field-yet this indoor field was only tested for 25 minutes. That study recommended that indoor fields need additional testing and that all indoor artificial turf fields need to be adequately ventilated in order to protect human health.

Despite industry's claims that synthetic turf fields with crumb rubber are safe, many towns and schools have become skeptical of these claims. Because of this skepticism, many are opting for alternative infills, even though most of the alternative infills are more expensive and more importantly, none have had independent testing.

Environment and Human Health, Inc. maintains that there is no safer surface for athletic play than natural grass. If towns and schools would take half of the money they put into synthetic turf fields and invest instead in state-of-the-art natural grass fields, our children, athletes and our planet would be healthier.

[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 chemical concentrations in air above crumb rubber turf fields under active use (CA OEHHA 2010). Air samples were taken above fields and analyzed for VOCs and metals.

Results suggested that adverse health effects were unlikely to occur from inhalation of VOCs or metals in particulates above these fields. To assess the potential for skin infections due to bacteria or to skin abrasions on these fields, tests for bacterial contamination 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 than natural turf fields, and the study authors made various recommendations to help prevent skin abrasions (e.g., protective equipment or clothing) and prompt treatment of skin abrasions.

[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 outdoor artificial turf fields with crumb rubber infills (most relevant to Medway) under summer conditions (Simcox et al. 2011). Air measurements were taken using stationary air sampling monitoring devices as well as personal samplers (placed on people using the fields). They concluded that exposure opportunities to turf contaminants were not associated with elevated health risks and suggested that their findings were consistent with other studies available at the time. A letter prepared by the Connecticut Department 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 for various constituents in these products. APT submitted a written statement dated October 29, 2014, that reported that the APT Gridiron turf systems (essentially the grass fibers of the artificial turf) are manufactured and installed without the use of any lead or heavy metals. They reported that this included all materials used for the turf fibers and backings. No other documentation about 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 very important. 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 risk factor is anything that increases a person's chance of developing cancer and can include 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 that multiple risk factors influence the development of most cancers. In addition, an individual's risk may depend on a complex interaction between their genetic make-up and exposure to environmental agents, including infectious agents and/or chemicals . This may explain why some individuals have a fairly low risk of developing a particular type of cancer as a result of an environmental exposure, while others are more vulnerable.

[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 for children 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.

Hodgkin Lymphoma

[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 a previous cancer) may pose an increased risk. Some studies have also suggested that exposure to chemicals such as benzene and certain herbicides and insecticides may be linked with an increased risk of NHL. Smoking has been associated in some studies with 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.

 

Osteosarcoma

[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.

Summary

[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 limits established for children's products. For the turf fibers, APT provided a statement that this material did not have lead used in its manufacture, but no additional documentation was 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 diagnosed with cancer in the state. All newly diagnosed cancer cases among Massachusetts residents are required by law to be reported to the MCR within six months of the date of diagnosis (MGL, c.111, s.111 B). This information is kept in a confidential database and reviewed for accuracy and completeness.

Available information on the occurrence of cancers in children living in Medway indicates no diagnoses of Hodgkin Lymphoma, NHL, or osteosarcoma have been reported to the MCR in a search of their files from 2006 to the present. Although it is possible that a very recent diagnosis may not yet have been reported to the MCR, the fact 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 of this material, we would be happy to assist the Town of Medway in developing a sampling 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 not indicate exposure opportunities of health concern, MDPH/BEH continues to recommend common sense ways to minimize any potential exposure to chemicals that may be contained in synthetic turf fields made of crumb rubber. MDPH/BEH suggests washing hands after playing on the field and before eating, particularly for younger children with frequent 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 heat levels on artificial turf fields may rise as outdoor temperatures increase (New York State 2009). Thus, for protection of the players, MDPH/BEH recommends increasing hydration, taking frequent breaks, and watering down the field to cool it on hot days to prevent the potential for burns or heat stress. Finally, based on recent work in California, MDPH/BEH recommends that steps be taken to minimize the potential for skin 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 particular  environment. 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.  This  suggests 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 and  chest 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 are  NOW 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 turf  fields 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.