Patricia Kilday Hart
Field of Nightmares
Can playing sports on artificial turf kill you? As the debate rages on, parents need to hear the story of one young Texas athlete who’s lucky to be alive.
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Life-threatening infections like Boone’s could be avoided with some basic health precautions. Yet a CDC study released in February about the Rams’ experience indicates that, even at the professional level, trainers have been slow to appreciate the risk of MRSA. On an average week, Rams players reported two to three “turf burns,” severe abrasions where the skin is rubbed raw by high-velocity contact with artificial turf. Most of the burns were left uncovered during subsequent play. Trainers who treated the wounds on the sidelines did not have ready access to hand-washing or sanitizing materials. Players shared soap, towels, whirlpools, and workout equipment. The CDC study also determined that the infected players had a history of unusually high use of antibiotics, which could have made them more susceptible to the methicillin-resistant strain of staph. In fact, researchers believe that overuse of antibiotics in the community at large has enabled the new strain of bacteria to emerge. The CDC is advising schools that the best way to prevent MRSA is to disinfect common areas, like whirlpools and showers; stop the practice of sharing towels and soap; and encourage frequent hand washing. Players should see trainers about every abrasion, which should be cleaned and covered immediately.
If the prevention of MRSA is relatively simple, the treatment is anything but. When Boone arrived at Brackenridge Hospital, he was immediately placed in the intensive-care unit. For the first night, he was given fluids intravenously while awaiting the results of blood tests to determine whether he had MRSA. By the time the infection was confirmed as MRSA, two days later, the bacteria had erupted in pustules all over his body. Doctors ordered massive doses of antibiotics and waited for his system to respond. But it didn’t. Something was blocking the antibiotics from taking effect. Boone’s heart was racing at a rate that doctors compared to running a marathon at top speed. His midsection became bloated as his kidneys and liver began to fail. “He was dying, effectively,” his dad recalls.
By this time, whole teams of doctors were standing at Boone’s bedside. A decision was made to conduct a full-body MRI. After a torturous five-hour session (the MRI was halted several times when Boone’s temperature spiked and sent him into uncontrollable chills), doctors found the source of his paralysis: two baseball-size abscesses around the base of his spine. On Monday, Boone underwent back surgery to drain and remove the abscesses and received another round of intensive antibiotics. He remained in the ICU, and doctors immediately began to see progress.
But Wednesday brought another scare: Upon removal of the breathing tube that had been placed down his throat during surgery, Boone said, “Mom, I can’t see out of my right eye.” Yet another specialist was called in, who confirmed that the MRSA was indeed attacking his eye. For the next couple days, Boone would need to be awakened every hour so a nurse could administer three types of antibiotic eyedrops.
On Super Bowl Sunday, seventeen days after he had arrived at the hospital, Boone was allowed to have visitors. A physical therapist helped him take his first painful steps with the aid of a walker. But Boone experienced another setback when it was discovered that he had some blood clots and that a small pustule on his lung had not responded to the antibiotics. More surgery would be needed.
While Boone had fought for his life in the hospital, his illness had become a statistic in one of the ongoing issues involving MRSA: whether artificial turf can cause the infection. This is a question that affects sports at all levels and can have a major economic impact on companies that produce artificial turf. The CDC, however, is not inclined to blame turf. In its study of the St. Louis Rams outbreak, testing of the turf did not turn up evidence of contamination. “We didn’t really feel it was the main mechanism for transmission,” says Jeff Hageman, an epidemiologist for the CDC. Rather, Hageman said, researchers found a high incidence of infection among players with the most skin-to-skin contact.
But that has not stopped the MRSA scare from fueling the prolonged dispute between natural-turf and artificial-turf advocates. Brad Fresenburg, a University of Missouri turf grass expert, recently conducted studies of the temperature of his school’s synthetic field and found an astonishing 173-degree temperature on a 98-degree day, a temperature disparity he believes contributes to bacterial proliferation. “Natural grass has a microbial system. It’s self-cleaning,” Fresenburg wrote. “These synthetic fields don’t have that.” He suggests that synthetic turf be sprayed with a disinfectant when an infection is suspected.
Advocates for synthetic fields disagree, noting that the new generation of turf contains ground automobile tires, which include sulfur and zinc, agents that kill bacteria. “There’s no evidence to support the theory that synthetic turf breeds bacteria,” says Andrew McNitt, an assistant professor of soil science at Penn State University. “The majority of the data shows that the fact that there are more abrasions means the athletes have more entry points for the bacteria to get in their bodies.”
Yet the industry itself is concerned about the possibility of bacterial contamination. In November Astro Corporation unveiled a new product containing an antibacterial agent that it says will protect the turf from corrosion. Several companies have developed products to fight MRSA, including Cleveland-based Pioneer Manufacturing, which, in addition to making paint used to mark athletic fields, now sells an artificial-turf disinfectant called Titan Turf Gard. But the CDC’s Hageman believes that the best way to prevent MRSA from spreading is for trainers to immediately treat and cover wounds like Boone’s.
Boone’s doctors don’t know where the MRSA originated, though they believe it entered his body through the turf burn. Westlake trainer Brad Hawkins says he knows of no MRSA cases at the school, leading him to conclude that the school’s artificial turf is not contaminated. But Westlake athletic director and head football coach Derek Long acknowledges that the school once scrubbed down its field following a staph outbreak (not of the MRSA variety), in 2003. The Bakers aren’t interested in assigning blame but want parents, kids, and trainers to know what to watch for and how to avoid infections. Coalter is haunted by a doctor’s comment that Boone would have died if he and Missy had waited another day to get him to the emergency room.
Shortly before Boone left the hospital, I took my son, Michael, who is a friend of Boone’s, for a brief visit. Missy had prepared us to expect him to look like a prisoner of war. She wasn’t exaggerating: He had lost 41 pounds. Finally, on February 14, more than three weeks after he had been rushed to the emergency room, Boone was cleared to go home, where he remained for a couple months, staying current on his schoolwork and taking his antibiotics intravenously. His vision has returned, but he can’t return to playing sports until he finishes all his medicine—July at the earliest—and an orthopedic specialist determines that no bones have been compromised.
I dropped in to see him a few days after he got home, and though he had put on a few pounds, he still looked gaunt. He was sitting in a chair with an IV in his arm. We chatted for a few minutes, and then I asked him: “Will you play football again?” His answer was immediate. “Oh, sure,” he said, as if nothing had ever happened.
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