Exploring the Human Health Impact of Artificial Turf Worldwide: A Systematic Review.
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The growing use of artificial turf in place of natural turf in residential, recreational and commercial settings has raised concerns regarding its potential impact on human health. A systematic review of databases revealed 5673 articles of which, 30 were deemed eligible. Those performing total concentration analyses, bioaccessibility analyses or human health risk assessments (HHRAs) of artificial turf fibres or crumb rubber infill were of interest. Health hazards and risks were explored in relation to three groups of chemicals of concern: polycyclic aromatic hydrocarbons (PAH), heavy metals and other rubber additives. Twenty-five studies performed total concentration analyses on samples of artificial turf infill and/or turf fibres. Of these studies, median reported concentrations of eight PAHs, cadmium, mercury and zinc exceeded the European limits used. Eight studies performed bioaccessibility assays using synthetic biofluids and simulated organ systems. PAHs were not found to be bioaccessible except for benzo[a]pyrene in gastric fluid; heavy metals were bioaccessible except arsenic, and rubber additives were mostly bioaccessible except for three plasticisers: diisobutyl phthalate, benzyl butyl phthalate and dibutyl phthalate. Fourteen studies performed HHRAs to determine non-carcinogenic and carcinogenic risk. Cancer risks were identified for ingestion exposure to PAH in children with pica and heavy metal exposure via dermal, inhalation and ingestion pathways. Non-carcinogenic risks were identified for the ingestion of cobalt in a child spectator and the ingestion of arsenic, cobalt, thallium and zinc. Potentially hazardous concentrations of chemicals were found across both artificial turf infill and artificial turf fibre samples; bioaccessibility of these chemicals varied. Definitive conclusions were unable to be derived on the human health risks posed to users of artificial turf under real-world exposure scenarios. Future studies are recommended to explore the risks associated with the potential synergistic toxicities of chemical mixtures found in artificial turf.