Health impacts

Have you considered the Health impacts of the playing surface?


Due to the limited reported research to date on injuries on the latest versions of synthetic turf, there is little consensus on whether the risk of injury is greater than on natural turf surfaces. The main report gives a detailed account of the knowledge on injuries between the surfaces. However, the following are properties that could contribute to an increased injury risk and need to be considered.

Abrasion/friction – burns, abrasions, and grazes

Natural grass

  • As natural grass is generally soft and non-abrasive, this property is usually only a problem for injuries when the ground has become bare and dry. This can be avoided with good management practices.

Synthetic turf

  • The surface needs to satisfy the requirements outlined by the sport’s governing body to reduce this type of injury.
  • Most fibres are relatively non-abrasive so the choice of infill is critical, sand based infill will be more abrasive than rubber but rubber can cause friction burns if sliding is a characteristic of your sport.

Traction – knee and ankle sprains, and muscle strains

Natural grass

  • The current evidence suggests that the choice of grass type is important for traction as too much traction has been linked to an increased risk of severe knee injuries and too little of muscle strains and facial fractures.
  • Couch grass has been associated with a higher level of rotational traction than rye grass resulting in an increase in knee injuries.

Synthetic Turf

  • Similar to abrasion, the surface needs to satisfy the requirements outlined by the sport’s governing body to reduce traction injuries.
  • Footwear plays a major role in the amount of traction a player experiences, so you need to consider if you are going to impose footwear rules on users to reduce the injury risk.

Shock absorbency – concussions, fractures, shoulder dislocations

Natural grass

  • The shock absorbency on natural turf fields comes from a combination of grass cover combined with the soil composition and is usually not a problem unless the ground is very hard and dry.

Synthetic turf

  • The selection of an appropriate shockpad with the synthetic surface is important for this property; too soft causes fatigue-related injuries and too hard can result in traumatic head injuries from falls.
  • The playing characteristics of the sport are also critical, for example are the players falling on the surface or just running over the top of it?
  • Some synthetic surfaces have increased the amount of infill to increase the shock absorbency and satisfy requirements; however, it can become a problem if the surface is not very regularly maintained.


The heat difference between natural and synthetic turf surfaces is significant and needs to be considered in the selection of a surface.

Natural grass

  • Grass dissipates heat and naturally cools the environment so there is rarely a heat-related injury on natural grass.
  • Most sporting bodies have heat policies in place to counteract heat-related injuries.

Synthetic turf

  • Synthetic turf surfaces appear to create an increase in the heat island effect above the surface, which has implications for heat–related injuries, particularly in junior players.
  • The selection of a heat-resistant fibre and a non-black infill will help reduce the risk of heat-related injuries.
  • Work is being undertaken in Australia and will provide greater guidelines in 2012.

Other health considerations

As mentioned under the environmental considerations section above there have been some concerns raised about the health risks of the crumbed rubber infill used in later synthetic surfaces. There is a need to check the quality of the rubber supplied if this type of infill is being considered.

More information

Chapter 9 of the Natural Grass vs. Synthetic Turf Surfaces Study Final Report

Next step

Step 7 - Life cycle management


The information in this guide was published in 2011 and cannot be relied upon as professional advice concerning the decision as to natural grass v synthetic turf. No assurance is given as to the accuracy of any information contained in this guide and readers should seek more up to date information prior to making a decision. Readers should obtain their own independent and professional advice in relation to their project.