The Physician and Sportsmedicine
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THE PHYSICIAN AND SPORTSMEDICINE - VOL 31 - NO. 2 - FEBRUARY 2021


Sending Sports Gear to the Showers

Benefits for Players' Skin?

Hockey pads start stinking. Football pads get grungy. But is dirty sports equipment a health hazard? Esporta Wash Systems, Inc, the Kelowna, British Columbia-based maker of a new sports equipment laundering system, started out with the simple goal of making it tolerable to be in the same room or car with well-worn hockey pads. Soon after, athletes and coaches began hailing the washing process as a way to reduce rashes and skin infections.

How the System Works

Laundering services using the Esporta system are available to the general public in seven Canadian provinces and 16 US states. Esporta machines are often located at hockey arenas, sports centers, and sports stores, and as independent cleaners. The average cost to launder a set of sports gear is $45. A list of sites is available on the company Web site (https://www.esporta.ca).

According to the company Web site, after an athlete drops off the sports gear, the washing staff places it in a protective mesh bag (figure 1A), folds the bag in half, and loads it into one of eight compartments in the Esporta washing machine (figure 1B). The equipment then goes through a four-stage water-based cleaning process, using detergents and disinfectants specifically formulated for the machine, that cleans, sanitizes, and partially dries the equipment. (The cleaning solution contains antibacterial and antifungal agents.) A finishing fragrance is added at the end of the cycle. To avoid damaging leather or plastic, the equipment is air-dried after it reaches a 10% to 15% moisture content.

Rash Ravages

Tom Reid, who played in the National Hockey League from 1967 to 1978, suffered a severe rash that eventually forced him to retire. "I had some sort of eczema. It was like I had no skin from my neck to my waist," says Reid, who is radio announcer for the Minnesota Wild. "The rash emitted fluids and blood, and I had to play with towels wrapped around me underneath my uniform." His physicians prescribed barrier creams, changing jerseys every period, cotton undergarments, and corticosteroid medication, but none of the methods resolved Reid's rash. He estimates that about 40 other players at that time had a similar skin condition, though not as severe.

Reid says he's not certain if frequent washing of his gear would have prolonged his career; however, he believes gear washing might prevent skin infections, particularly in younger players who don't have the luxury of having a professional staff on hand to keep surfaces and garments clean. Perspiration, body contact, and blood make the environment ripe for infections, he says, pointing to a recent incident in which Mikael Renberg, a Toronto Maple Leafs forward, developed a near-fatal infection after popping a finger blister while tightening his skate laces.

Theoretical Benefit?

Brian B. Adams, MD, an associate professor in the department of dermatology at the University of Cincinnati College of Medicine, says that although rashes are a concern in sports such as football and hockey that require occlusive gear, no scientific data currently exist to suggest that cleaner pads contribute to fewer rashes and infections. He says, however, that there is evidence that sharing equipment with athletes who have skin infections can spread the infection to otherwise unaffected athletes.

He says skin rashes and infections in sports are caused by multiple factors: occlusion, friction, moisture, and some microorganisms. "Acne mechanica is not an infection, and it's not going to get any better with cleaner pads," he says, "however, bacteria can superinfect acne mechanica."

Adams says cleaner pads provide a theoretical benefit for patients who already have infections and share pads or equipment. He also notes that cleaner pads could theoretically decrease the chance of reinfection in patients who have had skin infections. He says that researchers, however, have been somewhat unsuccessful at culturing organisms off of affected mats and pads. (The company's own cultures of rinse water have revealed bacteria and fungi.)

Sweating macerates the stratum corneum, making the skin more vulnerable to contact with microorganisms and antigens, Adams says. Frequent sensitizers in sports gear include leather tanning accelerants, preservatives, and rubber. Thoroughly washing the pads, he says, may remove the sensitizers.

Adams says that coaches and athletes often have a hard time distinguishing between rashes and skin infections. "Contact dermatitis and acne mechanica look completely different," he says. Early lesions of herpes infections and bacterial folliculitis can mimic acne mechanica.

Physicians are in a position to resolve misconceptions about skin infections and also provide sports teams realistic expectations about the new washing system, Adams says. "Frankly, though, as an athlete and as a physician of athletes, pads that smell better make a lot of sense."

Lisa Schnirring
Minneapolis


Field Notes

Physician Group Rates Popular Diet Books

In an analysis of the 15 most popular weight-loss books, the Physicians Committee for Responsible Medicine (PCRM) awarded only one book its five-star rating: Eat More, Weigh Less (Ornish D, Quill, 2021). The two books that received the lowest rating both focused on high-protein diets.

In its reviews, the PCRM used five daily criteria that it believes are critical to good nutrition and safe weight loss: a minimum of 25 g of fiber, five servings of fruits and vegetables, no more than 50 mg of cholesterol, no more than 30% of total calories from fat, and no more than 10% saturated fat. Besides the Ornish book, other dieting books that were reviewed (categorized by rating) include:

Four stars (good):

Get With the Program (Greene B, Simon & Schuster, 2021)

The pH Miracle (Young RO, Warner Books, 2021)

Three stars (marginal):

Eat Right for Your Type (Type A) (D'Adamo P, Berkley Pub Group, 2021)

8 Minutes in the Morning (Cruise J, HarperResource, 2021)

The Peanut Butter Diet (McCord H, St Martins, 2021)

The Zone (Sears B, HarperCollins, 1995)

Two stars (unsatisfactory):

Body for Life (Phillips B, HarperCollins, 1999)

Eat Right for Your Type (Type O) (D'Adamo P, Berkley Pub Group, 2021)

The Fat Flush Plan (Gittleman AL, McGraw-Hill Trade, 2021)

The Insulin Resistance Diet (Grossman MK, McGraw-Hill Contemporary Books, 2021)

The Omega Diet (Simopoulos AP, HarperCollins, 1999)

Sugar Busters! (Steward HL, Ballantine Books, 192021)

One star (poor):

Eat Right for Your Type (Type AB) (D'Adamo P, Berkley Pub Group, 2021)

Eat Right for Your Type (Type B) (D'Adamo P, Berkley Pub Group, 2021)

The Schwarzbein Principle II (Schwarzbein D, Heath Communications, 1999)

No stars (unsafe):

Dr Atkins' New Diet Revolution (Atkins RC, Avon, 2021)

Protein Power (Eades M, Bantam Books, 1997)


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