America's Clean Team
If the Yankees' anti-microbial locker room is such a breakthrough, why aren't hospitals using it?
Say you just invented a surefire way to kill 99.9 percent of the bacteria, viruses, and fungi that dwell on surfaces like tabletops and doorknobs. Would you sell your product to medical centers, where an estimated 100,000 people die annually from hospital-acquired microbes? Or would you instead approach the New York Yankees and help them develop the "first antimicrobial Major League Baseball facility"?
If you're the Coatings Specialist Group, the answer is easy. The self-proclaimed "world leader in sustainable, environmentally beneficial surface treatments" sold the Yankees on the idea of going clean using its Sports Antimicrobial System in their spankin'-new stadium.
In recent years, MRSA (drug-resistant Staphylococcus), creepy molds, and various other superbugs have inched their way out of dreary microbiology texts and onto ESPN and the pages of Sports Illustrated as players have missed substantial amounts of playing time due to infected wounds. Even the New England Journal of Medicine tackled the topic in a February 2005 article (complete with a drawing of a football field) describing an outbreak of MRSA among the St. Louis Rams. Since then, additional reports from various teams ranging from Little League to the pros have further highlighted the phenomenon. CSG claims that its SportsAide (a durable surface treatment) and FabricAide (some sort of high-end laundry detergent) will help shield the Yankees from the Murderer's Row of microbes.
As an infectious-disease specialist who has spent a career trying to prevent these same hospital-acquired infections, I was a bit surprised at the news. If it's this easy to banish bacteria from the House That Ruth Rebuilt, can't those same CSG guys come to my hospital, coat whatever they coat, and lay waste to my hospital microbes, too? After all, we all end up in the hospital sooner or later: Today's energetic CSG salesperson is tomorrow's inpatient.
Apparently not. So how did the Yankees get to the front of the line? I can think of only three explanations: a) The company figured there was more money to be made selling the package to sports teams that follow a cash-and-carry business model and work in places that are fun to visit; b) the company does want to help hospitals, but the regulatory climate, the cost of conducting studies, and the basic Debbie Downer tone of working in a hospital are just too debilitating for any sane person; or c) the product just doesn't work that well.
The answer is all of the above. Regarding a), well, one ought never to vote against the profit motive. As for b), CSG's Web site lists health care as a priority and mentions an old study from a flooded hospital in Malaysia, but having a medical center as a client must not be very appealing: American hospitals are simultaneously frantic and incredibly dull—and they don't come with fan bases. I don't blame CSG or any other company for running the other way.
It's c) that I worry about. To my eye, both the "disease" (the clear and imminent danger to our Bronx Bombers) and the cure (SAS) seem like horseshit, the latest entries in the proud American tradition of quackery. Not that this is a surprise: Among other bad national habits (cigarettes, alcohol, celebrities, subprime mortgages), we are addicted to snake oil.
This particular brand of nonsense started more than 120 years ago, soon after Louis Pasteur sold scientists on the germ theory and ended centuries of alternative explanations for human disease such as demonic possession, imbalanced humors, and bad food. Among the first to traffic in the promisingly slippery universe of antisepsis was William Radam, a Prussian immigrant living in Austin, Texas. Radam was a gardener who set out to cure his own chronic malaria by fiddling with the plants in his backyard. One day, he concocted a pink liquid he named the Microbe Killer, and a legend briefly was born; indeed in 1890, he produced a memoir, Microbes and the Microbe Killer, and soon moved to a large apartment on Central Park South. Radam's ad copy for the Microbe Killer—a "new and Improved Fumigating Composition for Preserving and Purifying Pur-poses" promises to "kill all fungus, germs, parasites, and other matter producing fermentation or decay"—is not very different than the current claims for SAS.
My guess is that the SAS system will help the Yankees about as much as the Microbe Killer might have, at least as far as preventing infected wounds and oozing boils. It may decrease the number of colds the Yanks catch, but so, too, would cheaper methods like regular handwashing and staying home while contagious.
SAS uses a sword that impales and electrocutes bacteria; silane, or silicone tetrahydride, provides the base of the sword. This base is then hooked onto a positively charged nitrogen moiety, which in turn is attached to a long, skinny molecule. Microbes, which are negatively charged, become fatally attracted to the manly allure of the positive silane-nitrogen base. In their rush to mate, they inadvertently impale themselves on the long, skinny molecule, then deflate into a useless heap. All in all, the SAS approach seems roughly akin to toilet seat covers—a logical-sounding intervention that cashes in on free-floating anxiety and is guaranteed to be useless. In both public health and pro-sports hygiene, all that is really gross (public restrooms) is not necessarily contagious, and all that is contagious (your neighbor's supercute toddler) is not necessarily gross.
There is something more critical at play here than the salesmanship of one persuasive company or the Yankees' gullibility. The entire premise fails to consider the basic facts: We are full of bacteria. Millions, billions, trillions of bacteria are in us and on us and around us every minute of every day. Staph was here long before Hominids crowded the Olduvai Gorge and will be here long after we have globally warmed ourselves into extinction. The grass and dirt at Yankee Stadium also are full of microbes, teeming with them; it's a microbe riot out there at second base. Once you start to think about them, bacteria and their ilk are just like the Commies—they're everywhere. And like the Commies, the more you look for them, the more you find: under your sink, on your phone, behind your daughter's ear. You could even argue that our national anti-germ mania started as the Iron Curtain fell, when we were looking left and right for a convenient bad guy.
Against this everyday onslaught, CSG's Sports Antimicrobial System doesn't have a prayer even if it were good at what it claimed, at least for people healthy enough to slap an outside pitch to right field. The Yankees are not critically ill people with weakened immune systems, though fans watching the 2008 season might argue otherwise. In the high-risk hospital world, any attempt at microbe control (hand-washing, gowning, masking, even SAS) is worthy, but in Yankee Stadium, it's just a waste of money.
The New York Yankees have decided their clearest path to a return to baseball dominance is to coat their furniture with microscopic swords provided by a company that features an Amway-like fundraising scheme on its Web site. At its core, this conjunction of the Yankees and CSG represents a watershed moment in American hucksterism. The regal Yankees, decked out in snobbish pinstripes but still willing to sell you the turf from under their feet, embody the Barnum & Bailey world of professional sports. CSG, on the other hand, descends from William Radam and his shady acolytes working the hygiene-or-die market, an industry that resembles nothing so much as a chapter from Charles MacKay's classic Extraordinary Popular Delusions and the Madness of Crowds. Right now, it's unclear which type of slime will prevail, but this much is certain: The baseball fan, who will foot the bill for all those chemical coatings, is guaranteed to come out the biggest loser once more.
Kent Sepkowitz is a physician in New York City who writes about medicine.
Photograph of Yankee Stadium on Slate's home page by Mario Tama/Getty Images.