Barefoot in the Park? Watch Your Step

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Barefoot in the Park? Watch Your Step

Summer's near, and New Yorkers are kicking off their shoes. But some

doctors say that can lead to infection.

http://www.nytimes.com/2008/05/26/nyregion/26barefoot.html?

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By ANEMONA HARTOCOLLIS

People have walked barefoot in the grass for thousands of years, and

barefoot in New York City's parks at least since the days of Olmsted

and Vaux. Neil Simon wrote a play about it, and Redford and

Jane Fonda starred in the movie.

As sun blankets the city, many people hardly think twice before

shedding their inhibitions — and their shoes. Neither New York's

health department nor the parks department has any rules against

going barefoot on the city's streets or in its parks, officials said.

But while many doctors say there is nothing wrong with walking

barefoot in New York, some see small but definite risks. They range

from the obvious, like contracting tetanus from stepping on a rusty

nail, to the invisible, like developing athlete's foot from walking

in wet grass.

" When something doesn't happen to you, you don't consider yourself

lucky, " said Dr. Judith Hellman, a Manhattan dermatologist and

assistant professor at Mount Sinai School of Medicine. " But when you

go barefoot, you are exposing yourself beyond what you really need

to. "

Don't tell Thao Le, a business development coordinator who, if not

for a drizzle, might have been among the regulars going shoeless in

the emerald green of Park in Midtown the other day.

" You take off your shoes, it's the best, " said Ms. Le, 40. " You're in

tune with Mother Nature. "

But, the experts say, it is the grass in many city parks, so innocent-

looking, so tempting, so redolent of the free-spirited days of

childhood, that may pose the most unexpected risks, because unlike a

rusty nail, they are invisible to the naked eye.

Bacteria are everywhere, from the sidewalks to the subway, and

normally, the skin forms a fairly good barrier to infection, doctors

said. In general, people with cuts or cracks on their feet or people

with compromised immune systems are more likely to pick up an

infection from walking barefoot. But getting wet feet by walking

barefoot in damp grass can damage the skin's natural barrier,

allowing infections to take hold, said Dr. Giuseppe Militello, an

assistant professor of clinical dermatology at Columbia University.

People could be vulnerable to infection from three main types of

organism from going barefoot in the grass, he said, including

pseudomonas bacteria, the type of fungus that causes athlete's foot,

and the virus that causes plantar warts.

" These organisms are found in the common environment, " Dr. Militello

said, " and you need to give them the right conditions to infect you. "

The right conditions can be found in many manicured city parks, he

said, where the grass is moist and shaded, well-watered by automatic

sprinkler systems, and well-trampled by thousands of feet, shod and

unshod, human and animal, carrying countless infectious organisms.

" It resides in the grass and earth, you pick it up and it festers in

your shoes, " Dr. Militello said. " I think the best thing to do is to

wear sandals or flip-flops or to just not get your feet wet. And when

you do get your feet wet, thoroughly dry them before putting your

shoes back on. "

Dr. Sessions, a pediatrician at the F. Community

Health Center on the Upper West Side of Manhattan, said she hated to

be a spoilsport, but nonetheless recommended that her patients wear

shoes outdoors. " At least if it's on your shoe, you take your shoes

off at the door, " she said. " If it's on your feet, you bring it all

into the apartment. "

Benepe, the city's parks commissioner, reacted warily at first

when asked for his recommendation about going barefoot in the

park. " My official view is there's no rules against it, " he

said. " However, in certain areas, like playgrounds, we do advise

people to wear shoes, particularly children. "

The black rubber surface of some playgrounds can get burning hot, he

said, and people could stub their toes or step on broken glass.

But Mr. Benepe admitted that he allowed his own children, now 17 and

21, to go barefoot outdoors, " and they managed to survive. "

He even confessed to having done it himself on many a beautiful

summer day. Mr. Benepe said that doctors, knowing the worst that can

happen, " are going to be cautious; that's the nature of doctors. "

Jerome Barth, the operations director at Park, works hard to

keep his grass looking pristine. It is an acre and a quarter of

Kentucky bluegrass, the strips of turf unfurled on top of six inches

of sand and replaced twice a year.

It is picked clean of litter three to four times daily; trod by about

1,200 pairs of feet on a typical warm sunny afternoon at 1:15, its

busiest time; watered at night; and photographed daily from the 31st

floor of a nearby building to detect imperfections that cannot be

seen at ground level.

Yes, Mr. Barth has shed his shoes outdoors — " mostly on weekends when

I have brought my little girls to the park, " he said — with no ill

effects.

" It is pleasant, " he said in an e-mail message. " Do you recall that

scene in `Pretty Woman' where Gere walks barefoot on the

grass? The imagery suggests that he does so to reconnect to his

premogul persona. Well, I think there is a bit of that in

every `barefoot walk,' one feels a touch closer to nature. "

Too close to nature, according to Dr. Militello.

He said he never touched bare toe to public parkland. " If I'm in the

park, I put a blanket down, and I'm on that blanket and I don't

venture off, " he said. " The only place I go barefoot is on the beach. "

In the worst case, pseudomonas bacteria — which Dr. Militello says

has a " very pungent, vinegary smell " — can be fatal if it gets into

the lungs or bloodstream, as it sometimes does when it is contracted

at hospitals. (Such a serious consequence, he said, is an unlikely

outcome of a skin infection, whose symptoms would typically be

limited to redness, pain and pus.)

A parasite like hookworm, carried in dog or cat feces, could also be

picked up in a sandbox or dirt, though it is more common in the

warmer Southeast, doctors said. Hookworm can cause a rash, or more

seriously, anemia.

Dr. Greenbaum, a podiatrist affiliated with St. Francis

Hospital in Roslyn, on Long Island, says he has seen more sprained

ankles and stubbed toes than infections from bare feet.

Diabetics are more prone to foot injuries, he said, because they tend

to have limited sensation in their feet and may unwittingly step on

hot surfaces or sharp objects.

But Dr. Hellman, the dermatologist, said that outside of the obvious

hazards, danger could lurk in even the most innocuous places, like a

rose or a lawn.

Grass can be sharp enough to cut, she said, allowing bacteria or

parasites to enter the skin. Rose bushes can transmit a fungal

infection called sporotrichosis. The fungus could be injected into

the body, she said, just by stepping on a thorn.

But for many people, the joy of feeling the cool grass underfoot may

outweigh one of its consequences, bromhidrosis, known colloquially as

stinky feet, which is caused by bacteria that thrive in moist places —

and thus is a risk of putting wet feet back into shoes and free

spirits under wraps again.