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Gutiérrez-Manzanedo JV, González-Montesinos JL, Aguilera-Arjona J, Rodríguez-Martínez A, Vaz-Pardal C, España-Romero V, Rivas-Ruiz F, Blázquez-Sánchez N, De Gálvez-Aranda MV, De Troya-Martín M. Ultraviolet sun exposure and sun protection behaviors in outdoor rock climbers. Photochem Photobiol Sci 2023; 22:2817-2826. [PMID: 37847459 DOI: 10.1007/s43630-023-00488-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure. AIMS We sought to quantify the sun radiation exposure received by outdoor rock climbers and assess their sun exposure habits, sun protection behaviors, attitudes, and knowledge regarding skin cancer. METHODS From April to June 2021, outdoor rock climbers contacted via email completed an online validated self-reported questionnaire on sun related habits, behaviors, attitudes and knowledge. As a pilot trial, ten participants wore a personal dosimeter during two outdoor climbing weekends in May and November 2021. Ambient ultraviolet radiation (UVR) was also recorded. RESULTS A total of 217 outdoor rock climbers (103 women), mean age 36.8 ± 8.8 years (range 20-70 years) and median climbing practice per week of 8 h (IQR 7.5) were studied. Two in three (65.9%) participants reported at least one sunburn event during the previous rock climbing season. Of the survey respondents, 49.3% reported using sunscreen with SPF ≥ 15, 47% wore sunglasses, and 14.3% indicated they reapplied sunscreen every two hours. The median personal UVR dose measured during the two outdoor climbing weekends analyzed was 5.2 (IQR 1.8) and 8.8 (IQR 1.1) standard erythemal doses, respectively. CONCLUSIONS The high rates of sunburn, the elevated personal UVR measured and the clearly insufficient sun protection practices followed during rock climbing together with unsatisfactory attitudes towards tanning reveal the need to develop explicit sun protection campaigns and educational strategies to reduce the risk of skin cancer among the athletes studied.
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Affiliation(s)
- José V Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda. República Saharaui s/n, Puerto Real, 11519, Cádiz, Spain.
| | - José Luis González-Montesinos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda. República Saharaui s/n, Puerto Real, 11519, Cádiz, Spain
| | - José Aguilera-Arjona
- Photobiological Dermatology Laboratory Medical Research Centre, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | | | - Vanesa España-Romero
- MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | | | | | - María Victoria De Gálvez-Aranda
- Photobiological Dermatology Laboratory Medical Research Centre, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
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Duncan MA, Welch D, Shuryak I, Brenner DJ. Ocular and Facial Far-UVC Doses from Ceiling-Mounted 222 nm Far-UVC Fixtures. Photochem Photobiol 2023; 99:160-167. [PMID: 35818780 PMCID: PMC10087841 DOI: 10.1111/php.13671] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/08/2022] [Indexed: 01/25/2023]
Abstract
Far-UVC radiation, defined in this paper as ultraviolet (UV) radiation with wavelengths from 200 to 235 nm, is a promising tool to help prevent the spread of disease. The unique advantage of far-UVC technology over traditional UV germicidal irradiation lies in the potential for direct application of far-UVC into occupied spaces since antimicrobial doses of far-UVC are significantly below the recommended daily safe exposure limits. This study used a ceiling-mounted far-UVC fixture emitting at 222 nm to directly irradiate an indoor space and then evaluated the doses received upon a manikin. Radiation-sensitive film was affixed to the head, nose, lip and eyes of the manikin, and the 8-h equivalent exposure dose was determined. Variables examined included manikin height (sitting or standing position), manikin offset from directly below the fixture, tilt of the manikin, the addition of glasses, the addition of hair and different anatomical feature sizes. Importantly, at the manikin position with the highest dose to eyes, the average eye dose was only 5.8% of the maximum directly measured dose. These results provide the first experimental analysis of possible exposure doses a human would experience from an indoor far-UVC installation.
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Affiliation(s)
- Michael A Duncan
- Center for Radiological Research, Columbia University Irving Medical Center, New York, NY, USA
| | - David Welch
- Center for Radiological Research, Columbia University Irving Medical Center, New York, NY, USA
| | - Igor Shuryak
- Center for Radiological Research, Columbia University Irving Medical Center, New York, NY, USA
| | - David J Brenner
- Center for Radiological Research, Columbia University Irving Medical Center, New York, NY, USA
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de Castro Maqueda G, Gutiérrez-Manzanedo JV, González-Montesinos JL, Vaz Pardal C, Rivas Ruiz F, de Troya Martín M. Sun Exposure and Photoprotection: Habits, Knowledge and Attitudes Among Elite Kitesurfers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:517-523. [PMID: 32720132 DOI: 10.1007/s13187-020-01838-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but also to reflection from the water surface, which aggravates the impact of solar radiation on the skin. This study sought to analyse the photoprotection and photoexposure habits and knowledge of elite kitesurfers and their beliefs and attitudes in this respect. A sample of convenience of 72 male kitesurfers completed a validated questionnaire in full. By Fitzpatrick phototype, the most common classes were types I and II (69.4%). On average, kitesurfers had been practising their sport for 10.93 years, at a rate of 13.93 h per week. During the last sports season, 84.7% of respondents had suffered at least one sunburn, while 43.1% had been sunburned at least three times. The sun protection practice most commonly adopted was the use of sunscreen cream, which was used by 79.2% of respondents. Although 43.2% of respondents recognized to be worried about they might get skin cancer from the sun, 31.9% does not like using sunscreen and 44.4% like sunbathing. Regarding the respondents' knowledge of facts about sun exposure, the average rate of correct answers for the items evaluated was 66.9%. In conclusion, elite kitesurfers are potentially exposed to dangerous levels of UV radiation, which caused numerous sunburn episodes during the last sports season. It is necessary to raise these athletes' awareness of their risk of developing skin cancer and of the need to improve their sun protection and skin surveillance practices.
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Affiliation(s)
- Guillermo de Castro Maqueda
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain.
| | - José Vicente Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain.
| | - José Luis González-Montesinos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain
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Gilaberte Y, Trullàs C, Granger C, de Troya-Martín M. Photoprotection in Outdoor Sports: A Review of the Literature and Recommendations to Reduce Risk Among Athletes. Dermatol Ther (Heidelb) 2022; 12:329-343. [PMID: 35099755 PMCID: PMC8850489 DOI: 10.1007/s13555-021-00671-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Indexed: 01/04/2023] Open
Abstract
Solar exposure, for long hours and often at peak times with limited shade available, predisposes athletes to episodic sunburn and chronic damage, causing increased risk of precancerous lesions and skin cancer. Environmental factors and training intensity affect risk. Clothing provides good protection, but changing established "uniforms" may not be possible for reasons of practicality, safety, or simply custom. Although physical activity should be encouraged for its physical and mental benefits, risk of skin damage should be minimised. We review existing behaviours, skin cancer risk, and campaigns in the sporting population and highlight key recommendations to help sun protection practices become engrained in sports practice.
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Affiliation(s)
- Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital IIS Aragon, Paseo Isabel la Católica, 3, 50009, Zaragoza, Spain.
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Sun Exposure during Water Sports: Do Elite Athletes Adequately Protect Their Skin against Skin Cancer? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020800. [PMID: 33477791 PMCID: PMC7832317 DOI: 10.3390/ijerph18020800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/09/2021] [Accepted: 01/15/2021] [Indexed: 11/16/2022]
Abstract
Excessive sun exposure is the main avoidable cause of skin cancer. Outdoor sports performed without adequate photoprotection are risky practices in this respect. This study examines whether elite athletes in water sports (specifically surfing, windsurfing, and sailing) take appropriate measures to protect their skin from the sun, and whether there are differences in this respect according to age, gender, or sports discipline. This study is based on a questionnaire-based health survey. World championship competitors completed a self-administered questionnaire on their sun protection and exposure habits, as well as sunburns during the last sports season. In total, 246 participants, with an age range of 16–30 years, completed the questionnaire. Of these, 49.6% used inadequate sun protection. Those who protected their skin appropriately tended to be older than those who did not (average age = 23.28 and 20.69 years, respectively; p = 0.000). There were no significant differences in sun protection habits between male and female athletes. The rate of sunburn was very high (76.7%). A high proportion (22.5%) of participants never used sunscreen. Elite athletes in water sports are at real risk of skin lesions from overexposure to the sun, associated with inadequate photoprotection practices. Campaigns to raise awareness and to promote the early detection of skin cancer should target these risk groups.
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Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities. SPORTS MEDICINE - OPEN 2020; 6:42. [PMID: 32880767 PMCID: PMC7471243 DOI: 10.1186/s40798-020-00272-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Skin cancer is the most common cancer in the USA. Therefore, it is important to review the contribution of ultraviolet radiation (UVR) exposure to skin cancer in individuals with the highest risk. Documenting the relationship between outdoor sports solar ultraviolet exposure and their risk of skin cancer along with appropriate risk mitigation strategies can help inform clinicians of practical information for counseling sun protective behaviors in this population. METHODS We conducted a review of the current evidence using PubMed to answer the following research questions: (1) How is ultraviolet radiation measured? (2) What is the modern utility of the ultraviolet index in modifying recreational sun protection behaviors? (3) What is the risk of developing skin cancer for outdoor sport participants? (4) What is the prevalence of skin cancer in sport participants? and (5) Is the number of nevi and solar lentigines elevated in outdoor sport participants? RESULTS Based on the literature, individuals who practice outdoor sport-related activities receive high ultraviolet radiation exposure, have a high risk for skin cancer, have a high prevalence for pigmented lesions, and may benefit from electronic sun protection educational interventions. CONCLUSIONS Individuals who practice outdoor sports experience substantially higher ultraviolet radiation exposure, routinely exceed the recommended exposure limits, and are at a higher risk of developing skin cancer. Therefore, those who are frequently engaged in outdoor leisure activities should be coached about efficient sun protective practices and relevant mobile technologies that may facilitate adherence.
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Affiliation(s)
- Alan Snyder
- College of Graduate Studies, Medical University of South Carolina, Charleston, SC, USA.
| | - Manuel Valdebran
- Division of Pediatric Dermatology, Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
| | - David Terrero
- College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristen M Kelly
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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Measured UV Exposures of Ironman, Sprint and Olympic-Distance Triathlon Competitors. ATMOSPHERE 2020. [DOI: 10.3390/atmos11050440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Triathletes present an extreme case of modelled behaviour in outdoor sport that favours enhanced exposure to solar ultraviolet radiation. This research presents personal solar ultraviolet exposures, measured using all-weather polysulphone film dosimeters, to triathletes during the distinct swimming, cycling and running stages of competitive Sprint, Olympic and Ironman events conducted within Australia and New Zealand. Measurements of exposure are made for each triathlon stage using film dosimeters fixed at a single site to the headwear of competing triathletes. Exposures are expressed relative to the local ambient and as absolute calibrated erythemally effective values across a total of eight triathlon courses (two Ironman, one half Ironman, one Olympic-distance, and four Sprint events). Competitor exposure results during training are also presented. Exposures range from between 0.2 to 6.8 SED/h (SED: standard erythema dose) depending upon the time of year, the local time of each event and cloud conditions. Cycle stage exposures can exceed 20 SED and represent the highest exposure fraction of any triathlon (average = 32%). The next highest stage exposure occurred during the swim (average = 28%), followed by the run (average = 26%). During an Ironman, personal competitor exposures exceed 30 SED, making triathlon a sporting discipline with potentially the highest personal ultraviolet exposure risk.
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