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Martínez AR, Pardal CV, Arjona JA, Ruiz FR, Molinero DD, Paulano MR, Subert A, Manzanedo JVG, Cambil Martín J, de Gálvez Aranda MV, López LJ, Sánchez NB, de Troya Martín M. Skin cancer prevention in extreme sports: Intervention in a 24-h race. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12940. [PMID: 38288775 DOI: 10.1111/phpp.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Excessive sun exposure and sunburns are the main preventable causes of skin cancer. The growing popularity of outdoor sports in developed countries has motivated the objective of this work to study the risk of photoexposure and the skin cancer prevention needs of athletes in an extreme race and evaluate an intervention targeted at this population. METHODS An observational study was conducted during the XXIII edition of the 101 km de Ronda race, which consisted of trail running and mountain biking categories. Environmental and personal dosimetry, monitoring of meteorological conditions, evaluation of the athletes' photoprotection and skin examination habits, a dermatological checkup, and a satisfaction questionnaire were performed. RESULTS The ultra-endurance race was carried out under adverse conditions (maximum ultraviolet index (UVI) = 9.2, temperatures above 30°C, and relative humidity >35%). The mean effective erythema dose received by race athletes (n = 11) was 2959.2 ± 404.2 J/m2 , equivalent to 29.6 standard erythema doses (SED). The CHACES questionnaire (n = 1145) showed a sunburn rate of 58% and poor protective habits: 62.9% of athletes do not usually use sunscreen and 67.2% do not self-examine their skin. Actinic keratoses (4.7%) and suspicious skin cancer lesions (4.2%) were found in dermatologic screening exams (n = 170). On the satisfaction questionnaire (n = 111), this intervention was rated as excellent (95.5%). CONCLUSION This research highlights the extreme risk of photoexposure that athletes are subjected to during ultra-endurance competitions. In the same way, it shows the need to carry out interventions aimed at the acquisition of healthy photoprotection habits and skin surveillance in this target group.
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Affiliation(s)
| | - Carmen Vaz Pardal
- Andalusian Centre for Sports Medicine, Cádiz, Spain
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
| | | | - Francisco Rivas Ruiz
- Research Unit, Hospital Costa del Sol, Marbella, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, Spain
| | - Diego Doncel Molinero
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Hospital Costa del Sol, Marbella, Spain
| | | | - Andras Subert
- Research Unit, Hospital Costa del Sol, Marbella, Spain
| | - Jose Vicente Gutiérrez Manzanedo
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Jacobo Cambil Martín
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
| | | | | | - Nuria Blázquez Sánchez
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
| | - Magdalena de Troya Martín
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
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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: 0] [Impact Index Per Article: 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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Morton SK, Harrison SL. Slip, Slop, Slap, Slide, Seek and Sport: A Systematic Scoping Review of Sun Protection in Sport in Australasia. Curr Oncol 2022; 30:401-415. [PMID: 36661682 PMCID: PMC9858120 DOI: 10.3390/curroncol30010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Australia and New Zealand have the highest incidence of skin cancer. Sport is a fundamental part of Australasian culture, beginning in childhood, often with life-long participation. Participating in outdoor sports can contribute significantly to the lifetime ultraviolet radiation (UVR) dose individuals receive and their risk of developing skin cancer. This systematic scoping review explores the use of sun-protection by outdoor sporting participants in Australasia and considers how sun-protection practices may be improved and better evaluated in the community. A search of electronic databases using the search strategy "sun protection" AND "sport" AND "Australia" yielded 17 studies published in English from January 1992 to August 2021. Study methods included using UV-dosimeters to measure individual UVR-exposure; remote estimates of clothing-adjusted UVR-exposure; direct observation of sun-protection practices; and self-reported sun-exposure and sun-protection. Despite 40 years of 'Slip, Slop, Slap' campaigns in Australia, the use of sun-protection in most outdoor sports is inadequate. The paucity of comparable data limited our analyses, demonstrating a need for standardized, objective evaluation tools. Such tools, if used across a range of sports, should inform the development of workable recommendations that sporting clubs could implement and adopt into policy, thus empowering them to better protect the health of their participants.
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Affiliation(s)
- Sarah K. Morton
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, Division of Public Health and Tropical Medicine, James Cook University, Douglas, Townsville, QLD 4811, Australia
- Royal Brisbane Women’s Hospital, Metro North Hospital and Health Service, Queensland Health, Brisbane, QLD 4029, Australia
| | - Simone L. Harrison
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, Division of Public Health and Tropical Medicine, James Cook University, Douglas, Townsville, QLD 4811, Australia
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Gutiérrez-Manzanedo JV, Vaz Pardal C, Blázquez-Sánchez N, De Gálvez MV, Aguilera-Arjona J, González-Montesinos JL, Rivas Ruiz F, De Troya-Martín M. Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022. [PMID: 36208003 DOI: 10.1111/phpp.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. OBJECTIVES This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. METHODS Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. RESULTS A total of 13 sailors (7 women), with mean age of 27.6 ± 4.7 years and sports experience of 17.7 ± 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 ± 263.6 J/m2 , 3.0 ± 1.1 minimal erythemal dose and 7.6 ± 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). CONCLUSIONS Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes.
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Affiliation(s)
| | | | | | - Maria Victoria De Gálvez
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - José Aguilera-Arjona
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
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Henning A, J Downs N, Vanos JK. Wearable ultraviolet radiation sensors for research and personal use. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:627-640. [PMID: 34743221 DOI: 10.1007/s00484-021-02216-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/06/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
Skin cancers are strongly linked to personal exposure to ultraviolet (UV) radiation, yet UV exposure is also the most preventable risk factor. People are exposed to UV rays when they engage in outdoor activities, particularly exercise, which is an important health behavior. Thus, researchers and the general public have shown increasing interest in measuring UV exposure using wearable sensors during outdoor physical activity. However, minimal research exists at the intersection of UV sensors, personal exposure, adaptive behavior due to exposures, and risk of skin damage. Recent years have seen an influx of new consumer-based and research-based UV-sensing technologies with wide-ranging form factors and purposes to fill this research gap, yet a thorough review of available sensors for specific purposes does not exist. Hence, the overall goal of this state-of-the-art review is to synthesize the current academic and gray literature surrounding personal UV-sensing technologies. Peer-reviewed journal articles and "gray literature," such as working papers, manuals, and UV sensor websites, were reviewed, assessing attributes of UV wearables marketed for research use, personal use, or both. Overall, 13 wearable UV sensors are available for personal use and/or research applications. These sensors vary from electronic to photochromic, with large differences in price, data outputs, accuracy, and precision. Recommendations are provided for which sensors are most suitable for various types of research or public use. Notably, the review findings will help guide researchers in future studies assessing UV exposure during physical activity.
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Affiliation(s)
- Alyssa Henning
- School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ, USA
| | - Nathan J Downs
- School of Sciences, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Jennifer K Vanos
- School of Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.
- School of Sustainability, Arizona State University, 800 Cady Mall #108, Tempe, AZ, 85281, USA.
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Buxton LS, Reeder AI, Marsh L, Iosua E, McNoe BM. Erythemal ultraviolet radiation exposure of high school rowers in Aotearoa/New Zealand. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 222:112254. [PMID: 34284225 DOI: 10.1016/j.jphotobiol.2021.112254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 11/16/2022]
Abstract
Athletes who compete in outdoor sports can receive potentially harmful levels of solar ultraviolet radiation (UVR). Rowing is a popular outdoor sport that takes place during the peak UVR season. Using electronic dosimeters attached to the shoulder strap of the rower's uniform, this study aimed to quantify the real-time solar UVR exposure experienced by high school rowers during competition. We measured personal UVR exposure (PE) during the time spent on the water in order to compete in a single rowing-race (race-time), when rowing administrators are responsible for athletes' wellbeing. Data collection took place in Aotearoa (New Zealand) at Lake Ruataniwha (44.28°S, 170.07°E), during two consecutive rowing seasons (December-February 2018-19 and 2019-20). Analysis of dosimeter data generated from 56 race-times over five regattas revealed a median personal UVR exposure (PE) of 1.15 standard erythemal dose (SED), where 1 SED is defined as an effective radiant exposure of 100 Jm-2. Mean race-time was 46 min. Over two-thirds of race-times (69.6%) exceeded the Australian Radiation Protection and Nuclear Safety Agency recommendation of 1 SED being considered safe for most people in a day. An exposure of 1.5-3.0 SED produces perceptible erythema for people with light coloured skin and the lower parameter of 1.5 SED was exceeded in 14 (25.0%) of the race-times. By regatta, the median SED/h ranged from 0.96-2.40 and the median percentage of total concurrent ambient UVR ranged from 17 to 31%. Our results indicate that rowing is a high UVR sport and that races outside of peak UVR times also warrant the use of sun protection even when the UVI < 3. Given that acute and cumulative UVR exposure are recognised risk factors in the development of ocular diseases and skin cancers later in life, risk management guidelines for competitive school rowing will be incomplete until a long-term approach to well-being is considered and comprehensive sun protection measures adopted.
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Affiliation(s)
- Linda S Buxton
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, P O Box 56, Dunedin, New Zealand.
| | - Anthony I Reeder
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, P O Box 56, Dunedin, New Zealand.
| | - Louise Marsh
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, P O Box 56, Dunedin, New Zealand.
| | - Ella Iosua
- Biostatistics Centre, Division of Health Sciences, University of Otago, New Zealand.
| | - Bronwen M McNoe
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, P O Box 56, Dunedin, New Zealand.
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