Photoprotection in Outdoor Sports: A Review of the Literature and Recommendations to Reduce Risk Among Athletes.
Athletes
Cancer
Photoprotection
Skin
Solar
Sports
Ultraviolet
Journal
Dermatology and therapy
ISSN: 2193-8210
Titre abrégé: Dermatol Ther (Heidelb)
Pays: Switzerland
ID NLM: 101590450
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
29
10
2021
pubmed:
1
2
2022
medline:
1
2
2022
entrez:
31
1
2022
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 35099755
doi: 10.1007/s13555-021-00671-0
pii: 10.1007/s13555-021-00671-0
pmc: PMC8850489
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
329-343Subventions
Organisme : ISDIN
ID : writing and publication costs
Informations de copyright
© 2022. The Author(s).
Références
Adams BB. Dermatologic disorders of the athlete. Sports Med. 2002;32(5):309–21.
pubmed: 11929358
Patel AV, Friedenreich CM, Moore SC, et al. American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc. 2019;51(11):2391–402.
pubmed: 31626056
pmcid: 6814265
Haluza D, Simic S, Moshammer H. Sun exposure prevalence and associated skin health habits: results from the Austrian population-based UV skin risk survey. Int J Environ Res Public Health. 2016;13(1):141.
pmcid: 4730532
Christoph S, Cazzaniga S, Hunger RE, Naldi L, Borradori L, Oberholzer PA. Ultraviolet radiation protection and skin cancer awareness in recreational athletes: a survey among participants in a running event. Swiss Med Wkly. 2016;146:w14297.
pubmed: 26999653
De Luca JF, Adams BB, Yosipovitch G. Skin manifestations of athletes competing in the summer Olympics: what a sports medicine physician should know. Sports Med. 2012;42(5):399–413.
pubmed: 22512412
Price J, Ness A, Leary S, Kennedy C. Sun-safety behaviors of skiers and snowboarders on the South Island of New Zealand. J Cosmet Dermatol. 2006;5(1):39–47.
pubmed: 17173570
Allen M, McKenzie R. Enhanced UV exposure on a ski-field compared with exposures at sea level. Photochem Photobiol Sci. 2005;4(5):429–37.
pubmed: 15875076
Rigel DS, Rigel EG, Rigel AC. Effects of altitude and latitude on ambient UVB radiation. J Am Acad Dermatol. 1999;40(1):114–6.
pubmed: 9922027
Moehrle M, Koehle W, Dietz K, Lischka G. Reduction of minimal erythema dose by sweating. Photodermatol Photoimmunol Photomed. 2000;16(6):260–2.
pubmed: 11132129
Moehrle M. Outdoor sports and skin cancer. Clin Dermatol. 2008;26(1):12–5.
pubmed: 18280899
Ambros-Rudolph CM, Hofmann-Wellenhof R, Richtig E, Müller-Fürstner M, Soyer HP, Kerl H. Malignant melanoma in marathon runners. Arch Dermatol. 2006;142(11):1471–4.
pubmed: 17116838
Vierck HB, Darvin ME, Lademann J, et al. The influence of endurance exercise on the antioxidative status of human skin. Eur J Appl Physiol. 2012;112(9):3361–7.
pubmed: 22270481
De Castro-Maqueda G, Gutierrez-Manzanedo JV, Ponce-Gonzalez JG, Fernandez-Santos JR, Linares-Barrios M, De Troya-Martin M. Sun protection habits and sunburn in elite aquatics athletes: surfers, windsurfers and Olympic sailors. J Cancer Educ. 2020;35(2):312–20.
pubmed: 30637576
de Castro MG, Gutierrez-Manzanedo JV, Gonzalez-Montesinos JL, Vaz Pardal C, Rivas Ruiz F, de Troya MM. Sun exposure and photoprotection: habits, knowledge and attitudes among elite kitesurfers. J Cancer Educ. 2020;27:1–7.
Duarte AF, Nagore E, Silva JNM, Picoto A, Pereira AC, Correia OJC. Sun protection behaviour and skin cancer literacy among outdoor runners. Eur J Dermatol. 2018;28(6):803–8.
pubmed: 30698149
Purim KS, Leite N. Sports-related dermatoses among road runners in Southern Brazil. An Bras Dermatol. 2014;89(4):587–92.
pubmed: 25054745
pmcid: 4148272
Fernandez-Morano T, de Troya-Martin M, Rivas-Ruiz F, et al. Sun exposure habits and sun protection practices of skaters. J Cancer Educ. 2017;32(4):734–9.
pubmed: 27085551
Wysong A, Gladstone H, Kim D, Lingala B, Copeland J, Tang JY. Sunscreen use in NCAA collegiate athletes: identifying targets for intervention and barriers to use. Prev Med. 2012;55(5):493–6.
pubmed: 22975268
Berndt NC, O’Riordan DL, Winkler E, McDermott L, Spathonis K, Owen N. Social cognitive correlates of young adult sport competitors’ sunscreen use. Health Educ Behav. 2011;38(1):6–14.
pubmed: 21059896
Lawler S, McDermott L, O’Riordan D, et al. Relationships of sun-protection habit strength with sunscreen use during outdoor sport and physical activity. Int J Environ Res Public Health. 2012;9(3):916–23.
pubmed: 22690172
pmcid: 3367286
Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007;31(3):230–4.
pubmed: 17679240
Walker N, Love TD, Baker DF, et al. Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: a cross-sectional study. J Int Soc Sports Nutr. 2014;11(1):47.
pubmed: 25253998
pmcid: 4172920
Noble-Jerks J, Weatherby RP, Meir R. Self-reported skin cancer protection strategies and location of skin cancer in retired cricketers: a case study from membership of the Emu Cricket Club. J Sci Med Sport. 2006;9(6):441–5.
pubmed: 16846751
Rivas-Ruiz F, Fernandez-Morano T, Gilaberte Y, Garcia-Montero P, Blazquez-Sanchez N, de Troya-Martin M. Sun exposure and long-distance runners on the Spanish Costa del Sol: habits, attitudes, and knowledge. Actas Dermosifiliogr. 2021;112(6):541–5.
Garcia-Malinis AJ, Gracia-Cazana T, Zazo M, et al. Sun protection behaviors and knowledge in mountain marathon runners and risk factors for sunburn. Actas Dermosifiliogr (Engl Ed). 2021;112(2):159–66.
Gutiérrez-Manzanedo JV, De Castro-Maqueda G, Caraballo Vidal I, et al. Sun-related behaviors, attitudes and knowledge among Paralympic sailors. Disabil Health J. 2021;14(3):101095.
pubmed: 33840618
Doncel Molinero D, Ruiz Paulano M, Rivas Ruiz F, et al. Sun protection behaviour and sunburns in Spanish cyclists. J Cancer Educ. 2020;27:1–8.
Buller DB, Andersen PA, Walkosz BJ, et al. Compliance with sunscreen advice in a survey of adults engaged in outdoor winter recreation at high-elevation ski areas. J Am Acad Dermatol. 2012;66(1):63–70.
pubmed: 21742410
pmcid: 3193866
De Castro-Maqueda G, Gutierrez-Manzanedo JV, Lagares-Franco C, Linares-Barrios M, de Troya-Martin M. Photoprotection practices, knowledge and sun-related skin damage in Spanish beach handball players. PeerJ. 2019;7:e7030.
pubmed: 31249733
pmcid: 6587929
Zink A, Koch E, Seifert F, Rotter M, Spinner CD, Biedermann T. Nonmelanoma skin cancer in mountain guides: high prevalence and lack of awareness warrant development of evidence-based prevention tools. Swiss Med Wkly. 2016. https://doi.org/10.4414/smw.2016.14380 .
doi: 10.4414/smw.2016.14380
pubmed: 27922162
Zink A, Thome F, Schielein M, Spinner CD, Biedermann T, Tizek L. Primary and secondary prevention of skin cancer in mountain guides: attitude and motivation for or against participation. J Eur Acad Dermatol Venereol. 2018;32(12):2153–61.
pubmed: 29846981
de Galvez MV, Ruiz Sanchez JM, Navarrete-de Galvez M, et al. Sun exposure risks in athletes who were recipients of solid organ and bone marrow transplants. J Am Acad Dermatol. 2019;81(1):253–5.
pubmed: 30771417
Holman DM, Berkowitz Z, Guy GP Jr, Hartman AM, Perna FM. The association between demographic and behavioral characteristics and sunburn among US adults—National Health Interview Survey, 2010. Prev Med. 2014;63:6–12.
pubmed: 24589442
pmcid: 4535173
Petersen B, Thieden E, Lerche CM, Wulf HC. Validation of self-reported erythema: comparison of self-reports, researcher assessment and objective measurements in sun worshippers and skiers. J Eur Acad Dermatol Venereol. 2013;27(2):214–9.
pubmed: 22239741
Kikuchi-Numagami K, Suetake T, Yanai M, Takahashi M, Tanaka M, Tagami H. Functional and morphological studies of photodamaged skin on the hands of middle-aged Japanese golfers. Eur J Dermatol. 2000;10(4):277–81.
pubmed: 10846254
Zanetti R, Rosso S, Martinez C, et al. Comparison of risk patterns in carcinoma and melanoma of the skin in men: a multi-centre case-case-control study. Br J Cancer. 2006;94(5):743–51.
pubmed: 16495934
pmcid: 2361214
de Castro MG, Gutiérrez-Manzanedo JV, González-Montesinos JL, Vaz Pardal C, Rivas Ruiz F, de Troya MM. Sun exposure and photoprotection: habits, knowledge and attitudes among elite kitesurfers. J Cancer Educ. 2020. https://doi.org/10.1007/s13187-020-01838-7 .
doi: 10.1007/s13187-020-01838-7
Richtig E, Ambros-Rudolph CM, Trapp M, et al. Melanoma markers in marathon runners: increase with sun exposure and physical strain. Dermatology. 2008;217(1):38–44.
pubmed: 18367839
Janssen E, van Kann D, de Vries H, Lechner L, van Osch L. Sun protection during snow sports: an analysis of behavior and psychosocial determinants. Health Educ Res. 2015;30(3):380–7.
pubmed: 25838552
Petty KN, Knee CR, Joseph AK. Sunscreen use among recreational cyclists: how intentions predict reported behavior. J Health Psychol. 2013;18(3):439–47.
pubmed: 22679263
Janssen E, van Osch L, de Vries H, Lechner L. Examining direct and indirect pathways to health behaviour: the influence of cognitive and affective probability beliefs. Psychol Health. 2013;28(5):546–60.
pubmed: 23259546
Boggild AK, From L. Barriers to sun safety in a Canadian outpatient population. J Cutan Med Surg. 2003;7(4):292–9.
pubmed: 12879334
Parrott R, Duggan A, Cremo J, Eckles A, Jones K, Steiner C. Communicating about youth’s sun exposure risk to soccer coaches and parents: a pilot study in Georgia. Health Educ Behav. 1999;26(3):385–95.
pubmed: 10349575
Lupton D, Gaffney D. Discourses and practices related to suntanning and solar protection among young Australians. Health Educ Res. 1996;11(2):147–59.
Basch CH, Hillyer GC, Ethan D, Berdnik A, Basch CE. Tanning shade gradations of models in mainstream fitness and muscle enthusiast magazines: implications for skin cancer prevention in men. Am J Mens Health. 2015;9(4):301–6.
pubmed: 25038234
Basch CH, Ethan D, Hillyer GC, Berdnik A. Skin cancer prevention coverage in popular US women’s health and fitness magazines: an analysis of advertisements and articles. Glob J Health Sci. 2014;6(4):42–8.
pubmed: 24999136
pmcid: 4825453
Moore SC, Lee IM, Weiderpass E, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816–25.
pubmed: 27183032
pmcid: 5812009
Rosso S, Zanetti R, Martinez C, et al. The multicentre south European study “Helios”. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer. 1996;73(11):1447–54.
pubmed: 8645596
pmcid: 2074492
Rosso S, Joris F, Zanetti R. Risk of basal and squamous cell carcinomas of the skin in Sion, Switzerland: a case-control study. Tumori. 1999;85(6):435–42.
pubmed: 10774562
Kaskel P, Lange U, Sander S, et al. Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden, Germany. J Eur Acad Dermatol Venereol. 2015;29(1):134–42.
pubmed: 24684198
Loria D, Matos E. Risk factors for cutaneous melanoma: a case-control study in Argentina. Int J Dermatol. 2001;40(2):108–14.
pubmed: 11328391
Schnohr P, Gronbaek M, Petersen L, Hein HO, Sorensen TI. Physical activity in leisure-time and risk of cancer: 14-year follow-up of 28,000 Danish men and women. Scand J Public Health. 2005;33(4):244–9.
pubmed: 16087486
Dozier S, Wagner RF Jr, Black SA, Terracina J. Beachfront screening for skin cancer in Texas Gulf coast surfers. South Med J. 1997;90(1):55–8.
pubmed: 9003825
Climstein M, Furness J, Hing W, Walsh J. Lifetime prevalence of non-melanoma and melanoma skin cancer in Australian recreational and competitive surfers. Photodermatol Photoimmunol Photomed. 2016;32(4):207–13.
pubmed: 27232425
Mahé E, Beauchet A, de Paula CM, et al. Outdoor sports and risk of ultraviolet radiation-related skin lesions in children: evaluation of risks and prevention. Br J Dermatol. 2011;165(2):360–7.
pubmed: 21574980
del Boz J, Fernandez-Morano T, Padilla-Espana L, Aguilar-Bernier M, Rivas-Ruiz F, de Troya-Martin M. Skin cancer prevention and detection campaign at golf courses on Spain’s Costa del Sol. Actas Dermosifiliogr. 2015;106(1):51–60.
pubmed: 25172442
Clatici VGRD, Dalle C, Voicu C, et al. Erceived age and life style. The specific contributions of seven factors involved in health and beauty. Maedica (Bucur). 2017;12(3):191–201.
Downs NJ, Parisi AV, Schouten PW, Igoe DP, De Castro-Maqueda G. The simulated ocular and whole-body distribution of natural sunlight to kiteboarders: a high-risk case of UVR exposure for athletes utilizing water surfaces in sport. Photochem Photobiol. 2020;96(4):926–35.
pubmed: 31883381
Kimlin MG, Martinez N, Green AC, Whiteman DC. Anatomical distribution of solar ultraviolet exposures among cyclists. J Photochem Photobiol B. 2006;85(1):23–7.
pubmed: 16730999
Moehrle M, Heinrich L, Schmid A, Garbe C. Extreme UV exposure of professional cyclists. Dermatology. 2000;201(1):44–5.
pubmed: 10971059
ICNIRP, IRPA. Protection ICONIR. ICNIRP guidelines on UV radiation exposure limits. Health Phys. 1996;71:978.
Downs NJ, Schouten PW, Parisi AV, Turner J. Measurements of the upper body ultraviolet exposure to golfers: non-melanoma skin cancer risk, and the potential benefits of exposure to sunlight. Photodermatol Photoimmunol Photomed. 2009;25(6):317–24.
pubmed: 19906167
Rigel EG, Lebwohl MG, Rigel AC, Rigel DS. Ultraviolet radiation in alpine skiing: magnitude of exposure and importance of regular protection. Arch Dermatol. 2003;139(1):60–2.
pubmed: 12533166
Downs NJ, Axelsen T, Schouten P, Igoe DP, Parisi AV, Vanos J. Biologically effective solar ultraviolet exposures and the potential skin cancer risk for individual gold medalists of the 2020 Tokyo Summer Olympic Games. Temperature (Austin). 2020;7(1):89–108.
Serrano MA, Cañada J, Moreno JC. Erythemal ultraviolet exposure of cyclists in Valencia, Spain. Photochem Photobiol. 2010;86(3):716–21.
pubmed: 20158673
Serrano MA, Cañada J, Moreno JC. Ultraviolet exposure for different outdoor sports in Valencia, Spain. Photodermatol Photoimmunol Photomed. 2011;27(6):311–7.
pubmed: 22092735
Serrano MA, Canada J, Moreno JC, Members of The Valencia Solar Radiation Research Group. Erythemal ultraviolet solar radiation doses received by young skiers. Photochem Photobiol Sci. 2013;12(11):1976–83.
pubmed: 24057156
Serrano MA, Canada J, Moreno JC, Gurrea G. Personal UV exposure for different outdoor sports. Photochem Photobiol Sci. 2014;13(4):671–9.
pubmed: 24535504
Moehrle M. Ultraviolet exposure in the Ironman triathlon. Med Sci Sports Exerc. 2001;33(8):1385–6.
pubmed: 11474342
Gurrea Ysasi G, Moreno JC, Serrano MA. Ultraviolet erythematic radiation dose received by golfers in winter, Valencia. Photochem Photobiol. 2014;90(5):1170–3.
pubmed: 24893676
Robinson JD, Silk KJ, Parrott RL, Steiner C, Morris SM, Honeycutt C. Healthcare providers’ sun-protection promotion and at-risk clients’ skin-cancer-prevention outcomes. Prev Med. 2004;38(3):251–7.
pubmed: 14766106
Walkosz B, Voeks J, Andersen P, et al. Randomized trial on sun safety education at ski and snowboard schools in western North America. Pediatr Dermatol. 2007;24(3):222–9.
pubmed: 17542868
Walkosz BJ, Buller DB, Andersen PA, et al. Increasing sun protection in winter outdoor recreation a theory-based health communication program. Am J Prev Med. 2008;34(6):502–9.
pubmed: 18471586
pmcid: 2657339
Andersen PA, Buller DB, Walkosz BJ, et al. Testing a theory-based health communication program: a replication of Go Sun Smart in outdoor winter recreation. J Health Commun. 2009;14(4):346–65.
pubmed: 19466647
pmcid: 2925541
Walkosz BJ, Buller DB, Andersen PA, et al. Translation of a ski school sun safety program to north American ski and snowboard schools. Health Promot Pract. 2015;16(4):560–70.
pubmed: 25761916
pmcid: 4485589
Ally MS, Swetter SM, Hirotsu KE, et al. Promoting sunscreen use and sun-protective practices in NCAA athletes: impact of SUNSPORT educational intervention for student-athletes, athletic trainers, and coaches. J Am Acad Dermatol. 2018;78(2):289-92 e2.
pubmed: 28993006
Horsham C, Ford H, Hacker E. Promoting sunscreen use in adolescents playing outdoor sports using UV detection stickers. Prev Med Rep. 2020;19:101166.
pubmed: 32714780
pmcid: 7378694
Stölzel F, Wolff M, Fieber V, et al. UV protection for young athletes: using participatory program planning to develop a sports schools program. Environ Health Prev Med. 2020;25(1):39.
pubmed: 32778053
pmcid: 7418192
Igoe DP, Amar A, Schouten P, Parisi AV, Turner J. Assessment of biologically effective solar ultraviolet exposures for court staff and competitors during a major Australian tennis tournament. Photochem Photobiol. 2019;95(6):1461–7.
pubmed: 31206185
Ghazi S, Couteau C, Coiffard LJ. How to guarantee adequate sun protection for a young sportsperson. J Dtsch Dermatol Ges. 2011;9(6):470–4.
pubmed: 21489156
Williams JD, Maitra P, Atillasoy E, Wu MM, Farberg AS, Rigel DS. SPF 100+ sunscreen is more protective against sunburn than SPF 50+ in actual use: results of a randomized, double-blind, split-face, natural sunlight exposure clinical trial. J Am Acad Dermatol. 2018;78(5):902-10.e2.
pubmed: 29291958
Conklin RJ. Common cutaneous disorders in athletes. Sports Med. 1990;9(2):100–19.
pubmed: 2180022
De Gálvez MV. Antioxidants in photoprotection: do they really work? Actas Dermosifiliogr. 2010;101(3):197–200.
pubmed: 20398594
Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar ultraviolet exposure in individuals who perform outdoor sport activities. Sports Med Open. 2020;6(1):42.
pubmed: 32880767
pmcid: 7471243
Lynch BM, Dunn J. Scoreboard advertising at sporting events as a health promotion medium. Health Educ Res. 2003;18(4):488–92.
pubmed: 12939130