Athletes and Skin Cancer: Risk and Prevention

With Vineman 70.3 coming up this week, it occurred to me that many of you have been and will be spending a lot of time in the sun. We all know to wear sunscreen and a hat and sunglasses to protect ourselves, but is that enough? Taking care of our bodies through exercise and proper nutrition is important, but we can’t neglect the largest organ in the human body: our skin.

UV radiation is pivotal in the development of skin cancers. Athletes are at a particularly high risk level of developing these cancers, and should take proper precautions to limit their exposure. Unfortunately, there are times when we don’t realize just how exposed we are, either during training or competition. Sometimes, we don’t even have a choice in our level of exposure. What can we do to prevent ourselves from being overexposed?

When I say that we don’t realize just how exposed we are, it’s because the majority of athletes really are overexposed; athletes spend numerous hours outdoors everyday. This has likely been the case since childhood. Time spent outside is typically spent during peak UV radiation times; between 10:00 AM and 4:00 PM, as many practices and competitions take place during this time frame. This is most evident with school-age children and adults in college, whose sports practices take place right after school. “One study of 290 National Collegiate Athletic Association (NCAA) collegiate athletes in 13 different sports found a mean outdoor training duration of 4 h per day and 10 months per year equating to approximately 1,000 h of sun exposure annually” (Jinna and Adams).

Athletes are also at an increased risk because of their high rates of sweat. Sweat increases the photosensitivity of the skin, increasing sunburn risk. Athletes at higher elevations are at an even greater risk, as the UV rays have less time to be scattered and dispersed at higher altitudes than at lower altitudes. When ocean swimming, water reflects a significant portion of UV radiation onto the athlete.

So, what can we do to decrease our risk?

First off, we need to start wearing sunscreen.

“Several studies have identified extraordinarily low use of sunscreen among athletes. One study examined collegiate soccer and cross-country track athletes and found that 85 % of them reported no sunscreen use over the previous seven sunny days. In another survey study of 274 collegiate athletes, only 11 % reported consistent use of sunscreen (<75 % of the time). Other researchers noted that only 29 of 554 (5.2 %) adolescent athletes (11–18 years) in Buenos Aires, Argentina, used sunscreen on a routine basis while playing sports” (Jinna and Adams).

Even competition rules are contributing to overexposure, like Ironman’s competitive regulations prohibiting sunscreen application on parts of the body marked with numbers, like the shoulders. Some Ironman athletes were sunburned after 8-9 hours of competition, even when wearing SPF 25+ sunscreen.

We need to wear higher SPF sunscreen, and reapply consistently. New regulations in the sunscreen industry prevent any manufacturer from producing anything higher than “SPF 50+,” as the FDA has not found any evidence proving that anything higher than SPF 50 offers greater protection.

Secondly, we need to start protecting ourselves early. “Sun avoidance during childhood and adolescence impacts melanoma risk greater than sun avoidance during adult-hood. Prevention, therefore, in the form of sun-screen use, protective clothing, and sun avoidance represent critical interventions for young athletes” (Jinna and Adams).

Lastly, while sunscreen is important, clothing offers levels of protection far greater than that of sunscreen. We can start wearing more clothes, at least during training. “Among marathon runners, 96.7 % wore shorts and 98.6 % wore shirts that did not cover their back or extremities. Athletes detailed a statistically significant lower use of long shirts (27.9 vs. 39.8 %) and pants (38.8 vs. 63 %) than non-athletes even though they had higher total sun exposure” (Jinna and Adams). Hats and sunglasses do nothing to protect our arms and legs. We must also not forget the tops of our heads; many triathletes wear visors rather than caps. Triathletes with full heads of hair may not have to worry so much about this, but there are many triathletes with shaved heads.

So, to summarize: wear good sunscreen and reapply; Start early with protecting yourself and your kids; and wear more clothing (at least during training).

Let’s get a conversation going. What do you do to minimize exposure? Do you think you do enough? Not enough? Do you have any questions? Let me know.

-Chris

Quotes and other information taken from the following journal article:

Jinna, Sphoorth, and Bryan B. Adams. “Ultraviolet Radiation and the Athlete: Risk, Sun Safety, and Barriers to Implementation of Protective Strategies.” Sports Med 43 (2013): 531-37. 9 Apr. 2013. Web. 9 July 2013.

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