Ultraviolet Radiation Exposure, Risk, and Protection in Military and Outdoor Athletes

The effects of sport, setting, and demographics on sunscreen use and education in young athletes

Participation in outdoor sports increases exposure to ultraviolet radiation, necessitating mitigation through sunscreen use. This prospective study examined the effects of sport, setting (practice vs. competition), gender, age and geographic location on sunscreen use and education among youth athletes in various sports. Six hundred and twelve athletes ≤18 years old completed an online survey on sunscreen education and use during competitions and practices. Regardless of sport, reported sunscreen use was higher during practices than competition (p < 0.0001). Sunscreen was used most by swimmers/divers (odds ratio: OR ≥ 1.9, p < 0.001) and least by American football players (OR ≤ 0.57, p ≤ 0.001). Coaches mentioned sunscreen use the most in track and field (OR 1.84, p = 0.001) and the least in American football (OR 0.67, p = 0.03). Athletes used sunscreen more if they were female (OR ≥ 1.9 1.38, p ≤ 0.06) and younger (age OR ≤ 0.88, p < 0.001). In conclusion, youth athletes differ in sunscreen use by sport and setting, highlighting the need for continued photoprotective education.

Sunscreen does not alter sweating responses or critical environmental limits in young adults (PSU HEAT project)

Outdoor athletes often eschew using sunscreen due to perceived performance impairments, which many attribute in part to the potential for reduced thermoregulatory heat loss. Past studies examining the impact of sunscreen on thermoregulation are equivocal. The purpose of this study was to determine the effects of mineral and chemical-based sunscreens on sweating responses and critical environmental limits in hot-dry (HD) and warm-humid (WH) environments. Nine subjects (3 M/6 F; 25 ± 2 yr) were tested with 1) no sunscreen (control), 2) chemical-, and 3) mineral-based sunscreen. Subjects were exposed to progressive heat stress with either 1) constant dry-bulb temperature (Tdb) at 34°C and increasing water vapor pressure (Pa) (WH trials) or 2) constant Pa at 12 mmHg and increasing Tdb (HD trials). Subjects walked at 4.9 ± 0.5 metabolic equivalents (METs) until an upward inflection in gastrointestinal temperature was observed (i.e., the critical environmental limit). Compared with control (39.9 ± 3.0°C), critical Tdb was not different in mineral (39.2 ± 3.5°C, P = 0.39) or chemical (39.7 ± 3.0°C, P = 0.98) sunscreen trials in HD environments. Compared with control (18.8 ± 4.0 mmHg), critical Pa was not different in mineral (18.9 ± 4.8 mmHg, P = 0.81) or chemical (19.5 ± 4.6 mmHg, P = 0.81) sunscreen trials in WH environments. Sweating rates, evaporative heat loss, skin wettedness, and sweating efficiency were not different among the three trials in the WH (all P ≥ 0.48) or HD (all P ≥ 0.87) environments. Critical environmental limits are unaffected by sunscreen application, suggesting sunscreen does not alter integrative thermoregulatory responses during exercise in the heat.NEW & NOTEWORTHY Our findings demonstrate that neither sweating nor critical environmental limits were affected by mineral-based and chemical-based sunscreen applications. The rates of change in core temperature during compensable and uncompensable heat stress were not changed by wearing sunscreen. Evaporative heat loss, efficiency of sweat evaporation, skin wettedness, and sweating rates were unaffected by sunscreen. Sunscreen did not alter integrative thermoregulatory responses during exercise in the heat.

Skin Cancer Risk, Sun-Protection Knowledge and Behavior in Athletes-A Narrative Review

Outdoor sports are associated with increased exposure to ultraviolet radiation, which may result in sunburn, solar damage, and skin cancers. Water and winter sports create additional adverse conditions, such as washing away sunscreen by water and reflection of UV rays by the water and snow. Sweating-increased skin photosensitivity and activity-induced immunosuppression are associated with a greater risk of developing skin cancers. In this review, we focus on a group of athletes and sports participants and analyze 62 articles concerning sun exposure during outdoor sports, the risk of developing skin cancer, and knowledge and behavior regarding photoprotection methods. Various practices have been linked to an increased risk of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM), or UV-induced skin damage. Water sports and mountaineering increase the risk of BCC. Surfing and swimming are risk factors for SCC. Melanoma is more common in swimmers, surfers, and marathon runners. Photoprotection behaviors can reduce potential skin damage and skin cancers. Athletes' knowledge about the risk of malignant lesions was satisfactory, but despite the risks, outdoor sports participants seem not to protect themselves from the sun adequately.

IOC consensus statement on recommendations and regulations for sport events in the heat

This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor environmental conditions before and during an event; to provide sufficient ice, shading and cooling; and to work with the IF to remove regulatory and logistical limitations. The second section summarises recommendations that are directly associated with athletes' behaviours, which include the role and methods for heat acclimation; the management of hydration; and adaptation to the warm-up and clothing. The third section explains the specific medical management of exertional heat stroke (EHS) from the field of play triage to the prehospital management in a dedicated heat deck, complementing the usual medical services. The fourth section provides an example for developing an environmental heat risk analysis for sport competitions across all IFs. In summary, while EHS is one of the leading life-threatening conditions for athletes, it is preventable and treatable with the proper risk mitigation and medical response. The protection of athletes competing in the heat involves the close cooperation of the local organising committee, the national and international federations, the athletes and their entourages and the medical team.

An Assessment on the Efficiency of Clothing with UV Protection among the Spanish Navy School Students

Concern about the harmful effects that ultraviolet (UV) rays have on the skin of people who are routinely exposed to solar radiation has driven the industry of skin protection creams, sunglasses and clothing. Spanish Navy personnel are subject to different levels of exposure depending on their rank and function. The objective of this research is to analyze the behavioral variables associated to the effects on the skin caused by UV rays, denoted by the combined effects of perceived susceptibility and perceived severity, on their decision to purchase and wear uniforms with UV protection. A confirmatory analysis using a structural equation modeling (SEM) was performed on a sample of 100 respondents. The model results revealed a strong mediating characteristic of the intention to use, variable associated with the exogenous variables. Attitude towards the use of clothing and social influence, as well as the exogenous variable clothing action planning, on the sun protective clothing use during tactical maneuvers. These relationships were significant with p-values close to zero. However, exogenous variables related to perceived susceptibility and perceived severity in exposure to sunlight did not represent a significant influence when mediated by self-efficacy in use. The results revealed the consequence of awareness about the importance of protecting oneself and the influence that usage habits can have on the military with respect to the decision to purchase uniforms with UV protection.

Knowledge, Behaviour and Attitudes Related to Sun Exposure in Sportspeople: A Systematic Review

People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that in many athletes, sun protection behaviours are inadequate, with the risk that this entails. The aim of this review is to collect the information published to date about the knowledge, attitudes and habits of athletes in relation to sun exposure and its risks. A systematic review was conducted using PubMed and Embase with the search algorithm "(skin cancer OR melanoma) AND (exercise OR sport OR athletes)". All studies analysing the knowledge, attitudes and habits of photoprotection in athletes were included. A total of 2,365 publications were found, of which 23 were selected, including a total of 10,445 sportspeople. The majority of participants declared their voluntary intention to tan and stated that the sun made them feel better, although they also showed concern about possible damage associated with UV radiation. In most studies, less than half of the participants made adequate use of photoprotective measures. In general, most athletes had a high level of knowledge regarding the risk of skin cancer associated with sun exposure. In conclusion, most athletes are aware of the risks associated with UV radiation but do not make adequate use of photoprotective cream. New training programs on photoprotection could help improve athletes' photoprotective behaviour, reducing the incidence of skin cancer and precancerous lesions in this population.

Preparation and Evaluation of Liposomes and Niosomes Containing Total Ginsenosides for Anti-Photoaging Therapy

Ginsenosides are the principal bioactive compounds of ginseng. Total ginsenosides (GS) contain a variety of saponin monomers, which have potent anti-photoaging activity and improve the skin barrier function. To enhance the efficiency of GS transdermal absorption, GS liposomes (GSLs) and GS niosomes (GSNs) were formulated as delivery vehicles. Based on the clarified and optimized formulation process, GSL and GSN were prepared. The structure, cumulative transmittance, skin retention, total transmittance, and bioactivity of GSLs and GSNs were characterized. GSL and GSN were shown to inhibit lipid peroxidation and increase the contents of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in human keratinocytes (HaCaTs). In addition, HaCAT cell migration, proliferation, and GS cellular uptake were significantly increased. The therapeutic effects of GSL and GSN were also evaluated in a rat model of photoaging. Histopathological changes were assessed in rat skin treated with GSL, GSN, or GS by hematoxylin–eosin (H&amp;E) and aldehyde fuchsine staining. Malondialdehyde (MDA), SOD, GSH-Px, matrix metalloproteinases (MMPs), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) expression levels were determined. Results indicated that the optimal formulation of GSL used soybean lecithin (SPC) as the phospholipid, with a lipid–drug ratio of 1:0.4 and a phospholipid–cholesterol ratio of 1:3.5. The optimal temperature for the preparation process of GSN by ethanol injection was 65°C, with a ratio of the organic phase to aqueous phase of 1:9. It was demonstrated that the cumulative release rate, skin retention rate, and total transmission rate of GSL-7 at 24 h were higher than those of GSN-4 and GS. GSL-7 significantly inhibited skin lipid peroxidation caused by ultraviolet (UV) radiation. In addition, GSL-7 reduced the contents of MMPs and inflammatory cytokines in skin tissue. In conclusion, GSL-7 may reduce skin aging caused by UV radiation and contribute to skin tissue repair.

Physical activity and cutaneous melanoma risk: A Norwegian population-based cohort study

Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. Overall PA was reported by 151,710 women, aged 30-75 at inclusion, using a validated 10-point-scale at enrolment and during follow-up, together with recent numbers of sunburns, indoor tanning sessions and weeks on sunbathing vacations. Seasonal outdoor walking and seasonal PAs were recorded in subsamples (n = 102,671 and n = 29,077, respectively). Logistic and Cox regression were used. Mean follow-up was 18.5 years, and 1565 invasive incident melanoma cases were diagnosed. Overall PA was inversely associated with sunburns, while positively associated with sunbathing vacations and indoor tanning. Overall PA was not associated with melanoma risk in all body sites combined (ptrend = 0.61), but reduced risk was found in upper limb melanomas (hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.51-0.96; high versus low PA). Non-significant reduced risks were found for seasonal outdoor walking >2 h/day versus 30-60 min/day (summer HR = 0.81, 95% CI 0.66-1.00; autumn HR = 0.74, 95%CI 0.55-1.01). Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.

Skin problems of Korean military personnel changes in the use of cosmetics and differences in preference according to different characteristics: Focused on comparison pre- and post-enlistment

BACKGROUND

Recently, men's interest and participation in cosmetology have increased, and the number of "grooming" men who are exorbitantly investing in fashion and looks has increased, further increasing the growth potential of men's cosmetics.

OBJECTIVES

The purpose of this study was to analyze the skin diseases of men in their 20s and 30s in Korea, focusing on the comparison before and after enlistment, and to study the changes in cosmetic use and the difference in cosmetic preference according to the military service problem of Korean men.

METHODS

We enrolled 450 people, after excluding 50 dishonest respondents. Statistical data processing collected with the data analysis method were analyzed using the Statistical Package for Social Science (SPSS) WIN25.0 statistical package program through data coding and cleaning.

RESULTS

A total of 217 (48.2%) people preferred the cosmetic type of skin/lotion preferred by the private sector, and the cosmetic type required by the military was a complex skin lotion (48.2%) with 216 people (48.2%). All-in-one products were the most common products. The P-value was P < .001 or more.

CONCLUSION

The results of this comprehensive study indicated skin problems of Korean military personnel changes in the use of cosmetics and differences in preference according to different characteristics focused on comparison pre- and post-enlistment was assessed.

Protective effects of halophyte complex extract against UVB-induced damage in human keratinocytes and the skin of hairless mice

Limonium tetragonum, Triglochin maritimum, Artemisia scoparia and red ginseng have been used as folk remedies for treating a variety of diseases. In the current study, the protective effects of halophyte and red ginseng against ultraviolet (UV)-induced skin damage were investigated. Halophyte red ginseng complex extract (HRCE) was prepared and its effects on UV-B irradiated human keratinocytes and mouse skin were studied through ELISA, Western blotting immunofluorescence and histological staining. HRCE inhibited peroxide-induced damage in human keratinocytes. HRCE also inhibited UVB-induced collagen and elastin degradation in human keratinocytes and mouse skin. In addition, HRCE inhibited mast cell infiltration in the skin of mice irradiated with UVB light. This effect was likely due to HRCE inhibiting the activation of MAPK and NF-κB. By protecting the skin from UVB-induced skin damage, HRCE has the potential to be used in the treatment and prevention of UV-induced skin damage and photoaging.