{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:33:06Z","timestamp":1789018386722,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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\u201330 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.<\/jats:p>","DOI":"10.3390\/ijerph18020800","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T04:55:31Z","timestamp":1611032131000},"page":"800","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Sun Exposure during Water Sports: Do Elite Athletes Adequately Protect Their Skin against Skin Cancer?"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5744-7901","authenticated-orcid":false,"given":"Guillermo","family":"De Castro-Maqueda","sequence":"first","affiliation":[{"name":"Department of Physical Education, Faculty of Education Sciences, University of C\u00e1diz, 11510 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0621-0469","authenticated-orcid":false,"given":"Jose V.","family":"Gutierrez-Manzanedo","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Faculty of Education Sciences, University of C\u00e1diz, 11510 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Lagares-Franco","sequence":"additional","affiliation":[{"name":"Department of Statistics and Operational Research, University of C\u00e1diz, 11510 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"de Troya-Martin","sequence":"additional","affiliation":[{"name":"Dermatology Department, Costa del Sol Hospital, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1002\/ijc.11360","article-title":"Changing epidemiology of malignant cutaneous melanoma in Europe 1953\u20131997: Rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia","volume":"107","author":"Bray","year":"2003","journal-title":"Int. J. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.piel.2014.02.009","article-title":"Epidemiolog\u00eda del melanoma en una poblaci\u00f3n multicultural mediterr\u00e1nea","volume":"29","year":"2014","journal-title":"Piel"},{"key":"ref_3","first-page":"39","article-title":"Changes in the incidence of skin cancer between 1978 and 2002","volume":"101","year":"2010","journal-title":"Actas Dermosifiliogr."},{"key":"ref_4","unstructured":"American Cancer Society (2015). Cancer Facts and Figures 2014, American Cancer Society."},{"key":"ref_5","unstructured":"Australian Institute of Health and Welfare and Australasian Association of Cancer (2012). Australian Institute of Health and Cancer in Australia: An Overview, 2012."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.clindermatol.2007.10.001","article-title":"Outdoor sports and skin cancer","volume":"26","author":"Moehrle","year":"2008","journal-title":"Clin. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/phpp.12289","article-title":"The tanning habits and interest in sunscreen of Google users: What happened in 12 years?","volume":"33","author":"Kirchberger","year":"2017","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0140-6736(98)12168-2","article-title":"Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: A randomised controlled trial","volume":"354","author":"Green","year":"1999","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1158\/1055-9965.EPI-06-0352","article-title":"Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use","volume":"15","author":"Williams","year":"2006","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"916","DOI":"10.3390\/ijerph9030916","article-title":"Relationships of sun-protection habit strength with sunscreen use during outdoor sport and physical activity","volume":"9","author":"Lawler","year":"2012","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_11","unstructured":"American Cancer Society (2007). Cancer Facts and Figures 2007, American Cancer Society."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s10865-009-9219-2","article-title":"Skin cancer-related prevention and screening behaviors: A review of the literature","volume":"32","author":"Kasparian","year":"2009","journal-title":"J. Behav. Med."},{"key":"ref_13","first-page":"566","article-title":"Changes in skin protection behaviors, attitudes, and sunburn: In a population with the highest incidence of skin cancer in the world","volume":"20","author":"Baade","year":"1996","journal-title":"Cancer Detect. Prev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1001\/archdermatol.2007.46","article-title":"Measures of sun exposure and sun protection practices for behavioral and epidemiologic research","volume":"144","author":"Glanz","year":"2008","journal-title":"Arch. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/php.13147","article-title":"Sun Protection Habits and Sun Exposure of Physical Education Teachers in the South of Spain","volume":"95","year":"2019","journal-title":"Photochem. Photobiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e7030","DOI":"10.7717\/peerj.7030","article-title":"Photoprotection practices, knowledge and sun-related skin damage in Spanish beach handball players","volume":"7","year":"2019","journal-title":"PeerJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s13187-018-1466-x","article-title":"Sun Protection Habits and Sunburn in Elite Aquatics Athletes: Surfers, Windsurfers and Olympic Sailors","volume":"35","year":"2020","journal-title":"J. Cancer Educ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1001\/archderm.1988.01670060015008","article-title":"The validity and practicality of sun-reactive skin types I through VI","volume":"124","author":"Fitzpatrick","year":"1988","journal-title":"Arch. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.amepre.2005.04.007","article-title":"Reducing ultraviolet radiation exposure to prevent skin cancer: Methodology and measurement","volume":"29","author":"Glanz","year":"2005","journal-title":"Am. J. Prev. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/ajim.20722","article-title":"Measured occupational solar UVR exposures of lifeguards in pool settings","volume":"52","author":"Gies","year":"2009","journal-title":"Am. J. Ind. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.ypmed.2012.08.020","article-title":"Sunscreen use in NCAA collegiate athletes: Identifying targets for intervention and barriers to use","volume":"55","author":"Wysong","year":"2012","journal-title":"Prev. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1001\/archdermatol.2010.327","article-title":"Environmental cues to UV radiation and personal sun protection in outdoor winter recreation","volume":"146","author":"Andersen","year":"2010","journal-title":"Arch. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jaad.2010.11.044","article-title":"Compliance with sunscreen advice in a survey of adults engaged in outdoor winter recreation at high-elevation ski areas","volume":"66","author":"Buller","year":"2012","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/00001622-199403000-00011","article-title":"Etiology, epidemiology, risk factors, and public health issues of melanoma","volume":"6","author":"Elwood","year":"1994","journal-title":"Curr. Opin. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12970-014-0047-6","article-title":"Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: A cross-sectional study","volume":"11","author":"Walker","year":"2014","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1046\/j.1365-2133.1999.02659.x","article-title":"The water resistance of sunscreen and day-care products","volume":"140","author":"Stokes","year":"1999","journal-title":"Br. J. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1046\/j.1467-2494.2000.00027.x","article-title":"A novel ex vivo technique to assess the sand\/rub resistance of sunscreen products","volume":"22","author":"Stokes","year":"2000","journal-title":"Int. J. Cosmet. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/07448481.2013.806926","article-title":"Predictors of sun-related behaviors among young women: Comparisons between outdoor tanners, fake tanners, and tan avoiders","volume":"61","author":"Day","year":"2013","journal-title":"J Am. Coll. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1067\/mjd.2001.117385","article-title":"When should sunscreen be reapplied?","volume":"45","author":"Diffey","year":"2001","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1001\/archderm.138.10.1319","article-title":"Application patterns among participants randomized to daily sunscreen use in a skin cancer prevention trial","volume":"138","author":"Neale","year":"2002","journal-title":"Arch. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1001\/archderm.1995.01690140054008","article-title":"High sun protection factor sunscreens in the suppression of actinic neoplasia","volume":"131","author":"Naylor","year":"1995","journal-title":"Arch. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1056\/NEJM199310143291602","article-title":"Reduction of solar keratoses by regular sunscreen use","volume":"329","author":"Thompson","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1007\/s13187-016-1036-z","article-title":"Sun Exposure Habits and Sun Protection Practices of Skaters","volume":"32","year":"2017","journal-title":"J. Cancer Educ."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1467-842X.2007.00053.x","article-title":"Sun exposure and sun protection behaviours among young adult sport competitors","volume":"31","author":"Lawler","year":"2007","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/1090198110367996","article-title":"Social cognitive correlates of young adult sport competitors\u2019 sunscreen use","volume":"38","author":"Berndt","year":"2011","journal-title":"Health Educ. Behav."},{"key":"ref_36","unstructured":"World Triathlon Corporation (1999). Ironman Triathlon Word Championship: Contestant Information Guide, Word Triathlon Corporation."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s40279-013-0021-5","article-title":"Ultraviolet radiation and the athlete: Risk, sun safety, and barriers to implementation of protective strategies","volume":"43","author":"Jinna","year":"2013","journal-title":"Sports Med."},{"key":"ref_38","unstructured":"Federation Internationale de Volleyball (2012). Official Volleyball Rules 2013\u20132016, Federation Internationale de Volleyball."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"De Castro Maqueda, G., Guti\u00e9rrez-Manzanedo, J.V., Gonz\u00e1lez-Montesinos, J.L., Vaz Pardal, C., Rivas Ruiz, F., and de Troya Mart\u00edn, M. (2020). Sun Exposure and Photoprotection: Habits, Knowledge and Attitudes Among Elite Kitesurfers. J. Cancer Educ., 1\u20137.","DOI":"10.1007\/s13187-020-01838-7"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jaad.2005.04.056","article-title":"Sunscreen use among collegiate athletes","volume":"53","author":"Hamant","year":"2005","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/php.13200","article-title":"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","volume":"96","author":"Downs","year":"2020","journal-title":"Photochem. Photobiol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Doncel Molinero, D., Ruiz Paulano, M., Rivas Ruiz, F., Bl\u00e1zquez S\u00e1nchez, N., de G\u00e1lvez Aranda, M.V., de Castro Maqueda, G., and de Troya Mart\u00edn, M. (2020). Sun Protection Behaviour and Sunburns in Spanish Cyclists. J. Cancer Educ., 1\u20138.","DOI":"10.1007\/s13187-020-01906-y"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/2\/800\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:12:39Z","timestamp":1760159559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/2\/800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,19]]},"references-count":42,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["ijerph18020800"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18020800","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,19]]}}}