Shielding the Sun: Exploring Sun Protection Habits of College Athletes

Summary: Background: Collegiate athletes in sports such as soccer, football, baseball, and lacrosse spend up to 4 hours outside daily per NCAA guidelines during their competitive athletic season. With this high level of repeated sun exposure during outdoor training, athletes are predisposed to the development of skin disease. This population has been encouraged to take protective measures, such as wearing long sleeves, headwear, and attire made from dark, tightly woven fabric with an ultraviolet protective factor (UPF) of >15, and use of sunscreen with a sun protective factor (SPF) of ≥30 has been broadly recommended; however, individual athlete adherence to these advocations at the university level has been questioned. This study aimed to assess the level of university involvement in skin protection for their outdoor student-athletes and the student population's level of compliance. Methods: An anonymous online survey platform, SurveyMonkey, was used to directly contact student-athletes participating in athletics during the 2021 fall semester. All Division I athletes in Ohio participating in outdoor sports were included. The primary outcomes were patient demographic characteristics, volume of sun exposure, sunburn frequency, protective measures, and university involvement in protective measures. Results: The study population consisted of 83 Division 1 student athletes from Ohio schools, of whom 54 (65%) were male and 29 (35%) females. Of these, 43 respondents (52%) reported they practiced outdoor >90 days per year, and 59 (71%) stated the length of exposure during those periods was ≥4 hours (Table). A total of 53 respondents (64%) reported sunburns following practices with only 6 of the 53 (11%) wearing sunscreen. Fifty-two of the student athletes surveyed (63%) reported they were not instructed or reminded by their university to wear sun protective attire while outdoors, and 61 of respondents (73%) reported they were not instructed or reminded by their university to wear sunscreen with an SPF of ≥30 while outdoors (Figure). More than one-third of the student athlete respondents (n = 33; 39%) reported permanent sunburn-induced freckling on their sun exposure areas. Conclusion: The cumulative effect of repeated sun exposure without adequate protection may predispose student athletes to skin disease. The authors support increased university advocation for skin protection and a more involved skin disease education system for student athletes. Increased use of adequate sunscreen protection (≥30 SPF) or sun-protective attire with sufficient UPF (>15) is needed to protect the long-term health of this population with extremely high levels of sun exposure annually.