Skiing and Sunburn!

In recent years, skiing has been increasingly popular as a winter sport. As the memories of summer fade away, most people don’t think to use sun protection during their winter holidays in ski resorts. However, epidemiological studies have shown skiers to be at increased risk for the development of squamous cell carcinoma and indirectly at possible increased risk of melanoma^[1][2].

There is no doubt that UV radiation is an important risk factor for both melanoma and non melanoma skin cancers. At typical alpine skiing elevations ambient UV irradiance increases approximately 2% to 3% for each 100 m of altitude, and irradiance may be further increased by up to 40% due reflection from snow.^[3]

The reason for this is that the higher the altitude, there is less atmosphere to filter UV rays so skiers at high altitudes are exposed to higher UV radiation than at ground level. Apart from the higher UV radiation found at skiing altitudes, snow reflects 85% of UV rays off the ground back to skiers. Areas like under the nose or chin which is not usually exposed to sun becomes vulnerable to UV radiation and therefore should be adequately sun protected.

A recent study from the US^[4] has reported that the strongest predictors of UV were temporal proximity to noon, deviation from winter solstice, and clear skies. By contrast, altitude and latitude had more modest associations with UV- but all of these are important factors to consider.

Studies have shown that skiers knew little about the risk of sun exposure and often took no precautions at all, especially in cold and cloudy weather^[4][5]. Good sun protection should include protective clothing with long sleeved jackets, long trousers, hats, gloves, wrap around sunglasses and regular application of sunscreen of at least SPF 30 to all exposed skin. So, to all our potential skiers, take note and remember your sun protection this winter!

YN Lau, CJ Fleming.

1. Rosso S, et al (1999) Risk of basal and squamous cell carcinomas of the skin in Sion, Switzerland: a case-control study. Tumori 1999;85: 435-42.
2. Zanetti R et al (1988). A case-control study of melanoma of the skin in the province of Torino, Italy. Rev Epidemiol Sante Publique. ;36:309-317.
3. Rigel DS, et al (1999). Effects of altitude and latitude on ambient UVB radiation. J Am Acad Dermatol. 40:114-116.
4. A Andersen PA, et al (2010) Environmental cues to UV radiation and personal sun protection in outdoor winter recreation. Arch Dermatol. 146(11):1241-7.
5. Buller DB, et al (1998) Sun safety behaviours of alpine skiers and snowboarders in the western United States. Cancer Prev Control ;2:133-9.

This article was originally published in the SCPN Newsletter Volume 3, Issue 1.
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