Skiers at elevated risk of skin cancer, dermatologist says

With Australia’s ski season well and truly underway, MoleMap dermatologist Dr Niyati Sharma is reminding the country’s 1.2 million skiers and snowboarders¹ that they are not immune from skin cancer — quite the opposite, in fact.

According to latest air quality data from Yale and Columbia Universities, Australia has the world’s cleanest air when compared with 180 countries.² The downside is that this lack of pollution significantly increases exposure to UV — particularly at altitude — with Sharma saying UV exposure on a ski field is up to 30% higher than at sea level.³

“What we know about leisure activities at altitude is that there is decreased atmospheric shielding from UV radiation, which leads to significantly more UV exposure than at sea level,” Sharma said.

“For every 1000 m increase in altitude, the UV radiation level will increase about 10%.⁴ Australia’s highest ski field is over 2000 m and the peak exposure levels could be three times higher than at sea level.

“This means the level of UV exposure while skiing in the winter is equivalent to playing a round of golf in the summer.”⁵

Sharma noted that with winter being synonymous with less sun, this leads to a level of complacency among regular skiers. But research shows that the surface of snow acts as a mirror, reflecting up to 80% of the sun’s rays back at us — intensifying the levels of UV absorbed through the skin.⁶

“We know that spending time around reflective surfaces like snow and ice means you are getting up to 200% more harmful UV exposure than at the beach,”⁷ Sharma said.

“This can result in permanent damage to areas of the upper torso not commonly exposed to UV — such as the underside of the chin.⁸

“Research has found that those who work on ski fields and spend long periods of time at altitude have higher rates of actinic keratosis, a precancerous lesion found on sun-damaged skin, than the general population — which tends to highlight the risk skiers may face.”⁹

Sharma said it is important to mitigate the exposure to UV by protecting your skin and eyes, including through good-quality sunscreen with maximum SPF (reapplied every two hours), SPF lip balm, UV protective eye gear (ideally wraparound goggles, rather than sunglasses) and UV protective clothing to cover the neck.

She concluded by noting that the Earth’s elliptical orbit means southern countries are exposed to more sunlight than Northern Hemisphere counterparts.

“We know that Australians are already seeing around 13% more UV exposure than the countries above the equator on the equivalent latitude — along with the clean air and our outdoor lifestyles it is one of the reasons we have the world’s highest prevalence of skin cancer,”¹⁰ she said.

“It is essential that Aussies, particularly those with common risk factors such as fair skin, red or blond hair or a history of sun damage, get screened regularly to prevent the development of melanoma.

“This can be done by your GP or through a skin cancer surveillance service such as MoleMap.”

References

1. Roy Morgan Survey. Accessible here.

2. Wolf, M. J., Emerson, J. W., Esty, D. C., de Sherbinin, A., Wendling, Z. A., et al. (2022). 2022 Environmental Performance Index. New Haven, CT: Yale Center for Environmental Law & Policy. Epi.yale.edu. Accessible here.

3. UV Exposure on NZ Ski Fields. Accessible here.

4. World Health Organization. Accessible here.

5. UV Exposure on NZ Ski Fields. Accessible here.

6. McKenzie, Richard & Paulin, K. & Madronich, Sasha. (1998). Effects of snow cover on UV irradiance and surface albedo: A case study. Journal of Geophysical Research. 103. 28785-28792. doi: 10.1029/98JD02704.

7. World Health Organization. Accessible here.

8. Siani, A. M., Casale, G. R., Diémoz, H., Agnesod, G., Kimlin, M. G., Lang, C. A., and Colosimo, A.: Personal UV exposure in high albedo alpine sites, Atmos. Chem. Phys., 8, 3749–3760, https://doi.org/10.5194/acp-8-3749-2008, 2008.

9. Gilaberte Y, Casanova JM, García-Malinis AJ, et al. Skin Cancer Prevalence in Outdoor Workers of Ski Resorts. J Skin Cancer. 2020;2020:8128717. Published 2020 Jan 28. doi: 10.1155/2020/8128717

10. Environmental Health Intelligence NZ. Accessible here.

Image credit: ©stock.adobe.com/au/LightItUp

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