Cancer Council expert talks sun safety offshore

It’s easy to become complacent about sun protection when you’re sailing offshore. You might be soaring along at 15-knots of boat speed, with razor sharp focus on the task at hand, completely forgetting to reapply your sunscreen or to grab your neck gaiter.

When it comes to sun safety, especially when you’re exposed to UV rays for hours on end, complacency is not an option says Liz King, Skin Cancer Prevention Manager at *Cancer Council NSW.

Sun protection matters for all sailors, King says. And it doesn’t make any difference if you’re sailing on a beautiful day in Sydney Harbour or racing in cloud cover off Hobart.

The Cancer Council has this dire warning: “At least 2 in 3 Australians will be diagnosed with skin cancer.”

King says small actions like wearing a wide-brimmed hat and a collared shirt with a UPF rating could be the difference between staying healthy and a skin cancer diagnosis.

Highest rates of skin cancer and melanoma in the world

Liz: A key point of what we do in our sun protection work is the SunSmart program and promoting the mantra, “No hat, no play,” which has become normalised to the culture of what kids do when they’re outside.

We encourage everybody, adults included, to make sun protection part of their usual routine. It’s like putting on a sports uniform without calling it that. It’s what you always wear when you’re outside. We encourage that sort of thinking so it’s like you’re looking after your skin because it’s a normal thing to do, while protecting your skin at the same time.

We have unique challenges in Australia. Australia and New Zealand have the highest rates of skin cancer and melanoma in the world because we are slammed with UV.

The other risk factor is that UV can scatter and bounce around in the atmosphere. The UV rays reflecting off surfaces and scattering in the atmosphere can match the UV coming straight from the sun. UV bounces off reflective surfaces. The sea surface, for example, can reflect between 25 to 30 per cent of all the UV radiation in the atmosphere. UV also bounces off hard surfaces, including metal. So, you’re going to have UV bouncing off the boat and the sea surface.

Sailors who are offshore for several days are exposed to UV rays from dawn till dusk. They’re getting UV all around them. Even if they wear the best hat in the world, they still need to think about other forms of sun protection.

Northern Australia

UV levels are different to temperature. In Darwin, for example, the UV doesn’t fall below a very high level. It’s still classified as very high in the winter months of June and July.

Tasmania

There’s only four months in Tassie where the UV average is below a three, and that includes the most southern parts of the island. We think Tassie has a cold, cool climate, but the UV is high for eight months of the year.

Sydney

In Sydney, June is the only one month where the UV will average below three.

Australia receives so much UV, and it’s not just about temperature. UV is invisible, it can harm us on sunny and cloudy days. It’s not related to temperature, and in the coolest months of the year you still need to protect your skin.

It’s never too late to protect your skin

Liz: We know that 95 per-cent of all skin cancer is directly related to UV exposure. That highlights the importance of regular skin protection to reduce risk. And it’s never too late. Some people who have sailed for years might say, “Oh, the damage is done.” That’s not the case. You certainly need to know your skin, but we recommend that people continue to protect their skin, even if they’ve had a skin cancer cut out, because we know that cumulative exposure is irreversible.

Why is sun safe clothing so important?

Liz: Clothing and accessories are effective. Cover your arms and legs with clothing that’s got a good UPF (Ultraviolet Protection Factor) factor. What that normally means is that the weave of the clothing is thicker. Often darker colours are better than lighter colours because sometimes UV can penetrate thin fabric and if it’s a lighter colour. You can still get burnt through clothing. A dark colour doesn’t need to be navy blue or black, it can be any colour that is not white.

Sun safe clothing recommendations

Liz:

• Wear clothing with a UPF rating, which means that the clothing will protect your skin.
• Wear a broad-brimmed hat. We know sailors like their peaked caps. But if they can find a type of broad rim that they can clip onto their shirt so it doesn’t blow away in strong winds, that’s going to be much more effective in covering the sides of their faces, ears and the back of their neck.
• Put the collar up on your shirt to protect your neck.
• Wearing sunglasses is a must because we know that UV can damage your eyes.

Sunscreen:

Liz:

While sunscreen can be effective in preventing skin cancer, the real challenge with sunscreen is you need to apply quite a lot [see the above guide].

For example, if a sailor’s covering their skin through clothing and a hat, then it might be just their hands and face that are exposed.

It needs to be reapplied every two hours. Most sunscreen is SPF50+ broad-spectrum, which means that it covers all UV types and is water resistant. Reapplying is important, and that can be challenging for sailors while they’re outside. Neck gaiters are effective because they provide you with a barrier between you and the sun.

Really lather on the sunscreen because it can come off with rubbing. Zinc is also good because it’s so thick. It can be really protective for the skin.

Slip, slop, slap, seek and slide

Liz: Sunscreen (slop) is the last line of defence. There are four other measures: slip (clothing), slap (hat), seek (shade) and slide (sunglasses). Shade can be really effective, but on a boat it’s probably challenging. While sunscreen is important, there’s so many things that can go wrong. People don’t put enough on, they don’t reapply, they might miss a spot, and they might rub it off if they just wanted to wipe their face with a towel.

What time of the day should someone apply sunscreen?

Liz: For those who sail regularly, their sport makes them an outdoor worker, and their risks of UV exposure are huge. Obviously, the UV is higher closer to midday. But we don’t have a cut-off for the best time to start applying sunscreen. People who are outdoors regularly need to protect their skin every day and every time they’re outside when the sun is up.

An Australian Institute of Sport (AIS) study highlighted all of the athletes who get so much more harmful exposure to UV radiation than your average person. They need to think of themselves as needing a specialist sort of regime to manage this, just like they would reduce the risk of any other sports injury.

Some people don’t like sunscreen because of the chemicals. Is sunscreen safe to apply every day?

Liz: There’s been a lot of misinformation about sunscreen on social media. There is clear evidence that sunscreens are safe and effective to use. Sunscreen is regulated by the Therapeutic Goods Administration (TGA) with the same standards as any medication, but misinformation is undermining that fact. Cancer Council is an evidence-based organisation, and the evidence supports that sunscreen is safe and effective to use.

I read that sunscreen should not be stored above 30 degrees and used by the use-by-date.

Liz: Don’t leave sunscreen in direct sunlight or heat because the active ingredient and emulsifiers can separate, so it won’t work as effectively. Check the use-by date and store it away from direct sunlight.

The differences between sunburn and windburn

Liz: When you’re outside in the elements, you can sustain both sun damage and skin inflammation, which is also known as windburn. The key difference is that sun damage, including sunburn, is a permanent carcinogenic impact. It can result in DNA mutations that lead to skin cancers, including melanoma.

Windburn is very different to sun damage. It is a form of inflammation of the skin due to it being irritated by the environment. It’s a bit like contact dermatitis [caused by exposure to a substance that irritates skin or triggers an allergic reaction]. While windburn is temporary, it still needs to be managed. A GP, dermatologist or pharmacist can recommend topical treatments that help protect skin in the first instance. It could be a really thick moisturiser applied before sunscreen.

What time of the day should someone apply sunscreen?

Liz: For those who sail regularly, their sport makes them an outdoor worker, and their risks of UV exposure are huge. Obviously, the UV is higher closer to midday. But we don’t have a cut-off for the best time to start applying sunscreen. People who are outdoors regularly need to protect their skin every day and every time they’re outside when the sun is up.

An Australian Institute of Sport (AIS) study highlighted all of the athletes who get so much more harmful exposure to UV radiation than your average person. They need to think of themselves as needing a specialist sort of regime to manage this, just like they would reduce the risk of any other sports injury.

Should sailors in Europe take the same sort of precautions recommended for Australia and NZ?

Liz: They might not be exposed to UV that is as intense as Australia and New Zealand but they’re exposed to the UV over a prolonged period of time. It’s not just that the UV is high, it’s the frequency.

Sunspots

If a sailor spots a suspicious sunspot, why is early medical review so critical?

Liz: The Cancer Council recommends that people get to know their skin, so they’re familiar with what’s typical. If they notice anything unusual — if [a mole] has changed in shape, colour, size or grown in number — contact a doctor who is familiar with skin cancer.

Checking for skin cancer cannot replace being sun safe in your regular behaviour. There’s a lot of evidence to show that preventing the damage being done in the first place is much more effective than just doing a skin check. Someone who’s been sailing for some time might get regular skin checks, and that’s great. But they still need to protect their skin because it’s that cumulative exposure that can cause damage. Someone might have been exposed for decades, then suddenly something like an abnormal mole might develop. It’s about preventing that tipping point.

More on Cancer Council and Liz King

*Cancer Council is a nonprofit organisation which aims to promote cancer-control policies and to reduce the illness caused by cancer in Australia.

King’s background lies in public health, which includes services and treatment planning for a range of organisations including those that raise awareness for breast cancer, lung cancer, a bowel cancer screening program and pandemic planning. Her role at these various organisations and now at Cancer Council NSW is to engage people in healthy habits before disease occurs.

Featured image – CYCA/Salty Dingo pic.