UV and Outdoor Sports: The Importance of Coaches in Educating Athletes

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The incidence of skin cancer, including malignant melanoma, squamous cell carcinoma, and basal cell carcinoma, has been rising globally.¹ This trend is compounded by the increasing exposure to ultraviolet (UV) radiation, a significant health risk exacerbated by climate change.² Outdoor sports enthusiasts are considered high-risk individuals due to prolonged exposure to UV radiation. Coaches play a crucial role in educating athletes about sun safety, yet their understanding of UV-related health risks remains underexplored. With this in mind, a recent study examined the UV-specific skin cancer knowledge of outdoor sports coaches across Germany, identifying sport-, coach-, and club-specific factors that influence their awareness and understanding of UV risks and prevention.³

“Serious knowledge deficiencies are evident among German outdoor sports coaches,” researchers wrote. “The study results emphasize the necessity for enhanced coach education and the implementation of evaluated concepts for climate adaptation in sports.”

Materials and Methods

The study was part of the 'C³O Study' (Climate Change, Coaches and Outdoor Sports), a nationwide cross-sectional survey targeting outdoor sports coaches from the 10 largest outdoor sports associations in Germany. A total of 1,200 coaches participated, providing data on their knowledge of skin cancer risks, UV exposure, and prevention strategies. The Skin Cancer and Sun Knowledge Scale (SCSK) was used to measure UV-specific knowledge. Participants also provided information about their training experience, club characteristics, and the institutional sources of UV-related education they had received.

Results

The study revealed coaches averaged 17.76 points on the SCSK scale, indicating significant knowledge gaps about UV risks and skin cancer prevention. Results revealed the true-false statements ‘A tan is a sign that the skin is damaged’ (true) and ‘When using sunscreen, you can tan without any negative effects’ (false) were most frequently answered incorrectly. Researchers noted coaches from football and tennis exhibited the greatest deficits, while those in sports like skiing, swimming, and mountaineering demonstrated better knowledge. They found factors such as age, experience, and club size influenced knowledge levels, with younger and older coaches, as well as those in small clubs, showing poorer understanding. The majority of coaches reported receiving limited UV-related education from sports institutions, highlighting the need for improved training and resources.

The study's strengths include its large, representative sample and the use of the validated SCSK, ensuring robust and comparable results. However, researchers noted limitations include potential selection bias, as trainers with higher UV awareness may have been more inclined to participate, and limited generalizability to regions beyond Germany.

Discussion

Despite the preventable nature of skin cancer through sun protection, the study found many outdoor sports coaches lack adequate knowledge of UV risks and preventive measures. The results highlight that coaches in high-risk sports such as football and tennis are particularly vulnerable to knowledge deficits. This underscores the need for targeted educational interventions, particularly through sports organizations. Researchers suggested climate and health literacy should be incorporated into regular coach training to improve awareness and protective behaviors. Additionally, structural and organizational measures, such as providing shade and altering training schedules, could further mitigate UV risks for athletes.

Conclusion

The C³O study revealed critical gaps in UV-specific skin cancer knowledge among outdoor sports coaches in Germany. These gaps are particularly pronounced in certain sports, such as football and tennis, and among specific coach demographics. To reduce skin cancer risks, researchers statedcomprehensive education and structural interventions are needed to improve sun protection practices in outdoor sports. Enhanced coach training and more widespread UV-related education are essential steps in safeguarding the health of athletes, particularly children and adolescents who are especially vulnerable to skin damage.

References

1. Glanz K, Yaroch AL, Dancel M, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008;144(2):217-222. doi:10.1001/archdermatol.2007.46
2. Intergovernmental Panel on Climate Change (IPCC). Climate change 2021 – The physical science basis: working group I contribution to the sixth assessment report of the intergovernmental panel on climate change. Cambridge: Cambridge University Press; 2023.
3. Schneider S, Parsons ZA, Leer S. Beyond the scoreboard: Coaches' UV-related skin cancer knowledge in outdoor sports. J EurAcad Dermatol Venereol. Published online December 5, 2024. doi:10.1111/jdv.20461