Ultraviolet exposure in the Ironman triathlon

MATTHIAS MOEHRLE
Department of Dermatology, University of Tuebingen, GERMANY

ABSTRACT
MOEHRLE, M. Ultraviolet exposure in the Ironman triathlon. Med. Sci. Sports Exerc., Vol. 33, No. 8, 2001, pp. 1385–1386. Purpose:
Skin cancer is increasing worldwide and exposure to ultraviolet (UV) radiation is thought to be the most important environmental risk
factor. People practicing outdoor sports are exposed to considerable amounts of UV radiation from the sun. Methods: Three triathletes
participated in the Ironman Triathlon World Championships 1999 in Hawaii (3.9-km swim, 180.2-km bike, 42.4-km run). They attached
Bacillus subtilis spore film dosimeters (VioSpor) on the back between their shoulders. The dosimeter system measured cumulative
biologically weighted erythemal UV exposure. UV exposure is given in minimal erythema doses (1 MED corresponds to 250 J·m⫺2
at 298 nm). Results: The mean personal UV exposure was 8.3 MED (6.9 –9.7 MED) after 8:43 to 9:44 h of competition corresponding
to 0.8 to 1.3 MED·h⫺1 (bike and run). The athletes were sunburned despite the use of water-resistant sunscreen (SPF 25⫹) on sun
exposed skin. Conclusion: The International Radiation Protection Agency has issued guidelines for professional UV exposure. Ironman
triathletes considerably exceeded these limits of exposure similar to other outdoor sports. Professional and amateur athletes should be
aware of hazards caused by UV radiation. Adequate protection by water-resistant sunscreens and clothing as well as training and
competition schedules with low sun exposure seem to be a reasonable recommendation. Key Words: DOSIMETRY, EXPOSURE

U
ltraviolet (UV) radiation is estimated to be the most
important environmental risk factor for the devel-
opment of melanoma and nonmelanoma skin cancer
(3,4). Practicing outdoor sports amateurs and professionals
may considerably be exposed to UV radiation from the sun
(5,8,9). Endurance athletes such as (Ironman distance) tria-
thletes spend about 20 h·wk⫺1 training outdoors. The aim of
this study was to assess the UV exposure of athletes partic-
ipating in the Ironman Triathlon World Championships
1999 in Hawaii using a new biological dosimeter system.
MATERIALS AND METHODS
Dosimeter. A new method of UV measurement has
been developed using a film dosimeter containing dried
spores of Bacillus subtilis. The spectral response of the
spore film (VioSpor, Biosense, Bornheim, Germany) has
been verified using spectroradiometers and is quite similar
to the curve of erythema (2,7,12). The detector measures
cumulative biologically weighted erythemal UV exposure.
UV exposure is given in minimal erythema doses (1 MED
⫽ 250 J·m⫺2 at 298 nm; 1 MED ⫽ the dose to generate
erythema (sunburn) in nontanned skin (skin type 2).
Subjects. At the Ironman Triathlon World Champion-
ships 1999 in Hawaii (3.9-km swim, 180.2-km cycling,
42.4-km run), three male triathletes carried dosimeters at-
tached to the back of their sports dress. During the swim UV
exposure was limited, because the detectors were covered
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Submitted for publication June 2000.
Accepted for publication October 2000.
1385
by a swimsuit. Written informed consent was obtained from
all subjects.
RESULTS
The athletes needed between 8:43 and 9:44 h for the
whole distance. During the competition personal UV expo-
sures from 6.9 to 9.7 MED (mean 8.3 MED) were measured,
corresponding to 0.8 –1.3 MED·h⫺1 during the cycling
(180.2 km) and the marathon run (42.4 km).
Despite the use of water-resistant sunscreen (SPF 25⫹)
on sun exposed skin, there was visible erythema (sunburn).
It was more intense on the shoulders and thighs, as the
Ironman rules prohibit the application of sunscreens on
these sites.
DISCUSSION
UV exposure limits issued by the International Commis-
sion for Nonionizing Radiation Protection (ICNIRP) (6) and
the American Conference of Governmental Industrial Hy-
gienists (ACGIH) (1) were exceeded more than 30 times
during this triathlon competition. UV exposure of triathletes
can be compared with UV doses that have been measured in
other outdoor sports, such as professional cycling or moun-
taineering (8,9). In most outdoor activities with exposed
skin, even if performed for a short time in sunny conditions,
the limit of exposure of 0.3 MED per 8-h workshift is likely
to be exceeded.
The sunscreens partially might have been washed off by
the sea water and sweating, thus being less effective. In
addition, swimming in sea water (13) and sweating during
cycling and running may additionally have increased indi-
vidual UV sensitivity (11). Tanning always results from
low-dose UV-related DNA damage of the skin, requiring
DNA repair. However, tanning may prevent acute damage
(sunburn). The tan the athletes had from previous outdoor
training and the use of water-resistant sunscreens was not
sufficient to prevent sunburn during the competition. In
addition, the rules and regulations of the Ironman competi-
tion prohibited sunscreen application on sites where race
numbers were marked on the skin (14). Competitors should
be advised to use sunscreen on these sites after race numbers
had been marked. The application of sunscreen with a better
water resistance and/or higher SPF is desirable.
Triathletes preparing for the Ironman competition spend
about 20 h·wk⫺1 training outdoors. As in other outdoor
sports, protection of the skin by clothing should be extended
but is limited by discipline specific conditions. Most sports
clothing offers good clinical protection against UV radia-
tion, depending on color and type of the fabric (10).
The study was limited by the small number of athletes and
the lack of control (e.g., spectators, ambient radiation). UV
exposure was measured at one single body site, on the back
between the shoulders. Other sites, such as shoulders or
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1386 Official Journal of the American College of Sports Medicine
head, were likely to receive higher UV doses. However,
extended measurements, even with the small, lightweight
dosimeters being used, would not have been tolerated by the
athletes during the Ironman competition. It could be dem-
onstrated that the dosimeter system is suitable for UV mea-
surements in extreme outdoor sports. In conclusion, UV
exposure of outdoor sport professionals as well as amateurs
should be reduced by water-resistant sunscreens, adequate
clothing, and by training and competition schedules with
low sun exposure.
Special thanks to Matthias Klumpp for his active help during the
Ironman 1999.
The study was performed with funds of the Department of Der-
matology, University of Tuebingen, Germany. There is no profes-
sional relationship with companies or manufacturers who will benefit
from the results of the present study. The results of the present
study do not constitute endorsement of the product by the authors
or the ACSM.
Address for correspondence: Dr. med. Matthias Moehrle, Depart-
ment of Dermatology, Liebermeisterstr. 25, 72076 Tuebingen, Ger-
many; E-mail: matthias.moehrle@med.uni-tuebingen.de.
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http://www.acsm-msse.org