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Vol. 115. Núm. 5.
Páginas 466-474 (mayo 2024)
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Vol. 115. Núm. 5.
Páginas 466-474 (mayo 2024)
Original Article
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Exposure to UV Radiation in Lifeguards on Barcelona's Beaches: An Underestimated Occupational Risk
Exposición a radiación UV en socorristas de las playas de Barcelona: un riesgo laboral infravalorado
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P. Giavedonia,b,
Autor para correspondencia
giavedonip@gmail.com

Corresponding author.
, A. Combaliaa,b, N. Espinosaa,b,c, J. Aguilerad, S. Puiga,b,c
a Department of Dermatology, ICMiD (Institut Clínic de Medicina i Dermatologia), Spain
b University of Barcelona, Barcelona, Spain
c Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
d Dermatological Photobiology Laboratory, Medical and Health Research Center, Department of Medicine and Dermatology, University of Málaga, Spain
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P. Giavedoni, A. Combalia, N. Espinosa, J. Aguilera, S. Puig
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Tablas (5)
Table 1. UV radiation measurements at different points of the lifeguard's chair every 30min during a full working day over four different working days.
Table 2. Total doses for erythema and vitamin D production.
Table 3. MEDs that a lifeguard would receive for each working hour performed for the different working periods.
Table 4. Maximum UV index levels. Maximum total potential erythematous dose if exposure is direct to the sun.
Table 5. Minutes for MED in phototype II, in a direct sun exposure.
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Abstract
Background

The development of skin cancer is closely related to high exposure to UV radiation. Lifeguards are at an increased risk of excessive sun exposure.

Objectives

The main objective of this study was to measure the exposure of Barcelona's beach lifeguards to UV radiation.

Methods

Measurements in the work chair were taken every 30min on a typical working day from 10:45 am to 19:15 pm. These measurements were carried out on four different days. These data were used to calculate the erythematous doses received during working hours, as well as those potentially received throughout the summer season. Vitamin D production was also estimated for the four days that the radiation received was measured, and the amount generated was calculated for the entire summer season.

Results

Exposure to UV radiation among Barcelona lifeguards far exceeds safety limits. In some locations, the exposure to UVB radiation is more than 16 times the minimum erythematous dose for phototype II skin.

Limitations

This study assessed the radiation received during only four days. However, is a much higher number than most of the published papers.

Conclusion

Although the health risks of excessive exposure to UV radiation are known, Barcelona's beach lifeguards are insufficiently protected.

Keywords:
UV radiation
Lifeguards
Occupational risk
Work chair
Skin cancer
Melanoma
Resumen
Antecedentes

El desarrollo del cáncer de piel está estrechamente relacionado con la alta exposición a la radiación UV. Los socorristas tienen un riesgo aumentado de exposición al sol.

Objetivos

El objetivo principal de este estudio fue medir la exposición de los socorristas de las playas de Barcelona a la radiación UV.

Métodos

Se tomaron mediciones en la silla de trabajo cada 30min en un día típico de trabajo desde las 10:45 am hasta las 19:15 pm. Estas mediciones se realizaron en 4 días diferentes. Estos datos se utilizaron para calcular las dosis eritematosas recibidas durante las horas de trabajo, así como las potencialmente recibidas a lo largo de la temporada estival. También se estimó la producción de vitamina D durante los 4 días en que se midió la radiación recibida, y se calculó la cantidad generada durante toda la temporada estival.

Resultados

La exposición a la radiación UV de los socorristas de Barcelona supera con creces los límites de seguridad. En algunos lugares, la exposición a la radiación UVB es más de 16 veces superior a la dosis eritematosa mínima para pacientes con fototipo ii.

Limitaciones

Este estudio evaluó la radiación recibida durante solo 4 días. Sin embargo, es una cifra muy superior a la de la mayoría de los trabajos publicados.

Conclusión

Aunque se conocen los riesgos para la salud de una exposición excesiva a la radiación UV, los socorristas de las playas de Barcelona no están suficientemente protegidos.

Palabras clave:
Radiación UV
Socorristas
Riesgo laboral
Silla de trabajo
Cáncer de piel
Melanoma
Texto completo
Introduction

UV exposure is associated with the incidence of melanoma and non-melanoma skin cancer.1,2 It is estimated that 90% of skin cancer can be prevented by using adequate sun protection, wearing hats and protective clothing, and avoiding the sun during peak hours.1 Certain groups of workers are at a higher risk of exposure to UV radiation, such as airplane pilots, gardeners, and lifeguards, among others.3–5

The main objective of this study was to measure the exposure of lifeguards on Barcelona's beaches to UV radiation during a working day. From these data, we then estimated the mean daily UV radiation received by lifeguards during an entire summer season in Barcelona along with the production of vitamin D.

Methods

This study was carried out by dermatologists from the Hospital Clínic and lifeguards from the beaches of the city of Barcelona. Lifeguards from “Pro Activa Serveis Aquatic” company participated in our study.

The radiation received by the lifeguards at their workplace was measured. The chair used by the lifeguards was the Silla de vigilancia look out manufactured by Esteva® (Fig. 1), with a sunshade on the top. UV radiation measurements were performed using the Solameter 5.0®, which is useful for measuring both UVA (320–380nm) and UVB (280–320nm) rays.

Figure 1.

Lifeguards chair. “Silla de vigilancia look out” manufactured by Esteva®.

(0,38MB).

Measurements were made by the lifeguards at four different workstations on beaches in the city of Barcelona, every 30min from 10:45 to 19:15, with a total of 18 measurements being recorded. The radiation received was measured on four different days. In addition, they were carried out at six different positions in the lifeguard's chair: left arm, right arm, back, footrest, seat base, and the top rung of the chair. General direct radiation from the sun as well as at 90° to the sun was measured.

The orientation of the chair was determined by compass. The maximum temperature of the day was recorded. The weather assessment at each measurement was sunny, slightly cloudy, or partially cloudy.

From the measurement data and considering the corresponding maximum UV index value for that day under clear sky conditions, the radiation doses needed for the development of erythema and vitamin D production at each of the measurement points in each workstation were calculated, and mean values were recorded.

The levels of UV light exposure, the minimum erythematous dose (MED), and also the potential for vitamin D formation were determined from the UV radiation received.

MED is the dose of UV radiation needed to cause a minimum erythematous skin response within 24h of exposure and varies according to the skin type set out in the Fitzpatrick scale.6

The total dose that a worker would receive at different working hours and the total MED received during the working day were calculated. The potential MED during the April–October period was also determined assuming that sun exposure had been continuous during working hours.

The data were analyzed by an expert photobiologist from the University of Malaga. All analyses were carried out using SPSS.

Results

Two lifeguards recorded the radiation doses received at four different workstations, on four different days.

Table 1 shows the radiation received at different points of the lifeguard's chair, every 30min, for the full working day over four different days. In Table 2, the MED and vitamin D production are shown at each of the measuring points in each workstation, representing the mean values. For example, lifeguards in Station 3 with phototype II received 16.39 times more radiation than necessary to produce erythema on the right arm. Furthermore, it can be observed that, according to the UV radiation of that day, direct exposure to the sun (outside the work chair) caused the lifeguards with phototype II to receive 22.8 times the radiation needed to produce erythema.

Table 1.

UV radiation measurements at different points of the lifeguard's chair every 30min during a full working day over four different working days.

Date: June 27th 2018Beach: BarcelonetaSurveillance post: Chair 21Orientation: 92°
Location: 41°21′40.8″N 2°11′32″ESolar protection of the post: AwningMaximum temperature: 29°CWind: moderate
TimeLevel of UV radiation
Left armrest  Right armrest  Backrest  Footrest  Seat base  Top rung  Direct to the sun  Direct to the sky 90° 
10:45 am  Clear  1.4  1.5  0.5  2.2  2.3  1.4  –  – 
11:15 am  Clear  0.8  1.9  0.4  3.3  2.3  –  – 
11:45 am  Partially cloudy  0.7  1.2  0.4  1.9  3.8  2.7  –  – 
12:15 pm  Partially cloudy  0.8  2.7  0.4  4.4  3.8  –  – 
12:45 pm  Partially cloudy  0.8  0.4  3.3  3.8  3.3  –  – 
13:15 pm  Clear  0.9  4.2  0.6  4.6  1.3  0.7  –  – 
13:45 pm  Clear  0.9  4.4  0.4  4.5  0.6  –  – 
14:15 pm  Clear  0.9  4.4  0.5  4.3  0.9  0.4  –  – 
14:45 pm  Clear  0.8  4.1  0.8  2.7  0.9  0.4  –  – 
15:15 pm  Clear  0.8  0.4  1.1  0.6  0.4  –  – 
15:45 pm  Clear  0.8  3.7  0.7  0.7  0.3  –  – 
16:15 pm  Clear  0.7  3.1  0.5  0.9  0.7  0.2  –  – 
16:45 pm  Partially cloudy  0.7  2.5  2.5  0.9  0.8  0.2  –  – 
17:15 pm  Partially cloudy  0.7  1.5  1.9  0.8  0.6  0.2  –  – 
17:45 pm  Partially cloudy  0.8  1.2  1.6  0.8  0.5  0.2  –  – 
18:15 pm  Partially cloudy  0.6  0.5  0.7  0.5  0.2  –  – 
18:45 pm  Partially cloudy  0.4  0.4  0.4  0.5  0.3  0.3  –  – 
19:15 pm  Partially cloudy  –  –  –  –  –  –  –  – 
Date: June 29th 2018Beach: Sant SebastiàSurveillance post: Chair 11Orientation: 100°
Location: 41°22′18.5″N 2°11′21.4″ESolar protection of the post: AwningMaximum temperature: 27°CWind: light
TimeLevel of UV radiation
Left armrest  Right armrest  Backrest  Footrest  Seat base  Top rung  Direct to the sun  Direct to the sky 90° 
10:45 am  Clear  2.7  3.5  0.3  2.9  3.5  1.7  3.8  – 
11:15 am  Clear  3.3  3.1  0.2  3.3  2.5  4.3  – 
11:45 am  Clear  0.8  3.1  0.2  3.5  3.2  2.6  4.5  – 
12:15 pm  Clear  0.2  4.1  4.7  – 
12:45 pm  Clear  3.1  0.3  4.2  1.2  3.2  4.8  – 
13:15 pm  Clear  0.9  0.4  4.3  0.7  4.9  – 
13:45 pm  Clear  0.8  3.4  0.4  4.3  0.9  0.6  – 
14:15 pm  Partially cloudy  0.8  2.4  0.4  2.8  0.6  2.6  – 
14:45 pm  Partially cloudy  3.1  0.5  3.1  1.1  0.7  4.6  – 
15:15 pm  Partially cloudy  0.9  3.1  0.4  1.3  1.1  0.6  – 
15:45 pm  Clear  0.8  2.7  0.4  0.6  0.5  4.8  – 
16:15 pm  Clear  0.7  2.5  0.5  0.8  0.5  4.6  – 
16:45 pm  Clear  0.7  2.5  2.2  0.9  0.6  0.4  4.2  – 
17:15 pm  Partially cloudy  0.8  2.5  2.1  0.9  0.7  0.4  3.9  – 
17:45 pm  Partially cloudy  1.2  1.3  1.4  1.4  0.6  0.3  3.1  – 
18:15 pm  Clear  1.1  0.4  0.4  1.4  0.2  2.7  – 
18:45 pm  Clear  0.6  0.6  0.5  0.5  0.4  0.2  – 
19:15 pm  Clear  0.4  0.4  0.3  0.3  0.4  0.3  1.6  – 
Date: July 4th 2018Beach: Sant SebastiàSurveillance post: Chair 11Orientation: 100°
Location: 41°22′18.5″N 2°11′21.4″ESolar protection of the post: AwningMaximum temperature: 27°CWind: light (morning); moderate (afternoon)
TimeLevel of UV radiation
Left armrest  Right armrest  Backrest  Footrest  Seat base  Top rung  Direct to the sun  Direct to the sky 90° 
10:45 am  Clear  2.4  2.6  0.4  3.6  4.3 
11:15 am  Clear  2.9  2.8  0.4  3.2  3.4  2.6  4.8  3.2 
11:45 am  Clear  0.8  3.6  0.2  3.6  3.8  3.2  3.9 
12:15 pm  Clear  0.8  0.2  3.6  4.1 
12:45 pm  Clear  0.8  4.1  0.2  4.3  0.9  3.8  5.2  4.6 
13:15 pm  Clear  0.8  4.4  0.3  4.6  0.8  0.6  5.2  4.8 
13:45 pm  Clear  0.8  4.3  0.3  4.6  0.8  0.5  5.2  4.8 
14:15 pm  Clear  0.7  4.1  0.3  4.5  0.7  0.5  5.2  4.9 
14:45 pm  Clear  0.7  4.1  0.3  1.2  0.7  0.5  5.1  4.6 
15:15 pm  Clear  0.7  3.8  0.3  1.2  0.8  0.5  5.3  4.6 
15:45 pm  Clear  0.8  3.7  0.5  1.1  0.8  0.4  4.9  4.1 
16:15 pm  Clear  0.7  3.1  0.5  0.7  0.4  4.6  3.6 
16:45 pm  Clear  0.7  2.7  0.3  0.9  0.6  0.4  4.6  3.2 
17:15 pm  Clear  0.6  2.2  1.6  0.7  0.5  0.3  4.1  2.9 
17:45 pm  Clear  0.7  1.5  1.9  0.6  0.5  0.3  3.7  2.2 
18:15 pm  Clear  1.3  1.3  1.5  0.6  0.4  0.2  3.2  1.6 
18:45 pm  Clear  0.5  0.5  0.4  0.5  0.5  0.2  2.6  1.1 
19:15 pm  Clear  0.3  0.4  0.3  0.2  0.4  0.2  0.7 
Date: July 5th 2018Beach: Sant SebastiàSurveillance post: Chair 11Orientation: 100°
Location: 41°22′18.5″N 2°11′21.4″ESolar protection of the post: AwningMaximum temperature: 28°CWind: light (morning); moderate (afternoon)
TimeLevel of UV radiation
Left armrest  Right armrest  Backrest  Footrest  Seat base  Top rung  Direct to the sun  Direct to the sky 90° 
10:45 am  Clear  2.4  0.3  0.6  2.2  2.6  2.6  2.8 
11:15 am  Clear  0.4  0.7  2.7  0.8  2.3  4.4  3.2 
11:45 am  Clear  1.3  0.6  0.8  3.7  2.6  4.9  3.9 
12:15 pm  Clear  1.1  0.7  0.7  3.7  0.8  0.2  4.8  4.1 
12:45 pm  Clear  0.7  0.8  3.9  0.6  0.6  4.9  4.2 
13:15 pm  Clear  0.7  0.6  0.8  3.9  0.7  0.5  4.9  4.4 
13:45 pm  Clear  0.8  0.5  0.9  0.9  0.6  0.4  4.6 
14:15 pm  Clear  0.8  0.5  0.9  0.9  0.7  0.4  4.6 
14:45 pm  Clear  0.8  0.4  2.5  0.9  0.6  0.4  4.6 
15:15 pm  Clear  0.8  0.4  3.9  0.8  0.6  0.3  4.9  4.3 
15:45 pm  Clear  0.8  0.5  3.8  0.7  0.6  0.3  4.8  3.9 
16:15 pm  Clear  0.5  2.9  0.6  0.5  0.3  4.5  3.7 
16:45 pm  Clear  2.7  2.5  3.1  0.6  2.3  0.3  4.4  3.4 
17:15 pm  Clear  2.8  2.9  2.4  0.6  0.6  0.3  3.9  2.6 
17:45 pm  –  –  –  –  –  –  –  –  – 
18:15 pm  Cloudy  0.7  0.6  0.8  0.7  0.6  0.3  1.2 
18:45 pm  Cloudy  0.7  0.4  0.7  0.6  0.5  0.3  1.1  0.9 
19:15 pm  Cloudy  0.5  0.3  0.4  0.4  0.4  0.2  0.7  0.6 
Table 2.

Total doses for erythema and vitamin D production.

  Station 1  Station 2  Station 3  Station 4  Average  Standard deviation 
Left armrest
Erythematous total dose  109.4  157.14  118.26  174.2  139.7  30.9 
DEMs phototype II  4.4  6.29  4.73  7.0  5.6  1.2 
DEMs phototype III  3.1  4.49  3.38  5.0  4.0  0.9 
DoVitD phototype II  17.5  25.14  18.92  27.9  22.4  5.0 
DoVitD phototype III  12.5  17.96  13.52  19.9  16.0  3.5 
Right armrest
Erythematous total dose  358.8  367.74  409.86  101.3  309.4  140.6 
DEMs phototype II  14.4  14.71  16.39  4.1  12.4  5.6 
DEMs phototype III  10.3  10.51  11.71  2.9  8.8  4.0 
DoVitD phototype II  57.4  58.84  65.58  16.2  49.5  22.5 
DoVitD phototype III  41.0  42.03  46.84  11.6  35.4  16.1 
Backrest
Erythematous total dose  108.5  89.91  76.95  211.4  121.7  61.2 
DEMs phototype II  4.3  3.60  3.08  8.5  4.9  2.4 
DEMs phototype III  3.1  2.57  2.20  6.0  3.5  1.7 
DoVitD phototype II  17.4  14.39  12.31  33.8  19.5  9.8 
DoVitD phototype III  12.4  10.28  8.79  24.2  13.9  7.0 
Footrest
Erythematous total dose  304.6  325.62  298.08  207.4  283.9  52.4 
DEMs phototype II  12.2  13.02  11.92  8.3  11.4  2.1 
DEMs phototype III  8.7  9.30  8.52  5.9  8.1  1.5 
DoVitD phototype II  48.7  52.10  47.69  33.2  45.4  8.4 
DoVitD phototype III  34.8  37.21  34.07  23.7  32.4  6.0 
Seat base
Erythematous total dose  209.0  182.25  164.43  96.4  163.0  48.0 
DEMs phototype II  8.4  7.29  6.58  3.9  6.5  1.9 
DEMs phototype III  6.0  5.21  4.70  2.8  4.7  1.4 
DoVitD phototype II  33.4  29.16  26.31  15.4  26.1  7.7 
DoVitD phototype III  23.9  20.83  18.79  11.0  18.6  5.5 
Top rung
Erythematous total dose  136.1  153.90  147.42  78.6  129.0  34.4 
DEMs phototype II  5.4  6.16  5.90  3.1  5.2  1.4 
DEMs phototype III  3.9  4.40  4.21  2.2  3.7  1.0 
DoVitD phototype II  21.8  24.62  23.59  12.6  20.6  5.5 
DoVitD phototype III  15.6  17.59  16.85  9.0  14.7  3.9 
Direct to the sun
Erythematous total dose    575.91  613.17  521.6  570.2  46.0 
DEMs phototype II    23.04  24.53  20.9  22.8  1.8 
DEMs phototype III    16.45  17.52  14.9  16.3  1.3 
DoVitD phototype II    92.15  98.11  83.5  91.2  7.4 
DoVitD phototype III    65.82  70.08  59.6  65.2  5.3 
Direct to the sky 90°
Erythematous total dose      477.09  437.4  457.2  28.1 
DEMs phototype II      19.08  17.5  18.3  1.1 
DEMs phototype III      13.63  12.5  13.1  0.8 
DoVitD phototype II      76.33  70.0  73.2  4.5 
DoVitD phototype III      54.52  50.0  52.3  3.2 

MED: minimal erythematous dosages; DoVitD: minimum dose of vitamin D.

The total dose that a worker would receive during one working hour in the different periods of the year were calculated as well as the total MED received during the entire work period, as is shown in Table 3. These calculations were made from the average values estimated in the various positions at each of the measurement points. We can observe that in the period July–August, a phototype II lifeguard will receive 0.92 times the MED in one working hour. Additionally, they will receive 415.71 times the MED during all hours worked from March to September.

Table 3.

MEDs that a lifeguard would receive for each working hour performed for the different working periods.

Season level  Months  Total working hours  Surveillance hours  Average MED phototype II  Average MED phototype III  Total MED phototype II  Total MED phototype III 
Low level 1  March–September  1000  500  0.83  0.57  415.71  287.14 
Low level 2  May–September  900  450  0.89  0.62  402.55  278.05 
Medium  June–September  750  375  0.89  0.61  333.44  230.31 
High level 1  June 9–September 9  550  275  0.93  0.65  256.87  177.43 
High level 2  July–August  380  190  0.92  0.63  174.06  120.23 

MED: minimal erythematous dosages.

Fig. 2 shows the daily UV index cycles on the 15th of each month, between April and October, on the Barcelona coast. The maximum values always correspond approximately to the time 2.15 pm on each day.

Figure 2.

Daily UV index cycles on the 15th of each month between April and October on the Barcelona coast. The maximum values always correspond to 14.15 approximately.

(0,14MB).

Table 4 shows the different daily cycles of erythematous sun exposure and analyzes the potential exposure data for the different time slots and the average cumulative total on the 15th day of each month.

Table 4.

Maximum UV index levels. Maximum total potential erythematous dose if exposure is direct to the sun.

Months  UV index  Erythematous irradiance (mJcm−2Minutes for MED in phototype II  Minutes for MED in phototype III  Minutes for vitamin D production in phototype II  Minutes for vitamin D production in phototype III  MED/hour in phototype II  MED/hour in phototype III 
January  0.01  83.3  116.7  20.8  29.2  0.22  0.15 
February  3.5  0.01  47.6  66.7  11.9  16.7  0.38  0.26 
March  5.5  0.01  30.3  42.4  7.6  10.6  0.59  0.41 
April  0.02  23.8  33.3  6.0  8.3  0.75  0.52 
May  8.5  0.02  19.6  27.5  4.9  6.9  0.92  0.63 
June  0.02  18.5  25.9  4.6  6.5  0.97  0.67 
July  0.02  18.5  25.9  4.6  6.5  0.97  0.67 
August  0.02  20.8  29.2  5.2  7.3  0.86  0.60 
September  0.02  23.8  33.3  6.0  8.3  0.75  0.52 
October  0.01  41.7  58.3  10.4  14.6  0.43  0.30 
November  2.1  0.01  79.4  111.1  19.8  27.8  0.23  0.16 
December  1.8  0.00  92.6  129.6  23.1  32.4  0.19  0.13 

MED: minimal erythematous dosages.

The minutes needed to produce MED and vitamin D in each month are shown in phototypes II and III, as well as the MED received per hour according to the month of the year and the phototype. For example, in July, phototype III lifeguards take 25.9min to reach MED and 6.5min to produce vitamin D.

Table 5 shows the MED values for phototype II lifeguards. Values are listed for each hour in each month, when exposure to the sun was direct in clear sky conditions. The lowest value was observed at 2 pm in June and July when the MED was reached in 18min.

Table 5.

Minutes for MED in phototype II, in a direct sun exposure.

Time  Minutes for an erythematous dose for phototype II
  January  February  March  April  May  June  July  August  September  October  November  December 
11  180  103  65  51  42  40  40  45  52  90  171  200 
12  117  67  42  33  27  26  26  29  34  58  111  130 
13  91  52  33  26  21  20  20  23  26  45  86  101 
14  82  47  30  24  19  18  18  21  24  41  78  91 
15  86  49  31  25  20  19  19  22  25  43  82  96 
16  104  60  38  30  25  23  23  26  30  52  99  116 
17  150  86  55  43  35  33  34  38  44  75  143  167 
18  267  153  97  76  63  59  60  67  78  134  255  297 
19  652  373  237  186  153  144  146  163  190  326  621  725 
20  2709  1548  985  774  637  596  606  677  787  1354  2580  3010 

MED: minimal erythematous dosages.

Discussion

Excessive exposure to UV radiation suffered by outdoor workers continues to be an occupational health problem.1 UV radiation is the leading cause of malignant skin tumors and photoaging as well. In fair-skinned people, it is responsible for 50%–70% of squamous cell carcinomas and 50%–90% of basal cell carcinomas.7 A strong positive association with the development of melanoma has also been found in outdoor workers who receive high exposure to UV radiation.8

The optimal use of sunscreen routinely applied was associated with a decreased risk of melanoma.9,10 However, the use of measures to reduce exposure to UV radiation for lifeguards, such as hats, specific clothing, sunscreens, and sunglasses, is not universally accepted and is used irregularly, depending on the employer.

Most lifeguards are at an increased risk of excessive sun exposure and sunburn and receive levels of UV radiation that exceed the occupational guidelines proposed by the International Commission on Non-Ionizing Radiation Protection.11

We frequently see that lifeguards on the beaches of Spain do not use bathing suits that cover most of the body, glasses, or protective caps. As a result, lifeguards receive high levels of UV radiation exposure in the workplace.4 Several authors have described this increased exposure of lifeguards to UV radiation.3,11

In this work, we specifically analyzed the UV radiation received by lifeguards of Barcelona in their work chairs. The chair is chosen by the company employing the lifeguards and is specially selected to reduce the risk of work-related illnesses. Among the most important factor to be considered is protection from UV radiation, thus decreasing the incidence of skin cancer. However, many of the lifeguards’ chairs have areas totally exposed to the sun at different times of the day.

In 2009, Gies et al. reported the exposure to UV radiation received by lifeguards working at swimming pools. They observed that more than 74% received UV radiation above the recommended values for occupational exposure. Thirty-nine percent were exposed to more than four times the limit, and 65% of this exposure was sufficient to induce sunburn.11 In this study, they did not analyze the exposure in the work chair.

The idea that “people are more attractive if they tan” persists.2 Lifeguard surveys have confirmed this conception of beauty.12 Another concept that many workers are not clear about is that to achieve healthy vitamin D production levels, about one-third of the exposure time needed to produce MED is required.3 In this respect, there is much that dermatologists can contribute to the training of outdoor workers.

To encourage the implementation of these preventive measures, studies assessing exposure to UV radiation in lifeguards are necessary.13

In our study, we found that exposure to UV radiation among Barcelona lifeguards far exceeds safety limits. These workers, then, have a high risk of developing different types of skin cancer, both non-melanoma, and melanoma.4

Our results are relevant because these high values of exposure to UV radiation were taken in the lifeguard's work chair, thus demonstrating the insufficient protection that they provide. It is the responsibility of the employer to carry out training programs and provide work elements that are aimed at reducing exposure to UV radiation to safe levels. On the basis of these results, we believe that it is essential to inform employers about the need to use work chairs that are safe for the health of lifeguards.

The lack of adequate photo-protection has been described by many outdoor workers, including, in addition to lifeguards, landscapers, farmers, fishermen, and mountain guides, among others.14 Sanlorenzo et al. demonstrated that airline pilots and cabin crew have high radiation exposure. They observed that the windscreen of the plane blocked UVB rays but not UVA rays.5

However, there is still a need for studies to establish recommendations on UV dose limits as related to occupation. These studies should include more accurate workplace measurements.

Based on our results, we suggest prioritizing the two following aspects: the lifeguard's chair should be optimized; and the use of photo-protective measures, i.e., hat, clothes sunscreen, should be promoted and/or made obligatory.

We believe that better UV protection at lifeguard workstations is necessary to provide a safe working environment. We strongly recommend the use of appropriate clothing, sunscreens, and periodic skin checks for lifeguards. We hope that work chairs will improve photo-protective conditions for these vulnerable groups of workers. We think that more research is needed in this field to improve photo-protective measures in the workplace.

Limitations

This study assessed the radiation received during only one working day. However, 72 measurements of UV radiation were made, which is a much higher number than most of the published papers. Only four workstations were assessed, however, describing the UV radiation received in the work chair provides unpublished data that can improve the health of workers.

Conclusions

Although the risks of UV radiation are known, many outdoor workers now receive doses thar are harmful to their health. The work chair used by many lifeguards is chosen for study by people trained in occupational health. In spite of this, we were able to demonstrate the insufficient protection that they have from UV radiation.

Conflict of interests

The authors declare that they have no conflict of interest.

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