Addressing the need for UV protection in preparticipation physical evaluations: An exploratory study

Objective: Athletes who regularly train outdoors are more likely to be exposed to ultraviolet (UV) radiation, a major risk factor for skin cancer. However, the importance of adequate UV protection in sports is still an underdiscussed topic among athletes and officials. We developed a strategy for UV protection consultation (UVPC) for compulsory preparticipation physical evaluations (PPEs) and conducted this study to explore athletes’ UV exposure and protective behaviors, as well as feasibility and acceptance of UVPC. Methods: In a cross-sectional study, we administered a survey to athletes who underwent a PPE at one of 23 participating certified sports medicine centers in Germany (22 in Saxony, 1 in Schleswig-Holstein) from February to June 2025. The questionnaire assessed individual UV exposure and protective behaviors. Based on the results, sports physicians provided a structured UVPC. Physicians provided online feedback on feasibility and acceptance of the procedure. The outcomes are described descriptively. Regression analyses were conducted to identify factors associated with protective behaviors. Results: Athletes’ (N=375; mean age=16 years; male=50%) UV exposure varied greatly by sport. Increasing outdoor training time and prior sunburn were significantly associated with protective behaviors. Half of the athletes received a UVPC. The procedure was feasible and well-accepted by the majority of physicians (N=9). Conclusions: Overall, a UVPC is feasible and well-accepted in its suggested form within PPE. Athletes’ individual UV exposure should be considered for a more targeted approach.