PROTECTIVE BEACHES AND HARMLESS PROTECTION: THE IMPORTANCE OF SUN EXPOSURE POLICIES IN COASTAL ENVIRONMENTS

Abstract

Background: Skin cancer (SC) is recognized globally as a serious public health problem, with its incidence having multiplied over the last three decades, largely due to excessive exposure to ultraviolet (UV) radiation. While SC is highly preventable (with an estimated 65% of melanomas and 90% of cutaneous carcinomas being avoidable through healthy photoprotection habits), relying solely on individualized prevention strategies has proven insufficient to curb the rising rates. The necessity for systemic change underscores the need for public policies and supportive physical-regulatory environments, mirroring successful international models like Australia’s SunSmart campaign, which demonstrated significant reductions in incidence and high cost-effectiveness.

The One Health paradigm: Adopting the One Health paradigm is essential for a comprehensive and sustainable approach to SC prevention. Historically focused on zoonotic diseases, its application is crucial to addressing non-communicable diseases like SC, as it formally recognizes the interconnectedness of human health, animal health, and the environment. This framework is particularly relevant given that climate change, ozone depletion, and temperature increases—all interconnected environmental factors—amplify UV exposure risk and alter human behavior, necessitating transdisciplinary policies and practices at a systemic level to create health-promoting environments.

Coastal environments and dual risk: The beach represents a uniquely high-risk setting for photoexposure due to the cumulative effect of direct sunlight and high reflection from surfaces like sand and water, leading to elevated rates of sunburn among beachgoers and outdoor workers, such as lifeguards. Simultaneously, the widespread use of sunscreens —the most common protection measure— introduces a critical environmental concern: UV filters can harm marine ecosystems, including coral reefs, posing a dual challenge. Following the One Health mandate, effective photoprotection must not harm the environment, making the development and promotion of environmentally friendly protection alternatives imperative alongside responsible use.

The Soludable Beach model: To address these complex risks within the Spanish context, the Soludable project, initiated in Andalusia (a high-risk region for SC), promotes a multisectoral strategy. This initiative focuses on the creation of policies and infrastructures that regulate and adapt coastal spaces, including the implementation of accessible shaded areas, real-time UV index information, and the promotion of eco-sustainable protection measures. As an innovative solution, the project launched the “Soludable Beach Mention” in collaboration with the Blue Flag program, integrating SC prevention standards into quality certification criteria for coastal municipalities. This approach seeks to reduce sunburn and SC incidence in the long term, while simultaneously fostering coastal sustainability and promoting a smart, responsible, and resilient tourism model aligned with the One Health paradigm.