Sport is a crucial part of Australia’s way of life and provides many social, physical and mental health benefits. Summer ambient temperatures can regularly exceed 35 to 40C, which creates a number of different risks to sport participants. Direct sun exposure and vigorous exercise places some people at risk of heat illness, especially in hot weather. If untreated, heat illness can lead to the more serious and potentially life-threatening condition of heat stroke.
As part of protecting your club members and as part of standard risk management planning, it is recommended that State Sporting Organisations, associations and/or clubs consider developing heat and hazardous air quality policy or inclusion of specific heat and hazardous air quality statements and guidelines in their existing risk management or weather policies.
Sporting organisations should also consider implementing a sun protection policy to protect participants, officials and spectators from the harmful effects of UV radiation and provide a sporting environment that supports sun safety awareness and practices.
Every sport is different, and each will have a different risk profile based on the potential impact of heat or hazardous air quality on participants. Unique factors of sport include variables such as the level of exertion, the length of competition or whether activity occurs indoors or outdoors.
Further to any policy is the need to reinforce that each individual is different and will be impacted by heat and hazardous air differently and at different levels.
It is recommended that additional advice is given to participants concerning their responsibilities to follow any additional guidelines or medical advice in relation to any personal risk factors. This includes any decision made by carers on behalf of vulnerable people and children who have additional personal risk factors.
While there are links to a number of expert resources on this webpage that you can turn to for more information, sporting organisations should consult with their National or State Sporting Organisations and/or associations in the first instance for more information as they may already have policies in place. Further, sporting organisations should seek out specialist advice from human health experts when developing their heat and hazardous air policies.
UV Exposure, Heat Illness and Extreme Heat
The ultraviolet (UV) radiation levels from the sun are high enough to damage unprotected skin most months of the year in NSW and reach Extreme (11+) levels across most of the country during summer. UV radiation is present not only on sunny days but also when it’s cool and cloudy. When outdoor sports participants don’t protect their skin from UV exposure they are at immediate risk of sunburn and also risk permanent skin damage, eye damage and skin cancer.
The Australian Institute of Sport: Sun Safe Sports position statement introduced in December 2023, aims to reduce the risks of skin cancer in sport. It was jointly developed by the Australian Institute of Sport, Cancer Council, Paddle Australia, the Australian Radiation Protection and Nuclear Safety Agency and Melanoma Institute Australia. The goal of the position statement is to assist sporting organisations to recognise the inherent risk of UV radiation exposure in their sport and provide guidance on how to implement sun safe practices. It should not be interpreted as a guideline for clinical practice or legal standard.
| Sport | Evidence
| References |
| All sports | Athletes are at greater risk of skin cancer than non-athletes due to high cumulative exposure throughout their lives and inadequate use of sun protection. The risk increases again for competitive and professional athletes. Coaches, support staff and volunteers can also be over-exposed to UV. | Harrison SC, Bergfeld WF. Ultraviolet light and skin cancer in athletes. Sports Health. 2009; 1(4):335-340.
Downs NJ, Axelsen T, Schouten P, Igoe DP, Parisi AV, Vanos J. Biologically effective solar ultraviolet exposures and the potential skin cancer risk for individual gold medallists of the 2020 Tokyo Summer Olympic Games. Temperature. 2020; 7(1):89-108.
Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007; 31(3):230-234.
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Athletics Little Athletics | Outdoor runners have an increased risk of skin cancer. | Duarte AF, Nagore E, Silva JNM, Picoto A, Pereira AC, Correia OJC. Sun protection behaviour and skin cancer literacy among outdoor runners. Eur J Dermatol. 2018 Dec 1;28(6):803-808. |
| Water Sports Wind surfing, Sailing | The incidence of skin cancer is particularly high among participants in outdoor water sports. UV can penetrate 50 cm into the water and also reflects back from the water surface increasing exposure to unprotected skin. | Climstein M, Doyle B, Stapelberg M, et al. Point prevalence of non-melanoma and melanoma skin cancers in Australian surfers and swimmers in Southeast Queensland and Northern New South Wales. PeerJ. 2022; 10:e13243.
Moehrle M. Outdoor sports and skin cancer. Clin Dermatol. 2008; 26(1):12-15. |
| Surfing | The incidence of skin cancer is particularly high among participants in outdoor water sports. UV can penetrate 50 cm into the water and also reflects back from the water surface increasing exposure to unprotected skin. One study has found that the prevalence of melanoma was 76 times higher in surfers and swimmers compared to the general population. The more time in the sun without protection the higher the risk, especially during peak UV index times. Competitive surfers in Australia have been found to have twice the exposure to solar UV that that experienced by recreational surfers. Queensland research found that 69% of young adult participants in hockey, tennis, soccer and surf sports experienced sunburn in the previous season. | Climstein M, Furness J, Hing W, Walsh J. Lifetime prevalence of non-melanoma and melanoma skin cancer in Australian recreational and competitive surfers. Photodermatol Photoimmunol Photomed. 2016; 32(4):207-213.
Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007; 31(3):230-234.
Climstein M, Doyle B, Stapelberg M, et al. Point prevalence of non-melanoma and melanoma skin cancers in Australian surfers and swimmers in Southeast Queensland and Northern New South Wales. PeerJ. 2022; 10:e13243.
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| Swimming | One study has found that the prevalence of melanoma was 76 times higher in surfers and swimmers compared to the general population. High profile tennis athletes Bernadette Wallace OLY, Cate Campbell OLY and Sam Short and coach Jackie Byrnes have spoken about their own experiences on melanoma. The more time in the sun without protection the higher the risk, especially during peak UV index times. | Climstein M, Doyle B, Stapelberg M, et al. Point prevalence of non-melanoma and melanoma skin cancers in Australian surfers and swimmers in Southeast Queensland and Northern New South Wales. PeerJ. 2022; 10:e13243. |
| Skiing | A study in Switzerland found skiers to have an increased risk in Squamous Cell Carcinomas. | Rosso S, Joris F, Zanetti R. Risk of Basal and Squamous Cell Carcinomas of the Skin in Sion, Switzerland: A Case-control Study. Tumori. 1999; 85(6):435-442.
Rigel EG, Lebwohl MG, Rigel AC, Rigel DS. Ultraviolet radiation in alpine skiing: magnitude of exposure and importance of regular protection. AMA Arch Derm. 2003; 139(1):60-62.
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| Mountain climbing | Skin cancer and pre-cancerous skin lesions have been found to be higher in mountain climbers. This is because of altitude and the UV reflectivity of snow. | Moehrle M. Outdoor sports and skin cancer. Clin Dermatol. 2008; 26(1):12-15. |
| Tennis | Tennis players are exposed to high UV especially in the summer. Australian Open players have been found to be exposed to extreme UV i.e. up to nine-times the safe daily dose. | Igoe DP, Amar A, Schouten P, Parisi AV, Turner J. Assessment of biologically effective solar ultraviolet exposures for court staff and competitors during a major Australian tennis tournament. Photochem Photobiol. 2019; 95(6):1461-1467.
Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007; 31(3):230-234.
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| Triathlon | In one Ironman triathlon world championship athletes were found to be exposed to at least 6.9 times the safe daily limit of UV solar exposure in a single hour of cycle and run legs of the race.
| Moehrle M. Ultraviolet exposure in the Ironman triathlon. Med Sci Sports Exerc. 2001; 33(8):1385-1386.
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| Golf | Playing gold has been associated with significant levels of sun exposure and skin cancer. | Scott, N., Matthews, A., Acton, R., Watson, M., Glover, D., & Murray, A. (2023). A Scoping Review of Golf and Skin Health. International Journal of Golf Science, Volum 11(1).
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| Hockey | Queensland research found that 69% of young adult participants in hockey, tennis, soccer and surf sports experienced sunburn in the previous season. | Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007; 31(3):230-234.
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| Soccer | Queensland research found that 69% of young adult participants in hockey, tennis, soccer and surf sports experienced sunburn in the previous season. | Lawler S, Spathonis K, Eakin E, Gallois C, Leslie E, Owen N. Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health. 2007; 31(3):230-234.
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| Cycling | One study has shown that professional cyclists can be exposed to significantly high levels of UV. | Moehrle M, Heinrich L, Schmid A, Garbe C. Extreme UV exposure of professional cyclists. Dermatology. 2000;201(1):44-5. |
These guidelines assist athletes, officials, coaches, parents, volunteers, staff, sports trainers and spectators to ensure a balanced approach to ultraviolet (UV) radiation exposure to reduce the health risks associated with overexposure (such as permanent skin damage, eye damage and skin cancer) and maintain adequate vitamin D levels protect participants from heat-related illness and injury create your own guidelines that are flexible, achievable and relevant to your sport or activity, which in turn may help to increase participation and improve performance.
Further advice on developing and implementing a best-practice sun protection policy can be found on the Cancer Council NSW website.
Sports Medicine Australia (SMA) has developed resources to ensure a balanced approach to manage risks caused by UV radiation exposure and extreme heat for sports participants This policy is intended for sporting administrators, coaches and sports medical teams responsible for the safety and wellbeing of people engaging in sport.
It provides evidence-based guidance for protecting the health of those participating in sport and physical activity from the potentially ill effects of extreme heat in the summer, while ensuring that play is not unnecessarily interrupted.
Sports Medicine Australia is a peak national multi-disciplinary member organisation that provides leadership in the areas of sports exercise and medicine, sports injury, physical activity, sports exercise and science, and the healthy performance and participation of Australians in physical activity and sport. SMA is widely acknowledged internationally as a leading multi-disciplinary sports medicine body.
Sporting organisations can use the free SunSmart app to plan, prepare and reduce risk to participants when the UV levels are 3 and above (level that can damage skin and eyes). The SunSmart app uses forecast information from the Bureau of Meteorology (BOM) and live UV data from the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) to provide daily sun protection times for more than 600 locations across Australia.
The SunSmart app is available to download on the App Store and Google Play store.
Current Air Quality in NSW
Outdoor air can become polluted by a number of sources, including the combustion processes from motor vehicles, solid fuel burning and industry. Other pollution sources include smoke from bushfires, windblown dust, and biogenic emissions from vegetation such as pollen or mould spores.
Air quality in New South Wales is usually very good by international standards. However, with the impact of climate change on our environment, it is acknowledged by the NSW Government that the risk and dangers of bushfires are increasing. As seen in the 2019-20 bushfire season, in addition to property damage and human and animal life destroyed by fire, bushfire smoke can have a significant impact on human health.
In NSW, air quality monitoring is undertaken by the Department of Planning and Environment. Visit their website for the latest Air Quality Categories data which is updated hourly and daily across NSW. Follow the Air Quality Category colours and use the activity guide to protect health.
During hazard reduction burn season please monitor Fires Near Me by the NSW Rural Fire Service for the location of Hazard Reduction Burns. Visit the website below or download the Fires Near Me app for your smartphone device from iOS App Store or Google Play stores.
Hazardous Air Health Advice
Hazardous air quality, including that caused by bushfire smoke, has a significant impact on human health. In a sporting or recreational environment, during exercise, respiratory rate and volume increase, which increases the total airway exposure to pollutants. It is important to modify behaviour and activities when air quality is poor.
As some people are more sensitive to air pollution than others, it is vital that individuals monitor both the recommendations from sport as well as any additional recommendations or medical advice related to their own risk factors in regard to Hazardous Air and participation in sport.
Sensitive groups include people with heart or lung condition including asthma, people over the age of 65, infants and children, and pregnant women.
The NSW Government has developed a Health Activity Guide with recommendations for sensitive groups for each air quality category as well as general advice on actions you can take to protect yourself and your health at each colour category.
The Healthy Activity guide was developed to assist sensitive groups and the general public to follow recommended actions based on the current based on threshold values for air pollutants’ concentrations and visibility data. This provides advice in relation to air quality category of good, fair, poor, very poor and extremely poor including when it is recommended to stay indoors and reduce or avoid physical activity.
NSW Health has developed a suite of information, fact sheets and resources regarding bushfire smoke and minimising health impacts.
Developed by a team of leading Australian researchers specialising in environmental health, the AirRater app is designed to help people with asthma, hay fever of other lung conditions to better manage their symptoms.
The app is available to download from both the iOS App Store and Google Play app store for smartphones
Developed by SMA to provide quick general advice about heat risks for participants of sport based on the type of activity being undertaken and the temperature at the location based on postcode.