Sun Protective Clothing: A Cross-Sectional Analysis of Online Availability

Abstract

Skin cancer is the most common cancer in the UK and Ireland, with the number of non-melanoma and melanoma skin cancer diagnoses in the UK expected to rise by 39% [1] and 9% [2] by 2040, respectively. The World Health Organisation (WHO) advocates for the use of photoprotective clothing including wide-brimmed hats, tightly woven clothing, and wraparound style sunglasses that provide 100% ultraviolet-A (UV-A) and ultraviolet-B (UV-B) protection to combat the deleterious effects of UV radiation and increasing skin cancer rates [3]. The photoprotective standard of clothing is often measured as the ultraviolet photoprotective factor (UPF). UPF measures skin erythema at various UV radiation doses, and is analogous to the SPF of sunscreen [4]. UPF is defined as the ratio of the average effective UV irradiance calculated for unprotected skin, to the average effective UV irradiance calculated for skin protected by a given fabric [5]. The European Committee for Standardisation (CEN) has developed a standard on requirements for test methods and labelling of sun-protective garments. UV protective clothing for which compliance with this standard is claimed must have a UPF of greater than 40 (UPF 40+) and must maintain an average UVA transmittance of less than 5% [6]. We aimed to investigate the frequency of UPF-rated photoprotective clothing sold online by the United Kingdom's largest retailers.

The UK's top 30 retailers based on annual revenue generated were identified for the year 2023–2024 [7]. Each online retailer's website was searched for “UPF clothing” and “UPF” between September and December 2024 (Table 1). Seven online retailers were excluded as they did not sell clothing; the remaining 23 retailers were included for analysis in this study. Of the 23 remaining stores, 35% (8/23) sold UPF-rated clothing online. Three retailers sold UV protective clothing for men, women, and children, while this photoprotective clothing was less widely available on the remaining 5 retailer's online catalogues. Of the stores that did have UPF-rated clothing, 50% (4/8) had fewer than 15 UPF-graded items for sale; 25% (2/8) had over 200 UPF-graded items on their website. All UPF-rated clothing identified from these retailers websites were rated UPF 40+ or above, thereby complying with the CEN's guidance on UV protective clothing. The stores that had a selection of UPF-rated clothing on their website included Amazon, H&M, John Lewis, JD Sports, NEXT, House of Fraser, Screwfix and Very. The vast majority of UPF rated clothing identified were activewear and children's swimwear; there was a scarcity of “every day” casual clothing with a UPF rating.

Our online search of UPF-rated garments revealed that this photoprotective clothing is not readily available, with only 35% of the UK's largest online retailers stocking UPF-rated clothing. The poor availability of UPF-graded clothing may be partially attributed to the time of year in which we conducted our online search, months of the year that typically receive less sunshine. Furthermore, UPF-rated clothing may incur extra production costs that limit its availability; the cost of UPF testing, the cost of photoprotective fabrics, and costs associated with quality control measures in the production of photoprotective fabrics [8]. Prior head-to-head studies of UV protective clothing to sunscreen have indicated that clothing should be considered the cornerstone of UV protection [9]. Public health campaigns may provide a potential solution to target this public health concern, placing emphasis on UPF-rated clothing as an essential photoprotective measure. Furthermore, a role also exists for government intervention where the promotion of photoprotective practices and skin cancer prevention is concerned, a role which has already been realised in both the UK and Ireland with the implementation of a Skin Cancer Prevention Strategy and Action Plan (2011–21) by the Department of Health, Social Services, and Public Safety in Northern Ireland, and a Skin Cancer Prevention Plan by the National Cancer Control Programme (NCCP) in Ireland [10, 11].

Nicola Kearney: conceptualisation, methods, writing–original draft. Mary Laing: writing–review and editing subsequent drafts, supervision.

Not applicable.

The authors declare no conflicts of interest.