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Correspondence to: Fleta Bray, MD, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave, RMSB, Room 2023-A, Miami, FL 33136
they have received widespread publicity leading to legislative and marketing changes. In 2019, Key West, Florida, followed Hawaii in banning sunscreens containing oxybenzone and octinoxate. Sunscreen brands have responded by implementing “reef safe” labeling.
This study aimed to determine what proportion of sunscreens labeled as “reef safe” met the legislative ban and NOAA criteria. A secondary aim was to determine whether “reef safe” sunscreens cost more than regular sunscreens.
We conducted an online search of the largest online retailer, Amazon, in June 2019 to identify the most popular sunscreens and included all those with at least 150 reviews. We separated these by whether they did and did not make a claim to be “reef safe”. We analyzed and recorded the price-per-ounce cost and ingredients of each product. Products with zinc oxide or titanium dioxide were considered to contain nanoparticles unless otherwise stated. Data were analyzed using SPSS 25.0 software (IBM Corp, Armonk, NY).
We evaluated 97 products, with 52 (54%) labeled as “reef safe”. The 52 products marketed as “reef safe” were analyzed to determine whether the labeling reflected NOAA and legislative criteria. Fig 1 outlines the percentage of sunscreens labeled as “reef safe” and the proportion of compliant products. Table I lists the cost of each sunscreen type.
Table ICost of sunscreen according to labeling and compliance with various “reef safe” standards
Average cost (95% CI) in dollars/oz
Products labeled as “reef safe”
Products not labeled as “reef safe”
Products free of oxybenzone and octinoxate
Products contain oxybenzone and/or octinoxate
Products meet NOAA criteria
Products do not meet NOAA criteria
CI, Confidence interval; NOAA, The National Oceanic and Atmospheric Administration.
Representative products were obtained from a single distributor, and the number of reviews was used as a proxy for popularity; both are limitations of this study. Many labels failed to specify the size of zinc or titanium dioxide particles. We considered these as nanoparticles. This could have caused underestimation of NOAA compliance.
A proportion of the “reef safe”–labeled sunscreens do not meet legislative (4%) or NOAA (48%) criteria. In theory, the label should help consumers select safe products. However, the current United States Food and Drug Administration sunscreen labeling regulation lacks a formal “reef safe” definition, allowing companies to meet standards of “truthful and non-misleading” labeling without providing evidence.
Clearly, defining “reef safe” could resolve this issue.
Our study suggests “reef safe” sunscreen— whether defined by label, legislative standards, or NOAA criteria—may be more expensive than regular sunscreen. This substantiates concerns that sunscreen bans may create an increased economic burden that disproportionately affects individuals of lower socioeconomic status.
Although efforts to preserve reefs and improve sunscreen safety should not be ignored, the existing literature provides insufficient evidence to conclude that these sunscreen ingredients threaten reef safety.
Future research efforts should clarify the impact of these sunscreen ingredients under authentic reef conditions and sunscreen concentrations. In the meantime, it is important for legislators to consider the public health impact of sunscreen bans.
Toxicological effects of the sunscreen UV filter, benzophenone-2, on planulae and in vitro cells of the coral, Stylophora pistillata.