Dutch beach restaurants add sunscreen shots to their menu in fight against cancer | Netherlands

Zand Katwijk doesn’t just serve food and drinks – this beach restaurant also offers “shots” of sun protection.

It is one of 160 restaurants in the Netherlands taking part in a new sunburn prevention program. The small, humid and windy country may not be known for its tropical climate, but the Netherlands has one of the highest diagnosis rates for melanoma, the deadliest form of skin cancer, in Europe.

“They studied different types of cancer and where they are most common and came to the conclusion that there is more skin cancer in places like Katwijk than average,” says Dirk Schipper, who runs the company in the fourth generation of his family. “People come here to enjoy the sun, sea and sand… but a lot has changed in our 94 years.”

Lately, customers sometimes ask for a squirt of sunscreen. When a health insurance company produced 100,000 promotional “shots” of SPF 30 in June, Schipper ordered three boxes and sold the 30 ml bottles at cost price of €2.99. “People called it a lifesaver,” he said. “We have a temperate maritime climate, so the wind often cools, but at the same time the sun's rays are very strong. You can get sunburnt without realizing it. Offering this should be as normal as a napkin.”

According to the Netherlands Cancer Organisation (IKNL), one in five people in the Netherlands will develop some form of skin cancer in their lifetime. It is the most common form, accounting for 52% of all cancer cases and is increasing faster than the population ages. This is causing concern among charities such as the Dutch Cancer Society (KWF), the Dutch authorities and the insurers who cover the costs.

More and more Dutch people are not of dying from skin cancer – probably due to good diagnosis and treatment – but costs are rising. The health insurer behind the program, Zilveren Kruis, believes that 95% of cases could be prevented with proper sun protection.

Healthcare in the Netherlands is provided by compulsory health insurance provided by private companies. The state regulates what a “basic health insurance” must include. Zilveren Kruis is one of the largest providers.

Local authorities, sports clubs and schools have also installed sunscreen dispensers in public places such as beaches and parks to encourage use, but new research suggests that restaurant terraces are a particularly popular destination for sunburn.

At Zand Katwijk, 71-year-old customer Petra Hoogeveen from Leiden said both her mother and son had skin cancer. “People who live in warmer countries like Spain try to avoid the sun, but we don't do that: we seek the sun,” she said. “I don't really go out in the sun because it's too hot for me… but I don't use sunscreen either.”

Dagje Den Haag in The Hague has ordered 100 tubes. Owner Rogier Soetekouw said his employees are encouraged to wear hats and sunscreen. “It's logical to take it to the beach, but you also need it in the city,” he said.

Dermatologist Dr. Daniel Kadouch and founder of Tenue Soleil, a UV clothing manufacturer that developed the sunscreen for the campaign, said: “I think it's a combination of the UV index, which has gone up over the last 10, 20 years, but it also has a lot to do with lifestyle. We try to teach people that sun protection is a combination of measures: staying out of the sun during peak sun hours, trying to cover as much skin as possible with clothing… including a hat and sunglasses, and then applying and reapplying an SPF of 30 or higher on the rest of the exposed skin.”

“The American Skin Cancer Foundation is clear about the link between sunburn and skin cancer: If you have five or more sunburns, especially in childhood, [this] doubles your risk. A study by Maastricht University on the psychology of sun protection found that a third of people still get sunburned.”

Dr Arjan van Dijk, a researcher at the RIVM, a public health institute, who advised the Ministry of Health on an awareness campaign on skin cancer, said that while the exact causes were difficult to determine, the number of cases was increasing due to the ageing population, which suffers from skin damage throughout their lives.

“The problem starts with the fact that the Dutch are lucky to have an increasing life expectancy: this is the main cause of the skin cancer trend,” he said. “We are similar to the Danes and Scots: [many people] have a relatively light skin type, which puts you at a disadvantage in this respect. And the Dutch love the sun, so in the spring we all run outside and expose ourselves to the sun!”

According to Prof. Peter Jan Margry, a cultural historian at the University of Amsterdam, a history of bad weather is one reason for societal behavior around the sun. “The Dutch always feel like they miss the sun because the sky is so cloudy, it's always raining and we never close our curtains,” he said. “I lived in Rome and everyone keeps their shutters and curtains closed to keep the sun out – but the Dutch want the light inside because there is so little sun.”

But as climate change brings warmer weather, heatwaves and drought, some believe a cultural shift is needed. “We're not saying sunbathing or holiday behaviour is to blame,” said van Dijk, “but the advice we give to change behaviour is the only steering wheel we have to turn this oil tanker years in advance.”