The measurement index goes from 0 to 5, with 0 being the worst and 5 being the best. Labels and certification
Over 50 ecolabels on tourism exist. These include (but are not limited to):

Austrian Ecolabel for Tourism
Asian Ecotourism Standard for Accommodations (AESA)
Eco-certification Malta
EarthCheck Australia
Ecotourism Australia
Ecotourism Ireland
Ecotourism Kenya
European Ecotourism Labelling Standard (EETLS)
Korean Ecotourism Standard

Guidelines and education
An environmental protection strategy must address the issue of ecotourists removed from the cause-and-effect of their actions on the environment. More initiatives should be carried out to improve their awareness, sensitize them to environmental issues, and care about the places they visit.Tour guides are an obvious and direct medium to communicate awareness. With the confidence of ecotourists and intimate knowledge of the environment, tour guides can actively discuss conservation issues. Informing ecotourists about how their actions on the trip can negatively impact their environment and the local people. A tour guide training program in Costa Ricas Tortuguero National Park has helped mitigate negative environmental impacts by providing information and regulating tourists on the parks beaches used by nesting endangered sea turtles. Small scale, slow growth and local control
The underdevelopment theory of tourism describes a new form of imperialism by multinational corporations that control ecotourism resources. These corporations finance and profit from the development of large scale ecotourism that causes excessive environmental degradation, loss of traditional culture and way of life, and exploitation of local labor.
Fibromatosis colli (FMC), also termed sternocleidomastoid tumor of infancy, pseudotumor of infancy, and infancy sternocleidomastoid pseudotumor, is an uncommon (incidence: 0.4%-1.3% of live births), congenital tumor in one of the two sternocleidomastoid neck muscles although rare cases have presented with a FMC tumor in both sternocleidomastoid muscles. A tumor is here defined as a growth of tissue that is not coordinated with the normal surrounding tissue and persists in growing even if the original trigger for its growth is removed. FMC tumors are benign growths that may cause disfigurements but are not cancers and do not metastasize (i.e. spread) to distant tissues.As judged by microscopic cytology analyses, fibromatosis colli tumors consist of spindle-shaped fibroblasts (i.e. the most common cell type in connective tissue) located in a background of collagen fibers, decomposing skeletal muscle fibers, and, in some cases, regenerating skeletal muscle fibers. The fibroblasts have a completely normal appearance with no evidence suggesting that they are malignant. The World Health Organization, 2020, classified fibromatosis colli as in the category of benign fibroblastic and myofibroblastic tumors.In the majority of cases, FMC tumors decrease in size and completely resolve by the newborns second year. If left untreated, however, a significant percentage of cases progress to, and are the most frequent cause of, congenital muscular torticollis, i.e. an abnormal, asymmetrical head or neck position commonly called wry neck. Untreated FMC tumors may also progress to facial asymmetry, plagiocephaly (i.e. flattened head), permanent loss of neck mobility, scoliosis (i.e.