Absence of vitamin D deficiency among common outdoor workers in Delhi

Abstract

Background There is reservation about accepting the notion of widespread vitamin D deficiency (VDD) in sunny countries because information base is largely urban indoors, and the cut‐off serum 25(OH)D > 75.0 nmol/L to define sufficiency is perceived as high. Objective We assessed the vitamin D status of subjects engaged in six types of outdoor jobs with freedom to seek shade, when needed. Design Descriptive observational study. Subjects and methods A total of 573 outdoors, (hawkers, n = 144; auto‐rickshaw drivers, n = 113; manual rickshaw pullers, n = 49; fuel‐station attendants, n = 84; gardeners, n = 96; traffic police personnel, n = 87) were assessed for serum 25(OH)D, iPTH and total calcium during summer and winter. Bank employees were indoor controls (n = 72). Serum 25(OH)D was defined as sufficient if ≥50.0 nmol/L and deficient when <30.0 nmol/L, as per ‘Institute of Medicine’. Results Mean serum 25(OH)D of 573 outdoors was 44.8 ± 19.6 nmol/L and showed a physiological inverse relation with iPTH (P < 0.001). 77.5% of the outdoors did not have VDD. Hawkers, gardeners, fuel‐station attendants and rickshaw pullers had sufficient or near sufficient serum 25(OH)D. The mean serum 25(OH)D (30.6 ± 23.2 nmol/L) of indoors though lower by 12.7 nmol/L than outdoors was above the cut‐off of VDD. Proportions with supranormal iPTH were comparable between outdoors and indoors (14.0% vs 20.8%). Despite winter dip, the mean serum 25(OH)D (31.2 ± 14.3 nmol/l) of outdoors was not deficient. Conclusions Vitamin D deficiency is not universal. Most urban outdoor workers do not have VDD.

Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study

“… State/ union territories Case/million Death/million Total no. of healthy subjects Mean 25(OH)D levels (ng/ml) References Andhra Pradesh 5530 50 1936 18 [32] , [33] , [34] , [35] , [36] Assam 2390 6 768 26 [37] , [38] , [39] Bihar 940 4 50 30 [40] Chandigarh 1830 27 878 34 [41] , [42] , [43] , [44] , [45] , [46] Delhi 8970 249 2919 15 [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] Goa 7520 64 …”

Vitamin D Perspective in Front Line Healthcare Workers Amid COVID-19

“…Another interesting finding was that females were comparatively less deficient than males, contrary to the expected element of more covered clothing [27], [31], lesser outdoor time [32] and consequently lesser exposure to sunlight [32], [33].…”

“…Low sun exposure was identified as another major risk factor for hypovitaminosis D. With availability of near to ample sunlight throughout the year in the country, the heliophobic tendency of South Asian culture [34], sun avoidance behavior [35], fear of tanning [34], indoor working hours [32], lack of deliberate sun exposure [32] and covered clothing [27], [31] could account for the high prevalence of Vitamin D deficiency in Pakistan.…”

Absence of Vitamin D Deficiency Among Outdoor Workers With Type 2 Diabetes Mellitus in Southern West Bengal, India

“…Several studies from India and abroad have shown widely prevalent vitamin D deficiency in patients with T2DM [3,9,10]. On the other hand, various studies have shown that outdoor workers have adequate sunlight exposure, and most of them usually have sufficient serum 25(OH)D levels [14,16,17]. The present study was carried out to assess the vitamin D status of outdoor workers with T2DM -an area where there is a dearth of data not only from India but also globally.…”

“…From an Indian perspective, this assumes special significance as about 75% of its total labor force is engaged in outdoor work, including farming and construction activity [15]. There are two studies from North India that looked at outdoor workers in New Delhi and found a considerably low prevalence of vitamin D deficiency [16,17]. A small study from South India also found normal serum 25(OH)D levels in outdoor laborers and fishermen from Thiruvananthapuram [18].…”