The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency

Hoseinzadeh, Edris; Taha, Parisa; Wei, Chiang; Godini, Hamid Reza; Ashraf, Ghulam Md; Taghavi, Mahmoud; Miri, Mohammad

doi:10.1016/j.fct.2018.01.052

Cited by 68 publications

(62 citation statements)

References 83 publications

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“…Air pollution has been reported as a significant factor in the etiology of VD deficiency in children, which adds further complexity to the analysis of the differential impact of SR and PM2.5 on bronchiolitis incidence. PM2.5 pollutants can absorb or scatter solar radiation in the troposphere, and reports show that urban areas affected by air pollution have significantly reduced UV radiation reaching the surface . Thus, the risk of VD deficiency associated with low SR is heightened in strongly polluted regions.…”

Section: Discussionmentioning

confidence: 99%

“…PM2.5 pollutants can absorb or scatter solar radiation in the troposphere, and reports show that urban areas affected by air pollution have significantly reduced UV radiation reaching the surface. 41 Thus, the risk of VD deficiency associated with low SR is heightened in strongly polluted regions. The association between residential firewood and/or coal-based heating with bronchiolitis hospitalizations confirms the strong impact of ambient air pollution on bronchiolitis.…”

Section: Discussionmentioning

confidence: 99%

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Solar radiation, air pollution, and bronchiolitis hospitalizations in Chile: An ecological study

Terrazas

Castro-Rodriguez

Camargo

et al. 2019

Pediatric Pulmonology

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Objective To evaluate trends and geographic distribution of infant bronchiolitis hospitalizations in Chile, a country with large variation in solar radiation (SR) and high rates of urban air pollution. Methods We performed a nationwide ecological study of bronchiolitis hospitalizations from 2001 to 2014. We investigated the associations of regional SR (a proxy of vitamin D status) and regional fine particulate matter (PM2.5) air pollution with bronchiolitis hospitalizations. We also evaluated the role of sociodemographic factors, including regional poverty, education, indigenous population, and rurality rates. Results During the study period, 119 479 infants were hospitalized for bronchiolitis in Chile; 59% were boys. The mean bronchiolitis hospitalization rate increased from 29 to 41 per 1000 infants per year (P = .02). There was an inverse correlation between regional SR and incidence of hospital admissions for bronchiolitis (r = −0.52, P = .049), accounting for 27% of these hospitalizations. There was also a significant direct correlation between regional ambient PM2.5 and bronchiolitis hospitalizations (R = 0.68, P = .006), accounting for 42% of the variation in admission rate. High firewood and/or coal residential use for heating, high regional poverty, lower years of education, and high rurality rates were also significantly correlated with bronchiolitis hospitalization rates. None of the environmental or sociodemographic factors evaluated were correlated with regional case fatality rates or length of stay at the hospital. Conclusions This ecological study revealed significant associations between regional SR, air pollution, and sociodemographic factors with infant bronchiolitis hospitalizations in Chile, suggesting that these factors play a major role in the incidence and severity of respiratory infections in early childhood.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Solar radiation, air pollution, and bronchiolitis hospitalizations in Chile: An ecological study

Terrazas

Castro-Rodriguez

Camargo

et al. 2019

Pediatric Pulmonology

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“…30 Environmental factors are seasonal change, latitude, time of day, altitude and air pollution. [32][33][34] Behavioral factors are calcium intake and physical activity. [32][33][34] Behavioral factors are calcium intake and physical activity.…”

Section: Discussionmentioning

confidence: 99%

“…30,31 Personal factors include skin pigmentation, race, age and BMI. [32][33][34] Behavioral factors are calcium intake and physical activity. 35 Studies by Chailurkit et al 14 and others, 9,28 including our study, showed lower serum levels in females, which may be attributable to less sun exposure, less outdoor activity and more sun-protective behavior.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D status in Thai dermatologists and working‐age Thai population

Rajatanavin

Kanokrungsee

Aekplakorn

2018

The Journal of Dermatology

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This study aimed to determine the prevalence of vitamin D insufficiency among Thai dermatologists compared with the general working‐age population in Bangkok. A cross‐sectional study was conducted in healthy Thai physicians who had at least 1 years’ experience in dermatology practise and a subsample of the general Thai population from the Fourth National Health Survey. Serum 25‐hydroxyvitamin D (25[OH]D), a combination of 25(OH)D2 and 25(OH)D3, levels in both groups were measured using liquid chromatography coupled with mass spectrometry. The majority of dermatologists were of Fitzpatrick skin type III (n = 61, 61.3%) or IV (n = 32, 33.3%). The mean serum 25(OH)D and 25(OH)D3 levels were 18.9 and 18.2 ng/mL, respectively, whereas the corresponding levels in the general population were 26.5 and 25.8 ng/mL. None of the dermatologist had serum 25(OH)D sufficiency (>30 ng/mL), 38 (38.78%) had vitamin D insufficiency (20–30 ng/mL) and 60 (61.22%) had vitamin D deficiency (<20 ng/mL). The frequency of vitamin D deficiency in dermatologists was significantly higher than in the general population (61.2% vs 19.2%, P < 0.001). Ninety percent of dermatologists used sunscreen daily and spent time mostly indoors. Dermatologists used physical sun‐protection more than half of the time when outdoors, for example, a book or paper as a sunshade (70.3%), an umbrella (48.4%), a long‐sleeved shirt (20.4%) or a hat (9.7%). In conclusion, dermatologists showed a remarkably high prevalence of vitamin D deficiency which may be due to inadequate exposure to sunlight, regular use of sunscreen and practicing various sun‐protection activities.

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“…Clinical Severe cases associated with pneumonia Inverse correlation for CAP [68,69] Increased production of pro-inflammatory cytokines such as IL-6 Inverse correlation [70,71] Increased CRP Inverse correlation [72,73] Increased risk of sepsis Inverse correlation [74,75] Risk of ARDS Inverse correlation [76,77] Risk of heart failure Inverse correlation [78,79] Risk of diabetes mellitus Inverse correlation [67,80] Epidemiological Began in December 2019 in China, spread mainly to northern midlatitude countries Low 25(OH)D values in winter [48,81] Males have higher incidence and much higher CFRs than females Smoking reduces 25(OH)D [82] CFR increases with age Chronic disease rates increase with age; vitamin D plays a role in reducing risk of chronic diseases [83] Higher CFR for diabetics Diabetics may have lower 25(OH)D [84] Higher CFR for diabetics Lower 25(OH)D associated with increased risk of incidence [85] Higher CFR for hypertension Lower 25(OH)D may be associated with increased risk of incidence [86] Higher CFR for cardiovascular disease Lower 25(OH)D associated with increased risk of incidence and death [87] Higher CFR for chronic respiratory disease For COPD patients, 25(OH)D inversely correlated with risk, severity, and exacerbation [88] Found at higher rates in regions with elevated air pollution Air pollution associated with lower 25(OH)D concentrations [89] Note: 25-hydroxyvitamin D ((25(OH)D); acute respiratory distress syndrome (ARDS); community-acquired pneumonia (CAP); case-fatality rate (CFR); interleukin 6 (IL-6); chronic obstructive pulmonary disease (COPD); C-reactive protein (CRP); vitamin D deficiency (VDD). Table 3 lists some findings for vitamin D supplementation in reducing the clinical effects of COVID-19 infection found from treating other diseases.…”

Section: Characteristics Relation To 25(oh)d Referencementioning

confidence: 99%

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

et al. 2020

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The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D 3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D 3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

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The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency

Cited by 68 publications

References 83 publications

Solar radiation, air pollution, and bronchiolitis hospitalizations in Chile: An ecological study

Solar radiation, air pollution, and bronchiolitis hospitalizations in Chile: An ecological study

Vitamin D status in Thai dermatologists and working‐age Thai population

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

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