ORIGINAL ARTICLE

The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India

K S Agarwal¹, M Z Mughal², P Upadhyay³, J L Berry⁴, E B Mawer⁴, J M Puliyel¹

¹ Department of Paediatrics and Neonatology, Saint Stephen's Hospital, Delhi, India
² Department of Paediatric Medicine, Saint Mary's Hospital for Women and Children, Manchester, UK
³ Centre for Science Education and Communication, University of Delhi, Delhi, India
⁴ University Department of Medicine, Manchester Royal Infirmary, Manchester, UK

Correspondence to:
Correspondence to:
Dr J M Puliyel, Department of Paediatrics, St Stephen's Hospital, Tis Hazari, Delhi, India 110054;
puliyel{at}vsnl.com

Aims: To compare the vitamin D status of 34 children, 9–24 months old, living in an area of Delhi renowned for high levels of atmospheric pollution (Mori Gate), with a comparable age matched group of children from a less polluted (Gurgaon) area of the city.

Methods: Serum concentrations of calcium, alkaline phosphatase (ALP), parathyroid hormone (PTH), 25-hydroxyvitamin D (25(OH)D), and 1,25-dihydroxyvitamin D (1,25(OH)₂D) were measured. Haze scores, regarded as a surrogate marker of solar UVB radiation reaching ground level, were measured in both areas.

Results: Mean 25(OH)D of children in the Mori Gate area was 12.4 (7) ng/ml, compared with 27.1 (7) ng/ml in children living in the Gurgaon area (p < 0.001). The median ALP (p < 0.05) and mean PTH (p < 0.001) concentrations were higher in children living in the Mori Gate area than in the Gurgaon area. The mean haze score in the Mori Gate area (2.1 (0.5)) was significantly lower (p < 0.05) than in the Gurgaon area (2.7 (0.4)), indicating less solar UVB reaching the ground in Mori Gate.

Conclusion: We suggest that children living in areas of high atmospheric pollution are at risk of developing vitamin D deficiency rickets and should be offered vitamin D supplements.

Keywords: vitamin D; atmospheric pollution; ultraviolet B radiation

Abbreviations: ALP, alkaline phosphatase; PTH, parathyroid hormone; UVB, ultraviolet B

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