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Community child health, public health and epidemiology
The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India
  1. K S Agarwal1,
  2. M Z Mughal2,
  3. P Upadhyay3,
  4. J L Berry4,
  5. E B Mawer4,
  6. J M Puliyel1
  1. 1Department of Paediatrics and Neonatology, Saint Stephen's Hospital, Delhi, India
  2. 2Department of Paediatric Medicine, Saint Mary's Hospital for Women and Children, Manchester, UK
  3. 3Centre for Science Education and Communication, University of Delhi, Delhi, India
  4. 4University Department of Medicine, Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to:
    Dr J M Puliyel, Department of Paediatrics, St Stephen's Hospital, Tis Hazari, Delhi, India 110054;
    puliyel{at}vsnl.com

Abstract

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.

  • vitamin D
  • atmospheric pollution
  • ultraviolet B radiation
  • ALP, alkaline phosphatase
  • PTH, parathyroid hormone
  • UVB, ultraviolet B

https://doi.org/10.1136/adc.87.2.111

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