{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:43:50Z","timestamp":1780505030592,"version":"3.54.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mid and South Essex Hospitals Charity"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The role of Vitamin D in immune function is well reported with a growing evidence base linking low levels to poorer outcomes from infectious disease. Vitamin D deficiency and insufficiency are prevalent worldwide with healthcare workers identified as a known at-risk group. Here we aim to investigate serum Vitamin D levels in a UK population of front line healthcare workers and to promote the occupational risk.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study of 639 volunteers was conducted to identify the prevalence of Vitamin D deficiency and insufficiency amongst a population of front-line health care workers in the UK. Participant demographics and co-morbid factors were collected at the time of serum sampling for multivariate analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Only 18.8% of the population had a normal vitamin D level greater than or equal to 75nmol\/L. This is compared to Public Health England\u2019s (PHE) stipulated normal levels of 60% during winter. 81.2% had a level less than 75nmol\/L, with 51.2% less than 50nmol\/L and 6.6% less than 25nmol\/L. For serum levels less than 25nmol\/L, Asian ethnicity was more likely to have a vitamin D deficiency than non-asian (OR (95%CI): 3.81 (1.73-8.39), p = 0.001), whereas white ethnicity was less likely to have a vitamin D deficiency compared to non-white (OR (95%CI: 0.43 (0.20-0.83), p = 0.03). Other factors that contributed to a higher likelihood of lower-than-normal levels within this population included male sex, decreased age and not taking supplementation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>It is concluded that our population of healthcare workers have higher rates of abnormal vitamin D levels in comparison with the general UK population reported prevalence. Furthermore, Asian ethnicity and age 30 years and below are more at risk of vitamin D insufficiency and deficiency. This highlights an occupational risk factor for the healthcare community to consider.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0296247","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T17:27:10Z","timestamp":1713288430000},"page":"e0296247","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Vital D: A modifiable occupational risk factor of UK healthcare workers"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1848-3982","authenticated-orcid":true,"given":"James","family":"Phelan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angukumar","family":"Thangamuthu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasagam","family":"Muthumeenal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsteen","family":"Houston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Everton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathyanarayana","family":"Gowda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jufen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0145-9377","authenticated-orcid":true,"given":"Rengarajan","family":"Subramanian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"pone.0296247.ref001","doi-asserted-by":"crossref","first-page":"3693","DOI":"10.1111\/febs.15495","article-title":"Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study","volume":"287","author":"E Merzon","year":"2020","journal-title":"The FEBS journal"},{"key":"pone.0296247.ref002","first-page":"1","article-title":"The Correlation between Serum Level of Vitamin D and Outcome of Sepsis Patients; a Cross-Sectional Study","volume":"7","author":"M Shojaei","year":"2019","journal-title":"Archives of Academic Emergency Medicine"},{"key":"pone.0296247.ref003","first-page":"29242924","article-title":"Vitamin D Deficiency: An Underestimated Factor in Sepsis?","volume":"2424","author":"C Delrue","year":"2023","journal-title":"International Journal of Molecular Sciences"},{"key":"pone.0296247.ref004","doi-asserted-by":"crossref","first-page":"491S","DOI":"10.1093\/ajcn\/88.2.491S","article-title":"From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health","volume":"88","author":"AW Norman","year":"2008","journal-title":"The American Journal of Clinical Nutrition"},{"key":"pone.0296247.ref005","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/ajim.10108","article-title":"Historical risks of tuberculin skin test conversion among non-physician staff at a large urban hospital","volume":"42","author":"AK Miller","year":"2002","journal-title":"American Journal of Industrial Medicine"},{"key":"pone.0296247.ref006","doi-asserted-by":"crossref","first-page":"e0242589","DOI":"10.1371\/journal.pone.0242589","article-title":"Initial estimates of COVID-19 infections in hospital workers in the United States during the first wave of pandemic","volume":"15","author":"JA Razzak","year":"2020","journal-title":"PLOS ONE"},{"key":"pone.0296247.ref007","first-page":"226","article-title":"Occupational respiratory infections","volume":"16","author":"A Trajman","year":"2010","journal-title":"Current Opinion in Pulmonary Medicine"},{"key":"pone.0296247.ref008","doi-asserted-by":"crossref","first-page":"e35797","DOI":"10.1371\/journal.pone.0035797","article-title":"Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review","volume":"7","author":"K Tran","year":"2012","journal-title":"PLOS ONE"},{"key":"pone.0296247.ref009","author":"B Beverley","year":"2022","journal-title":"National Diet and Nutrition Survey Rolling programme Years 9 to 11 (2016\/2017 to 2018\/2019)\u2014A survey carried out on behalf of Public Health England and the Food Standards Agency"},{"key":"pone.0296247.ref010","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1007\/s40618-020-01265-x","article-title":"Monthly fluctuations in 25-hydroxy-vitamin D levels in day and rotating night shift hospital workers","volume":"43","author":"S Rizza","year":"2020","journal-title":"Journal of endocrinological investigation"},{"key":"pone.0296247.ref011","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1002\/jmv.26031","article-title":"The value of clinical parameters in predicting the severity of COVID-19","volume":"92","author":"W Shang","year":"2020","journal-title":"Journal of medical virology"},{"key":"pone.0296247.ref012","doi-asserted-by":"crossref","first-page":"e3517","DOI":"10.1002\/dmrr.3517","article-title":"The effect of vitamin D supplementation on mortality and intensive care unit admission of COVID-19 patients. A systematic review, meta-analysis and meta-regression","volume":"38","author":"N Tentolouris","year":"2022","journal-title":"Diabetes\/Metabolism Research and Reviews"},{"key":"pone.0296247.ref013","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s40618-021-01614-4","article-title":"Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis","volume":"45","author":"R Pal","year":"2022","journal-title":"Journal of Endocrinological Investigation"},{"key":"pone.0296247.ref014","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1136\/emermed-2021-211973","article-title":"Severe vitamin D deficiency in patients admitted to the emergency department with severe sepsis is associated with an increased 90-day mortality","volume":"40","author":"S Malinverni","year":"2023","journal-title":"Emergency Medicine Journal"},{"key":"pone.0296247.ref015","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-017-4436-z","article-title":"Vitamin D levels and deficiency with different occupations: a systematic review","volume":"17","author":"D Sowah","year":"2017","journal-title":"BMC public health"},{"key":"pone.0296247.ref016","first-page":"1952","volume":"94","author":"GM McQuillan","year":"2011","journal-title":"Racial and Ethnic Differences in the Seroprevalence of 6 Infectious Diseases in the United States: Data From NHANES III, 1988\u20131994"},{"key":"pone.0296247.ref017","first-page":"1251","volume":"91","author":"JH Richardus","year":"2011","journal-title":"Black\u2013White Differences in Infectious Disease Mortality in the United States"},{"key":"pone.0296247.ref018","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1007\/s40520-020-01677-y","article-title":"Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients","volume":"32","author":"A Daneshkhah","year":"2020","journal-title":"Aging clinical and experimental research"},{"key":"pone.0296247.ref019","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.aucc.2018.02.005","article-title":"A systematic review on risk factors associated with sepsis in patients admitted to intensive care units","volume":"32","author":"M Fathi","year":"2019","journal-title":"Australian Critical Care"},{"key":"pone.0296247.ref020","first-page":"1","article-title":"Integrated cytokine and metabolite analysis reveals immunometabolic reprogramming in COVID-19 patients with therapeutic implications","volume":"12","author":"N Xiao","year":"2021","journal-title":"Nature Communications 2021 12:1"},{"key":"pone.0296247.ref021","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"E von Elm","year":"2007","journal-title":"BMJ"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T17:27:29Z","timestamp":1713288449000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296247"}},"subtitle":[],"editor":[{"given":"Nasser Hadal","family":"Alotaibi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0296247","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}