Vitamin D status and COVID-19 prevention in a worker subgroup in Italy
Francesca Ubaldi, Enrico Montanari, Lory Marika Margarucci, Claudio Caprara, Gianluca Gianfranceschi, Elena Scaramucci, Antonio Piccolella, Federica Valeriani, Vincenzo Romano Spica
Work, doi:10.3233/wor-220387
BACKGROUND: Low levels of vitamin D are widespread in the world's population and associated with sun exposure, genetics, and lifestyles. Office workers in different occupational sectors seem more vulnerable than others. Scientific evidence reports a contribution of vitamin D in resistance to infections, opening to supplementation as a preventive action against pathogens, including SARS-CoV-2. OBJECTIVE: A pilot campaign in the workplace during the coronavirus 2019 (COVID-19) pandemic was conducted based on the preliminary measurement of vitamin D amount and its integration. METHODS: A preventive action to contrast the deficiency of vitamin D was offered to a population of 700 bank employees. Vitamin D supplementation was performed between April and June 2021, on workers (n = 139) and showed 25(OH)D serum levels ≤ 30 ng/ml. Demographic, anthropometric and lifestyle information were collected by survey and changes in the serum 25(OH)D amounts were monitored.
RESULTS: The adherence of the target population to the prevention campaign was 21%. 75% of the enrolled workers had low levels of vitamin D. After the intervention, serum vitamin D levels increased (1.28-fold; p = 0.0001) and 80% of the subjects reported optimal values > 30 ng/ml. Only 2.9% reported slight flu-like symptoms, but only 0.7% was confirmed as COVID-19, with respect to a ten-fold higher incidence in the general population. CONCLUSIONS: Vitamin D supplementation can be achieved by simple and noninvasive approaches and can bring along further insights into health literacy on diet and lifestyles, representing an opportunity to protect the population by the widespread state of vitamin deficiency.
References
Adams, Clemens, Parrish, Holick, Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects, N Engl J Med
Aguiar, Andronis, Pallan, Högler, Frew, Preventing vitamin D deficiency (VDD): a systematic review of economic evaluations, Eur J Public Health
Andrade, Grandoff, Schneider, Vitamin D Intake and Factors Associated With Self-Reported Vitamin D Deficiency Among US Adults: A 2021 Cross-Sectional Study, Front Nutr
Autier, Boniol, Pizot, Mullie, Vitamin D status and ill health: a systematic review, Lancet Diabetes Endocrinol
Azizi, Pavlotsky, Vered, Kudish, Occupational exposure to solar UVB and seasonal monitoring of serum levels of 25-hydroxy vitamin D3: a casecontrol study, Photochem Photobiol
Bikle, Vitamin D metabolism, mechanism of action, and clinical applications, Chem Biol
Bischoff-Ferrari, Giovannucci, Willett, Dietrich, Hughes, Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes, Am J Clin Nutr
Cashman, Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing, Calcif Tissue Int
Cesareo, Attanasio, Caputo, Castello, Chiodini et al., Italian Association of Clinical Endocrinologists (AME) and Italian Chapter of the American Association of Clinical Endocrinologists (AACE) Position Statement: Clinical Management of Vitamin D Deficiency in Adults, Nutrients
Chalcraft, Cardinal, Wechsler, Vitamin D Synthesis Following a Single Bout of Sun Exposure in Older and Younger Men and Women, Nutrients
Charoenngam, Holick, Immunologic Effects of Vitamin D on Human Health and Disease, Nutrients
Charoenngam, Holick, Immunologic effects of vitamin D on human health and disease, Nutrients
Choi, Oh, Choi, Choi, Kim et al., Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008, J Clin Endocrinol Metab
Christakos, Dhawan, Verstuyf, Verlinden, Carmeliet, Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects, Physiological Reviews
Coppeta, Papa, Magrini, Are Shiftwork and Indoor Work Related to D3 Vitamin Deficiency? A Systematic Review of Current Evidences, J Environ Public Health
D'ecclesiis, Gavioli, Martinoli, Raimondi, Chiocca et al., Vitamin D and SARS-CoV2 infection, severity and mortality: A systematic review and metaanalysis, PLoS One
Daneshkhah, Agrawal, Eshein, Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients, Aging Clin Exp Res
Descatha, Fadel, Sembajwe, Peters, Using the COVID-19 Job Exposure Matrix for Essential Workplace Preparedness, J Occup Environ Med
Devgun, Paterson, Martin, Seasonal changes in the activity of serum alkaline phosphatase, Enzyme
Divakar, Sathish, Soljak, Bajpai, Dunleavy et al., Prevalence of Vitamin D Deficiency and Its Associated Work-Related Factors among Indoor Workers in a Multi-Ethnic Southeast Asian Country, Int J Environ Res Public Health
Doyle, Dearin, Mcgirr, Vitamin D deficiency and segregation status in prisoners, Int J Prison Health
Fiedler, Sanghvi, Saunders, A review of the micronutrient intervention cost literature: program design and policy lessons. The International journal of health planning and management
Fiorino, Gallo, Zippi, Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy, Aging Clin Exp Res
Grant, Anouti, Boucher, Dursun, Gezen-Ak, A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health, Nutrients
Grant, Garland, Holick, Comparisons of estimated economic burdens due to insufficient solar ultraviolet irradiance and vitamin D and excess solar UV irradiance for the United States, Photochem Photobiol
Griffin, Hewison, Hopkin, Kenny, Quinton et al., Vitamin D and COVID-19: evidence and recommendations for supplementation, R Soc Open Sci
Harrison, Oliver, Kashi, Carswell, Edwards et al., Influence of Vitamin D Supplementation by Simulated Sunlight or Oral D3 on Respiratory Infection during Military Training, Med Sci Sports Exerc
Harvey, Cooper, Vitamin D: Some perspective please, BMJ
Hengel, Burdorf, Pronk, Schlünssen, Stokholm et al., Exposure to a SARS-CoV-2 infection at work: development of an international job exposure matrix (COVID-19-JEM), Scand J Work Environ Health
Holick, High prevalence of vitamin D inadequacy and implications for health, Mayo Clin Proc
Holick, The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention, Rev. Endocr. Metab. Disord
Islam, Shamim, Kemi, Nevanlinna, Akhtaruzzaman et al., Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh, Br J Nutr
Istiany, Rahman, Kasim, Chee, Yassin et al., Effect of nutrition education and sun exposure on vitamin D status among postmenopausal Malay women, Int. J. Sci. Eng. Investig
Itoh, Weng, Saito, Ogawa, Nakayama et al., Association between night-shift work and serum 25-hydroxyvitamin D levels, Ind Health
Janoušek, Pilařová, Macáková, Nomura, Veiga-Matos, Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites, Crit Rev Clin Lab Sci
Jastrzębska, Skalska, Radzimiński, López-Sánchez, Weiss et al., Changes of 25(OH)D Concentration, Bone Resorption Markers and Physical Performance as an Effect of Sun Exposure, Supplementation of Vitamin D and Lockdown among Young Soccer Players during a One-Year Training Season, Nutrients
Jeong, Hong, Heo, Chun, Kim et al., Vitamin D status and associated occupational factors in Korean wage workers: data from the 5 th Korea national health and nutrition examination survey (KNHANES 2010-2012), Ann Occup Environ Med
Karonova, Chernikova, Golovatyuk, Bykova, Grant et al., Vitamin D Intake May Reduce SARS-CoV-2 Infection Morbidity in Health Care Workers, Nutrients
Kawashima, Hiraiwa, Ishizuka, Kawai, Hoshino et al., Comparison of vitamin D sufficiency between indoor and outdoor elite male collegiate athletes, Nagoya J Med Sci
Klenk, Rapp, Denkinger, Seasonality of vitamin D status in older people in Southern Germany: implications for assessment, Age and Ageing
Kumar, Rathi, Haq, Wimalawansa, Sharma, Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19, Virus Res
Kwon, Son, Kim, Chae, Kim et al., Association between serum vitamin D and depressive symptoms among female workers in the manufacturing industry, Ann Occup Environ Med
Lansdown, Cowan, Nioi, Cowie, Wendelboe-Nelson et al., Vitamin D and UV exposure in construction workers-a randomized control trial using text messaging to promote positive behaviours, J Public Health (Oxf)
Levis, Gomez, Jimenez, Vitamin D deficiency and seasonal variation in an adult south Florida population, Journal of Clinical Endocrinology and Metabolism
Lippi, Ferrari, Targher, Is COVID-19 lockdown associated with vitamin D deficiency?, Eur J Public Health
Lips, Vitamin D to prevent acute respiratory infections, Lancet Diabetes Endocrinol
Lips, Worldwide status of vitamin D nutrition, J Steroid Biochem Mol Biol
Mandal, Baktash, Hosack, Missouris, Vitamin D status and COVID-19 in older adults, Aging Clin Exp Res
Manferdelli, Torre, Codella, Outdoor physical activity bears multiple benefits to health and society, J Sports Med Phys Fitness
Maratos-Flier, Obesity, None, Williams Textbook of Endocrinology
Margarucci, Montanari, Gianfranceschi, Caprara, Valeriani et al., The role of vitamin D in prevention OF COVID-19 and its severity: an umbrella review, Acta Biomed
Maxwell, Seasonal variation in vitamin D, Proceedings of the Nutrition Society
Medicines, Drugs in Note: cholecalciferol, cholecalciferol / calcium salts, calcifediol
O'connor, Evans, Ivlev, Rushkin, Thomas et al., Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force, JAMA
Parsons, Gifford, Stacey, Lamb, Shea et al., Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence, BMJ Mil Health
Pludowski, Holick, Grant, Konstantynowicz, Mascarenhas et al., Vitamin D supplementation guidelines, J Steroid Biochem Mol Biol
Rizzoli, Vitamin D supplementation: upper limit for safety revisited?, Aging Clin Exp Res
Romano, Vigna, Belluigi, Conti, Barberi et al., Shift work and serum 25-OH vitamin D status among factory workers in Northern Italy: Crosssectional study, Chronobiol Int
Roomi, Farooq, Ullah, Lone, Hypovitaminosis D and its association with lifestyle factors, Pak J Med Sci
Serrano, Cañada, Moreno, Gurrea, Solar ultraviolet doses and vitamin D in a northern mid-latitude, Sci. Total Environ
Sowah, Fan, Dennett, Hagtvedt, Straube, Vitamin D levels and deficiency with different occupations: a systematic review, BMC Public Health
Suka, Shimazaki, Yamauchi, Yanagisawa, Increased Health Risk in Office Workers in the COVID-19 Era: Comparison of One-Year Incidence of Health Problems Before and During the COVID-19 Pandemic, J Occup Environ Med
Turrubiates-Hernández, Sánchez-Zuno, González-Estevez, Hernández-Bello, Macedo-Ojeda et al., Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: An ally for LatinAmerica (Review), Int. J. Mol. Med
Verdoia, Schaffer, Barbieri, Giovine, Marino et al., Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease, Nutr Metab Cardiovasc Dis
Vierucci, Pistoia, Fanos, Erba, Saggese, Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents, Ital J Pediatr
Villasis-Keever, López-Alarcón, Miranda-Novales, Zurita-Cruz, Barrada-Vázquez et al., Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial, Arch Med Res
Volpe, Marchant, A Golden Opportunity: Prevention in the Workplace, High Blood Press Cardiovasc Prev
Vu, Whiteman, Van Der Pols, Kimlin, Neale, Serum vitamin D levels in office workers in a subtropical climate, Photochem Photobiol
Vuichard Gysin, Dao, Gysin, Effect of vitamin D3 supplementation on respiratory tract infections in healthy individuals: a systematic review and meta-analysis of randomized controlled trials, PLoS ONE
Wang, Hung, Lin, Chang, Wu, Age, Gender and Season Are Good Predictors of Vitamin D Status Independent of Body Mass Index in Office Workers in a Subtropical Region, Nutrients
Yan, Zhang, Cheng, Wang, Qin, Gender Differences in Vitamin D Status in China, Med Sci Monit
Zhang, Poon, Wong, Li, Guo et al., Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Front Endocrinol
