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Vitamin D study (VITALS): Initial findings

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Despite Scientific Advisory Committee on Nutrition guidelines, approximately one in six adults has vitamin D deficiency in the UK. Current NICE recommendations state vitamin D concentrations lower than 50nmol/l impact bone health. NICE advises adults to consider taking a daily supplement containing 400 international units (IU) of vitamin D, particularly in the autumn and winter months, and for adults with risk factors, they recommend a daily supplement containing 400 IU of vitamin D throughout the year.

It is recognised that the ambulance workforce is routinely exposed to occupational risk factors for vitamin D deficiency. A previous EEAST service evaluation highlighted clear scope for improvement for staff vitamin D awareness and risk of deficiency. The main aim of VITALS was to explore the incidence of vitamin D deficiency across the EEAST workforce to inform relevant wellbeing initiatives and future research.

During October-December 2022, a total of 405 vitamin D finger-prick blood tests were obtained from EEAST employees across the Trust (and including Emergency and Urgent Care, Emergency Operations Centres, Support Services and Resilience roles), in accordance with manufacturer's guidance (www.vitamindtest.org.uk). Demographic, employment, lifestyle, and vitamin D status information was collated from each participant and analysed using descriptive statistics.

  • A convenience sample of 397 finger-prick blood tests was obtained. Eight samples had to be excluded due to insufficient blood being provided or the participant taking vitamin D supplementation on the day of testing.
  •  The study sample blood vitamin D range was 10.3-139.5nmol/l.
  •   Almost half (46%; n=182) of participants sampled had insufficient blood vitamin D levels (i.e., vitamin D level less than 50nmol/l), with 6% (n=23) being deficient (i.e., vitamin D level less than 25nmol/l).
  •   A previous diagnosis of vitamin D insufficiency or deficiency was self-reported by 15% (n=59) of participants.
  •   Characteristics associated with increased occurrence of vitamin D insufficiency were under 25 years, ethnicity other than ‘White British’, white/fair and light or pale white skin type, Emergency Operations Centre employment and smoker/ex-smoker.
  •   Characteristics associated with increased occurrence of vitamin D deficiency were vegetarian or vegan dietary lifestyle, ethnicity other than ‘White British’, ex-smoker, 10-14 years of ambulance service employment and menopause/andropause.
  •   Vitamin D supplementation appeared to have a protective effect against deficiency: for participants taking vitamin D supplementation, less than a quarter (23%, n=15) had either insufficient or deficient levels of vitamin D.

 

The study team received positive comments from participants about the opportunity to undertake vitamin D testing.

“Thanks for this! I can’t say I’m surprised ! Very close to being deficient again so I’m going to get some more prescription vit D before I go back to being deficient! Thanks so much for this.”

‘‘…Tbh I thought the vD test would be a waste of time. I could not of been any more wrong. I was so shocked at my result… Time to start taking [vitamin D supplements].’’

Almost half of EEAST staff who volunteered to receive a blood vitamin D test were found to have vitamin D insufficiency or deficiency. It was noted there were trends for certain demographic, lifestyle and employment characteristics associated with vitamin D insufficiency and deficiency; however, it was beyond the scope of this study to explore them in further detail. The VITALS findings are now being prepared for publication and dissemination to key professional groups and organisations.

EEAST Charitable Funds allowed procurement of 400 vitamin D test kits for use in the VITALS study, with laboratory analysis completed by Black Country Pathology Services.

NEWS!! EEAST Research is now in receipt of a College of Paramedics Small Grant Award to explore behaviours and lifestyle factors impacting vitamin D levels in ambulance staff. This study, EVOLVED, will commence in Summer 2023 and involve interviewing 40 VITALS participants with or without vitamin D insufficiency/deficiency.

Published 15th May 2023