Sex and race disparities in the association between work characteristics and vitamin D deficiency: findings from the National Health and Nutrition Examination Survey, 2005-2010.

ABSTRACT

OBJECTIVES: Vitamin D deficiency is highly prevalent worldwide; however, few large population-based studies have examined occupational risk factors. We examined associations between shift work, work schedule, hours worked, outdoor work, occupation and serum 25-hydroxyvitamin D (25(OH)D) levels in the US working population. METHODS: This cross-sectional study included 8601 workers from the 2005-2010 National Health and Nutrition Examination Survey (NHANES) cycles. NHANES occupational data were supplemented with measures of outdoor work from the Occupational Information Network. Serum 25(OH)D concentration in nanomoles per litre (nmol/L) was categorised as sufficient (≥75), insufficient (50-<75), moderately deficient (30-<50) and severely deficient (<30). Age-adjusted weighted multinomial and binary logistic regression were used to examine associations between work-related factors and vitamin D status with sex-race/ethnicity stratification. RESULTS: Shift workers had higher odds of severe vitamin D deficiency compared with day workers (OR 1.64, 95% CI 1.22 to 2.19). Compared with those in white-collar occupations, those in natural resources were less likely to be deficient (OR 0.31, 95% CI 0.19 to 0.52), while those in production were more likely to be deficient (OR 2.25, 95% CI 1.48 to 3.43). Women working ≥40 hours/week compared with <40 hours/week were more likely to be moderately deficient (OR 1.30, 95% CI 1.06 to 1.59). Black women working in sales were more likely to be deficient than those in management (OR 1.53, 95% CI 1.03 to 2.27). Mexican American men working nights had the highest odds of deficiency (OR 2.64, 95% CI 1.38 to 5.06). CONCLUSIONS: Work-related factors were associated with vitamin D status and there were race/ethnicity and sex differences. Targeted vitamin D screening and supplementation interventions may reduce these disparities.