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U of T study links increase in U.K. rickets to drop in sunshine

Photo of a cloudy UK
Hospitalizations of U.K. children due to rickets began dramatically increasing starting in the mid-1990s. A U of T study found the timing fit with weather that saw increasing cloud cover and decreasing hours of sunshine (photo by Andrew Foster via Flickr)

A University of Toronto student and professor have teamed up to discover that Britain鈥檚 increasing cloudiness during the summer could be an important reason for the mysterious increase in rickets among British children over the past few decades. 

Hospitalizations of children due to the disabling bone disease, caused by lack of vitamin D, began dramatically increasing starting in the mid-1990s, puzzling public health experts.  Some have pointed to changing immigration patterns, since people with darker skin absorb less vitamin D from the sun. Others are looking at shifting diets or changes in hospital admission policies. But Haris Majeed, a master鈥檚 student in medical imaging at U of T鈥檚 Faculty of Medicine, wondered if long-term climate variability in sea surface temperatures played a role.

With a bachelor鈥檚 in earth sciences, mathematics, and biology, a master鈥檚 in geophysics, and an interest in public health, Majeed was in a unique position to connect the dots between shifting climate patterns and population health. So he worked with his old thesis supervisor, Kent (G.W.K. ) Moore, an associate professor in the department of physics in the Faculty of Arts & Science, to compare Britain鈥檚 cloud cover against the rise of rickets.  

鈥淪ea surface temperatures are getting warmer over the North Atlantic, and are known to fluctuate every 60 to 80 years,鈥 says Majeed. 鈥淎fter the mid-1990s, North Atlantic sea surface temperatures entered a warm phase, decreasing average summer atmospheric pressures and causing more rain, and less sunshine, in the U.K.鈥

They found that median incidences of rickets, which had been declining since the 1960s, almost doubled between 1997 and 2011, going from 0.56 cases per 100,000 British children to 1.01 cases. In the U.K., health experts have determined that six hours a month of sunshine is needed to produce enough vitamin D in people鈥檚 skin. But since the mid-1990s, increasing cloud cover has deprived the islands of about four hours of sunshine per month in the summer. Since the mid-1990s, the U.K. has received only an average of 183 hours of sunshine per summer month. 

鈥淣obody thought of the sun,鈥 says Majeed, who is completing a master鈥檚 in diagnostic imaging, and hopes to work with big data in the emerging field of time series analysis. 鈥淐limatologists knew that the U.K. receives lower summer sunshine than other parts of the world, but no one ever thought of the effect it had on specific health implications, such as rickets.鈥

The results of their research were published on Nov. 17  . 

The duo studied Britain because it has the longest record of rickets, extending back to the 1960s.

Majeed鈥檚 interest in combining two seemingly disparate factors comes from his own personal life. 鈥淢y mother has rheumatoid arthritis, which led  me to rickets. Perhaps if we鈥檙e able to understand this condition based on long-term climate variability, can we as scientists save at least a few children from becoming disabled.鈥 

Majeed鈥檚 unusually broad academic background has taught him that physicians and scientists should collaborate more on interdisciplinary research and take a more holistic approach to disease mechanisms. 

鈥淭hey should step back and broaden their scope of question,鈥 he says. 鈥淣ot just focus on what we can do in terms of treatment options, although it is important, but also consider the roots. Rickets comes from lack of sun so ask what鈥檚 going on with the variability in climate around us? Take a broader view of the research question, and then you can dig in.鈥

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