56 cases of rickets uncovered

12:17am Monday 29th October 2007

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By Camilla Sutcliffe »

VITAMIN supplements are being introduced in Blackburn with Darwen after 56 cases of rickets have been revealed.

The amount of people afflicted with the vitamin D deficiency, which causes bone softening in very young children and was linked to poverty in the 1930s, was discovered in a study commissioned by East Lancashire Primary Care Trust.

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Blackburn with Darwen PCT is now set to introduce free vitamin D supplements for all young children and pregnant women in early 2008, bringing it into line with other areas across East Lancashire.

At the moment, only a minority of PCTs give out free supplements, but almost all health visitors recommend them to Asian families.

Almost all the 56 cases found between 2003 and 2005 were in Blackburn with Darwen's South Asian community.

Just 14 cases were found in the Burnley, Pendle and Rossendale area, where supplements are provided.

Experts said vitamin D, which is unique in being produced primarily by exposure to sunlight, was a relatively common deficiency among Asian immigrants, because of their darker skin, and Islam's requirements for clothing to cover limbs.

Until about 10 years ago, Government policy required that all health authorities gave out vitamin supplements to people from the Indian subcontinent, but then it was decided that it was no longer necessary.

Blackburn with Darwen's PCT, along with many around the country, stopped giving them out, but the practice continued in Burnley, Pendle and Rossendale.

Dr Ellis Friedman, director of public health for East Lancashire PCT, said: "Burnley, Pendle and Rossendale was unusual in continuing with it, but it led to a natural experiment.

"When my directorate looked to see what had happened to the incidence of rickets, we found it was four times higher in Blackburn and Darwen. We cannot of course be absolutely certain why, but it seems very likely that it is because of the vitamin policy."

Dr Friedman said the problem was linked to cultural factors, not deprivation.

He said: "Once you exclude a number of vary rare cases where there is some other underlying condition, virtually every case is someone from the Asian community.

"It is caused by a combination of skin colouration, diet and dress, not poverty. We don't, for example, find rickets in deprived white communities."

Dr Friedman said that some other areas of the country had similar findings.

But he said: "It is something we had thought would be a disease of the past, but what we are finding now is very early-stage cases identified before symptoms appear.

"Introducing the supplements is expected to mean a great improvement."

A spokesman for Blackburn with Darwen PCT said the problem had not been identified before the study was undertaken, which is why supplements had previously not been introduced.

He said: "This has been brought to attention by our clinicians and we are now working with them to get maximum impact in terms of how we deliver the service.

"We will have universal coverage for all young children and ante-natal, introduced at the beginning of next year.

"The PCT is committed to providing the best quality healthcare to all our population and as part of that we recognise that giving vitamin D supplements will provide better health and specifically address rickets.

"To that end, we have already agreed to invest in vitamin D."

But Councillor Roy Davies, chairman of Blackburn with Darwen Council's health scrutiny committee, said Asian women should think about the health risks of covering up, particularly during pregnancy.

He said: "The Asian community must take this on board. We want people to live longer and more healthily.

"It is up to the Asian councillors and the Imams to get the message through, because it will be most effective coming from them."

He added that the PCT should do as much as it could to campaign for healthier lifestyles and prevent people becoming ill.