Background: Vitamin D plays a critical role in bone mineralization and musculoskeletal health. In regions such as Hail, Saudi Arabia, factors like sun exposure habits, clothing practices, and lifestyle may influence vitamin D levels and fracture risks. This study investigates the association between vitamin D levels, sun exposure patterns, and fracture characteristics among residents in the Hail region. Methods: A cross-sectional study was conducted among 2,951 residents of the Hail region. Participants completed a structured questionnaire covering fracture history, sun exposure frequency and duration, clothing coverage, and vitamin D testing and levels. Among them, 1,342 individuals reported a history of bone fractures confirmed by X-ray. Descriptive statistics and chi-square tests were used to assess associations between variables using SPSS version 28, with significance set at p < 0.05. Results: Out of 2,951 participants, 45.5% reported a history of confirmed bone fractures. The majority occurred between ages 6–10 years (30.0%), with falls being the most common cause (70.0%). Upper extremities were the most frequently fractured site (40.1%). Most participants with fractures had limited sun exposure; 65.1% for less than 10 minutes per day, and only 15.0% had daily exposure. Full body coverage was reported by 45.0%. Among those with fractures, 55.0% had never tested their vitamin D levels, and 66.7% of those tested had low levels (20–40 ng/mL). Morning sun exposure correlated significantly with normal vitamin D levels (75.0%), while full-body coverage and midday/sunset exposure were associated with deficiency (p < 0.001). Participants with normal vitamin D levels experienced fractures primarily between ages 6–10 and more than six years ago, while those with low vitamin D had broader and more recent fracture histories. Low vitamin D levels were significantly linked to lower limb fractures and falls, whereas normal levels correlated with upper limb and exercise-related fractures. Conclusion: This study highlights a significant association between low vitamin D levels and recent, lower extremity fractures in the Hail population, especially among individuals with poor sun exposure and full-body clothing. Routine vitamin D testing and public awareness campaigns promoting early morning sun exposure and bone health education are recommended to reduce fracture risk in the region. Keywords Vitamin D deficiency, bone fractures, sun exposure, Saudi Arabia, orthopedic health, Hail region
Alhirabi et al. (Wed,) studied this question.