Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies

Abstract

Background Air particulate matter (PM) is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether PM is associated with loss of bone mineral density (BMD) and risk of bone fractures is undetermined. Methods We conducted two complementary studies of: (i) long-term PM <2.5 μm (PM2.5) levels and osteoporosis-related fracture hospital admissions among 9.2 million Medicare enrollees of the Northeast/Mid-Atlantic United States between 2003–2010; (ii) long-term black carbon [BC] and PM2.5 levels, serum calcium homeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin D), and annualized BMD reduction over a 8-year follow-up of 692 middle-aged (46.7±12.3 yrs), low-income BACH/Bone cohort participants. Findings In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2.5 levels (Risk ratio [RR] 1.041, 95% Confidence Interval [CI], 1.030, 1.051). This risk was particularly high among low-income communities (RR 1.076; 95% CI, 1.052, 1.100). In the longitudinal BACH/Bone study, baseline BC and PM2.5 levels were associated with lower serum PTH (Estimate for baseline one interquartile increase in 1-year average BC= −1.16, 95% CI −1.93, −0.38; Estimate for baseline one interquartile increase in 1-year average PM2.5= −7.39; 95%CI −14.17, −0.61). BC level was associated with higher BMD loss over time at multiple anatomical sites, including femoral neck (−0.08%/year per one interquartile increase; 95% CI −0.14, −0.02%/year) and ultradistal radius (−0.06%/year per one interquartile increase; 95% CI −0.12, −0.01%/year). Interpretation Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities.

An association between air pollution and daily most frequently visits of eighteen outpatient diseases in an industrial city

“…Air pollution caused oxidative damage and inflammation and resulted in the cytotoxic responses in the body [72][73][74][75][76] . Air pollution was found to cause inflammation, leading to accelerated bone loss and increased risk of bone fracture and osteoporosis 77 . Exposure to air pollution is associated with oxidative damage to DNA and lipids in humans 78 .…”

Association of Ambient and Household Air Pollution With Bone Mineral Content Among Adults in Peri-urban South India

“…A longitudinal design might have increased our statistical power and precision of the estimates. 10 Second, we relied on selfreported primary fuel use measured by questionnaires, which likely resulted in exposure misclassification that may have biased our estimates toward the null. We did not have data on the lifetime history of household biomass fuel use.…”

“…Evidence evaluating the association between PM and skeletal health is limited. 9 Some studies 10,11 have observed associations between PM and lower bone mineral density (BMD), increased BMD loss, or increased risk of osteoporotic fracture. However, other studies have study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies.…”

Calidad del aire e incidencia de fractura osteoporótica de cadera en Chile

“…Annual average of concentrations of (MP 2,5 ) in μg/m 3 2.5 and excessive loss of longitudinal bone. They also found that the population of areas with a higher concentration of PM 2.5 have a higher risk of suffering an osteoporotic fracture 6 .…”