Bad Break: Osteoporosis-Related Bone Fractures Linked to Air Pollution

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Exposure to air pollution is associated with osteoporosis-related loss of bone mineral density and risk of bone fractures, according to a new study by researchers at Columbia University’s Mailman School of Public Health. Their findings are published in The Lancet Planetary Health.

The researchers are the first to document high rates of hospital admissions for bone fractures in communities with elevated levels of ambient particulate matter (PM2.5), a component of air pollution, with risk of bone fracture admissions greatest in low-income communities. The findings, from a study of osteoporosis-related fracture hospital admissions among 9.2 million Medicare enrollees in the Northeast/Mid-Atlantic between 2003-2010, suggest that even a small increase in PM2.5 concentrations would lead to an increase in bone fractures in older adults.

A concurrent analysis of eight years of follow-up among 692 middle-aged, low-income adults in the Boston Area Community Health/Bone Survey cohort found that participants living in areas with higher levels of PM2.5 and black carbon, a component of air pollution from automotive emissions, had lower levels of parathyroid hormone, a key calcium and bone-related hormone, and greater decreases in bone mineral density than those exposed to lower levels of these pollutants.

Osteoporosis, the most common reason for a broken bone among the elderly, is a disease in which bones become brittle and weak as the body loses more bone mass than it can rebuild. There are an estimated 2 million osteoporosis-related bone fractures in the U.S. each year, resulting in as much as $20 billion in annual direct health costs. Typically, no symptoms are present prior to a break, which often happens spontaneously or from something as harmless as a hug. In the year after an older adult has a bone fracture, risk for death increases by as much as 20 percent, and only 40 percent of those who had fractures regain their independence.

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