Short-term association between outdoor air pollution and osteoporotic hip fracture

• Published in: Osteoporosis international Vol. 29; no. 10; pp. 2231 - 2241
• Main Authors: Mazzucchelli, R., Crespi Villarias, N., Perez Fernandez, E., Durban Reguera, M. L., Garcia-Vadillo, A., Quiros, F. J., Guzon, O., Rodriguez Caravaca, G., Gil de Miguel, A.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.10.2018; Springer Nature B.V
• Subjects: Age; Aged; Aged, 80 and over; Air pollution; Air Pollution - adverse effects; Air Pollution - analysis; Endocrinology; Environmental Exposure - adverse effects; Environmental Exposure - analysis; Environmental Monitoring - methods; Female; Fractures; Health risk assessment; Hip; Hip Fractures - epidemiology; Hip Fractures - etiology; Hospitalization - statistics & numerical data; Humans; Incidence; Male; Medicine; Medicine & Public Health; Middle Aged; Nitrogen dioxide; Nitrogen Dioxide - adverse effects; Nitrogen Dioxide - analysis; Original Article; Orthopedics; Osteoporosis; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Particulate matter; Particulate Matter - adverse effects; Pollutants; Pollution; Retrospective Studies; Rheumatology; Short term; Spain - epidemiology; Sulfur dioxide; Sulfur Dioxide - adverse effects; Sulfur Dioxide - analysis; Weather; Spain; Weather; Osteoporosis; Climate variables; Hip fracture; Seasonality; Air pollution; Spain
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-018-4605-7

Summary This study examines the association of the levels of different airborne pollutants on the incidence of osteoporotic hip fracture in a southern European region. Association was detected between SO 2 and NO 2 and hospital admissions due to hip fracture. Introduction To examine the short-term effects of outdoor air pollution on the incidence of osteoporotic hip fracture in a southern European region. Methods This is an ecological retrospective cohort study based on data obtained from three databases. In a time-series analysis, we examined the association between hip fracture incidence and different outdoor air pollutants (sulfur dioxide (SO 2 ), monoxide (NO), nitrogen dioxide (NO 2 ), ozone (O 3 ), and particulate matter in suspension < 2.5 (PM 2.5 ) and < 10-μm (PM 10 ) conditions by using general additive models (Poisson distribution). The incidence rate ratio (IRR), crude and adjusted by season and different weather conditions, was estimated for all parameters. Hip incidence was later analyzed by sex and age (under or over age 75) subgroups. The main outcome measure was daily hospital admissions due to fracture. Results Hip fracture incidence showed association with SO 2 (IRR 1.11 (95% CI 1.04–1.18)), NO (IRR 1.01 (95% CI 1.01–1.02)), and NO 2 (IRR 1.02 (95% CI 1.01–1.04)). For O 3 levels, this association was negative (IRR 0.97 (95% CI 0.95–0.99)). The association persisted for SO 2 and NO 2 when the models were adjusted by season. After adjusting by season and weather conditions, the association persisted for NO 2 . When participants were stratified by age and sex, associations persisted only in women older than 75 years. Conclusions A short-term association was observed with several indicators of air pollution on hip fracture incidence. This is the first study that shows these associations.