Risk of ozone exposure-induced fracture

Abstract

IntroductionOzone (O3) is known to induce oxidative stress that influences various cells and tissues, which may further lead to diminished bone mineral density. Nevertheless, few studies have investigated the association between O3 exposure and fractures. Considering the similar growing trends of O3 concentrations and fracture morbidity in recent years, in the present study, we aimed to examine whether O3 exposure is associated with the fracture morbidity.MethodsUsing a retrospective cohort study design, we analyzed the records of 8,075 patients with fracture admitted in the warm season to Beijing Jishuitan Hospital from 2014 to 2019 and matched them to the corresponding exposure time and concentration of O3.ResultsThe results showed that increased odds of fracture were associated with increased O3 concentrations, presumably because O3 induces oxidative stress (OS) that leads to bone mineral density (BMD) loss.DiscussionOur findings suggest that O3 exposure is a risk factor for fractures, providing new evidence of the adverse health effect induced by air pollution. We can conclude that more intensive air pollution control is needed for the prevention of fracture occurrence.

Causal Relationships between Air Pollutant Exposure and Bone Mineral Density and the Risk of Bone Fractures: Evidence from a Two-Stage Mendelian Randomization Analysis

“…A recent meta-analysis indicated that exposures to PM10, PM2.5, and NOx played negative roles in decreased BMD and increased the risk of osteoporotic fracture [ 38 ]. In addition, a retrospective cohort study has observed a positive association between ozone exposure and the risk of bone fracture development, potentially through ozone-induced oxidative stress injury that causes loss of bone mass [ 39 ]. This evidence suggests a positive association between long-term air pollutant exposure and bone damage, whereas, owing to the limitations of observational studies, they cannot rule out causality between air pollutants and bone health, thus previous observed findings may not always be generalizable.…”