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

Mazzucchelli, Ramón; Villarías, Natalia Crespí; Fernández, Elia Pérez; Durbán, Maŕıa; García-Vadillo, A.; Quirós, Francisco Javier; Guzón, O.; Caravaca, G. Rodríguez; Miguel, Ángel Gil de

doi:10.1007/s00198-018-4605-7

Cited by 49 publications

(35 citation statements)

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“…The included studies were published between 2007 and 2020, wherein 9 articles were cross-sectional studies, 81–89 4 were retrospective studies 90–93 and 2 were prospective studies. 93 , 94 All the articles are considered high quality according to JBI critical appraisal checklist as shown in Table S3 and S4 .…”

Section: Resultsmentioning

confidence: 99%

“… NS association between osteoporotic fracture and PM 2.5–10 and PM 10 Similar positive associations were found between PM 2.5 and osteoporotic spine fractures [aHR= 1.17, 95% CI= (1.00, 1.38) for 29.2–34.6 μg/m 3 ] and non-spine fractures [aHR= 1.16, 95% CI= (1.02, 1.33) for 26.8–29.2 μg/m 3 ; aHR= 1.16, 95% CI= (1.01, 1.33) for 29.2–34.6 μg/m 3 ] The sensitive analysis identified a similar positive association with PM 2.5 after excluding subjects diagnosed with osteoporotic fractures within 1 year and 2 years (all p≤0.008). 8 Retrospective or prospective cohorts Author Study period Study location Study type/design Sample size PM assessment Bone health, osteoporosis and fracture assessment Outcomes JBI score Mazzucchelli et al 2018 90 1 Jan 2000–31 Dis 2015 Alcorcón, Spain Retrospective cohort study 4271 subjects with men (n=925) and women (n=3346) aged 83.8 ± 8.9 years old Daily mean levels of PM 2.5 and PM 10 from the Air Pollution Monitoring Network, Community of Madrid Environmental Local Government and Regional Planning Department Hip fracture record from the Hospital Universitario Fundacion Alcorcon database NS association between hip fracture and PM 2.5 [IRR= 1.01, 95% CI= (0.92–1.09), p = 0.955] and PM 10 [IRR= 1.01, 95% CI= (0.99–1.03), p = 0.144], regardless of sex or age group (> or ≤ 75 years old; all p> 0.05) after adjusting a natural spline function of time, season and mean air temperature 8 Ormeño Illanes and Quevedo Langenegger 2019 91 2017 Chile Retrospective cohort study 8322 elderly aged > 65 years old Annual mean concentration of PM 2.5 from the National Air Quality Information System, Chile Osteoporotic hip fracture record from the Ministry of Health’s Department of Health Statistics and Information, Chile NS association between osteoporotic hip fracture IRR and PM 2.5 [r= −0.114, p > 0.05] regardless of sex (all p> 0.05) without covariate adjustment 6 …”

Section: Methodsmentioning

confidence: 99%

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Particulate Air Pollution and Osteoporosis: A Systematic Review

Pang

Ekeuku

Chin

2021

RMHP

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Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case–control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM 2.5 and PM 10 . Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects’ characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Particulate Air Pollution and Osteoporosis: A Systematic Review

Pang

Ekeuku

Chin

2021

RMHP

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“…What we are actually observing is that air pollution increases the risk of falls. 17 Reduced visual acuity has long been regarded as a risk factor for fracture. 18 35 The reduced hours of sunlight and increased air pollution reduce visual acuity, which predisposes to falls and hip fracture.…”

Section: Discussionmentioning

confidence: 99%

“…In foggy weather, air pollutants (dust, ash, clay, sand or ambient air pollutants) are suspended in the atmosphere. 17 …”

Section: Introductionmentioning

confidence: 99%

Effect of meteorological factors and air pollutants on fractures: a nationwide population-based ecological study

et al. 2021

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ObjectiveTo determine the association of meteorological factors and air pollutants (MFAPs) with fracture and to estimate the effect size/time lag.DesignThis is a nationwide population-based ecological study from 2008 to 2017.SettingEight large metropolitan areas in Korea.ParticipantsOf 8 093 820 patients with fractures reported in the Korea National Health Insurance database, 2 129 955 were analysed after the data set containing patient data (age, sex and site of fractures) were merged with MFAPs. Data on meteorological factors were obtained from the National Climate Data Center of the Korea Meteorological Administration. Additionally, data on air pollutants (atmospheric particulate matter ≤2.5 µm in diameter (PM2.5), PM10, ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide) were obtained from the Air Korea database.Primary and secondary outcome measuresWe hypothesised that there would be an association between MFAPs and the incidence of fracture. A generalised additive model was used while factoring in the non-linear relationship between MFAPs and fractures as well as a time lag ≤7 days. Multivariate analysis was performed. Backward elimination with an Akaike information criterion was used to fit the multivariate model.ResultsOverall, in eight urban areas, 2 129 955 patients with fractures were finally analysed. These included 370 344, 187 370, 173 100, 140 358, 246 775, 6501, 228 346, 57 183 and 719 978 patients with hip, knee, shoulder, elbow, wrist, hand, ankle, foot and spine fractures, respectively. Various MFAPs (average temperature, daily rain, wind speed, daily snow and PM2.5) showed significant association with fractures, with positive correlations at time lags 7, 5–7, 5–7, 3–7 and 6–7 days, respectively.ConclusionsVarious MFAPs could affect the occurrence of fractures. The average temperature, daily rain, wind speed, daily snow and PM2.5 were most closely associated with fracture. Thus, improved public awareness on these MFAPs is required for clinical prevention and management of fractures.

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“…Chiu et al 21 postulated that the hindrance of free movements and increased clumsiness of patients with many layers of clothes put on during the cold weather might be associated to an increase of the incidence of fractures. The study from Mazzucchelli et al 22 showed a short-term association between several indicators of air pollution and daily hospital admissions due to osteoporotic fracture, which can also in part explain the seasonal variations in the numbers of femur fractures. Other articles support the role of the low exposure to sunshine in the vitamin D deficiency 23 .…”

Section: Discussionmentioning

confidence: 99%

Seasonal variation of femoral fractures in the state of São Paulo, Southeast Brazil

Souza

Nunes

et al. 2019

Rev. saúde pública

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OBJECTIVE: To examine the effect of seasonality on femoral fracture incidence among people residing in the state of São Paulo, Brazil. METHODS: Ecological study based on a consecutive series of 216,348 reports of hospital admissions caused by femoral fractures. A Bayesian statistical model was used for time series analysis, considering the monthly average number of events of femoral fractures per day as a dependent variable. RESULTS: Among the female population, significant seasonal effects were observed only for older women, aged 60 years or more. Among younger men (aged less than 20 years) there is not a clear seasonal effect, but among the other age groups there seems to exist a higher number of cases of femoral fractures during the coldest months of the year. CONCLUSIONS: In general, more cases of fractures occur during the coldest months of the year; however, men and women have different patterns of incidence according to each age group.

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

Abstract: 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.

Cited by 49 publications

References 44 publications

Particulate Air Pollution and Osteoporosis: A Systematic Review

Particulate Air Pollution and Osteoporosis: A Systematic Review

Effect of meteorological factors and air pollutants on fractures: a nationwide population-based ecological study

Seasonal variation of femoral fractures in the state of São Paulo, Southeast Brazil

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