Diddier Prada1,2, Jia Zhong1,3, Elena Colicino1,3, Antonella Zanobetti1, Joel Schwartz1, Nicholas Dagincourt4, Shona C Fang4, Itai Kloog5, Joseph M Zmuda6, Michael Holick7, Luis A Herrera2, Lifang Hou8, Francesca Dominici9, Benedetta Bartali4, Andrea A Baccarelli1,3. 1. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave, Boston, MA, 02115, USA. 2. Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, 14080, Mexico. 3. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168 St. New York, NY, 10032, USA. 4. New England Research Institute, 480 Pleasant St, Watertown, MA, 02472, USA. 5. Department of Geography and Environmental Development, Ben-Gurion University of the Negev, 663 Beer Sheva, Israel. 6. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA. 7. School of Medicine Endocrinology, Diabetes, and Nutrition, Boston University, One Silber Way, Boston, MA, 02215, USA. 8. Institute for Public Health and Medicine, Northwestern University, Chicago, ILL, 60611, USA. 9. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave, Boston, MA, 02115, USA.
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.
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.
Authors: Russel Burge; Bess Dawson-Hughes; Daniel H Solomon; John B Wong; Alison King; Anna Tosteson Journal: J Bone Miner Res Date: 2007-03 Impact factor: 6.741
Authors: Hélder Fonseca; Daniel Moreira-Gonçalves; Hans-Joachim Appell Coriolano; José Alberto Duarte Journal: Sports Med Date: 2014-01 Impact factor: 11.136
Authors: Cynthia L Leibson; Anna N A Tosteson; Sherine E Gabriel; Jeanine E Ransom; L Joseph Melton Journal: J Am Geriatr Soc Date: 2002-10 Impact factor: 5.562
Authors: Melinda C Power; Marc G Weisskopf; Stacey E Alexeeff; Brent A Coull; Avron Spiro; Joel Schwartz Journal: Environ Health Perspect Date: 2010-12-20 Impact factor: 9.031
Authors: R Mazzucchelli; N Crespi Villarias; E Perez Fernandez; M L Durban Reguera; A Garcia-Vadillo; F J Quiros; O Guzon; G Rodriguez Caravaca; A Gil de Miguel Journal: Osteoporos Int Date: 2018-08-09 Impact factor: 4.507
Authors: Dean E Schraufnagel; John R Balmes; Clayton T Cowl; Sara De Matteis; Soon-Hee Jung; Kevin Mortimer; Rogelio Perez-Padilla; Mary B Rice; Horacio Riojas-Rodriguez; Akshay Sood; George D Thurston; Teresa To; Anessa Vanker; Donald J Wuebbles Journal: Chest Date: 2018-11-09 Impact factor: 9.410
Authors: Diddier Prada; Gerard López; Helena Solleiro-Villavicencio; Claudia Garcia-Cuellar; Andrea A Baccarelli Journal: Environ Res Date: 2020-04-06 Impact factor: 6.498
Authors: C Thongprayoon; P Acharya; C Acharya; J Chenbhanich; T Bathini; B Boonpheng; K Sharma; K Wijarnpreecha; P Ungprasert; M L Gonzalez Suarez; W Cheungpasitporn Journal: Osteoporos Int Date: 2018-04-30 Impact factor: 4.507