High pollution levels lead to brittle bones, fracture risk: study

news
10 November 2017

If the respiratory problems caused by the headline-making pollution in Delhi and northern India were not enough, a major new study suggests that if you are living in areas of high pollution, you are more likely to have bone fractures from osteoporosis or brittle bones.

The study was performed by researchers at Columbia University's Mailman School of Public Health in New York. They studied the records of more than nine million people and found that even slight rises in airborne particles from vehicle emissions was linked to lower bone density.

They believe that pollution affects the production of key hormones and bone minerals, leading to osteoporosis. The risk is greater for women and the elderly.

In some cases, patients suffer fractures simply from being given a hug.

Last month the UK's Duchess of Cornwall, whose mother and grandmother both died after spending ''agonising'' years living with the condition, urged young people to build up bone strength through good diet and exercise before they reach 30.

But the new study, published in The Lancet, found that pollution undermined bone strength regardless of lifestyle.

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.

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 per cent, and only 40 percent of those who had fractures regain their independence.

The researchers write that particulate matter, including PM2.5, is known to cause systemic oxidative damage and inflammation, which they suggest, could accelerate bone loss and increase risk of bone fractures in older individuals. Smoking, which contains several particulate matter components, has been consistently associated with bone damage.

"Decades of careful research has documented the health risks of air pollution, from cardiovascular and respiratory diseases, to cancer, and impaired cognition, and now osteoporosis," says Andrea Baccarelli, the study's senior author.

"Among the many benefits of clean air, our research suggests, are improved bone health and a way to prevent bone fractures."

In two studies published earlier this year, Baccarelli, a world leader in the science of epigenetics, reported that Vitamin B can diminish the effects of air pollution-induced cardiovascular disease, as well as epigenetic damage to DNA.

It is unclear if the benefits of Vitamin B extend to bone loss. Even so, he says, the best way to prevent air-pollution-related diseases is through policies to improve air quality.

The UK's National Osteoporosis Society advises eating most dairy products, green leafy vegetables, broccoli and baked beans to gain healthy amounts of calcium and vitamin D, which is known to help strengthen bones.

Weight-bearing exercise is also essential; however the greatest value is gained before the age of 30.





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