Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
Department of Orthopeadics, China-Japan Friendship Hospital, Beijing, China.
Osteoporos Int. 2022 Sep;33(9):1949-1955. doi: 10.1007/s00198-022-06445-4. Epub 2022 Jun 3.
To explore the association of air pollution and hip fracture and related mortality in the UK. The average levels of PM2.5, PM10, and NO2 exhibited a positive association with hip fracture and short-term mortality while O did not. Our study highlights the association of air pollution and hip fracture.
Until now, the influence of air pollution on bone mineral density and associated fractures has drawn little attention, and the consequences are controversial. To investigate the association between air pollution and hip fracture incidence and related short-term mortality.
We constructed a cohort of all the National Hip Fracture Database beneficiaries (513,540 patients) in the UK from 2013 to 2018. Per year averages of PM, PM, O, NO, and SO were estimated according to the person's residence. The incidence rate ratio with 95% confidence interval and all-cause mortality within 30-day post-fracture (ACM30D) rate ratios were estimated using generalized additive models.
The average levels of PM, PM, and NO exhibited a positive association with the incidence rate of hip fracture (IHF) and ACM30D. Whereas, this association was negative for O levels. Each increase of 5 μg per cubic meter in PM, PM, and NO leads to 9.5%, 9.2%, and 4.1% higher hip fracture rate, respectively, and also 9.3%, 8.3%, and 2.9% higher ACM30D, respectively. When we restricted the analysis to low-level exposure of air pollutants, similar results were obtained.
Our study found a moderate, positive association between IHF, ACM30D, and the levels of specific air pollutants in the entire National Hip Fracture Database population. A reduction in the levels of PM, PM, and NO may decrease the hip fracture incidence rate and associated short-term mortality in older adults. Our study highlights the influence of air pollution on hip fracture.
探讨英国空气污染与髋部骨折及相关死亡率的关系。PM2.5、PM10 和 NO2 的平均水平与髋部骨折和短期死亡率呈正相关，而 O 则不然。我们的研究强调了空气污染与髋部骨折之间的关联。
到目前为止，空气污染对骨密度和相关骨折的影响引起的关注较少，其后果也存在争议。研究目的是探讨空气污染与髋部骨折发病率及相关短期死亡率之间的关系。
我们构建了一个英国全国髋部骨折数据库（2013 年至 2018 年）受益人的队列。根据个人居住地，估算了 PM、PM、O、NO 和 SO 的每年平均水平。使用广义加性模型估算了发病率比（95%置信区间）和骨折后 30 天内全因死亡率（ACM30D）的比率比。
PM、PM 和 NO 的平均水平与髋部骨折（IHF）和 ACM30D 的发病率呈正相关。而 O 水平则相反。每立方米增加 5μg 的 PM、PM 和 NO 分别导致髋部骨折率升高 9.5%、9.2%和 4.1%，ACM30D 分别升高 9.3%、8.3%和 2.9%。当我们将分析仅限于低水平的空气污染物暴露时，得到了类似的结果。
本研究发现，在整个全国髋部骨折数据库人群中，IHF、ACM30D 与特定空气污染物水平之间存在中度正相关。降低 PM、PM 和 NO 的水平可能会降低老年人髋部骨折的发病率和相关的短期死亡率。我们的研究强调了空气污染对髋部骨折的影响。
