Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies

Diddier Prada, Jia Zhong, Elena Colicino, Antonella Zanobetti, Joel Schwartz, Nicholas Dagincourt, Shona C. Fang, Itai Kloog, Joseph M. Zmuda, Michael Holick, Luis A. Herrera, Lifang Hou, Francesca Dominici, Benedetta Bartali, Andrea A. Baccarelli*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Air particulate matter is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether particulate matter is associated with loss of bone mineral density and risk of bone fractures is undetermined. We did two independent studies with complementary designs, objectives, and measures to determine the relationship between ambient concentrations of particulate matter and bone health. Methods In the first study, we examined the association of long-term concentrations of particulate matter less than 2·5 μm (PM2·5) and osteoporosis-related fracture hospital admissions among 9·2 million Medicare enrollees (aged ≥65 years) of the northeast-mid-Atlantic USA between January, 2003, and December, 2010. In the second study, we examined the association of long-term black carbon and PM2·5 concentrations with serum calcium homoeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin [25(OH)D]) and annualised bone mineral density over 8 years (baseline, November, 2002–July, 2005; follow-up, June, 2010–October, 2012) of 692 middle-aged (46·7 years [SD12·3]), low-income men from the Boston Area Community Health/Bone Survey (BACH/Bone study) cohort. PM2·5 concentrations were estimated using spatiotemporal hybrid modelling including Aerosol Optical Depth data, spatial smoothing, and local predictors. Black carbon concentrations were estimated using spatiotemporal land-use regression models. Findings In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2·5 concentrations (risk ratio [RR] 1·041, 95% CI 1·030 to 1·051). This risk was particularly high among low-income communities (RR 1·076, 95% CI 1·052 to 1·100). In the longitudinal BACH/Bone study, baseline black carbon and PM2·5 concentrations were associated with lower serum parathyroid hormone (β=–1·16, 95% CI −1·93 to −0·38, p=0·004, for 1 IQR increase [0·106 μg/m3] in the 1-year average of black carbon concentrations; β=–7·39, 95% CI −14·17 to −0·61, p=0·03, for 1 IQR increase [2·18 μg/m3] in the 1-year average of PM2·5 concentrations). Black carbon concentration was associated with higher bone mineral density loss over time at multiple anatomical sites, including femoral neck (−0·08% per year for 1 IQR increase, 95% CI −0·14 to −0·02) and ultradistal radius (−0·06% per year for 1 IQR increase, −0·12 to −0·01). Black carbon and PM2·5 concentrations were not associated with serum calcium or serum 25(OH)D concentrations. Interpretation Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities. Funding National Institutes of Health, Institute on Aging, National Institute of Environmental Health, the US Environmental Protection Agency, Consejo Nacional de Ciencia y Tecnología, and the Fundación México en Harvard.

Original languageEnglish (US)
Pages (from-to)e337-e347
JournalThe Lancet Planetary Health
Volume1
Issue number8
DOIs
StatePublished - Nov 2017

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Soot
Bone Fractures
Air Pollution
air pollution
Particulate Matter
Bone and Bones
bone disease
Bone Density
Osteoporosis
low income
National Institutes of Health (U.S.)
Medicare
Calcium
health
Parathyroid Hormone
Serum
Odds Ratio
Air
air
community

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Prada, Diddier ; Zhong, Jia ; Colicino, Elena ; Zanobetti, Antonella ; Schwartz, Joel ; Dagincourt, Nicholas ; Fang, Shona C. ; Kloog, Itai ; Zmuda, Joseph M. ; Holick, Michael ; Herrera, Luis A. ; Hou, Lifang ; Dominici, Francesca ; Bartali, Benedetta ; Baccarelli, Andrea A. / Association of air particulate pollution with bone loss over time and bone fracture risk : analysis of data from two independent studies. In: The Lancet Planetary Health. 2017 ; Vol. 1, No. 8. pp. e337-e347.
@article{6f4ae534e78d4f2ba0b01ca3dbb0eb4c,
title = "Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies",
abstract = "Background Air particulate matter is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether particulate matter is associated with loss of bone mineral density and risk of bone fractures is undetermined. We did two independent studies with complementary designs, objectives, and measures to determine the relationship between ambient concentrations of particulate matter and bone health. Methods In the first study, we examined the association of long-term concentrations of particulate matter less than 2·5 μm (PM2·5) and osteoporosis-related fracture hospital admissions among 9·2 million Medicare enrollees (aged ≥65 years) of the northeast-mid-Atlantic USA between January, 2003, and December, 2010. In the second study, we examined the association of long-term black carbon and PM2·5 concentrations with serum calcium homoeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin [25(OH)D]) and annualised bone mineral density over 8 years (baseline, November, 2002–July, 2005; follow-up, June, 2010–October, 2012) of 692 middle-aged (46·7 years [SD12·3]), low-income men from the Boston Area Community Health/Bone Survey (BACH/Bone study) cohort. PM2·5 concentrations were estimated using spatiotemporal hybrid modelling including Aerosol Optical Depth data, spatial smoothing, and local predictors. Black carbon concentrations were estimated using spatiotemporal land-use regression models. Findings In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2·5 concentrations (risk ratio [RR] 1·041, 95{\%} CI 1·030 to 1·051). This risk was particularly high among low-income communities (RR 1·076, 95{\%} CI 1·052 to 1·100). In the longitudinal BACH/Bone study, baseline black carbon and PM2·5 concentrations were associated with lower serum parathyroid hormone (β=–1·16, 95{\%} CI −1·93 to −0·38, p=0·004, for 1 IQR increase [0·106 μg/m3] in the 1-year average of black carbon concentrations; β=–7·39, 95{\%} CI −14·17 to −0·61, p=0·03, for 1 IQR increase [2·18 μg/m3] in the 1-year average of PM2·5 concentrations). Black carbon concentration was associated with higher bone mineral density loss over time at multiple anatomical sites, including femoral neck (−0·08{\%} per year for 1 IQR increase, 95{\%} CI −0·14 to −0·02) and ultradistal radius (−0·06{\%} per year for 1 IQR increase, −0·12 to −0·01). Black carbon and PM2·5 concentrations were not associated with serum calcium or serum 25(OH)D concentrations. Interpretation Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities. Funding National Institutes of Health, Institute on Aging, National Institute of Environmental Health, the US Environmental Protection Agency, Consejo Nacional de Ciencia y Tecnolog{\'i}a, and the Fundaci{\'o}n M{\'e}xico en Harvard.",
author = "Diddier Prada and Jia Zhong and Elena Colicino and Antonella Zanobetti and Joel Schwartz and Nicholas Dagincourt and Fang, {Shona C.} and Itai Kloog and Zmuda, {Joseph M.} and Michael Holick and Herrera, {Luis A.} and Lifang Hou and Francesca Dominici and Benedetta Bartali and Baccarelli, {Andrea A.}",
year = "2017",
month = "11",
doi = "10.1016/S2542-5196(17)30136-5",
language = "English (US)",
volume = "1",
pages = "e337--e347",
journal = "The Lancet Planetary Health",
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Prada, D, Zhong, J, Colicino, E, Zanobetti, A, Schwartz, J, Dagincourt, N, Fang, SC, Kloog, I, Zmuda, JM, Holick, M, Herrera, LA, Hou, L, Dominici, F, Bartali, B & Baccarelli, AA 2017, 'Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies', The Lancet Planetary Health, vol. 1, no. 8, pp. e337-e347. https://doi.org/10.1016/S2542-5196(17)30136-5

Association of air particulate pollution with bone loss over time and bone fracture risk : analysis of data from two independent studies. / Prada, Diddier; Zhong, Jia; Colicino, Elena; Zanobetti, Antonella; Schwartz, Joel; Dagincourt, Nicholas; Fang, Shona C.; Kloog, Itai; Zmuda, Joseph M.; Holick, Michael; Herrera, Luis A.; Hou, Lifang; Dominici, Francesca; Bartali, Benedetta; Baccarelli, Andrea A.

In: The Lancet Planetary Health, Vol. 1, No. 8, 11.2017, p. e337-e347.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of air particulate pollution with bone loss over time and bone fracture risk

T2 - analysis of data from two independent studies

AU - Prada, Diddier

AU - Zhong, Jia

AU - Colicino, Elena

AU - Zanobetti, Antonella

AU - Schwartz, Joel

AU - Dagincourt, Nicholas

AU - Fang, Shona C.

AU - Kloog, Itai

AU - Zmuda, Joseph M.

AU - Holick, Michael

AU - Herrera, Luis A.

AU - Hou, Lifang

AU - Dominici, Francesca

AU - Bartali, Benedetta

AU - Baccarelli, Andrea A.

PY - 2017/11

Y1 - 2017/11

N2 - Background Air particulate matter is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether particulate matter is associated with loss of bone mineral density and risk of bone fractures is undetermined. We did two independent studies with complementary designs, objectives, and measures to determine the relationship between ambient concentrations of particulate matter and bone health. Methods In the first study, we examined the association of long-term concentrations of particulate matter less than 2·5 μm (PM2·5) and osteoporosis-related fracture hospital admissions among 9·2 million Medicare enrollees (aged ≥65 years) of the northeast-mid-Atlantic USA between January, 2003, and December, 2010. In the second study, we examined the association of long-term black carbon and PM2·5 concentrations with serum calcium homoeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin [25(OH)D]) and annualised bone mineral density over 8 years (baseline, November, 2002–July, 2005; follow-up, June, 2010–October, 2012) of 692 middle-aged (46·7 years [SD12·3]), low-income men from the Boston Area Community Health/Bone Survey (BACH/Bone study) cohort. PM2·5 concentrations were estimated using spatiotemporal hybrid modelling including Aerosol Optical Depth data, spatial smoothing, and local predictors. Black carbon concentrations were estimated using spatiotemporal land-use regression models. Findings In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2·5 concentrations (risk ratio [RR] 1·041, 95% CI 1·030 to 1·051). This risk was particularly high among low-income communities (RR 1·076, 95% CI 1·052 to 1·100). In the longitudinal BACH/Bone study, baseline black carbon and PM2·5 concentrations were associated with lower serum parathyroid hormone (β=–1·16, 95% CI −1·93 to −0·38, p=0·004, for 1 IQR increase [0·106 μg/m3] in the 1-year average of black carbon concentrations; β=–7·39, 95% CI −14·17 to −0·61, p=0·03, for 1 IQR increase [2·18 μg/m3] in the 1-year average of PM2·5 concentrations). Black carbon concentration was associated with higher bone mineral density loss over time at multiple anatomical sites, including femoral neck (−0·08% per year for 1 IQR increase, 95% CI −0·14 to −0·02) and ultradistal radius (−0·06% per year for 1 IQR increase, −0·12 to −0·01). Black carbon and PM2·5 concentrations were not associated with serum calcium or serum 25(OH)D concentrations. Interpretation Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities. Funding National Institutes of Health, Institute on Aging, National Institute of Environmental Health, the US Environmental Protection Agency, Consejo Nacional de Ciencia y Tecnología, and the Fundación México en Harvard.

AB - Background Air particulate matter is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether particulate matter is associated with loss of bone mineral density and risk of bone fractures is undetermined. We did two independent studies with complementary designs, objectives, and measures to determine the relationship between ambient concentrations of particulate matter and bone health. Methods In the first study, we examined the association of long-term concentrations of particulate matter less than 2·5 μm (PM2·5) and osteoporosis-related fracture hospital admissions among 9·2 million Medicare enrollees (aged ≥65 years) of the northeast-mid-Atlantic USA between January, 2003, and December, 2010. In the second study, we examined the association of long-term black carbon and PM2·5 concentrations with serum calcium homoeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin [25(OH)D]) and annualised bone mineral density over 8 years (baseline, November, 2002–July, 2005; follow-up, June, 2010–October, 2012) of 692 middle-aged (46·7 years [SD12·3]), low-income men from the Boston Area Community Health/Bone Survey (BACH/Bone study) cohort. PM2·5 concentrations were estimated using spatiotemporal hybrid modelling including Aerosol Optical Depth data, spatial smoothing, and local predictors. Black carbon concentrations were estimated using spatiotemporal land-use regression models. Findings In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2·5 concentrations (risk ratio [RR] 1·041, 95% CI 1·030 to 1·051). This risk was particularly high among low-income communities (RR 1·076, 95% CI 1·052 to 1·100). In the longitudinal BACH/Bone study, baseline black carbon and PM2·5 concentrations were associated with lower serum parathyroid hormone (β=–1·16, 95% CI −1·93 to −0·38, p=0·004, for 1 IQR increase [0·106 μg/m3] in the 1-year average of black carbon concentrations; β=–7·39, 95% CI −14·17 to −0·61, p=0·03, for 1 IQR increase [2·18 μg/m3] in the 1-year average of PM2·5 concentrations). Black carbon concentration was associated with higher bone mineral density loss over time at multiple anatomical sites, including femoral neck (−0·08% per year for 1 IQR increase, 95% CI −0·14 to −0·02) and ultradistal radius (−0·06% per year for 1 IQR increase, −0·12 to −0·01). Black carbon and PM2·5 concentrations were not associated with serum calcium or serum 25(OH)D concentrations. Interpretation Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities. Funding National Institutes of Health, Institute on Aging, National Institute of Environmental Health, the US Environmental Protection Agency, Consejo Nacional de Ciencia y Tecnología, and the Fundación México en Harvard.

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