Hip fractures and fluoridation in Utah's elderly population.
OBJECTIVE
To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.


METHODS
Ecological cohort.


METHODS
The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.


METHODS
All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).


METHODS
Rate of hospital discharge for hip fracture.


RESULTS
The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.


CONCLUSIONS
We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.
Danielson
C
C
Department of Family and Preventive Medicine, University of Utah, Salt Lake City 84132.
Lyon
J L
JL
Egger
M
M
Goodenough
G K
GK
D000368:Aged; D015982:Bias; D015331:Cohort Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000209:etiology; D005457:Fluoridation / Q000009:adverse effects; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014589:Utah / Q000453:epidemiology