Incidence of hospitalized osteoporotic fractures in cohorts with high dietary intake of persistent organochlorine compounds.
OBJECTIVE
Environmental factors might be of importance for the dramatically increasing incidence of osteoporotic fractures. Persistent organochlorine compounds (POCs) have, in animal studies, impaired normal bone metabolism and resulted in increased bone fragility. The goal of this study was to assess whether a high dietary intake of POCs through fatty fish from the Baltic Sea may result in an increased incidence of osteoporotic fractures.


METHODS
Fishermen and their wives from the Swedish east coast on the Baltic Sea (exposed) and west coasts (unexposed) constituted the study base. Information on vital status and hospitalization of persons with fractures from 1987 to 1996, classified according to the ninth revision of the International Classification of Diseases, was retrieved for 17,823 subjects through register linkages. The impact of coastal stretch on fracture incidence was assessed by Poisson regression models, with age and calendar year also being taken into account.


RESULTS
There was a significantly increased incidence rate ratio (IRR: 2.29, 95% confidence intervals (CI): 1.23-4.28) for vertebral fractures among east-coast women, and a similar, but non-significant, similar tendency in men (IRR 1.45, 95% CI 0.74-2.84). Such cohort differences were not seen for any other fracture type.


CONCLUSIONS
The results give some indirect support for the notion that a high dietary intake of POCs through fatty fish from the Baltic Sea might be a risk factor for vertebral fractures, but it cannot be excluded that confounding from differences in smoking habits might explain part of the observed effects. To clarify this, detailed individual information on exposure and potential confounders has to be ascertained.
Alveblom
Ann-Kathrine
AK
Department of Occupational and Environmental Medicine, Lund University Hospital, 221 85 Lund, Sweden.
Rylander
Lars
L
Johnell
Olof
O
Hagmar
Lars
L
D000818:Animals; D004032:Diet; D004781:Environmental Exposure; D005260:Female; D005399:Fishes; D005506:Food Contamination; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000506:poisoning*; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology*; D017747:Seafood; D013548:Sweden / Q000453:epidemiology
D006843:Hydrocarbons, Chlorinated