Exposure to air pollution increases the risk of osteoporosis: a nationwide longitudinal study.
Several studies have indicated that air pollution induces systemic as well as tissue-specific inflammation. Chronic inflammatory diseases such as rheumatoid arthritis and chronic obstructive pulmonary disease reduce bone mineral density (BMD), leading to increased release of immune cells from the bone marrow. However, the association between air pollution and osteoporosis remains poorly defined. Therefore, we conducted this population-based retrospective cohort study to evaluate the risk of osteoporosis in Taiwanese residents exposed to air pollution.We combined 2 nationwide databases in this study. The National Health Insurance Research Database of Taiwan was available from 2000 to 2010. Detailed daily data on air pollution were collected by Taiwan Environmental Protection Agency (EPA) from 1998 to 2010. We calculated the yearly average concentrations of air pollutants from the study start to the date of osteoporosis occurrence, or withdrawal from the NHI program, or December 31, 2010. The yearly average concentrations of air pollutants were categorized into quartiles, and the risks of osteoporosis were evaluated among 4 stages of air pollutants.Among Q1, Q2, Q3, and Q4 of pollutants in all subjects, the adjusted hazard ratios (HRs) of osteoporosis in Q2, Q3, and Q4 were compared with Q1. For carbon monoxide (CO), the adjusted HRs were 1.05 (95% confidence interval [CI], 0.97-1.14), 1.78 (95% CI, 1.65-1.92), and 1.84 (95% CI, 1.71-1.98), respectively. For nitrogen dioxide (NO2), the adjusted HRs were 1.35 (95% CI, 1.25-1.45), 1.24 (95% CI, 1.15-1.35), and 1.60 (95% CI, 1.48-1.73), respectively, in all subjects.The findings of the present study show that CO and NO2 exposure is associated with an increased risk of osteoporosis in the Taiwanese population.
From the Department of Public Health, China Medical University (K-HC, C-YC); Department of Medical Research, Taichung Veterans General Hospital, Taichung (K-HC); Department of Medical Laboratory Science and Biotechnology, School of Medical and Health Sciences, Fooyin University, Kaohsiung (M-YC); Management Office for Health Data, China Medical University Hospital (C-HM); Chair Professor and President, Department of Nursing, HungKuang University (T-NW); Department of Occupational Safety and Health, College of Public Health, China Medical University (B-FH); Department of Emergency, Kuang Tien General Hospital (T-HL); Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Kuang-Hsi
KH
Chang
Mei-Yin
MY
Chang
Chih-Hsin
CH
Muo
Trong-Neng
TN
Wu
Bing-Fang
BF
Hwang
Chiu-Ying
CY
Chen
Tsung-Hsing
TH
Lin
Chia-Hung
CH
Kao
D000393:Air Pollutants / Q000633:toxicity*; D015897:Comorbidity; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology
D000393:Air Pollutants