Further potential risk factor for osteoporosis identified: Research

Air pollution may lead to lower bone-mass density.
 
Such were the findings of new research published in JAMA Network Open.
 
The population-based cross-sectional study of 3717 participants in India found that ambient fine-particulate matter air pollution was associated with low bone mineral content and bone mineral density.
 
Conversely, it noted that household air pollution (from biomass cooking fuels) did not have a clear association with bone mass.
 
‘Our findings add to a growing body of evidence that indicates that particulate air pollution is relevant for bone health across a wide range of air pollution levels, including levels found in high income, and low and medium income countries,’ study co-author Cathryn Tome said.
 
The study’s first author, Dr Otavio Ranzani, hypothesised the link between poor air quality and low bone density could be due to oxidative stress and inflammation caused by air pollution.
 
Professor Dimity Pond, a GP with a special interest in aged care, was surprised by these findings.
 
‘It’s really interesting and suggestive that there might be some relationship between pollution and bone mineral density,’ she told newsGP.
 
While Professor Pond said the deleterious effects of air pollution are known on various aspects of health, she believes its effect on bone density is less understood.
 
‘[This research] raises a lot of questions about pollution which I had never thought of before,’ she said.
 
‘I know about the effects on the chest and the effect on cognitive [function], but this bone mineral density is a whole other area and it clearly needs more exploration.’
 
While there are many known risk factors for osteoporosis, Professor Pond said this study shows we may not yet have a full understanding of all factors that may contribute to this condition.
 
Consequently, she believes this research may change our views on why osteoporosis occurs.
 
Professor Pond said that one particularly interesting finding to emerge from the study is that people from rural areas had higher bone mass density than their urban counterparts – despite their vitamin D levels.
 
While low vitamin D levels have been implicated in poor bone health, Professor Pond said the association may not be as clear-cut as once thought.
 
‘My colleagues who are interested in vitamin D tell me the vitamin D story is a lot more complex than we realise,’ she said, adding the difference in bone health in rural versus urban participants may instead relate to exercise levels.
 
While Professor Pond said this study can help shed further light on the risk factors for osteoporosis, she’s keen to note the fact it focused on an Indian population, not an Australian one.
 
‘So it’s hard to know how relevant [this study] is to us,’ she said.
 
However, it may seem more relevant considering the current air pollution from the bushfires.
 
While Professor Pond worries about the effect of such air pollution on general health, she does not believe this will lead to long-term problems with bone health in particular.
 
‘There’s nothing in the [research] that would make us think that you could compare women who’ve been exposed to high pollution for years, with us in Sydney or Canberra just over one summer,’ she said.
 
‘I wouldn’t be expecting we’d get osteoporosis from a few months of pollution.’
 
She believes, however, there is a pressing need to reduce air pollution for health in general.
 
‘Clearly, we need to really think carefully about pollution and all do our best to reduce it and avoid it as much as possible,’ she said.
 
‘If it’s possible, I think you should avoid going to highly polluted areas. If you’re living in the centre of Canberra or Sydney, that’s not possible. But if you were thinking of taking a trip that was optional, you could … avoid that.
 
‘In the long-term we really need to think seriously about our carbon footprint, all of us.’
 
According to a report by Osteoporosis Australia on burden of disease, little progress is being made in preventing and managing osteoporosis in Australia.
 
The report notes that 66% of Australians aged over 50 (4.74 million people) have osteoporosis, osteopenia or poor bone health.
 
Meanwhile, it predicts there will be 6.2 million Australians with poor bone health by 2022, a 31% increase from 2012.
 
The total cost of osteoporosis and osteopenia in Australians aged over 50 was $2.75 billion in 2012. It is predicted the total cost will be $3.84 billion by 2022.
 
Professor Pond hopes this new research can add to our understanding of the pathogenesis, and therefore prevention, of a condition which causes such significant health burden.
 
She hopes further research will aid that understanding.
 
‘We need to watch this space,’ she said.
 
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