Air Pollution Accelerates Bone Loss Due to Osteoporosis

According to research conducted by researchers at Columbia University Mailman School of Public Health, postmenopausal women who are exposed to high levels of air pollutants are more likely to suffer from bone damage. Nitrous oxides were twice as harmful to the lumbar spine as normal aging, where the effects were most noticeable.

The study’s results are published in the journal eClinicalMedicine.

Past research on specific contaminants has revealed negative impacts on older people’s fracture risk, osteoporosis risk, and bone mineral density. The current study is the first to examine the relationship between air pollution and bone mineral density in postmenopausal women specifically and the first to investigate the effects of air pollution mixes on bone outcomes.

161,808 postmenopausal women from a variety of ethnic backgrounds participated in the Women’s Health Initiative study, which provided the researchers with data for their analysis. Based on the participants’ residential addresses, they calculated their exposure to air pollution (PM10, NO, NO2, and SO2). They measured bone mineral density (BMD; whole-body, total hip, femoral neck, and lumbar spine) using dual-energy X-ray absorptiometry at enrolment and during follow-up at years one, three, and six.

The annual effects of aging on any of the analyzed anatomical sites would be roughly double the annual effects of nitrogen oxides on lumbar spine BMD, amounting to decreases of 1.22 percent. These effects are thought to be brought on by oxidative damage to bone cells, among other processes.

“Our findings confirm that poor air quality may be a risk factor for bone loss, independent of socioeconomic or demographic factors. For the first time, we have evidence that nitrogen oxides, in particular, are a major contributor to bone damage and that the lumbar spine is one of the most susceptible sites of this damage,” says study first author Diddier Prada, MD, Ph.D., an associate research scientist in the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

“Improvements in air pollution exposure, particularly nitrogen oxides, will reduce bone damage in postmenopausal women, prevent bone fractures, and reduce the health cost burden associated with osteoporosis among postmenopausal women. Further efforts should focus on detecting those at higher risk of air pollution-related bone damage,” says lead author Andrea Baccarelli, MD, Ph.D., chair of the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

Nitrous oxides are mostly produced by the exhaust of cars and trucks as well as by the emissions of power plants.

Every year, 2.1 million bone fractures associated with osteoporosis occur, costing up to $20.3 billion in direct medical expenses. Women are more affected by osteoporosis than men, with 80 percent of the estimated 10 million Americans who have the disease being female. One in two women over the age of 50 experience a bone fracture due to osteoporosis, which increases the risk for postmenopausal women.

In the past, Columbia researchers have demonstrated that prolonged exposure to air pollution lowers BMD and raises the chance of developing bone fractures later in life. These results were subsequently supported by numerous human research.

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