High levels of air pollution are linked to bone loss in postmenopausal women, according to a new study led by scientists at Columbia University’s Mailman School of Public Health. The results were especially visible in the lumbar spine, where nitrous oxide was twice as destructive as normal aging. The findings were published in the peer-reviewed journal eClinicalMedicine, which is part of The Lancet Discovery Science family of open-access journals. Previous studies on individual pollutants have suggested adverse effects on bone mineral density, osteoporosis risk and fractures in older individuals.
The new study is the first to specifically explore the association between air pollution and bone mineral density in postmenopausal women, and the first to explore the effects of air pollution mixtures on bone outcomes. The researchers analyzed data collected through the Women’s Health Initiative Study, an ethnically diverse group of 161,808 postmenopausal women. They estimated exposure to air pollution (PM10, NO, NO2, and SO2) based on participants’ home addresses. They measured bone mineral density (BMD; whole body, total hip, femoral neck, and lumbar spine) at enrollment at year one, year three, and year six using dual-energy X-ray absorptiometry.
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The magnitude of the effect of nitrogen oxides on lumbar spine BMD would amount to a 1.22 percent annual reduction—about twice the annual effect of age at any of the anatomical sites assessed. These effects are thought to occur through oxidative damage and bone cell death through other mechanisms. There is 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,” said first author Didier Prada, MD, PhD, an associate research scientist in the department The study says. of Environmental Health Sciences at the Columbia Mailman School of Public Health.
“Improving air pollution exposure, especially nitrogen oxides, will reduce bone loss in postmenopausal women, prevent bone fractures, and reduce the burden of health costs associated with osteoporosis among postmenopausal women. Attention should be paid to detecting people at high risk of pollution-related bone damage,” says lead author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences at the Columbia Mailman School of Public Health.
Car and truck exhaust is a major source of nitrous oxide, as are emissions from electric power generation plants. Approximately 2.1 million osteoporosis-related bone fractures occur annually, resulting in annual direct healthcare costs of up to US$20.3 billion. Osteoporosis affects women more than men, with 80 percent of the estimated 10 million Americans with osteoporosis being women. Postmenopausal women are at higher risk, with more women over 50 experiencing bone fractures due to osteoporosis. Previously, researchers from Colombia showed that long-term exposure to air pollution reduces BMD and increases the risk of bone fractures in later life. Subsequently, these findings have been confirmed in several human studies.