Air pollution contributes to low bone mineral content, BMD
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Adults from India who live in areas with more air pollution have lower bone mineral content and bone mineral density compared with those living in areas with less fine particulate matter and black carbon in the air, according to findings published in JAMA Network Open.
“Our findings add to the evidence that air pollution is harmful to the human body, not only cardiovascular and lung health, but other organs, such as bone,” Otavio T. Ranzani, MD, PhD, postdoctoral fellow of the Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública and epidemiologist at ISGlobal in Spain, told Healio. “We observed a consistent association between ambient air pollution and low bone mass and bone mineral density, so we urge for mitigation measures to reduce air pollution.”
Ranzani and colleagues collected data on left hip and lumbar spine bone area, bone mineral content and BMD from 3,717 adult participants (mean age, 35.7 years; 46% women) from India in the Andhra Pradesh Children and Parents Study (APCAPS). The researchers then used information from the Cardiovascular Health Effects of Air Pollution in Telangana, India Project, to estimate the amount of fine particulate matter (PM2.5) and black carbon levels, based on where participants lived. The researchers also estimated household air pollution based on the type of cooking fuel participants said they used.
Annual mean exposure to PM2.5 was 32.8 µg/m3, which is more than three times the maximal level recommended by the World Health Organization, according to a press release from Barcelona Institute for Global Health.
There was a 0.57 g reduction in bone mineral content at the spine (95% CI, –1.06 to –0.07) and a 0.13 g reduction at the hip (95% CI, –0.3 to 0.03) for every 3 µg/m3 increase in PM2.5. Similarly, there was a 0.011 g/cm2 reduction in BMD at the spine (95% CI, –0.021 to 0) and a 0.004 g/cm2 reduction at the hip (95% CI, –0.008 to 0.001) for every rise of 3 µg/m3 increase in PM2.5.
“We found that the association between PM2.5 and low bone mass was greater for the lumbar spine, which is mainly composed of trabecular bone, than for the hip, which has a higher proportion of cortical bone,” the researchers wrote. “This finding could be explained by higher sensitivity of the trabecular bone compared with cortical bone to the underlying oxidative stress generated by PM.”
The researchers also noted that there was a 1.13 g reduction in bone mineral content at the spine (95% CI, –2.81 to 0.54) and a 0.35 g reduction at the hip (95% CI, –0.96 to 0.25) for every 1 µg/m3 increase in black carbon.
The researchers added that these findings had “higher magnitude and precision” in participants aged at least 40 years, but that they “did not observe a clear association between use of biomass as main cooking fuel and bone mass.”
“We should be aware that we filter roughly 10,000 liters of air per day. If this air is contaminated, our lungs are filters and so these pollutants are being accumulated in our body and triggering our immune responses. These pollutants are considered ‘foreign bodies’ by our body, and attacking it with our immune system and oxidative stress,” Ranzani said. “This chronic status of inflammation and stress can damage our bone health, likely decreasing their amount of calcium and disturbing the hormones which maintain our bone well-structured and organized, such as vitamin D and parathyroid hormone. Bones are living tissues in our body, and we should take care of their health too.” – by Phil Neuffer
For more information:
Otavio T. Ranzani, MD, PhD, can be reached at otavio.ranzani@isglobal.org.
Disclosures: The authors report no relevant financial disclosures.
Editor's Note: This article was updated on Jan. 7, 2020, to correctly identify that there was a 0.35 g reduction in bone mineral content at the hip for every 1 µg/m3 increase in black carbon. The editors regret the error.
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