If You Have Osteoporosis, Living In Certain Cities Could Make It Worse

Can where you live or work affect your bones? Yes, it can, and it has nothing to do with sidewalks or green space.

Osteoporosism3ron/ShutterstockYou just love the hustle and bustle of the big city, but if you live in one of the most polluted cities in America, you could be endangering your bones.

New research in the Lancet Planetary Health suggests that contamination and smog in the air may increase the risk for the brittle bone disease osteoporosis and related fractures.

Researchers crunched hospital admission data for 9.2 million Medicare participants in the Northeast/Mid-Atlantic between 2003 and 2010, and found that even a small increase in levels of ambient particulate matter, PM2.5 —that’s itty bitty bits of dirt in the air—may lead to an increase in bone fractures in older adults. What’s more, this risk was greatest in low-income communities, the study showed.

There’s more: Eight years of follow-up data from 692 middle-aged, low-income adults in the Boston Area Community Health/Bone Survey showed that participants living in areas with higher levels of PM2.5 and black carbon, a component of air pollution from automotive emissions, had lower levels of a key calcium and a bone-related hormone (parathyroid hormone or PTH) and a greater decrease in bone mineral density than those exposed to lower levels of these pollutants.

This study highlights several firsts, including the first association of pollution with PTH as well as a stronger bone-depleting effect in low-income individuals.

Still, more studies are needed to validate the findings and see how well they hold in other populations, explains study author Diddier Prada, MD, PhD, a cancer researcher at National Cancer Institute in Mexico City, Mexico.

Exactly how pollution can lead to bone loss is not 100 percent understood, but Prada believes it is similar to what has been observed with smoking. “Smoking shows reductions in PTH and in BMD, but also increases the risk of bone fractures,” he says.

The real question is what can be done to preserve bone in the face of pollution. “People should use personal air filters, but we are convinced that the best solution is working on clear air policies, reducing particulate air pollution concentrations and annual average limits, which will be reflected in better human health and reduced costs in health care,” he says.

Other hacks such as slowing down when biking or running outside may help protect your lungs from pollution.

Pollution causes many health problems, not just brittle bones, says Richard S. Bockman, MD, PhD, chief of the Endocrine Service at the Hospital for Special Surgery in New York City. The lungs, heart and all other body systems are also negatively affected. “Particulate matter triggers an inflammatory response in the airways which can lead to asthma,” he says.

“There is not any doubt that pollution, whether particulate matter, carbon monoxide, carbon dioxide or nitrogen oxides, is toxic, and we should do whatever we can to lower these levels across the board.”

Doing everything to keep our bones strong is an important way to stave off fractures. This includes:

  • Getting enough calcium and vitamin D
    Too many people fall short of getting the calcium and vitamin D they need for strong bones, Bockman says. “Every day we lose 300 mg of calcium and if we don’t replace it, we are starving our bones.” Exactly how much you need every day depends on your age and sex. This calculator can give you a more precise idea. Great sources of calcium include dairy and leafy green vegetables. Vitamin D helps the bones absorb calcium. For vitamin D, the current recommendation for men and women younger than 50 is 400 to 800 international units (IU) daily, and this number increases to 800 to 1,000 IU after age 50. Should you get your vitamin D levels checked?
  • Exercising
    Regular weight-bearing exercise such as jogging or tennis along with muscle strengthening moves can help keep bones in prime shape.
  • Avoiding bone-robbing habits
    Avoid smoking and limit alcohol to two to three drinks per day for stronger bones. There are some other “harmless” habits that could be contributing to osteoporosis too.
  • Knowing what you are up against
    If your mother had osteoporosis, you are at risk too, he says. Other risks include being over age 50, female and menopausal. If you are small and thin, you are also at a greater risk for osteoporosis.
  • Getting screened
    Current U.S. Preventive Services Task Force Guidelines call for osteoporosis screening in women aged 65 years and older and in younger women with an increased fracture risk. There are no screening recommendations for men. Discuss your risks with your doctor to make sure you are doing all that you can to keep fractures at bay. Certain medications are available to help maintain bone density and stave off fractures.

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Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.