OBJECTIVE: To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.
DESIGN: Ecological cohort.
SETTING: The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.
PATIENTS: All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).
OUTCOME MEASURE: Rate of hospital discharge for hip fracture.
RESULTS: The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.
CONCLUSIONS: We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.
A prospective study of bone mineral content and fracture in communities with differential fluoride exposure
In 1983/1984, a study of bone mass and fractures was begun in 827 women aged 20-80 years in three rural Iowa communities selected for the fluoride and calcium content of their community water supplies. The control community's water had a calcium content of 67 mg/liter and a fluoride content of
Exposure to natural fluoride in well water and hip fracture: a cohort analysis in Finland
In the retrospective cohort study based on record linkage, the authors studied a cohort of persons born in 1900-1930 (n = 144,627), who had lived in the same rural location at least from 1967 to 1980. Estimates for fluoride concentrations (median, 0.1 mg/liter; maximum, 2.4 mg/liter) in well water in
The effects of fluoridation on degenerative joint disease (DJD) and hip fractures
Fluoride strengthens bone, yet makes it more susceptible to fracture. If mechanical factors are important in DJD, an increased risk for DJD in communities where fluoride is consumed is also expected. Hip fractures and knee DJD joint replacements among those >65 years for 1991-1996 were compared between one community with
Bone resorption and quantitative ultrasound in an endemic fluorosis area of Turkey.
The purpose of this prospective study was to investigate the quantity and quality of bone by quantitative ultrasound (QUS) measurements and to assess bone resorption by urinary excretion measurement of C-terminal telopeptide of type I collagen (CTX) in an adult Turkish population living in an endemic fluorosis area and consuming
The effect of pregnancy and lactation on bone mineral density in fluoride-exposed rats
Fluoride increases metabolic turnover of the bone in favour of bone formation. Excessive intake of fluoride may lead to pathological changes in teeth and bones: dental and skeletal fluorosis. In this study, we investigated the effect of pregnancy and lactation on bone mineral density (BMD) in fluoride-exposed rats. Female Wistar
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The "in vitro" research on fluoride and bone strength confirms what has repeatedly been found in animal and human studies: the more fluoride a bone has, the weaker the bone becomes. In an in vitro bone study, the researcher directly exposes a human or animal bone to a fluoride solution
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