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.
Exposure to natural fluoride in well water and hip fracture: a cohort analysis in Finland
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A prospective study of bone mineral content and fracture in communities with differential fluoride exposure
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Bone resorption and quantitative ultrasound in an endemic fluorosis area of Turkey.
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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
Fluoride reduces bone strength in older rats
In response to recent concerns about the effect of water fluoridation on hip fracture rates, we studied the influence of fluoride intake on bone strength. Four groups of rats were fed a low-fluoride diet ad libitum and received 0, 5, 15, or 50 ppm of fluoride in their drinking water.
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