Proximity to major roads and the incidence of osteoporotic fractures in elderly women: The BONE study in Beijing

BACKGROUND: There is growing evidence to suggest that living near major roads (and suffering from the air pollution of urban streets) can have an adverse effect on bone health. However, little is known about its relationship to fractures caused by osteoporosis. OBJECTIVE: This study was designed to investigate the relationship between residents living near major roads and the incidence of osteoporotic fractures. METHODS: A retrospective cohort of 529 subjects was established based on community populations in older women aged 65–91. All participants lived in Beijing between September 27, 2007 and September 26, 2017. The distance between the residential sites of the subjects and the main roads was determined by the authors. Osteoporotic fracture diagnosis was based on medical histories and imaging examinations (DXA and X-rays). The Cox proportional hazard model was used to assess the association between traffic proximity and osteoporotic fractures, with suitable adjustments for individual and background factors. RESULTS: The age range of all participants was 65–91 years, with an average age of 75.8 years (and a standard deviation 6.8 years). Of these, 19 (3.59%) suffered from diabetes, and 48 (9%) had hypertension; 85 (14%) families had annual incomes below US $30,000 and 402 (76%) had received a secondary school education or higher. Nearly 25% of people lived within 50 m of a main road, while 50% lived within 300 m. Between 2007 and 2017, a total of 96 osteoporotic fractures were observed. For people living <50 m from a main road, the adjusted hazard ratio (HR) for osteoporotic fractures was 2.509 (95% CI 1.345–4.680), while it was 1.830 (95% CI 1.029–3.255) for those living at a distance of 50–300 m from a main road vs. those living further than 300 m away. CONCLUSION: In this community-based cohort, living near a major road was associated with a higher incidence of osteoporotic fractures.