Hip fractures and fluoridation in Utah's elderly population

Abstract

<h3>Objective.</h3> —To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly. <h3>Design.</h3> —Ecological cohort. <h3>Setting.</h3> —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. <h3>Patients.</h3> —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). <h3>Outcome Measure.</h3> —Rate of hospital discharge for hip fracture. <h3>Results.</h3> —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. <h3>Conclusions.</h3> —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. (<i>JAMA</i>. 1992;268:746-748)