Abstract
Objective. To evaluate differences in the short-term relationship between weather conditions and the incidence of hip fracture in people aged 65 and over among two regions of Spain. Methods. Hip fracture incidence was calculated for the years 2000–2008 for residents of Health Area 14 in Valencian Community (Mediterranean climate) and the “Mancha Centro” Health Area in Castilla-La Mancha (inland climate), Spain. The relationship between hip fracture incidence and weather was analyzed with a case-crossover design and explored in subgroups defined by sex, age, and fracture type. Results. In the inland area, a positive and significant tendency for hip fracture incidence was observed (annual increase: 1.5%) whereas in the Mediterranean area a seasonal increase of 9% was noted in autumn and winter with respect to spring. Weather conditions, especially wind, were significantly associated with hip fracture incidence: days with more frequent windy periods and/or a greater wind velocity were associated with an increase in hip fracture incidence of 51% in the Mediterranean area and 44% in the inland area. Conclusions. Hip fracture incidence exhibits seasonal changes that differ between the Mediterranean and inland areas. The short-term relationship with climate, although similar in both areas, may partly explain these seasonal changes.
Highlights
Climate has been suspected of being a determining factor in the incidence of hip fractures for over 30 years, with changes in bone tissue quality compatible with osteomalacia being observed at certain times of year in cases of femoral neck-fractures [1]
This study shows how adverse weather conditions may be associated with the incidence of hip fracture in two regions of the Iberian Peninsula
The results were statistically similar in both regions, but in the Mediterranean area, in which a more notable seasonality for hip fracture incidence was observed, the findings were clearer with regard to the relationship of hip fracture incidence with weather phenomena, especially wind
Summary
Climate has been suspected of being a determining factor in the incidence of hip fractures for over 30 years, with changes in bone tissue quality compatible with osteomalacia being observed at certain times of year in cases of femoral neck-fractures [1]. Empirical studies exploring this association using original data on weather patterns and fracture incidence are all relatively recent and mostly conducted in northern latitudes, in the Scandinavian countries [2,3,4], Canada [5, 6], the UK [7,8,9,10], and the USA [11,12,13] Studies in this field conducted in either warmer climates [14,15,16,17,18] or the Southern Hemisphere [19, 20] are relatively scarce. The greater risk of falls associated with bad weather, is considered in the present analysis
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