Prevalence Characteristics of Osteoporosis Fractures in the Elderly in Two Regions of China and Analysis of the Lag Effect of Air Pollutants on them

Abstract

Objective: Air pollution is increasing and threatening human health. The objective of this study is to investigate the population distribution characteristics of elderly osteoporosis fractures in Hebei Province and Xinjiang Uygur Autonomous Region and to analyze the effects of air pollutants on the number of elderly osteoporosis fracture inpatients in the two regions.

Method: A retrospective collection of elderly osteoporosis fracture cases was conducted in selected hospitals in Hebei Province and Xinjiang Uygur Autonomous Region from January 1, 2018 to December 31, 2022. The chi-square test was used to compare the distributional characteristics of the population in the two regions. Additionally, we used a distributed lag nonlinear model (DLNM) in order to assess the effect of air pollutants on the number of daily hospital admissions of elderly osteoporosis fracture patients in different regions.

Result: A total of 19,203 elderly osteoporosis fracture patients were included in the study. The average age of these patients was 76.66 ± 7.55 years, and the majority of them were female (13,514 instances, 70.37%). The disparities in age distribution (χ² = 133.9 p < 0.001), fracture site (χ² = 62.0 p < 0.001), and hospitalization cost (Z = –15.635 p < 0.001) between the two regions were statistically significant. The lag effect curves of PM2.5, PM10, and NO₂ on the number of elderly osteoporosis fracture hospitalizations in Xinjiang Uygur Autonomous Region exhibited a similar pattern resembling a “W”-shaped curve. All three pollutants reached their highest values after a lag time of 14 days (PM2.5: RR = 1.053, 95% CI: 1.031, 1.074; PM10: RR = 1.031, 95% CI: 1.018, 1.043; NO₂: RR = 1.125, 95% CI: 1.070, 1.182). In Hebei Province, the largest impacts of PM2.5 and PM10 were observed after a lag of 14 days (PM2.5: RR = 1.022, 95% CI: 1.013, 1.028; PM10: RR = 1.013, 95% CI: 1.008, 1.018). Similarly, the maximum effect of NO₂ was observed after a lag of 11 days (RR = 1.020, 95% CI: 1.010, 1.028).

Conclusion: There were differences in the epidemiological characteristics of hospitalized patients with osteoporosis fractures between the two regions, PM2.5, PM10, and NO₂ increased the number of hospitalizations for osteoporosis fractures. Exposure to air pollutants such as PM2.5 increases the risk of osteoporosis fractures in the elderly population.

Keywords

Air Pollutants / Distributed Lag Nonlinear Model / Epidemiological Features / Osteoporosis Fractures in the Elderly

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2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.